The effect of occlusal splint therapy on masticatory muscle activity-a systematic review

Abstract

Occlusal splints are used for the management of mandibular dysfunction, myofacial pain, prevention of tooth surface loss, pre-restorative stabilisation and protection of new restorations from parafunctional habits. Occlusal splint provides the patient with ideal occlusion, with posterior stability and anterior guidance. Different types of occlusal splints have been advo-cated, such as full or partial occlusal coverage, repositioning or stabilising, maxillary or mandibular. These are also made from different materials. For the clinician to assess the effectiveness of the splint therapy, Electromyogram (EMG) can be used. EMG has been used for evaluation as the occlusal changes are incorporated in the muscle engrams as and when it happens. Different designs and materials have been used in fabrication of splints. It is mandatory for the clinician to have a sound knowledge on this aspect for efficient splint therapy in various clinical scenarios. The databases of PubMed Central, Medline and Google Scholar were searched for related topics. Bibliographies of randomised control trials and reviews, identified in the electronic search, were analyzed for studies published outside the electronically searched journals. Randomised control trials, clinical studies, case control studies and animal studies assessing the effect of occlusal splints on EMG activity of the masticatory muscles were considered. Four studies were identified discussing EMG activity before and after splint therapy and the meta analysis performed revealed an overall effect size z=0.95 (p=0.34) at 95% CI. Two studies reported the difference in EMG activity between Soft and Hard splints and its meta analysis showed an overall effect size z=1.94 (p=0.05) at 95% CI.