Evidence-Based Selection of Occlusal Splints for Temporomandibular Disorders (TMDs): A Critical Review and Update
DOI:
https://doi.org/10.24191/cos.v13i2.10214Keywords:
temporomandibular joint, temporomandibular disorder, occlusal splintsAbstract
Occlusal splints are widely used for conservative management of temporomandibular disorders (TMDs), but evidence on the effectiveness of different splint types across TMD subtypes remains variable. TMDs involve musculoskeletal and intra-articular conditions of the temporomandibular joint (TMJ) and related structures. We conducted a targeted search of PubMed, Scopus, and Web of Science using keywords including “temporomandibular disorders,” “occlusal splint,” “stabilization splint,” and “anterior repositioning splint.” Adult randomized controlled trials, systematic reviews, and meta-analyses with clearly defined TMDs were included whereas, case reports, pediatric, and non-English studies were excluded. Articles were screened for splint type, TMD subtype, and clinical outcomes to guide evidence-based recommendations. Stabilization splints show clear benefit in myogenous TMDs with bruxism or muscle hyperactivity, whereas anterior repositioning splints provide short-term improvement in disc displacement with reduction. Digital splints achieve outcomes comparable to conventional acrylic devices with improved precision. Heterogeneity in diagnostic criteria, splint design, adjustment protocols, follow-up duration, and outcome measures limits evidence quality. Current data support individualized splint selection based on TMD subtype and symptoms, ideally within a multimodal treatment approach, and highlight the need for standardized diagnostics, core outcome measures, and long-term evaluation.
References
Al-Moraissi, E. A., Farea, R., Qasem, K. A., Al-Wadeai, M. S., Al-Sabahi, M. E., & Al-Iryani, G. M. (2020). Effectiveness of occlusal splint therapy in the management of temporomandibular disorders: network meta-analysis of randomized controlled trials. Int J Oral Maxillofac Surg, 49(8), 1042-1056. https://doi.org/10.1016/j.ijom.2020.01.004
Chan, N. H. Y., Ip, C. K., Li, D. T. S., & Leung, Y. Y. (2022). Diagnosis and Treatment of Myogenous Temporomandibular Disorders: A Clinical Update. Diagnostics (Basel), 12(12). https://doi.org/10.3390/diagnostics12122914
Da-Cas, C. D., Valesan, L. F., Nascimento, L. P. D., Denardin, A. C. S., Januzzi, E., Fernandes, G., Stuginski-Barbosa, J., & Mendes de Souza, B. D. M. (2024). Risk factors for temporomandibular disorders: a systematic review of cohort studies. Oral Surg Oral Med Oral Pathol Oral Radiol, 138(4), 502-515. https://doi.org/10.1016/j.oooo.2024.06.007
Ebrahim, S., Montoya, L., Busse, J. W., Carrasco-Labra, A., & Guyatt, G. H. (2012). The effectiveness of splint therapy in patients with temporomandibular disorders: a systematic review and meta-analysis. J Am Dent Assoc, 143(8), 847-857. https://doi.org/10.14219/jada.archive.2012.0289
Eftimie, S., Hedesiu, M., Dinu, C., Roman, R., & Almasan, O. (2022). Digital occlusal splints for temporomandibular joint disorders: a systematic review. Romanian Journal of Stomatology, 68, 97-105. https://doi.org/10.37897/RJS.2022.3.1
The Glossary of Prosthodontic Terms 2023: Tenth Edition. (2023). J Prosthet Dent, 130(4 Suppl 1), e1-e3. https://doi.org/10.1016/j.prosdent.2023.03.003
Greene, C. S., & Manfredini, D. (2020). Treating Temporomandibular Disorders in the 21st Century: Can We Finally Eliminate the "Third Pathway"? J Oral Facial Pain Headache, 34(3), 206-216. https://doi.org/10.11607/ofph.2608
Guo, Y.-n., Cui, S.-j., Zhou, Y.-h., & Wang, X.-d. (2021). An Overview of Anterior Repositioning Splint Therapy for Disc Displacement-related Temporomandibular Disorders. Current Medical Science, 41(3), 626-634. https://doi.org/10.1007/s11596-021-2381-7
Kurt, H., Mumcu, E., Sülün, T., Diraçoǧu, D., Ünalan, F., Aksoy, C., & Tuncer, N. (2011). Comparison of Effectiveness of Stabilization Splint, Anterior Repositioning Splint and Behavioral Therapy in Treatment of Disc Displacement with Reduction. Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi, 57, 25-30. https://doi.org/10.4274/tftr.57.05
List, T., & Jensen, R. H. (2017). Temporomandibular disorders: Old ideas and new concepts. Cephalalgia, 37(7), 692-704. https://doi.org/10.1177/0333102416686302
Niemelä, K., Korpela, M., Raustia, A., Ylöstalo, P., & Sipilä, K. (2012). Efficacy of stabilisation splint treatment on temporomandibular disorders. J Oral Rehabil, 39(11), 799-804. https://doi.org/10.1111/j.1365-2842.2012.02335.x
Patra, R. C., Kanungo, B., Yashudas, A., Mohanty, P., & Kaur, G. (2025). Multimodal physical therapy approach for the management of patients with temporomandibular disorder: Randomized control trial. J Oral Biol Craniofac Res, 15(3), 515-524. https://doi.org/10.1016/j.jobcr.2025.03.003
Poorna, T. A., John, B., E, K. J., & Rao, A. (2022). Comparison of the effectiveness of soft and hard splints in the symptomatic management of temporomandibular joint disorders: A randomized control study. Int J Rheum Dis, 25(9), 1053-1059. https://doi.org/10.1111/1756-185x.14379
Prati, S., Goker, F., Tumedei, M., Gianni, A. B., Del Fabbro, M., & Tartaglia, G. M. (2024). Comparison of Modified Occlusal Splint, Standard Splint Protocol, and Conventional Physical Therapy in Management of Temporomandibular Joint Disc Displacement with Reduction and Intermittent Locking: A Randomized Controlled Trial. Applied Sciences (2076-3417), 14(24).
Schiffman, E., Ohrbach, R., Truelove, E., Look, J., Anderson, G., Goulet, J. P., List, T., Svensson, P., Gonzalez, Y., Lobbezoo, F., Michelotti, A., Brooks, S. L., Ceusters, W., Drangsholt, M., Ettlin, D., Gaul, C., Goldberg, L. J., Haythornthwaite, J. A., Hollender, L., . . . Dworkin, S. F. (2014). Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. J Oral Facial Pain Headache, 28(1), 6-27. https://doi.org/10.11607/jop.1151
Sikora, R., Duspara, K., Matić, A., Petrović, A., Kralik, K., Smolić, R., Sikora, M., Šarac, M., Bojanić, K., & Smolić, M. (2025). Stabilization Splint Therapy for Patients with Temporomandibular Disorders Improves Opening Movements and Jaw Limitation and Attenuates Pain by Influencing the Levels of IL-7, IL-8, and IL-13 in the Gingival Crevicular Fluid. Medicina (Kaunas), 61(3). https://doi.org/10.3390/medicina61030375
Zhang, C., Wu, J. Y., Deng, D. L., He, B. Y., Tao, Y., Niu, Y. M., & Deng, M. H. (2016). Efficacy of splint therapy for the management of temporomandibular disorders: a meta-analysis. Oncotarget, 7(51), 84043-84053. https://doi.org/10.18632/oncotarget.13059
Zhang, Y., Zhang, H., Liu, R., Jin, S., Huo, T., Wei, H., & Qin, L. (2025). The efficacy of treatments for temporomandibular disorders with occlusal splints versus other conservative therapies: a meta-analysis of randomized controlled trials. Oral Surg Oral Med Oral Pathol Oral Radiol, 139(5), 509-520. https://doi.org/10.1016/j.oooo.2024.11.089
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Compendium of Oral Science
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Materials contained in the journal may be reproduced for educational purposes provided that both the author(s) and the journal are appropriately recognised; otherwise duplication is not permitted. No articles, reports, or portions there of may be translated into other languages, published in books, journals, magazines, or any other print form without written permission from the authors and from the journal.
Disclaimer: The statements, opinions and data expressed in the articles and reports herein are those of the author(s) and not of the publisher and the editor(s). The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any schemes, methods, instructions or ideas referred to in the content.
