DOI QR코드

DOI QR Code

No evidence on the effectiveness of oral splints for the management of temporomandibular joint dysfunction pain in both short and long-term follow-up systematic reviews and meta-analysis studies

  • 투고 : 2019.09.20
  • 심사 : 2019.12.17
  • 발행 : 2020.04.30

초록

The aim of this study was to determine the efficacy of oral splints in reducing the intensity of pain in patients with temporomandibular joint dysfunction in both short and long-term treatment durations. Electronic databases, Cochrane Library, MEDLINE via PubMed, Web of Science, Egyptian Knowledge Bank, and EMBASE were searched for randomized controlled trials comparing different types of splints to non-occluding splints, behavioral therapy, pharmacotherapy, counseling, and no treatment. The risk of bias was assessed by using Cochrane risk of bias recommendations. Fixed and random effects were used to summarize the outcomes. The effect estimates were expressed as standardized mean differences (SMD) or risk ratios with a 95% confidence interval (CI). Subgroup analyses were carried out according to the treatment duration. Twenty-two studies met the inclusion criteria. A meta-analysis of short-term studies up to three months revealed no significant difference between the study groups. However, long-term studies exhibited a significant difference in pain reduction in favor of the control group. Total analysis revealed that the control group resulted in significant pain reduction (SMD 0.14, 95% CI 0.05-0.23, P=0.002, I2=0%). Oral splints are not effective in reducing pain intensity or improving function in patients with temporomandibular joint dysfunction.

키워드

참고문헌

  1. Lee JY, Kim YK, Kim SG, Yun PY. Evaluation of Korean teenagers with temporomandibular joint disorders. J Korean Assoc Oral Maxillofac Surg 2013;39:231-7. https://doi.org/10.5125/jkaoms.2013.39.5.231
  2. Chisnoiu AM, Picos AM, Popa S, Chisnoiu PD, Lascu L, Picos A, et al. Factors involved in the etiology of temporomandibular disorders: a literature review. Clujul Med 2015;88:473-8. https://doi.org/10.15386/cjmed-485
  3. Garrigos-Pedron M, La Touche R, Navarro-Desentre P, Gracia-Naya M, Segura-Orti E. Effects of a physical therapy protocol in patients with chronic migraine and temporomandibular disorders: a randomized, single-blinded, clinical trial. J Oral Facial Pain Headache 2018;32:137-50. https://doi.org/10.11607/ofph.1912
  4. Ouanounou A, Goldberg M, Haas DA. Pharmacotherapy in temporomandibular disorders: a review. J Can Dent Assoc 2017;83:h7.
  5. De la Torre Canales G, Manfredini D, Grillo CM, Guarda-Nardini L, Machado Goncalves L, Rizzatti Barbosa CM. Therapeutic effectiveness of a combined counseling plus stabilization appliance treatment for myofascial pain of the jaw muscles: a pilot study. Cranio 2017;35:180-6. https://doi.org/10.1080/08869634.2016.1168071
  6. Fricton J, Look JO, Wright E, Alencar FG Jr, Chen H, Lang M, et al. Systematic review and meta-analysis of randomized controlled trials evaluating intraoral orthopedic appliances for temporomandibular disorders. J Orofac Pain 2010;24:237-54.
  7. Singh RK, Pal US, Goyal P, Nischal A, Gurung TR, Daga D. TMJ arthrocentesis alone and in combination with duloxetine in temporomandibular joint pain. J Maxillofac Oral Surg 2018;17:270-5. https://doi.org/10.1007/s12663-017-1037-4
  8. Zotelli VL, Grillo CM, Gil ML, Wada RS, Sato JE, da Luz Rosario de Sousa M. Acupuncture effect on pain, mouth opening limitation and on the energy meridians in patients with temporomandibular dysfunction: a randomized controlled trial. J Acupunct Meridian Stud 2017;10:351-9. https://doi.org/10.1016/j.jams.2017.08.005
  9. Xu GZ, Jia J, Jin L, Li JH, Wang ZY, Cao DY. Low-level laser therapy for temporomandibular disorders: a systematic review with meta-analysis. Pain Res Manag 2018;2018:4230583. https://doi.org/10.1155/2018/4230583
  10. Balaji SM, Balaji P. Surgical management of chronic temporomandibular joint dislocations. Indian J Dent Res 2018;29:455-8. https://doi.org/10.4103/ijdr.IJDR_493_18
  11. Klasser GD, Greene CS. Oral appliances in the management of temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:212-23. https://doi.org/10.1016/j.tripleo.2008.10.007
  12. Ekberg E, Vallon D, Nilner M. The efficacy of appliance therapy in patients with temporomandibular disorders of mainly myogenous origin. A randomized, controlled, short-term trial. J Orofac Pain 2003;17:133-9.
  13. Conti PC, de Alencar EN, da Mota Correa AS, Lauris JR, Porporatti AL, Costa YM. Behavioural changes and occlusal splints are effective in the management of masticatory myofascial pain: a short-term evaluation. J Oral Rehabil 2012;39:754-60. https://doi.org/10.1111/j.1365-2842.2012.02327.x
  14. Giannakopoulos NN, Rauer AK, Hellmann D, Hugger S, Schmitter M, Hugger A. Comparison of device-supported sensorimotor training and splint intervention for myofascial temporomandibular disorder pain patients. J Oral Rehabil 2018;45:669-76. https://doi.org/10.1111/joor.12662
  15. Kokkola O, Suominen AL, Qvintus V, Myllykangas R, Lahti S, Tolvanen M, et al. Efficacy of stabilisation splint treatment on the oral health-related quality of life-a randomised controlled one-year follow-up trial. J Oral Rehabil 2018;45:355-62. https://doi.org/10.1111/joor.12622
  16. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009;151:264-9, W64. https://doi.org/10.7326/0003-4819-151-4-200908180-00135
  17. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [Internet]. London: The Cochrane Collaboration [cited 2019 Mar 25]. Available from: https://handbook-5-1.cochrane.org/.
  18. Minakuchi H, Kuboki T, Matsuka Y, Maekawa K, Yatani H, Yamashita A. Randomized controlled evaluation of non-surgical treatments for temporomandibular joint anterior disk displacement without reduction. J Dent Res 2001;80:924-8. https://doi.org/10.1177/00220345010800031501
  19. Alencar F Jr, Becker A. Evaluation of different occlusal splints and counselling in the management of myofascial pain dysfunction. J Oral Rehabil 2009;36:79-85. https://doi.org/10.1111/j.1365-2842.2008.01913.x
  20. Haketa T, Kino K, Sugisaki M, Takaoka M, Ohta T. Randomized clinical trial of treatment for TMJ disc displacement. J Dent Res 2010;89:1259-63. https://doi.org/10.1177/0022034510378424
  21. Giannakopoulos NN, Katsikogianni EN, Hellmann D, Eberhard L, Leckel M, Schindler HJ, et al. Comparison of three different options for immediate treatment of painful temporomandibular disorders: a randomized, controlled pilot trial. Acta Odontol Scand 2016;74:480-6. https://doi.org/10.1080/00016357.2016.1204558
  22. Hasanoglu Erbasar GN, Alpaslan C, Eroglu Inan G. Can an NTItss device be effective as a first-line therapy in patients with TMD myofascial pain? J Oral Rehabil 2017;44:589-93. https://doi.org/10.1111/joor.12524
  23. Hosgor H, Bas B, Celenk C. A comparison of the outcomes of four minimally invasive treatment methods for anterior disc displacement of the temporomandibular joint. Int J Oral Maxillofac Surg 2017;46:1403-10. https://doi.org/10.1016/j.ijom.2017.05.010
  24. Niemela K, Korpela M, Raustia A, Ylostalo P, Sipila K. Efficacy of stabilisation splint treatment on temporomandibular disorders. J Oral Rehabil 2012;39:799-804. https://doi.org/10.1111/j.1365-2842.2012.02335.x
  25. Carmeli E, Sheklow SL, Bloomenfeld I. Comparative study of repositioning splint therapy and passive manual range of motion techniques for anterior displaced temporomandibular discs with unstable excursive reduction. Physiotherapy 2001;87:26-36. https://doi.org/10.1016/S0031-9406(05)61189-3
  26. Raphael KG, Marbach JJ. Widespread pain and the effectiveness of oral splints in myofascial face pain. J Am Dent Assoc 2001;132:305-16. https://doi.org/10.14219/jada.archive.2001.0173
  27. Shedden Mora MC, Weber D, Neff A, Rief W. Biofeedback-based cognitive-behavioral treatment compared with occlusal splint for temporomandibular disorder: a randomized controlled trial. Clin J Pain 2013;29:1057-65. https://doi.org/10.1097/AJP.0b013e3182850559
  28. Wassell RW, Adams N, Kelly PJ. The treatment of temporomandibular disorders with stabilizing splints in general dental practice: one-year follow-up. J Am Dent Assoc 2006;137:1089-98; quiz 1168-9. https://doi.org/10.14219/jada.archive.2006.0347
  29. Wahlund K, List T, Larsson B. Treatment of temporomandibular disorders among adolescents: a comparison between occlusal appliance, relaxation training, and brief information. Acta Odontol Scand 2003;61:203-11. https://doi.org/10.1080/00016350310003891
  30. Truelove E, Huggins KH, Mancl L, Dworkin SF. The efficacy of traditional, low-cost and nonsplint therapies for temporomandibular disorder: a randomized controlled trial. J Am Dent Assoc 2006;137:1099-107; quiz 1169. https://doi.org/10.14219/jada.archive.2006.0348
  31. Conti PC, Correa AS, Lauris JR, Stuginski-Barbosa J. Management of painful temporomandibular joint clicking with different intraoral devices and counseling: a controlled study. J Appl Oral Sci 2015;23:529-35. https://doi.org/10.1590/1678-775720140438
  32. Wahlund K, Nilsson IM, Larsson B. Treating temporomandibular disorders in adolescents: a randomized, controlled, sequential comparison of relaxation training and occlusal appliance therapy. J Oral Facial Pain Headache 2015;29:41-50. https://doi.org/10.11607/ofph.1285
  33. Qvintus V, Suominen AL, Huttunen J, Raustia A, Ylostalo P, Sipila K. Efficacy of stabilisation splint treatment on facial pain - 1-year follow-up. J Oral Rehabil 2015;42:439-46. https://doi.org/10.1111/joor.12275
  34. Ekberg E, Nilner M. Treatment outcome of appliance therapy in temporomandibular disorder patients with myofascial pain after 6 and 12 months. Acta Odontol Scand 2004;62:343-9. https://doi.org/10.1080/00016350410010063
  35. Gomes CA, Politti F, Andrade DV, de Sousa DF, Herpich CM, Dibai-Filho AV, et al. Effects of massage therapy and occlusal splint therapy on mandibular range of motion in individuals with temporomandibular disorder: a randomized clinical trial. J Manipulative Physiol Ther 2014;37:164-9. https://doi.org/10.1016/j.jmpt.2013.12.007
  36. Ahmed MA, Rahman QB, Uddin MW, Asaduzzaman M, Ali MH. Efficacy of acrylic splint in management of internal derangement of temperomandibular joint. Bangladesh Med Res Counc Bull 2016;42:72-7. https://doi.org/10.3329/bmrcb.v42i2.32040
  37. Katyayan PA, Katyayan MK, Shah RJ, Patel G. Efficacy of appliance therapy on temporomandibular disorder related facial pain and mandibular mobility: a randomized controlled study. J Indian Prosthodont Soc 2014;14:251-61. https://doi.org/10.1007/s13191-013-0320-4
  38. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097. https://doi.org/10.1371/journal.pmed.1000097
  39. Pficer JK, Dodic S, Lazic V, Trajkovic G, Milic N, Milicic B. Occlusal stabilization splint for patients with temporomandibular disorders: meta-analysis of short and long term effects. PLoS One 2017;12:e0171296. https://doi.org/10.1371/journal.pone.0171296
  40. Pettengill CA, Growney MR Jr, Schoff R, Kenworthy CR. A pilot study comparing the efficacy of hard and soft stabilizing appliances in treating patients with temporomandibular disorders. J Prosthet Dent 1998;79:165-8. https://doi.org/10.1016/S0022-3913(98)70211-2
  41. Kim SG. Clinical treatment for symptoms associated with temporomandibular disorder. J Korean Assoc Oral Maxillofac Surg 2014;40:153-4. https://doi.org/10.5125/jkaoms.2014.40.4.153
  42. Al-Ani MZ, Davies SJ, Gray RJ, Sloan P, Glenny AM. Stabilisation splint therapy for temporomandibular pain dysfunction syndrome. Cochrane Database Syst Rev 2004;(1):CD002778.

피인용 문헌

  1. Questions about "No evidence on the effectiveness of oral splints for the management of temporomandibular joint dysfunction pain in both short and long-term follow-up systematic reviews and meta- vol.46, pp.5, 2020, https://doi.org/10.5125/jkaoms.2020.46.5.367
  2. Comparative evaluation of occlusal splint therapy and muscle energy technique in the management of temporomandibular disorders: A randomized controlled clinical trial vol.21, pp.4, 2020, https://doi.org/10.4103/jips.jips_332_21