Background Psychological discomfort, physical disability and functional limitations of the orofacial system have a major impact on everyday life of patients with temporomandibular disorders (TMDs). In this study we sought to determine short and long term effects of stabilization splint (SS) in treatment of TMDs, and to identify factors influencing its efficacy. Methods MEDLINE, Web of Science and EMBASE were searched for randomized controlled trials (RCTs) comparing SS to: non-occluding splint, occlusal oral appliances, physiotherapy, behavioral therapy, counseling and no treatment. Random effects method was used to summarize outcomes. The effect estimates were expressed as odds ratio (OR) or standardized mean difference (SMD) with 95% confidence interval. Subgroup analyses were carried out according to the use of Research Diagnostic Criteria (RDC/TMD) and TMDs origin. Strength of evidence was assessed by GRADE. Meta-regression was applied. Results Thirty three eligible RCTs were inclu...ded in meta-analysis. In short term, SS presented positive overall effect on pain reduction (OR 2.08; p = 0.01) and pain intensity (SMD -0.33; p = 0.02). Subgroup analyses confirmed SS effect in studies used RDC/TMD and revealed its effect in patients with TMDs of muscular origin. Important decrease of muscle tenderness (OR 1.97; p = 0.03) and improvement of mouth opening (SMD -0.30; p = 0.04) were found. SS in comparison to oral appliances showed no difference (OR 0.74; p = 0.24). Meta-regression identified continuous use of SS during the day as a factor influencing efficacy (p = 0.01). Long term results showed no difference in observed outcomes between groups. Low quality of evidence was found for primary outcomes. Conclusion SS presented short term benefit for patients with TMDs. In long term follow up, the effect is equalized with other therapeutic modalities. Further studies based on appropriate use of standardized criteria for patient recruitment and outcomes under assessment are needed to better define SS effect persistence in long term.
TY - JOUR
AU - Kuzmanović-Pfićer, Jovana
AU - Dodić, Slobodan
AU - Lazić, Vojkan
AU - Trajković, Goran Z.
AU - Milić, Nataša
AU - Miličić, Biljana
PY - 2017
UR - https://smile.stomf.bg.ac.rs/handle/123456789/2197
AB - Background Psychological discomfort, physical disability and functional limitations of the orofacial system have a major impact on everyday life of patients with temporomandibular disorders (TMDs). In this study we sought to determine short and long term effects of stabilization splint (SS) in treatment of TMDs, and to identify factors influencing its efficacy. Methods MEDLINE, Web of Science and EMBASE were searched for randomized controlled trials (RCTs) comparing SS to: non-occluding splint, occlusal oral appliances, physiotherapy, behavioral therapy, counseling and no treatment. Random effects method was used to summarize outcomes. The effect estimates were expressed as odds ratio (OR) or standardized mean difference (SMD) with 95% confidence interval. Subgroup analyses were carried out according to the use of Research Diagnostic Criteria (RDC/TMD) and TMDs origin. Strength of evidence was assessed by GRADE. Meta-regression was applied. Results Thirty three eligible RCTs were included in meta-analysis. In short term, SS presented positive overall effect on pain reduction (OR 2.08; p = 0.01) and pain intensity (SMD -0.33; p = 0.02). Subgroup analyses confirmed SS effect in studies used RDC/TMD and revealed its effect in patients with TMDs of muscular origin. Important decrease of muscle tenderness (OR 1.97; p = 0.03) and improvement of mouth opening (SMD -0.30; p = 0.04) were found. SS in comparison to oral appliances showed no difference (OR 0.74; p = 0.24). Meta-regression identified continuous use of SS during the day as a factor influencing efficacy (p = 0.01). Long term results showed no difference in observed outcomes between groups. Low quality of evidence was found for primary outcomes. Conclusion SS presented short term benefit for patients with TMDs. In long term follow up, the effect is equalized with other therapeutic modalities. Further studies based on appropriate use of standardized criteria for patient recruitment and outcomes under assessment are needed to better define SS effect persistence in long term.
PB - Public Library Science, San Francisco
T2 - PLoS One
T1 - Occlusal stabilization splint for patients with temporomandibular disorders: Meta-analysis of short and long term effects
VL - 12
IS - 2
DO - 10.1371/journal.pone.0171296
ER -
@article{
author = "Kuzmanović-Pfićer, Jovana and Dodić, Slobodan and Lazić, Vojkan and Trajković, Goran Z. and Milić, Nataša and Miličić, Biljana",
year = "2017",
abstract = "Background Psychological discomfort, physical disability and functional limitations of the orofacial system have a major impact on everyday life of patients with temporomandibular disorders (TMDs). In this study we sought to determine short and long term effects of stabilization splint (SS) in treatment of TMDs, and to identify factors influencing its efficacy. Methods MEDLINE, Web of Science and EMBASE were searched for randomized controlled trials (RCTs) comparing SS to: non-occluding splint, occlusal oral appliances, physiotherapy, behavioral therapy, counseling and no treatment. Random effects method was used to summarize outcomes. The effect estimates were expressed as odds ratio (OR) or standardized mean difference (SMD) with 95% confidence interval. Subgroup analyses were carried out according to the use of Research Diagnostic Criteria (RDC/TMD) and TMDs origin. Strength of evidence was assessed by GRADE. Meta-regression was applied. Results Thirty three eligible RCTs were included in meta-analysis. In short term, SS presented positive overall effect on pain reduction (OR 2.08; p = 0.01) and pain intensity (SMD -0.33; p = 0.02). Subgroup analyses confirmed SS effect in studies used RDC/TMD and revealed its effect in patients with TMDs of muscular origin. Important decrease of muscle tenderness (OR 1.97; p = 0.03) and improvement of mouth opening (SMD -0.30; p = 0.04) were found. SS in comparison to oral appliances showed no difference (OR 0.74; p = 0.24). Meta-regression identified continuous use of SS during the day as a factor influencing efficacy (p = 0.01). Long term results showed no difference in observed outcomes between groups. Low quality of evidence was found for primary outcomes. Conclusion SS presented short term benefit for patients with TMDs. In long term follow up, the effect is equalized with other therapeutic modalities. Further studies based on appropriate use of standardized criteria for patient recruitment and outcomes under assessment are needed to better define SS effect persistence in long term.",
publisher = "Public Library Science, San Francisco",
journal = "PLoS One",
title = "Occlusal stabilization splint for patients with temporomandibular disorders: Meta-analysis of short and long term effects",
volume = "12",
number = "2",
doi = "10.1371/journal.pone.0171296"
}
Kuzmanović-Pfićer, J., Dodić, S., Lazić, V., Trajković, G. Z., Milić, N.,& Miličić, B.. (2017). Occlusal stabilization splint for patients with temporomandibular disorders: Meta-analysis of short and long term effects. in PLoS One
Public Library Science, San Francisco., 12(2).
https://doi.org/10.1371/journal.pone.0171296
Kuzmanović-Pfićer J, Dodić S, Lazić V, Trajković GZ, Milić N, Miličić B. Occlusal stabilization splint for patients with temporomandibular disorders: Meta-analysis of short and long term effects. in PLoS One. 2017;12(2).
doi:10.1371/journal.pone.0171296 .
Kuzmanović-Pfićer, Jovana, Dodić, Slobodan, Lazić, Vojkan, Trajković, Goran Z., Milić, Nataša, Miličić, Biljana, "Occlusal stabilization splint for patients with temporomandibular disorders: Meta-analysis of short and long term effects" in PLoS One, 12, no. 2 (2017),
https://doi.org/10.1371/journal.pone.0171296 . .
