Parallel Randomized Controlled Clinical Trial in Patients with Temporomandibular Disorders Treated with a CAD/CAM Versus a Conventional Stabilization Splint

Duc, Jean Marc Pho; Huning, Sandra; Grossi, Márcio Lima

doi:10.11607/ijp.4711

Cited by 18 publications

(10 citation statements)

References 3 publications

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“…Similarly, an 8-year follow-up survey reported reduced HA frequency with intraoral appliance use in TMD patients with MFP, arthralgia, and TMJ osteoarthritis in 88% of the respondents [ 64 ]. Additionally, this finding is consistent with a study reporting that SS was equally effective in reducing HA intensity regardless of their fabrication process, whether conventionally made or computer-aided design/computer-aided manufactured (CAD/CAM) [ 65 ].…”

Section: Discussionsupporting

confidence: 89%

Reduction of headache intensity and frequency with maxillary stabilization splint therapy in patients with temporomandibular disorders-headache comorbidity: a systematic review and meta-analysis

Manrriquez

Robles

Pareek

et al. 2021

J Dent Anesth Pain Med

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This systematic review and meta-analysis aimed to analyze the effectiveness of maxillary stabilization splint (SS) therapy to reduce headache (HA) intensity and HA frequency in patients with temporomandibular disorders (TMD)-HA comorbidity. Randomized controlled trials (RCTs) using full-arch coverage, hard resin, and maxillary SS therapy were included. Electronic databases, including Cochrane Library, MEDLINE through PubMed, Web of Science, and EMBASE, were searched. The risk of bias was analyzed based on Cochrane's handbook. The search yielded 247 references up to January 28, 2020. Nine RCTs were included at a high risk of bias. The comparison groups included other splints, counseling, jaw exercises, medications, neurologic treatment, and occlusal equilibration. Four studies reported a statistically significant reduction in HA intensity, and five studies reported significant improvement in HA frequency from baseline at 2-12 months in patients with TMD-HA comorbidity treated with a full-arch hard maxillary SS. HA frequency in tension-type HA (TTH) comorbid with TMD diagnoses of myofascial pain (MFP) or capsulitis/synovitis improved significantly with SS than that with full-arch maxillary non-occluding splint (NOS) in two studies. Comparison groups receiving hard partial-arch maxillary splint nociceptive trigeminal inhibition (NTI) showed statistically significant improvements in HA intensity in patients with mixed TMD phenotypes of MFP and disc displacement comorbid with “general HA.” Comparison groups receiving partial-arch maxillary resilient/soft splint (Relax) showed significant improvements in both HA intensity and frequency in patients with HA concomitant with MFP. The meta-analysis showed no statistically significant difference in the improvement of pain intensity at 2-3 months with comparison of the splints (partial-arch soft [Relax], hard [NTI], and full-arch NOS) or splint use compliance at 6-12 months with comparison of the splints (partial-arch Relax and full-arch NOS) versus the SS groups in patients with various TMD-HA comorbidities. In conclusion, although SS therapy showed a statistically significant decrease in HA intensity and HA frequency when reported, the evidence quality was low due to the high bias risk and small sample size. Therefore, further studies are required.

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Section: Discussionsupporting

confidence: 89%

Reduction of headache intensity and frequency with maxillary stabilization splint therapy in patients with temporomandibular disorders-headache comorbidity: a systematic review and meta-analysis

Manrriquez

Robles

Pareek

et al. 2021

J Dent Anesth Pain Med

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“…Recently Pho Duc et al. [ 32 ]) published a similar study, but with longer follow-up and larger sample size with 32 subjects completing the study. This study found no differences in splint adjustment time or in patient's preference in favor of one technique over another.…”

Section: Discussionmentioning

confidence: 99%

Clinical comparison of conventional and additive manufactured stabilization splints

Berntsen

Kleven²,

Heian³

et al. 2018

Acta Biomaterialia Odontologica Scandinavica

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The aim of this study was to compare conventional and digital additive manufacturing of hard occlusal stabilization splints (SS) using technical and clinical parameters. 14 subjects were subjected to DC/TMD Axis I clinical examination protocol and Axis II questionnaire. The subjects underwent treatment with splints over a period of 12 weeks. All subjects underwent both conventional alginate impression and intraoral digital scanning. Seven subjects received conventional manufactured stabilization splints (CM-SS), and seven subjects received CAD-CAM additive manufactured stabilization splints (AM-SS). 12 subjects completed the 12 weeks follow-up period. The subjects significantly preferred digital intraoral scanning compared to conventional alginate impression. There was a significant difference in VAS between CM-SS and AM-SS. The mean VAS result was 15 for AM-SS and 42 for CM-SS, 0 represented excellent comfort and 100 very uncomfortable. This was significant. Splint manufacturing method had no influence on treatment outcome. There was no significant difference in mean delta change for unassisted jaw opening from baseline to 12 weeks between the two groups, for CM-SS it was 2 mm difference and for AM-SS the difference was 3 mm. All subjects in both treatment groups showed improved oral function. In this study, the scanning procedure is more accepted by the subjects than alginate impressions, however the first procedure was more time consuming.

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“…The treating dentist was trained in TMD diagnosis in accordance with the German version of the RDC/TMD manual [ 26 , 27 ]. To evaluate a treatment effect, 4.5 months can be considered appropriate [ 28 ].…”

Section: Methodsmentioning

confidence: 99%

Effect of treatment with a full-occlusion biofeedback splint on sleep bruxism and TMD pain: a randomized controlled clinical trial

et al. 2020

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Objectives The purpose of the present study was to analyze treatment outcome with a full-occlusion biofeedback (BFB) splint on sleep bruxism (SB) and TMD pain compared with treatment with an adjusted occlusal splint (AOS). Materials and methods Forty-one patients were randomly allocated to a test (BFB) or a control (AOS) group and monitored over a 3-month period. Output variables were frequency and duration of bruxing events (bursts) and various pain symptoms. Results The BFB group showed a statistically significant reduction in the frequency and duration of bursts and a statistically significant improvement in the patients’ global well-being and the facial muscle pain parameter. After the treatment was stopped, the BFB group showed a statistically significant reduction in the average and maximum duration but no statistically significant change in the frequency of bursts. Conclusions The tested BFB splint is highly effective in reducing SB at the subconscious level, i.e., without waking the patient, and in achieving improvements in global pain perception. The results suggest that the BFB splint also provides a better treatment option for bruxism-related pain than an AOS. However, further research is needed, and specifically studies with a larger patient population displaying higher levels of pain at baseline. Clinical relevance By reducing burst duration and therefore the pathological load on the masticatory apparatus, the BFB splint reduces TMD and bruxism-related symptoms and improves patients’ physical well-being. In the long term, this could prevent damage to the TMJ. This study confirms the effectiveness and safety of this splint. The universal trial number U1111-1239-2450 DRKS-ID registration DRKS00018092

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Parallel Randomized Controlled Clinical Trial in Patients with Temporomandibular Disorders Treated with a CAD/CAM Versus a Conventional Stabilization Splint

Cited by 18 publications

References 3 publications

Reduction of headache intensity and frequency with maxillary stabilization splint therapy in patients with temporomandibular disorders-headache comorbidity: a systematic review and meta-analysis

Reduction of headache intensity and frequency with maxillary stabilization splint therapy in patients with temporomandibular disorders-headache comorbidity: a systematic review and meta-analysis

Clinical comparison of conventional and additive manufactured stabilization splints

Effect of treatment with a full-occlusion biofeedback splint on sleep bruxism and TMD pain: a randomized controlled clinical trial

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