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; I-2 = 0%) and 6 months (fixed: WMD= -0.08; 95% CI -0.27 to 0.42; P =.66; I-2 = 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; I-2 = 44%), and 6 months (fixed: WMD= -0.83; 95% CI -0.52 to 2.18; P =.23; I-2 = 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.