The efficacy of occlusal splints in the treatment of bruxism: A systematic review

Objectives
Bruxism is a commonly reported oral parafunctional activity characterised by excessive tooth grinding or clenching outside normal functional activity. The present systematic review aims to examine the available literature to determine the effectiveness of occlusal splints in the treatment of bruxism compared to no treatment and alternative treatment modalities.

Data
Data extraction was undertaken in conjunction with quality of evidence assessment.

Sources
A literature search of the following databases was undertaken: MEDLINE via OVID, Pubmed (Medline), Cochrane Oral Health Group’s Trials, The Cochrane Central Register of Controlled Trials and EMBASE.

Study selection
Randomised Controlled Trials (RCT) and quasi-RCTs which met the inclusion criteria were selected for analysis. These included studies comparing occlusal splints to no treatment or other interventions.

Results
Twenty-two studies were identified for review with fourteen meeting the inclusion criteria. Only a small number of studies were available in each comparison (one or two for some) all of which had a medium to high risk of bias.

Conclusions
There is insufficient evidence to determine whether occlusal splint therapy for the treatment of bruxism provides a benefit over no treatment, other oral appliances, TENS, behavioural or pharmacological therapy. Furthermore, there is a lack of studies in each comparison with many suffering from a high risk of bias. There is a need for further research in this area and improvement in trial quality.

Clinical significance statement
This systematic review aimed to determine the effectiveness of occlusal splints in the treatment of bruxism. It found there was insufficient evidence to recommend occlusal splint therapy over no treatment or other treatment modalities. This is relevant to dental clinicians who may provide such appliances and cautions them in treatment provision.