Occlusal Splint Therapy in the Management of Temporomandibular Disorders-Evidence from Systematic Reviews

Occlusal splints are commonly used to manage temporomandibular disorders (TMDs), yet their efficacy remains controversial. This study aimed to summarise and assess the methodological quality of available systematic reviews (SRs) regarding occlusal splint therapy in TMD patients.

Following a PROSPERO-registered protocol (CRD42021276856), a comprehensive search was conducted across PubMed, Scopus, Lilacs, and Cochrane. SRs focused on TMD management with occlusal splints were included. Two independent operators performed the review process, and the risk of bias was assessed using AMSTAR-2. Primary outcomes were pain intensity and maximum mouth opening (MMO).

After screening of 1740 abstracts followed by full text assessment, 21 SRs were included with diverse methodological quality ranging from critically low (5 SRs) to high (4 SRs). The majority of the included SRs (12) compared occlusal splint with other conservative treatments, with four of these reporting effective reduction in pain intensity, while three SRs did not. Furthermore, five SRs concluded that there was insufficient evidence for or against occlusal splint therapy over other active interventions for TMD treatment. Only one SR compared the effect of occlusal splint versus no treatment, supporting no differences in pain reduction in the jaw joint area. One SR compared the effects of different occlusal splint designs. Three SRs assessed the effects of occlusal splint in specific treatment settings or populations (in adolescents, compared to arthrocentesis, compared to jaw exercises).

The majority of findings from the existing SRs report small beneficial or neutral effects following OS therapy in TMD patients.