Self-exercise programmes and occlusal splints in the treatment of TMD-related myalgia—Evidence-based medicine?

Abstract

Background: The low-cost and reversible treatments concerning disorders of the masticatory muscles represent a vast array of regimens. Common treatments include information, stretching exercises, manual therapy, acrylic splints and cognitive behavioural therapy. Objective: The aim of this study was to evaluate the evidence behind the use of self-exercising programmes and occlusal splints in the treatment of myofascial pain. Methods: We conducted a thorough search of five databases, using four cardinal search terms in combination with twelve supporting terms. We also assessed the evidence quality, using GRADEpro software. Results: The search resulted in 4967 individual studies. 18 studies met the inclusion criteria and were re-evaluated. Conclusion: The selected studies were in favour of a self-care or an occlusal splint treatment of myalgia. However, a GRADE assessment showed that 14 of the 18 selected studies had low or very low evidence quality. Studies also showed weaknesses with regard to nomenclature and reproducibility. Hence, it is our professional opinion that the evidence level for prescribing self-exercises and occlusal splints in the treatment of myalgia is low.