Efficacy of added splint therapy after arthrocentesis vs arthrocentesis alone in the management of temporomandibular joint disorders: a systematic review and meta-analysis.

Abstract

Occlusal splints are commonly used in the management of temporomandibular joint (TMJ) disorders (TMD). However, it is unclear if it should be used after a second-line therapy like arthrocentesis. We systematically reviewed the evidence on the efficacy of post-arthrocentesis splint therapy in the management of TMD. PubMed, Embase, Scopus, Web of Science, CENTRAL, and Google Scholar were searched for studies published until 5th August 2024. The outcomes assessed were pain and maximal mouth opening (MMO). Eight studies were included. Five studies reported data for the meta-analysis. The pooled analysis found that there was no statistically significant difference in pain scores in the arthrocentesis + splint group vs arthrocentesis group at 1 month (MD: -0.01 95% CI: -0.46, 0.44), 3 months (MD: -0.02 95% CI: -0.67, 0.63) and 6 months (MD: 0.06 95% CI: -0.25, 0.37). The pooled analysis also showed that splint therapy after arthrocentesis may not significantly improve MMO as compared to no splint therapy at 1 month (MD: 0.08 95% CI: -2.11, 2.27), 3 months (MD: 0.76 95% CI: -0.84, 2.35) and 6 months (MD: 0.56 95% CI: -0.65, 1.78). Descriptive analysis of three studies showed that two supported the use of splints while one found no added improvement in outcomes. Limited evidence from low-quality studies shows that the use of splint therapy after arthrocentesis may not improve pain and MMO in patients with TMD. High-quality randomized controlled trials are needed to improve evidence.