Digital occlusal splints for temporomandibular joint disorders: a systematic review

Objectives. This systematic review aimed at assessing the therapeutic efficacy of computer-assisted or digitally constructed occlusal splints in comparison to conventional splint treatment for temporomandibular disorders or bruxism. Material and methods. The study was prospectively registered in the Open Science Framework. Four electronic databases, PubMed, Embase, Web of Science, and Scopus, were searched comprehensively. The following keywords were employed: “3D-printed”, “additive manufacture”, “computer-aided design/computer-aided manufacturing”, “temporomandibular joint”, “temporomandibular joint dysfunction”, “bruxism”, “disc displacement”, “temporo-mandibular disorder”, “splint’, “oral splint”, “occlusal splint”, “occlusal device”, “bite splint”, “occlusal appliance”. Two risk of bias evaluation instruments were used to assess the quality of the included studies. Outcomes. Following the application of the search strategy, a total of 557 publications were identified in the electronic databases. Seven eligible articles were finally included in the analysis. Six publications (85.7%) compared digitally manufactured occlusal splints to conventionally created splints, while one examined if the use of a facebow influences the performance of digital splints. Visual assessment scores or numerical rating scales of pain, optical axiography, tooth wear, and bruxism frequency were reported as outcomes. Conclusions. Computer aided design occlusal splints provide equivalent outcomes to traditional splints. Some generated superior results, mainly probable as a result of the virtual articulator's greater precision and the splint materials' material qualities.