Efficacy of added splint therapy after arthrocentesis vs arthrocentesis alone in the management of temporomandibular joint disorders: a systematic review and meta-analysis.

Objective: Occlusal splints are commonly used in the management of temporomandibular joint disorders. However, it is unclear if it should be used after a second-line therapy like arthrocentesis. The evidence on the efficacy of post-arthrocentesis splint therapy in the management of temporomandibular joint disorders was systematically reviewed.

Method And Materials: PubMed, Embase, Scopus, Web of Science, CENTRAL, and Google Scholar were searched for studies published until 5 August 2024. The outcomes assessed were pain and maximal mouth opening.

Results: Eight studies were included. Five studies reported data for the meta-analysis. The pooled analysis found that there was no statistically significant difference in pain scores in the arthrocentesis + splint group vs arthrocentesis group at 1 month (mean difference [MD] -0.01, 95% CI -0.46 to 0.44), 3 months (MS -0.02, 95% CI -0.67 to 0.63), and 6 months (MD 0.06, 95% CI -0.25 to 0.37). The pooled analysis also showed that splint therapy after arthrocentesis may not significantly improve maximal mouth opening as compared to no splint therapy at 1 month (MD 0.08, 95% CI -2.11 to 2.27), 3 months (MD 0.76, 95% CI -0.84 to 2.35), and 6 months (MD 0.56, 95% CI -0.65 to 1.78). Descriptive analysis of three studies showed that two supported the use of splints while one found no added improvement in outcomes.

Conclusions: Limited evidence from low-quality studies shows that the use of splint therapy after arthrocentesis may not improve pain and maximal mouth opening in patients with temporomandibular joint disorders. High-quality randomized controlled trials are needed to improve evidence.