Effect of computer-aided design/computer-assisted manufacture versus conventional occlusal splints on the management of temporomandibular disorders: A systematic review and meta-analysis

Abstract

With continuous debate and lack of consensus regarding which are more effective in management of the temporomandibular disorders (TMDs), computer-aided design/computer-assisted manufacture (CAD/CAM) or conventional occlusal splint. The aim of this systematic review and meta-analysis was to perform a qualitative and quantitative analysis of the scientific literature regarding the use of CAD/CAM versus conventional occlusal splint in the management of patient with TMDs. Manual and electronic database (PubMed and Cochrane) searches were performed to identify randomized controlled trials (RCTs), without language restriction, comparing CAD/CAM versus conventional occlusal splints. Data were extracted independently by two reviewers. The Cochrane tool was used for assessing the quality of included studies. Meta-analyses were performed for the two included RCTs of similar comparisons reported the same outcome measures. Eight trials were identified. Out of them two RCTs were included and six trials were excluded. The two included RCTs were considered to be at a low risk of bias. The pooled result revealed that the CAD/CAM occlusal splint has statistically significant less pain in jaw joint, face tension, and time needed for adjustment when compared to conventional occlusal splints. The meta-analysis revealed that the CAD/CAM occlusal splint has statistically potential in reduction of pain in jaw joint, face tension, and time needed for adjustment when compared to conventional occlusal splints. CAD/CAM occlusal splint may be suggested as an alternative manufacturing modality for TMDs patients who can offer the cost of this treatment modality. This review should be interpreted with caution because of limited number of included studies. Well-designed RCTs should be conducted and the outcome measures evaluation should be standardized between studies to reach potent conclusion.