Objective
To determine the best disocclusion guidance in occlusal splints (OSs) to manage and
treat temporomandibular disorder (TMD) and sleep bruxism (SB).
Study Design
The research was conducted on 7 major electronic databases and 3 gray literature sources.
We included randomized trials, nonrandomized clinical trials, and before-and-after
studies. The risk of bias (RoB) was assessed by Joanna Briggs Institute of Critical
Appraisal Tools. The Grading of Recommendations Assessment, Development and Evaluation
(GRADE) approach was used to grade the certainty of evidence.
Results
Qualitative synthesis included 16 surveys reporting data from 620 participants. Canine
guidance (CG) was widely searched. Bilateral balanced occlusion (BBO) and CG significantly
decreased pain levels compared with the placebo splint. Comparing between OS and absence
of therapy, only CG was assessed and showed significant improvements on mouth opening,
pain, sleep quality, and muscle activity. When compared different guide types among
themselves, no significant improvement was founded in any evaluated outcome. Three
studies presented high RoB, 7 presented moderate RoB, and 6 presented low RoB.
Conclusions
It is suggested there is not enough evidence to support that there are any specific
kind of guidance responsible for improving evaluated outcomes on TMD and SB.
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Article info
Publication history
Published online: July 22, 2022
Accepted:
July 12,
2022
Received in revised form:
June 8,
2022
Received:
September 30,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
