Treatment Outcomes of Thick Stabilization Splint Therapy on Pain Related Temporomandibular Disorders: A Retrospective Clinical Follow-up Study

Year 2025, Volume: 49 Issue: 2, 119 - 126, 28.08.2025

Hale Arıkan Kalaycı , Dilek Yılmaz

Abstract

Background: The most common complaints in temporomandibular disorder (TMD) patients include myofascial pain, muscle spasms, limited mouth opening, and reduced sleep quality. The purpose of this study was to evaluate the clinical outcomes of thick stabilization splint therapy in patients with myofacial pain.
Material/Methods: A retrospective clinical study was performed by reviewing the clinical data of patients exhibiting symptoms of TMD and sleep bruxism with myofacial pain. Thick occlusal splint therapy was applied to all patients. The patients were analyzed in three distinct age groups (20-30, 31-40, and 41-55). Clinical outcomes were assessed by analyzing maximum mouth opening values, pain scores on the visual analogue scale, and sleep quality before therapy and at the 3-month follow-up. The statistical analysis was conducted using the SPSS software, and the findings were assessed at a significance level of 0.05.
Results: A total of 90 patients participated in the study (70 women and 20 men, mean age 35.98 ± 11.68 years). VAS scores of pain was significantly decreased in all age groups (2.43±1.35). Increased maximum mouth opening values and improvements in sleep quality were observed (p<0.001).
Conclusions: Three-month thick stabilization splint therapy is effective in managing myofascial pain, restricted mouth opening, and poor sleep quality symptoms across different age groups.

Keywords

occlusal splint , pain score , sleep bruxism , sleep quality , temporomandibular disorders

Supporting Institution

Başkent Üniversitesi

Project Number

D-KA24/35

References

• 1. Durham J, Newton-John TR, Zakrzewska JM. Temporomandibular Disorders. Bmj 2015; 350: H1154.
• 2. Dworkin SF, Massoth Dl. Temporomandibular Disorders And Chronic Pain: Disease Or Illness? J Prosthet Dent 1994; 72: 29-38.
• 3. Garstka AA, Kozowska L, Kijak K, Brzózka M, Gronwald H, Skomro P et al. Accurate Diagnosis And Treatment Of Painful Temporomandibular Disorders: A Literature Review Supplemented By Own Clinical Experience. Pain Res Manag 2023; 2023: 1002235.
• 4. Tanaka E, Detamore MS, Mercuri LG. Degenerative Disorders Of The Temporomandibular Joint: Etiology, Diagnosis, And Treatment. J Dent Res 2008; 87: 296-307.
• 5. Lee YH, Auh QS. Comparison Of Sleep Quality Deterioration By Subgroup Of Painful Temporomandibular Disorder Based On Diagnostic Criteria For Temporomandibular Disorders. Sci Rep 2022; 12: 9026.
• 6. Chien YC, Seferovic D, Holland JN, Walji MF, Adibi SS. When Should Sleep Bruxism Be Considered In The Diagnosis Of Temporomandibular Disorders? Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130: 645-650.
• 7. Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP et al. 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 2014; 28: 6-27.
• 8. Bergmann A, Edelhoff D, Schubert O, Erdelt KJ, Pho Duc JM. Effect Of Treatment With A Full-Occlusion Biofeedback Splint On Sleep Bruxism And Tmd Pain: A Randomized Controlled Clinical Trial. Clin Oral Investig 2020; 24: 4005-4018.
• 9. Albagieh H, Alomran I, Binakresh A, Alhatarisha N, Almeteb M, Khalaf Y et al. Occlusal Splints-Types And Effectiveness In Temporomandibular Disorder Management. Saudi Dent J 2023; 35: 70-79.
• 10. Zhang L, Xu L, Wu D, Yu C, Fan S, Cai B. Effectiveness Of Exercise Therapy Versus Occlusal Splint Therapy For The Treatment Of Painful Temporomandibular Disorders: A Systematic Review And Meta-Analysis. Ann Palliat Med 2021; 10: 6122-6132.
• 11. Al-Moraissi EA, Farea R, Qasem KA, Al-Wadeai MS, Al-Sabahi ME, Al-Iryani GM. Effectiveness Of Occlusal Splint Therapy In The Management Of Temporomandibular Disorders: Network Meta- Analysis Of Randomized Controlled Trials. Int J Oral Maxillofac Surg 2020; 49: 1042-1056.
• 12. Olthoff LW, Van Der Glas HW, Van Der Bilt A. Influence Of Occlusal Vertical Dimension On The Masticatory Performance During Chewing With Maxillary Splints. J Oral Rehabil 2007; 34: 560-565.
• 13. Bilir H, Kurt H. Influence Of Stabilization Splint Thickness On Temporomandibular Disorders. Int J Prosthodont 2022; 35: 163-173.
• 14. Lin SL, Wu SL, Ko SY, Yen CY, Yang JW. Effect Of Flat-Plane Splint Vertical Thickness On Disc Displacement Without Reduction: A Retrospective Matched-Cohort Study. J Oral Maxillofac Surg 2017; 75: 1627-1636.
• 15. Manns A, Miralles R, Santander H, Valdivia J. Influence Of The Vertical Dimension In The Treatment Of Myofascial Pain- Dysfunction Syndrome. J Prosthet Dent 1983; 50: 700-709.
• 16. Ribeiro AB, Pita MS, Ribeiro AB, Garcia AR, Junqueira Zuim PR. Effect Of Short-Term Increase In Occlusal Vertical Dimension On Masticatory Muscle Electrical Activities And Pressure-To-Pain Threshold: A Crossover Clinical Study. J Prosthet Dent 2022; 128: 970-976.
• 17. Guarda-Nardini L, Piccotti F, Mogno G, Favero L, Manfredini D. Age-Related Differences In Temporomandibular Disorder Diagnoses. Cranio 2012; 30: 103-109.
• 18. Kapos FP, Exposto FG, Oyarzo JF, Durham J. Temporomandibular Disorders: A Review Of Current Concepts In Aetiology, Diagnosis And Management. Oral Surg 2020; 13: 321-334.
• 19. Ananya R, Santosh Kumar MP, Hinaz N. Effectiveness Of Splint Therapy In The Management Of Temporomandibular Joint Disorders. Int J Dent Oral Sci 2021; 8: 2792-2798.
• 20. My A. Pittsburgh Uyku Kalitesi Indeksinin Gecerligi Ve Guvenirligi. Turk Psikiyatri Dergisi 1996; 7: 107-115.
• 21. Buysse DJ, Reynolds CF, 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: A New Instrument For Psychiatric Practice And Research. Psychiatry Res 1989; 28: 193-213.
• 22. Nishi SE, Basri R, Alam MK. Uses Of Electromyography In Dentistry: An Overview With Meta-Analysis. Eur J Dent 2016; 10: 419-425.
• 23. Sheikholeslam A, Holmgren K, Riise C. Therapeutic Effects Of The Plane Occlusal Splint On Signs And Symptoms Of Craniomandibular Disorders In Patients With Nocturnal Bruxism. J Oral Rehabil 1993; 20: 473-482.
• 24. Ekberg E, Nilner M. Treatment Outcome Of Appliance Therapy In Temporomandibular Disorder Patients With Myofascial Pain After 6 And 12 Months. Acta Odontol Scand 2004; 62: 343-349.
• 25. Tsuga K, Akagawa Y, Sakaguchi R, Tsuru H. A Short-Term Evaluation Of The Effectiveness Of Stabilization-Type Occlusal Splint Therapy For Specific Symptoms Of Temporomandibular Joint Dysfunction Syndrome. J Prosthet Dent 1989; 61: 610-613.
• 26. Hegab AF, Youssef AH, Hameed H, Karam KS. Mri-Based Determination Of Occlusal Splint Thickness For Temporomandibular Joint Disk Derangement: A Randomized Controlled Clinical Trial. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125: 74-87.
• 27. Solanki N, Singh BP, Chand P, Siddharth R, Arya D, Kumar L et al. Effect Of Mandibular Advancement Device On Sleep Bruxism Score And Sleep Quality. J Prosthet Dent 2017; 117: 67-72.
• 28. Micarelli A, Viziano A, Granito I, Micarelli RX, Augimeri I, Alessandrini M. Temporomandibular Disorders And Cervicogenic Dizziness: Relations Between Cervical Range Of Motion And Clinical Parameters. Cranio 2022; 40: 348-357.
• 29. Dubé C, Rompré PH, Manzini C, Guitard F, De Grandmont P, Lavigne Gj. Quantitative Polygraphic Controlled Study On Efficacy And Safety Of Oral Splint Devices In Tooth-Grinding Subjects. J Dent Res 2004; 83: 398-403.
• 30. Singh PK, Alvi HA, Singh BP, Singh RD, Kant S, Jurel S et al. Evaluation Of Various Treatment Modalities In Sleep Bruxism. J Prosthet Dent 2015; 114: 426-431.
• 31. Abe S, Huynh NT, Romprß PH, De Grandmont P, Landry- Schönbeck A, Landry ML et al. Sleep Quality And Comfort Reported By Sleep Bruxism Individuals Wearing The Occlusal Splint And Mandibular Advancement Splint: Revisiting Two Crossover Studies. Int J Prosthodont 2023; 36: 138-147.
• 32. Kuzmanovic Pficer J, Dodic S, Lazic V, Trajkovic G, Milic N, Milicic B. Occlusal Stabilization Splint For Patients With Temporomandibular Disorders: Meta-Analysis Of Short And Long Term Effects. Plos One 2017; 12: E0171296.
• 33. Romero-Reyes M, Uyanik JM. Orofacial Pain Management: Current Perspectives. J Pain Res 2014; 7: 99-115.
• 34. Özden AN, Ersoy AE, Kişnişçi RS. “Clinical Aspects Of Temporomandibular Disorders”. Turk J Med Sci 2000; 30: 77-82.
• 35. Wadhwa S, Kapila S. Tmj Disorders: Future Innovations In Diagnostics And Therapeutics. J Dent Educ 2008; 72: 930-947.
• 36. Matusz K, Maciejewska-Szaniec Z, Gredes T, Pobudek- Radzikowska M, Glapiński M, Górna N et al. Common Therapeutic Approaches In Sleep And Awake Bruxism - An Overview. Neurol Neurochir Pol 2022; 56: 455-463.