Is splint therapy required after arthrocentesis to improve outcome in the management of temporomandibular joint disorders? A systematic review and meta-analysis.

OBJECTIVE: The aim of this systematic review was to assess the efficacy of splint therapy in improving outcomes after arthrocentesis for the management of temporomandibular joint disorders.

STUDY DESIGN: A comprehensive electronic search was conducted to search for randomized control trials, controlled clinical trials, and retrospective studies comparing arthrocentesis and splint therapy with arthrocentesis alone.

RESULTS: Six studies were included in this review. There was no statistical significant difference in pain reduction with or without the use of splint after arthrocentesis at 1 month (fixed: weighted mean difference [WMD] = -0.01; 95% confidence interval [CI] -0.46 to 0.44; P = .96; I2  = 0%) and 6 months (fixed: WMD = -0.08; 95% CI -0.27 to 0.42; P = .66; I2  = 0%). Similarly, no difference was seen in improvement in maximal mouth opening at 1 month (fixed: WMD = -0.16; 95% CI -1.75 to 1.42; P = .84; I2  = 44%), and 6 months (fixed: WMD = -0.83; 95% CI -0.52 to 2.18; P = .23; I2  = 0%).

CONCLUSIONS: Within the limitation of this review, there is some evidence that splint therapy may not improve outcomes after arthrocentesis. There is a need for well-designed RCTs evaluating the additional benefit of splint therapy after arthrocentesis for managing temporomandibular joint disorders.