Efficacy of stabilisation splint therapy combined with non‐splint multimodal therapy for treating RDC/TMD axis I patients: a randomised controlled trial

Abstract

JapanSUMMARY Stabilisation splint therapy has long been thought to be effective for the management of temporomandibular disorders (TMD). However, the superiority of stabilisation splint therapy compared to other TMD treatments remains controversial. The aim of this study was to determine the efficacy of stabilisation splint therapy combined with non-splint multimodal therapy for TMD. A total of 181 TMD participants were randomly allocated to a non-splint multimodal therapy (NS) group (n = 85) or a nonsplint multimodal therapy plus stabilisation splint (NS+S) group (n = 96). Non-splint multimodal therapy included self-exercise of the jaw, cognitive-behavioural therapy, self-management education and additional jaw manipulation. Three outcome measurements were used to assess treatment efficacy: mouth-opening limitation, orofacial pain and temporomandibular joint sounds. A two-factor repeated-measures analysis of variance (ANOVA) was used to evaluate the efficacy of the two treatment modalities (NS vs. NS+S), and

Self‐exercise programmes and occlusal splints in the treatment of TMD‐related myalgia—Evidence‐based medicine?

“…Frequent objective outcome measures include range of movement (ROM) and maximum pain free mouth opening (MMO) . Subjective outcome measures are typically pain‐scores . Simple outcome measures are easy for the researcher to interpret.…”

“…A simple way of making sure that the correlations are credible is to prescribe as few interventions as possible in each intervention group. Three studies manage to prescribe few and simple exercises, while other studies have prescribed several interventions in each intervention group, making it hard to tell whether the increased ROM is a result of manual therapy or relaxation exercises. This will downgrade the evidence quality with respect to indirectness.…”

“…The National Board of Health and Welfare in Sweden also ranks the different treatments from 1 to 10, based on level of evidence, cost vs effect and probability for success. Many of the treatments prescribed by general practitioners today are labelled as self‐care, implicating that the patients themselves are responsible for performing the prescribed treatment . These reversible and low‐cost treatments entail little risk for patient injury, but one would still expect the treatments to be supported by scientific evidence.…”

Oral splints for temporomandibular disorder or bruxism: a systematic review

“…However, the predominantly used criteria were the RDC, 6 used in 17 studies. 11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27 The DC criteria 7 were used in two studies, 28,29 and an additional three studies used criteria that approximated to the RDC (either by citing the instrument and/or their description matched a similar process). 30,31,32 No studies used the AAOP criteria.…”

TMD/Orofacial Pain and OSA, Correlation or Causation?

“…The answer to that, in truth, comes as the answer to all such questions in medicine: we never looked! We have heard that expression called the new meaning of the acronym WNL, and I have to say I would agree with it given my anecdotal observations of dentists and how they view their existing patient population at improvement of these symptoms with the use of the said occlusal/night guard or flat plane splints [31][32][33][34]. However we do see improvements in these pain symptoms when the mandible is advanced with anteriorly advancing orthotic therapy [35][36][37], and improvements again with mandibular advancements in patients with UARS [38] and OSA [39][40][41], along with the well observed significant reduction in SB with mandibular advancement [42][43][44][45][46].…”