title: The effectiveness of splint therapy in patients with temporomandibular disorders: a systematic review and meta-analysis.
abstract: OBJECTIVE
  The authors conducted a systematic review of all published randomized controlled trials in which investigators compared the effectiveness of splint therapy with that of minimal or no treatment in patients with temporomandibular disorders (TMDs).
  
  
  METHODS
  The authors searched MEDLINE, Embase and the Cochrane Central Register of Controlled Trials for studies published from inception of each database through August 2011. In eligible studies, investigators enrolled adult patients with TMDs and assigned them randomly to splint therapy or a control group receiving minimal or no treatment.
  
  
  RESULTS
  Of 1,567 potentially eligible studies, 11 proved eligible and were included. Moderate-quality evidence suggests that splint therapy reduced pain in the temporomandibular joint (TMJ) area (standardized response mean = -0.93, 95 percent confidence interval [CI], -1.33 to -0.53; risk difference for having continued pain = -0.35, 95 percent CI, -0.21 to -0.46; mean change on the 100-millimeter visual analog scale = -11.5 mm, 95 percent CI, -16.5 mm to -6.6 mm). Low to very low quality of evidence showed no significant differences between the splint therapy and control groups in terms of quality of life or depression. None of the trial reports described effect on function.
  
  
  CONCLUSIONS
  Although overall results are promising for the reduction of pain, establishing the role of splints for patients with TMDs will require large trials with stronger safeguards against bias.
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main St., West Hamilton, Ontario, Canada, L8S 4K1. shanil.ebrahim@utoronto.ca
authors.forename: Shanil
authors.initials: S
authors.lastname: Ebrahim
authors.forename: Luis
authors.initials: L
authors.lastname: Montoya
authors.forename: Jason W
authors.initials: JW
authors.lastname: Busse
authors.forename: Alonso
authors.initials: A
authors.lastname: Carrasco-Labra
authors.forename: Gordon H
authors.initials: GH
authors.lastname: Guyatt
mesh_terms: D006801:Humans; D017090:Occlusal Splints; D016032:Randomized Controlled Trials as Topic; D013705:Temporomandibular Joint Disorders / Q000628:therapy*