Reduction of headache intensity and frequency with maxillary stabilization splint therapy in patients with temporomandibular disorders-headache comorbidity: a systematic review and meta-analysis.
Meta-Analysis
Migraine
Stabilization Splint
Systematic Review
Temporomandibular Joint Disorders
Tension-Type Headache
Journal
Journal of dental anesthesia and pain medicine
ISSN: 2383-9309
Titre abrégé: J Dent Anesth Pain Med
Pays: Korea (South)
ID NLM: 101690691
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
16
01
2021
revised:
21
04
2021
accepted:
24
04
2021
entrez:
17
6
2021
pubmed:
18
6
2021
medline:
18
6
2021
Statut:
ppublish
Résumé
This systematic review and meta-analysis aimed to analyze the effectiveness of maxillary stabilization splint (SS) therapy to reduce headache (HA) intensity and HA frequency in patients with temporomandibular disorders (TMD)-HA comorbidity. Randomized controlled trials (RCTs) using full-arch coverage, hard resin, and maxillary SS therapy were included. Electronic databases, including Cochrane Library, MEDLINE through PubMed, Web of Science, and EMBASE, were searched. The risk of bias was analyzed based on Cochrane's handbook. The search yielded 247 references up to January 28, 2020. Nine RCTs were included at a high risk of bias. The comparison groups included other splints, counseling, jaw exercises, medications, neurologic treatment, and occlusal equilibration. Four studies reported a statistically significant reduction in HA intensity, and five studies reported significant improvement in HA frequency from baseline at 2-12 months in patients with TMD-HA comorbidity treated with a full-arch hard maxillary SS. HA frequency in tension-type HA (TTH) comorbid with TMD diagnoses of myofascial pain (MFP) or capsulitis/synovitis improved significantly with SS than that with full-arch maxillary non-occluding splint (NOS) in two studies. Comparison groups receiving hard partial-arch maxillary splint nociceptive trigeminal inhibition (NTI) showed statistically significant improvements in HA intensity in patients with mixed TMD phenotypes of MFP and disc displacement comorbid with "general HA." Comparison groups receiving partial-arch maxillary resilient/soft splint (Relax) showed significant improvements in both HA intensity and frequency in patients with HA concomitant with MFP. The meta-analysis showed no statistically significant difference in the improvement of pain intensity at 2-3 months with comparison of the splints (partial-arch soft [Relax], hard [NTI], and full-arch NOS) or splint use compliance at 6-12 months with comparison of the splints (partial-arch Relax and full-arch NOS) versus the SS groups in patients with various TMD-HA comorbidities. In conclusion, although SS therapy showed a statistically significant decrease in HA intensity and HA frequency when reported, the evidence quality was low due to the high bias risk and small sample size. Therefore, further studies are required.
Identifiants
pubmed: 34136641
doi: 10.17245/jdapm.2021.21.3.183
pmc: PMC8187022
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
183-205Informations de copyright
Copyright © 2021 Journal of Dental Anesthesia and Pain Medicine.
Déclaration de conflit d'intérêts
DECLARATION OF INTEREST: The authors have no conflicts of interest to declare.
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