Non-Cochrane · intervention · PM41924677
Digital Versus Conventional Splints in Patients With Temporomandibular Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Almansour Fahad W, Alshammari Khaled, Mohammed Alhajri Dhari, et al. · Cureus · 2026 · PubMed · doi:10.7759/cureus.105977
Findings
Population Patients with temporomandibular disorders
13 findings
| Digitally fabricated (CAD/CAM) occlusal splint | Conventionally fabricated occlusal splint | Pain intensity (VAS) Last available follow-up · Leave-one-out sensitivity analysis: omitting Pai et al. 2025 | MD -0.33 [-1.13, 0.47] GRADE not reported 6 studies · 354 participants |
| Digitally fabricated (CAD/CAM) occlusal splint | Conventionally fabricated occlusal splint | Pain intensity (VAS) Last available follow-up · Leave-one-out sensitivity analysis: omitting Hussein et al. 2025 | MD -0.22 [-1.08, 0.64] GRADE not reported 6 studies · 358 participants |
| Digitally fabricated (CAD/CAM) occlusal splint | Conventionally fabricated occlusal splint | Patient satisfaction (Likert scale) Not specified | MD 0.20 [-1.26, 1.66] GRADE not reported 4 studies · 80 participants |
| Digitally fabricated (CAD/CAM) occlusal splint | Conventionally fabricated occlusal splint | Pain intensity (VAS) Last available follow-up · Leave-one-out sensitivity analysis: omitting Pho Duc et al. 2016 | MD -0.31 [-1.07, 0.45] GRADE not reported 6 studies · 346 participants |
| Digitally fabricated (CAD/CAM) occlusal splint | Conventionally fabricated occlusal splint | Pain intensity (VAS) Last available follow-up · Leave-one-out sensitivity analysis: omitting Chen et al. 2026 | MD 0.03 [-0.65, 0.72] GRADE not reported 6 studies · 246 participants |
| Digitally fabricated (CAD/CAM) occlusal splint | Conventionally fabricated occlusal splint | Maximum mouth opening Not specified · Maximum mouth opening | MD -0.10 [-0.97, 0.77] GRADE not reported 3 studies · 158 participants |
| Digitally fabricated (CAD/CAM) occlusal splint | Conventionally fabricated occlusal splint | Limited mouth opening Not specified · Limited mouth opening | MD -0.09 [-1.03, 0.86] GRADE not reported 2 studies · 62 participants |
| Digitally fabricated (CAD/CAM) occlusal splint | Conventionally fabricated occlusal splint | Pain intensity (VAS) Last available follow-up · Leave-one-out sensitivity analysis: omitting Algabri et al. 2017 | MD -0.04 [-0.77, 0.68] GRADE not reported 6 studies · 348 participants |
| Digitally fabricated (CAD/CAM) occlusal splint | Conventionally fabricated occlusal splint | Pain intensity (VAS) Last available follow-up · Leave-one-out sensitivity analysis: omitting Berntsen et al. 2018 | MD -0.20 [-0.92, 0.51] GRADE not reported 6 studies · 364 participants |
| Digitally fabricated (CAD/CAM) occlusal splint | Conventionally fabricated occlusal splint | Mouth opening (limited and maximum combined) Not specified · Overall of limited and maximum subgroups | MD -0.09 [-0.73, 0.55] GRADE not reported 5 studies · 220 participants |
| Digitally fabricated (CAD/CAM) occlusal splint | Conventionally fabricated occlusal splint | Pain intensity (VAS) Last available follow-up | MD -0.22 [-0.92, 0.48] GRADE not reported 7 studies · 378 participants |
| Digitally fabricated (CAD/CAM) occlusal splint | Conventionally fabricated occlusal splint | Pain intensity (VAS) Last available follow-up · Leave-one-out sensitivity analysis: omitting Qin et al. 2025 | MD -0.45 [-1.13, 0.23] GRADE not reported 6 studies · 252 participants |
| Digitally fabricated (CAD/CAM) occlusal splint | Conventionally fabricated occlusal splint | Clinical occlusal adjustment time (minutes) Not specified | MD -9.10 [-15.18, -3.02] GRADE not reported 3 studies · 170 participants |
Included primary studies 7
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Abd Elgaleel 2025 matched by author and year (probable) | NR | this review only | Maximum mouth opening | not extracted yet |
| Algabri 2017 matched by author and year (probable) | NR | this review only | Pain intensity (VAS); Limited mouth opening; Maximum mouth opening; Mouth opening (limited and maximum combined) | not extracted yet |
| Berntsen 2018 Clinical comparison of conventional and additive manufactured stabilization splints. PMID:30128331 | 2018 | this review only | Pain intensity (VAS); Limited mouth opening; Maximum mouth opening; Mouth opening (limited and maximum combined) | not extracted yet |
| Chen 2026 Application of fully digital occlusal splints in painful temporomandibular disorders: a randomized controlled clinical study. PMID:41495778 | 2026 | this review only | Pain intensity (VAS) | not extracted yet |
| Hussein 2025 matched by author and year (probable) | NR | this review only | Pain intensity (VAS); Limited mouth opening | not extracted yet |
| Pho Duc 2016 Parallel Randomized Controlled Clinical Trial in Patients with Temporomandibular Disorders Treated with a CAD/CAM Versus a Conventional… PMID:27479339 | 2016 | this review only | Pain intensity (VAS); Limited mouth opening | not extracted yet |
| Qin 2025 Comparative Efficacy of Digital 3D-Printed and Conventional Stable Occlusal Splints in the Treatment of Temporomandibular Disorders. PMID:40384555 | 2025 | this review only | Pain intensity (VAS); Limited mouth opening; Mouth opening (limited and maximum combined) | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients diagnosed with temporomandibular disorders (TMD) | Patients with TMD (n=390) |
| Intervention | Digitally fabricated occlusal splints | Digital occlusal splints (CAD/CAM milled or 3D printed; intraoral scan and CAD) |
| Comparison | Conventionally fabricated occlusal splints | Conventional (heat-cured or self-curing acrylic) occlusal splints |
| Outcomes | Primary: pain intensity (VAS) at last follow-up; secondary: maximum and limited mouth opening, patient satisfaction (Likert), clinical occlusal adjustment time (T-Scan) | Pain (7 studies, n=378), mouth opening (5 studies), satisfaction (4 studies), occlusal adjustment time (3 studies) |
| Study designs | Randomized controlled trials (crossover trials: first period only) | RCTs (n=8; six parallel-group, two crossover) |
| Timing | Last available follow-up | Last available follow-up |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | No | No | yes |
| 3Choice of study designs explained | Yes | No | no |
| 4Comprehensive literature searchcritical | No | No | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | No | No | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | No | No | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |