Manual Therapy Techniques Versus Occlusal Splint Therapy for Temporomandibular Disorders: A Systematic Review with Meta-Analysis

Manual therapy (MT) and occlusal splint therapy (OST) are the most conservative therapies applied on patients with temporomandibular disorders (TMDs). The aim was to compare the efficacy of MT vs. OST in improving pain, maximal mouth opening (MMO), disability, and health related-quality of life (hr-...

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Published in:Dentistry journal 2024-11, Vol.12 (11), p.355
Main Authors: Villar-Aragón-Berzosa, Víctor, Obrero-Gaitán, Esteban, Lérida-Ortega, Miguel Ángel, López-Ruiz, María Del Carmen, Rodríguez-Almagro, Daniel, Achalandabaso-Ochoa, Alexander, Molina-Ortega, Francisco Javier, Ibáñez-Vera, Alfonso Javier
Format: Article
Language:English
Subjects:
Analysis
Bias
Care and treatment
Clinical trials
disability
Disorders
Effectiveness
Intervention
Jaw
Manipulative therapy
manual therapy
Medical research
Medicine, Experimental
Meta-analysis
occlusal splints
Pain
Quality of life
Splints
Subgroups
Systematic Review
temporomandibular disorders
Temporomandibular joint
Temporomandibular joint disorders
Therapy
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Summary:Manual therapy (MT) and occlusal splint therapy (OST) are the most conservative therapies applied on patients with temporomandibular disorders (TMDs). The aim was to compare the efficacy of MT vs. OST in improving pain, maximal mouth opening (MMO), disability, and health related-quality of life (hr-QoL) in these patients. According to PRISMA guidelines, a meta-analysis (CRD42022343915) was conducted including randomized controlled trials comparing the effectiveness of MT vs. OST in TMD patients, after searching in PubMed, PEDro, SCOPUS, and WOS up to March 2024. Methodological quality and risk of bias were assessed using the PEDro Scale. Cohen's standardized mean difference (SMD) and its 95% confidence interval (95% CI) were the pooled effect measures calculated. Nine studies, providing data from 426 patients, were included. Meta-analyses revealed that MT is more effective than OST in reducing disability (SMD = -0.81; 95% CI -1.1 to -0.54) and increasing MMO (SMD = 0.52; 95% CI 0.27 to 0.76) without differences for improving pain intensity and hr-QoL. Subgroup analyses revealed the major efficacy of OST in reducing pain in myogenic patients (SMD = 0.65; 95% CI 0.02 to 1.28). With caution, due to the low number of studies included, MT may be more effective than OST for improving disability and MMO in patients with TMDs.
ISSN:2304-6767
2304-6767
DOI:10.3390/dj12110355