Centric stabilization occlusal splints vs. other conservative therapies in the management of temporomandibular disorders: a systematic review and meta-analysis.

Abstract

Background: TMDs are frequently occurring musculoskeletal disorders that affect the orofacial region, leading to pain and functional limitations. Among conservative treatments, centric stabilization splints are widely used, but their superiority over other noninvasive therapies remains uncertain.

Objective: To systematically review and quantitatively evaluate the clinical effectiveness of centric stabilization occlusal splints versus other conservative managements in TMD patients.

Methods: Literature was searched in Cochrane, PubMed, Scopus, WoS, EMBASE, and LILACS from 2000 to 2023. The study included randomized controlled trials (RCTs) that compared centric stabilization splints to other conservative therapies. The main outcome assessed was the reduction in pain, determined through the Visual Analogue Scale (VAS). The quality of the evidence was appraised using the GRADE framework. Meta-analysis employed a random effect model.

Results: The analysis encompassed eight randomized controlled trials (RCTs) that included more than 400 participants. The combined standardized mean difference (SMD) found that centric stabilization splints had a substantial advantage in reduction of pain (SMD = 0.75; with 95% confidence interval: 0.32 to 1.18; p < 0.01). The evidence was assessed as moderately certain. Sensitivity analysis excluding high-risk studies showed minimal change in effect (SMD = 0.72). Functional outcomes and quality-of-life metrics were also identified as additional advantages.

Conclusion: Centric stabilization splints demonstrate clinically meaningful short-term pain relief in TMD compared to other conservative treatments. Their use is supported in patients with myogenous TMD, but long-term outcomes require further validation.