Occlusal Stabilization Splint Research Articles

Fully digital workflow for the fabrication of occlusal stabilization splints based on individual mandibular movement

ObjectiveThis study was conducted to present a completely digital workflow for the fabrication of occlusal stabilization splints using CAD/CAM systems and a digital face bow based on optical sensor technology. MethodsDigital scans of the maxillary and mandibular arches of 20 volunteers were obtained using an intraoral scanner. Jaw relation and mandibular movements were recorded with a digital face bow via optical sensors. The virtual increase of the vertical dimension of occlusion (VDO) was then performed, after which computer-aided design (CAD) of the occlusal stabilization splints was carried out. The corresponding splints were then manufactured using digitally controlled technology. ResultsA completely digital workflow for the manufacturing of occlusal stabilization splints was found to be clinically feasible. The corresponding data analysis revealed high congruence between virtual and physical occlusal contacts on the occlusal splint. Moreover, the appropriate guidance of the anterior teeth area was easily obtainable, and the time for adjusting the occlusion was less. ConclusionsThis study demonstrated that the fabrication of occlusal stabilization splints using a fully digital workflow is feasible. Compared to traditional impression-based manufacturing, several advantages of digital manufacturing include easy accessibility, time-efficient manufacturing, high-level accuracy in splint quality, and potential to manufacture duplicate splints. Clinical significanceThe proposed fully digital approach may help young dentists fabricating stable occlusal splints with beneficial curative effects. Meanwhile, it could also improve the production efficiency of stable occlusal splints, saving time for both doctors and patients while reducing labor costs.

Chirped Fiber Bragg Grating Sensors for Force Intensity and Location Assessment in Occlusal Splints: A Proof-of-Concept.

Fiber Bragg Grating (FBG) sensors are strain and temperature sensors with advantages such as small diameter, multiplexing capability, intrinsic safety and biocompatibility. In dentistry, FBG sensors were tested in appliances, implants and splints. In addition to the study of dental biomechanics, these sensors are used in the development of new techniques and products or in the comparison of established treatments. The working principle of measurement of bite forces applied to occlusal splints and the distributed sensing capability along the Chirped FBG (CFBG) are demonstrated in the present proof-of-concept using a PDMS silicone splint. The CFBG exhibits different spectral shapes for each of the four positions of the one-point force application. The average wavelength and the full width at half maximum (FWHM) of the spectra reflected by the CFBG are able to estimate the intensities and the positions, respectively, of the compression forces of the tooth. The instrumentation of occlusal splints with CFBG sensors can help in the distinction between different bite patterns in occlusal stabilization splints during bruxism episodes, along with the understanding of the effects and efficacy of these appliances in treatments and the comparison of different 3D-printed and traditional occlusal splints.

Evaluation of the Marginal Bone changes around Implants placed in Mandibular Class I Kennedy Patients with Sleep-Related Bruxism using 3D Printed versus Conventional Occlusal Stabilization Splints

Evaluation of the Marginal Bone changes around Implants placed in Mandibular Class I Kennedy Patients with Sleep-Related Bruxism using 3D Printed versus Conventional Occlusal Stabilization Splints

Evaluation of the effects of arthrocentesis combined with occlusal stabilization splint on disc displacement without reduction-induced acute and closed lock. A prospective cohort study

ObjectiveDisc displacement without reduction (DDWoR) of the temporomandibular joint is associated with limited mouth opening and arthralgia. In the natural course of the disorder, there is a tendency to progress to degenerative joint diseases. First-line treatment aims to reduce pain and restore joint function. The current study aims to examine the efficacy of an occlusal stabilization splint applied simultaneously with arthrocentesis as first-line treatment in acute and chronic closed-locks. Materials and methodsThe present prospective clinical trial included 40 patients who were diagnosed with DDWoR induced chronic (Group 1, n = 23) and acute (Group 2, n = 17) closed-locks. All participants underwent single session arthrocentesis and were applied occlusal stabilization splints. Maximum mouth opening amounts (MMO), Visual analogue scale (VAS), and McGill pain questionnaire (MPQ) scores were evaluated at baseline, on the operation day, and on seven days after the intervention. The obtained data was analyzed with the Wilcoxon signed-rank, Mann-Whitney U, Fisher's exact, Spearman's correlation tests. ResultsAccording to the baseline data, a significant increase was observed in the amount of MMO in postoperative measurements (p = 0.001 and p < 0.001). A statistically significant decrease in MPQ scores was observed in the postoperative period (p < 0.001 and p < 0.001). While a significant difference was observed between the postoperative VAS scores, the scores of Group 2 were lower (p = 0.018). ConclusionAlthough combined arthrocentesis and occlusal stabilization splint provided significant changes for acute and chronic closed-locks in line with first-line treatment goals, acute closed-lock with arthralgia responded better. Clinical trial registration numberNCT05671549

Changes of bite force and dynamic functional occlusion analysis after occlusal stabilization splint therapy in sleep bruxism patients: a pilot study

Changes of bite force and dynamic functional occlusion analysis after occlusal stabilization splint therapy in sleep bruxism patients: a pilot study

Assessment of the masseter stiffness in patients during conservative therapy for masticatory muscle disorders with shear wave elastography

BackgroundThe complex structure of the stomatognathic system plays a vital role in chewing, digestion, speaking, breathing, facial expression and swallowing. Its complexity is the primary reason for creating multidisciplinary teams to manage temporomandibular disorders (TMD). We aimed to assess the masseter stiffness in patients undergoing conservative therapy for masticatory muscle disorders and evaluate the efficacy of manual therapy and stabilization occlusal splint in the treatment of masticatory muscle disorders.MethodsThis uncontrolled prospective cohort study included 35 patients with masticatory muscle disorders. The study lasted for eight weeks. The patients were treated with manual therapy and stabilization occlusal splint and evaluated using shear wave elastography of the masseter muscles and patient-reported outcome measures (PROMs) to assess pain, anxiety, quality of sleep, satisfaction with life and perceived stress.ResultsAfter the treatment, the stiffness of both masseter muscles decreased significantly (by 4.21 kPa). The patients reported a significant reduction in pain. At baseline, the median scores ranged from 5 to 8; after treatment, they ranged from 0 to 1 (p < 0.0001). The patients also reported significant improvement in terms of all patient-reported outcome measures. The reduction in stiffness corresponded to the improvement in pain and PROMs, as shown by correlations which were insignificant for all measures.ConclusionsConservative therapy of masticatory muscle disorders involving manual therapy and stabilization occlusal splint is effective. It reduces the masseter stiffness as objectively shown in shear wave elastography and improves subjective PROMs scores, including numerical pain assessment and selected questionnaires. Shear wave elastography has the potential for broad application in clinical practice to monitor masticatory muscle disorders treatment effects due to its objectivity and non-invasive character. Further research is recommended on larger patient populations and longer follow-up.Trial registrationThe study was registered at clinicaltrials.gov (NCT03844854). First posted date: 19/02/2019.

Recent Advances in Dental Sensors

There have been advancements in sensing technologies in dentistry. Clinical applications in dentistry including Diagnosis as well monitoring disease and health in dental tissues are made easy with the advanced technologies in imaging and sensing tools. These recent advances in optical sources and detectors have unique applications including non-destructive testing, high speed and cost-effective electronic circuits, and novel signal processing methods. Some of the recent advances include optical coherence tomography, occlusal stabilization splint with stress-sensor system for bruxism, periodontal probe based on the fluorescent fiber position sensor, dental implantable temperature sensor for real time diagnosis of infectious periodontal disease, diamond probe/ perio2000 system, dental pulse oximeter with customized sensor holder, periodontal probe based on the flouroscent fiber position sensor etc.

Long-term adherence to oral stabilization splints: does pain matter?

Occlusal stabilization splints (OSSs) are first-line therapy for temporomandibular disorder (TMD) and sleep-related-bruxism (SRB). The main goal of this study was to quantify adherence rates to OSS therapy in TMD patients and among non-painful conditions such as clenching and bruxism. It was hypothesized that adherence rates would be similar to those for other chronic conditions. Medical records of 99 patients seen in the Orofacial Pain Clinic between 2006 and 2014 were reviewed. Patients meeting the inclusion criteria were interviewed over the telephone regarding OSS adherence. Of the 99 patients interviewed, 80 had chronic orofacial pain related to TMD and 19 received OSS due to (non-painful) SRB. Patients were divided according to usage; the USER group (58 patients, 58.6%) used their OSS for more than 1 year; the NUSE group was the remaining 41 (41.4%) patients who used their device for less than 1 year. Of the patients with pain as the reason for OSS use, 50 (62.5%) were in the USER group and 30 (37.5%) were in the NUSE group. The most common diagnosis was masticatory muscle disorders (MMD) with a 71.4% adherence rate, representing 60.3% of the USER group, which was significantly higher than those with SRB and other facial pain (P = .039). The most common reasons for non-adherence were sleep difficulties with OSS (31.6%) and resolution of the problem (25%). Patients reporting mild to major pain reduction had higher adherence rates than those with complete pain relief or none at all. Patients with MMD exhibited higher adherence rates than those with other facial pain types and SRB.

Finite element analysis of various thickness occlusal stabilization splint therapy on unilateral temporomandibular joint anterior disc displacement without reduction

Occlusal stabilization splint is the most common treatment modality for temporomandibular joint disorders, but the optimal thickness is still uncertain. This study investigated the effect of the occlusal splint with different thicknesses on the stress distribution of the temporomandibular joint. Cone-beam computed tomography and magnetic resonance images were used to reconstruct the maxillofacial and disc, and the unilateral anterior disc displacement without reduction was established manually as the basic model. Occlusal splint with 5 different thickness levels (2, 3, 4, 5, and 6 mm) was added to the basic model as the study models. The displacement and stress distribution of the disc were evaluated. The maximum von Mises stress of the condylar cartilage was the largest on the affected side, whereas the maximum von Mises stress of the disc was the largest on the unaffected side. The disc stress on the affected side was mainly distributed on the posterior zone and the intermediate zone for the unaffected side. The maximum von Mises stress of the bilaminar region on the affected side was greater than the unaffected side. The stress of the disc and bilaminar region was the lowest on the affected side in the 2 mm model. The disc displacement on the affected side gradually increased, whereas, on the unaffected side, it fluctuated. These results showed that occlusal stabilization splint could decrease the stress of disc and bilaminar region, and 2 mm was considered the optimal thickness for the treatment of unilateral temporomandibular joint anterior disc displacement without reduction.

Improvement of the prosthodontic treatment protocol in patients with TMD via functional diagnosis

Relevance. The purpose of the research is to improve the functional diagnosis protocol in prosthodontic treatment of patients with TMD.Materials and methods. The optimal position of the mandible was determined for each patient by two methods: 1) TENS (transcutaneous electrical nerve stimulation) and 2) TENS + kinesiography. Then, the cone-beam computed tomography (CBCT) data were analyzed to determine the most physiological position of the condyles.Results. The analysis of the CT scans of patients without TMD (control group) showed that the right and left condyles occupy an anterior or central symmetrical position relative to the glenoid fossa. In the first and second methods, the condyles occupy an anterior or central position, which is the most optimal position of the lower jaw for the manufacturing of an occlusal stabilization splint. The statistical coefficients allowed us to determine that the second method was more accurate, since the obtained values were lower than those of the first method.Conclusion. Based on the results of this study, we can conclude that the improvement of the protocol, namely a new method for determining the optimal position of the mandible is more time-consuming, but more accurate and allows increasing the effectiveness at all stages of treatment of patients with this pathology.

Construction and preliminary clinical evaluation of digital stabilization occlusal splint system

To established a digital workflow for stabilization occlusal splint with computer-aided design and computer-aided manufacturing (CAD/CAM) methods. Two subjects were enrolled from April 2019 to May 2019 from Department of Prosthodontics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (one male, 25 years old; one female, 24 years old). The working models of the participants' dentition were made. Two stabilization occlusal splints were manufactured for each participant using digital workflow and conventional workflow. With the digital workflow, the three-dimensional (3D) scanning of the cast, recording of the digital personalized mandibular movements and condyle trajectory, and the design and the 3D printing for the fabrication of the final appliance using CAD/CAM technologies were performed. With conventional workflow, conventional technologies were adopted based on requirements and experiment of designing and manufacturing of stabilization splint. During try-in, a checklist was built to compare the clinical performance of the two workflows. The digital workflow of the stabilization occlusal splint was built successfully. The total score of clinical primary evaluation by the two subjects were 26 and 26 for digital workflow splints, and 25 and 23 for conventional workflow splints. Digital stabilization occlusal splint workflow is feasible.

Does the facebow affect the outcome of CAD/CAM occlusal splint. Randomized clinical trial

BackgroundOcclusal appliances can distribute aggressive loads which are generated by bruxism and can reduce their frequency. The facebow record, when used in the construction of occlusal appliances, helps in minimizing occlusal discrepancies. This study aimed to compare the effect of CAD/CAM stabilization occlusal splint made with and without facebow for management of bruxer patients. Method24 Patients who were diagnosed as bruxers were randomly assigned into two equal groups and obtained maxillary CAD/CAM occlusal stabilizing splint recorded with centric relation either with or without using a facebow. The patient satisfaction using the visual analog scale (VAS) was recorded at baseline, one month and three months’ follow-up periods. The adjustment time of both splints, from the start of splint delivery until becoming well-fitted and occlusally adjusted, was calculated using a stopwatch. ResultsThe CAD/CAM occlusal splints with or without the use of facebow improved the patient's satisfaction with no statistically significant difference between both groups at baseline, one month and three months with p values of 0.73, 0.24 and 0.45 respectively. The comparison between the two modalities regarding the adjustment time showed no statistically significant difference between both groups (P = 0.06). ConclusionAccording to the results of this study; no difference was detected in patient satisfaction and the time required for adjustment of CAD/CAM occlus.

Long-term Changes of Temporomandibular Joint Osteoarthritis on Computed Tomography

This study aimed to understand long-term changes of the osteoarthritic temporomandibular joint (TMJ) condyle using computed tomography (CT) and to verify its correlation with clinical characteristics of temporomandibular disorders. Eighty-nine patients (152 joints; 76 female, 13 male) who had taken follow-up CTs (mean follow-up period: 644.58 ± 325.71 days) at least once in addition to their initial evaluation were selected. Cross-sectional demographic and clinical data and longitudinal CT images were collected. Data were analyzed by analysis of variance and logistic regression. Overall destructive change index (number of TMJ condyle sections in which destructive change was observed) decreased from 1.56 to 0.66. Improvement was seen in 93 joints (61.2%) and 27 joints (17.8%) worsened. In the pain positive group, both initial and final destructive change index were significantly higher compared to the pain negative group (p = 0.04). Occlusal stabilization splint therapy and nonsteroidal anti-inflammatory drug administration showed a significant effect on improving the prognosis of TMJ osteoarthritis (p = 0.015 and 0.011). In conclusion, TMJ osteoarthritis showed long-term improvement in the majority of cases. TMJ osteoarthritis accompanied by pain showed unfavorable prognosis with additional bone destruction. Occlusal stabilization splint and nonsteroidal anti-inflammatory drug administration were beneficial on the prognosis of TMJ osteoarthritis.

Comparison of immediate response to four conservative treatment modalities for management of masticatory myalgia with limited mandibular movement: a retrospective study.

Conservative treatment modalities are recommended for managing masticatory myalgia in individuals with temporomandibular disorders. The aim of this study was to retrospectively review and compare the effectiveness of four conservative treatments: counseling and occlusal splint therapy, counseling and manipulation integrated with electrophysiotherapy, the combination of the two treatments, and counseling only. One hundred and sixty-eight patients who had myalgia with limited jaw movement were retrospectively observed in this study. Between January 2015 and December 2017, 63 patients received counseling and stabilization occlusal splint therapy (Group 1), 35 patients received counseling and manipulation integrated with electrophysiotherapy (Group 2), 33 patients received the combination of counseling, splint therapy, and manipulation integrated with electrophysiotherapy (Group 3), and 37 patients received counseling only (Group 4). All subjects were followed up for 12 weeks. The intensity of spontaneous pain, palpation pain, chewing pain in the masticatory muscles, and range of pain-free maximal mouth opening were recorded in the clinical assessments. Intragroup and intergroup differences were examined by using analysis of variance (ANOVA) and the Kruskal-Wallis test. Spontaneous pain in the masticatory muscles was relieved significantly in all groups at the 6-week visit (P < .05), and no significant difference was found among the groups (P > .05). Palpation pain was relieved significantly at the 9-week visit in the counseling + occlusal splint therapy group, counseling + manipulation + electrophysiotherapy group, and counseling + occlusal splint + manipulation + electrophysiotherapy group (P < .05). In the treatment group with counseling alone, significant palpation pain relief occurred at 12 weeks. Chewing pain was relieved significantly at the 6-week visit in the counseling + occlusal splint therapy group, counseling + manipulation + electrophysiotherapy group, and counseling + occlusal splint + manipulation + electrophysiotherapy group (P < .05), yet no significant difference compared to the baseline was observed in the counseling-only group (P > .05). A significant increase in the maximal range of pain-free mouth opening was observed at the 9-week visit in the counseling + occlusal splint therapy group, and at the 3-week visit in the counseling + manipulation + electrophysiotherapy group and counseling + occlusal splint + manipulation + electrophysiotherapy group (P < .05). Nevertheless, no significant change in the range of mouth opening was found throughout the follow-up period in the counseling-only group (P > .05). Each of the included treatment modalities relieved spontaneous pain and tenderness to palpation of the masticatory muscles during the follow-up intervals. Counseling alone did not help patients with chewing pain and limited mouth opening in the short term. Treatment protocols including counseling, occlusal splint therapy, and manipulation, integrated with electrophysiotherapy showed the best short-term outcomes for symptomatic improvement.

Occlusal appliances - an alternative in temporomandibular disorders

Introduction/Objective. The pain that originates from musculoskeletal structures of the mastication system is one of the symptoms belonging to the category of temporomandibular disorders or temporomandibular dysfunction (TMD). The objective of the research was to evaluate the effect of therapy with stabilizing occlusal splint in the control of painful symptoms of TMD in comparison with the effect of drug therapy. Methods. Using standard Research Diagnostic Criteria for Temporomandibular Disorders diagnostic protocol proposed by Dworkin and LeResche, a group of 44 patients with painful TMD was included. The patients were divided into three treatment groups by random selection. The first group was treated with stabilization occlusal splint for a period of one month. In the two control groups, therapy with non-steroidal anti-inflammatory drug ibuprofen (Brufen, Mylan, Canonsburg, PA, USA) or a combination therapy of ibuprofen and diazepam, a medication from the benzodiazepine family (Diazepam, Hemofarm, Vrsac, Serbia) was carried out over a period of three weeks. In order to assess the effects of the therapy with stabilizing occlusal splint and the drug therapy, before and after the therapy, pain intensity measurements were performed with visual analogue scale and digital pressure algometer. Results. A significant reduction in the intensity of painful symptoms was achieved in all three therapeutic groups. No significant differences in the effectiveness of pain reduction between the proposed therapeutic modalities were noted. Conclusion. The obtained results confirm that the therapy with stabilization occlusal splint is a valid procedure in the reduction of pain in patients with TMD.

Clinical comparison of conventional and additive manufactured stabilization splints

The aim of this study was to compare conventional and digital additive manufacturing of hard occlusal stabilization splints (SS) using technical and clinical parameters. 14 subjects were subjected to DC/TMD Axis I clinical examination protocol and Axis II questionnaire. The subjects underwent treatment with splints over a period of 12 weeks. All subjects underwent both conventional alginate impression and intraoral digital scanning. Seven subjects received conventional manufactured stabilization splints (CM-SS), and seven subjects received CAD-CAM additive manufactured stabilization splints (AM-SS). 12 subjects completed the 12 weeks follow-up period. The subjects significantly preferred digital intraoral scanning compared to conventional alginate impression. There was a significant difference in VAS between CM-SS and AM-SS. The mean VAS result was 15 for AM-SS and 42 for CM-SS, 0 represented excellent comfort and 100 very uncomfortable. This was significant. Splint manufacturing method had no influence on treatment outcome. There was no significant difference in mean delta change for unassisted jaw opening from baseline to 12 weeks between the two groups, for CM-SS it was 2 mm difference and for AM-SS the difference was 3 mm. All subjects in both treatment groups showed improved oral function. In this study, the scanning procedure is more accepted by the subjects than alginate impressions, however the first procedure was more time consuming.

Occlusal stabilization splint for patients with temporomandibular disorders: Meta-analysis of short and long term effects.

BackgroundPsychological 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.MethodsMEDLINE, 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.ResultsThirty 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.ConclusionSS 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.

Using of occlusal stabilization splint in a patient with emotional problem and missing of anterior guidance

Using of occlusal stabilization splint in a patient with emotional problem and missing of anterior guidance

Rehabilitación oral en paciente con trastorno temporomandibular relacionado a factores oclusales

Se presenta el siguiente reporte de caso clínico: paciente de sexo femenino de 51 años de edad, edéntula parcial con maloclusión clase I que acude a la clínica de post grado al área de Rehabilitación Oral debido a los constantes ruidos y dolor periauricular con disminución del función masticatoria. El objetivo del presente reporte de caso clínico fué el diagnóstico y tratamiento del Trastorno Temporomandbular que se realizó tanto clínica como imagenologicamente a través de Resonancia Magnética de la articulación temporomandibular llegando al diagnóstico de desplazamiento discal unilateral derecha con reducción, por lo que se inicia el tratamiento en una primera fase con pacificación a través de un dispositivo oclusal de desplazamiento mandibular (DODAM) seguido de una férula estabilizadora oclusal para luego continuar con la rehabilitación protésica fija. La conclusión del presente reporte de caso clínico es dar importancia a la estabilidad articular a través del uso de férulas antes de iniciar el tratamiento de rehabilitación protésica en casos de Trastorno Temporomandibular que presentan desplazamiento discal con reducción, el conocimiento de los factores oclusales permitirá al clínico guiarse en el diagnóstico y tratamiento del trastorno temporomandibular considerando las condiciones de cada individuo.

Effects of Occlusal Stabilization Splints on Obstructive Sleep Apnea: A Randomized Controlled Trial

To assess the influence of occlusal stabilization splints on sleep-related respiratory variables in obstructive sleep apnea (OSA) patients. Ten OSA patients (47.3 ± 11.7 years of age) received a stabilization splint in the maxilla. All patients underwent three polysomnographic recordings with their splint in situ, and three recordings without their splint in situ, using a randomized crossover design. Repeated-measures ANOVAs did not yield statistically significant differences in the Apnea-Hypopnea Index (AHI) or in the Epworth Sleepiness Scale (ESS), neither between the three nights without the stabilization splint (AHI: F = 2.757, P = .090; ESS: F = 0.153, P = .860) nor between the nights with the splint in situ (AHI: F = 0.815, P = .458; ESS: F = 0.231, P = .796). However, independent ANOVAs revealed that the mean AHI of the three nights with the stabilization splint in situ (17.4 ± 7.0 events/hour) was significantly higher than that of the nights without the splint in situ (15.9 ± 6.4 events/hour) (F = 7.203, P = .025). The mean increase in AHI with the splint in situ was 1.4 ± 1.7 (95% confidence interval = -1.9-4.7). No difference in ESS was found when both conditions were compared (F = 1.000, P = .343). The use of an occlusal stabilization splint is associated with a risk of aggravation of OSA; however, the effect size was small, which reduces the clinical relevance of the study.