The efficacy of anterior repositioning splints in the management of temporomandibular disc displacement: a systematic review and meta-analysis

Abstract Objective This systematic review and meta-analysis aimed to evaluate the effectiveness of anterior repositioning splint (ARS) compared with other conservative treatments for temporomandibular joint (TMJ) disc displacement. Methods This systematic review and meta-analysis was conducted in ac...

Full description

Saved in:
Bibliographic Details
Main Authors: Liujing Wang, Yanni Zhang, Haiyan Chen, Chenxi Jin, Wei Shen, Ziyuan Li, Wei Zhang, Yuxin Shi, Yiyang Hou, Xiaoxuan Li, Jing Guo
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Oral Health
Subjects:
Online Access:https://doi.org/10.1186/s12903-025-06379-3
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849738128877682688
author Liujing Wang
Yanni Zhang
Haiyan Chen
Chenxi Jin
Wei Shen
Ziyuan Li
Wei Zhang
Yuxin Shi
Yiyang Hou
Xiaoxuan Li
Jing Guo
author_facet Liujing Wang
Yanni Zhang
Haiyan Chen
Chenxi Jin
Wei Shen
Ziyuan Li
Wei Zhang
Yuxin Shi
Yiyang Hou
Xiaoxuan Li
Jing Guo
author_sort Liujing Wang
collection DOAJ
description Abstract Objective This systematic review and meta-analysis aimed to evaluate the effectiveness of anterior repositioning splint (ARS) compared with other conservative treatments for temporomandibular joint (TMJ) disc displacement. Methods This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. Four databases (PubMed, Web of Science, Embase, and Cochrane) were searched up to January 8, 2024, so as to identify eligible randomized controlled trials (RCTs) of ARS for the treatment of TMJ disc displacement. Results This analysis finally included 14 studies. The research findings showed that after 3 months of treatment, ARS significantly improved VAS score compared to the physical therapy [MD: -1.90, 95%CI (-2.69, -1.11), P < 0.00001] and behavioral therapy [MD=-3.00, 95%CI (-4.30, -1.71), P < 0.05]. However, it was less effective than other occlusal splint treatments [MD: 0.71, 95%CI (0.30, 1.11), P = 0.0007]. In terms of pain free mouth opening, ARS significantly outperformed the physical therapy [MD = 2.83, 95%CI (1.04, 4.62), P = 0.002] and behavioral therapy [MD: 1.79, 95%CI (1.33, 2.26), P < 0.00001] after 3 months of treatment. No significant difference was observed between ARS and other occlusal splint treatments [MD=-0.97, 95%CI (-2.65, 0.71), P = 0.26]. Regarding maximal active mouth opening, after 3 months of treatment, ARS was significantly superior to the physical therapy [MD = 3.10, 95%CI (1.05, 5.15), P = 0.03] and behavioral therapy [MD: 3.19, 95%CI (2.71, 3.66), P < 0.00001]. There was no significant difference between ARS and other occlusal splint treatments [MD: − 1.92, 95%CI (-4.05, 0.21), P = 0.08]. In terms of maximal passive mouth opening, ARS was significantly more effective than physical therapy [MD: 1.91, 95%CI (0.13, 3.68), P = 0.04]. There was no significant difference between ARS and other occlusal splint treatments [MD: -2.25, 95%CI (-5.02, 0.53), P = 0.11]. For relieving jaw popping symptoms, ARS was significantly more effective than the physical therapy [RR:0.45, 95%CI (0.34, 0.58), P < 0.00001] and behavioral therapy [RR: 0.48, 95%CI (0.36, 0.64), P < 0.00001]. However, no significant difference was found between ARS and other occlusal splint treatments [RR: 1.29, 95%CI (0.83, 2.02), P = 0.26]. Conclusion A total of 14 studies were included in this systematic review and meta-analysis, which compared the efficacy of ARS with other conservative treatments for disc displacement. While ARS did not demonstrate a significant difference compared to physical therapy in improving TMJ pain, popping, and mandibular motor function in the initial treatment phase, it exhibited more pronounced effects than physical therapy and behavioral therapy with continued use. Splints have demonstrated significant efficacy in alleviating TMJ popping and improving mandibular movement. However, ARS has not shown superior effectiveness compared to other types of occlusal splints in alleviating pain.
format Article
id doaj-art-a2a26486e15d4fc3b0a571a433b98569
institution DOAJ
issn 1472-6831
language English
publishDate 2025-07-01
publisher BMC
record_format Article
series BMC Oral Health
spelling doaj-art-a2a26486e15d4fc3b0a571a433b985692025-08-20T03:06:43ZengBMCBMC Oral Health1472-68312025-07-0125112610.1186/s12903-025-06379-3The efficacy of anterior repositioning splints in the management of temporomandibular disc displacement: a systematic review and meta-analysisLiujing Wang0Yanni Zhang1Haiyan Chen2Chenxi Jin3Wei Shen4Ziyuan Li5Wei Zhang6Yuxin Shi7Yiyang Hou8Xiaoxuan Li9Jing Guo10Department of Stomatology, Ningbo Municipal Hospital of Traditional Chinese Medicine (TCM) Affiliated Hospital of Zhejiang Chinese Medical UniversityNingbo Stomatology HospitalDepartment of Stomatology, Women and Children’s Hospital of Ningbo UniversityNingbo Stomatology HospitalNingbo Stomatology HospitalNingbo Stomatology HospitalNingbo Stomatology HospitalNingbo Stomatology HospitalNingbo Stomatology HospitalNingbo Stomatology HospitalNingbo Stomatology HospitalAbstract Objective This systematic review and meta-analysis aimed to evaluate the effectiveness of anterior repositioning splint (ARS) compared with other conservative treatments for temporomandibular joint (TMJ) disc displacement. Methods This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. Four databases (PubMed, Web of Science, Embase, and Cochrane) were searched up to January 8, 2024, so as to identify eligible randomized controlled trials (RCTs) of ARS for the treatment of TMJ disc displacement. Results This analysis finally included 14 studies. The research findings showed that after 3 months of treatment, ARS significantly improved VAS score compared to the physical therapy [MD: -1.90, 95%CI (-2.69, -1.11), P < 0.00001] and behavioral therapy [MD=-3.00, 95%CI (-4.30, -1.71), P < 0.05]. However, it was less effective than other occlusal splint treatments [MD: 0.71, 95%CI (0.30, 1.11), P = 0.0007]. In terms of pain free mouth opening, ARS significantly outperformed the physical therapy [MD = 2.83, 95%CI (1.04, 4.62), P = 0.002] and behavioral therapy [MD: 1.79, 95%CI (1.33, 2.26), P < 0.00001] after 3 months of treatment. No significant difference was observed between ARS and other occlusal splint treatments [MD=-0.97, 95%CI (-2.65, 0.71), P = 0.26]. Regarding maximal active mouth opening, after 3 months of treatment, ARS was significantly superior to the physical therapy [MD = 3.10, 95%CI (1.05, 5.15), P = 0.03] and behavioral therapy [MD: 3.19, 95%CI (2.71, 3.66), P < 0.00001]. There was no significant difference between ARS and other occlusal splint treatments [MD: − 1.92, 95%CI (-4.05, 0.21), P = 0.08]. In terms of maximal passive mouth opening, ARS was significantly more effective than physical therapy [MD: 1.91, 95%CI (0.13, 3.68), P = 0.04]. There was no significant difference between ARS and other occlusal splint treatments [MD: -2.25, 95%CI (-5.02, 0.53), P = 0.11]. For relieving jaw popping symptoms, ARS was significantly more effective than the physical therapy [RR:0.45, 95%CI (0.34, 0.58), P < 0.00001] and behavioral therapy [RR: 0.48, 95%CI (0.36, 0.64), P < 0.00001]. However, no significant difference was found between ARS and other occlusal splint treatments [RR: 1.29, 95%CI (0.83, 2.02), P = 0.26]. Conclusion A total of 14 studies were included in this systematic review and meta-analysis, which compared the efficacy of ARS with other conservative treatments for disc displacement. While ARS did not demonstrate a significant difference compared to physical therapy in improving TMJ pain, popping, and mandibular motor function in the initial treatment phase, it exhibited more pronounced effects than physical therapy and behavioral therapy with continued use. Splints have demonstrated significant efficacy in alleviating TMJ popping and improving mandibular movement. However, ARS has not shown superior effectiveness compared to other types of occlusal splints in alleviating pain.https://doi.org/10.1186/s12903-025-06379-3Anterior repositioning splintJoint disc displacementBehavioral therapyPhysical therapyOcclusal splint
spellingShingle Liujing Wang
Yanni Zhang
Haiyan Chen
Chenxi Jin
Wei Shen
Ziyuan Li
Wei Zhang
Yuxin Shi
Yiyang Hou
Xiaoxuan Li
Jing Guo
The efficacy of anterior repositioning splints in the management of temporomandibular disc displacement: a systematic review and meta-analysis
BMC Oral Health
Anterior repositioning splint
Joint disc displacement
Behavioral therapy
Physical therapy
Occlusal splint
title The efficacy of anterior repositioning splints in the management of temporomandibular disc displacement: a systematic review and meta-analysis
title_full The efficacy of anterior repositioning splints in the management of temporomandibular disc displacement: a systematic review and meta-analysis
title_fullStr The efficacy of anterior repositioning splints in the management of temporomandibular disc displacement: a systematic review and meta-analysis
title_full_unstemmed The efficacy of anterior repositioning splints in the management of temporomandibular disc displacement: a systematic review and meta-analysis
title_short The efficacy of anterior repositioning splints in the management of temporomandibular disc displacement: a systematic review and meta-analysis
title_sort efficacy of anterior repositioning splints in the management of temporomandibular disc displacement a systematic review and meta analysis
topic Anterior repositioning splint
Joint disc displacement
Behavioral therapy
Physical therapy
Occlusal splint
url https://doi.org/10.1186/s12903-025-06379-3
work_keys_str_mv AT liujingwang theefficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT yannizhang theefficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT haiyanchen theefficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT chenxijin theefficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT weishen theefficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT ziyuanli theefficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT weizhang theefficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT yuxinshi theefficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT yiyanghou theefficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT xiaoxuanli theefficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT jingguo theefficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT liujingwang efficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT yannizhang efficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT haiyanchen efficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT chenxijin efficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT weishen efficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT ziyuanli efficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT weizhang efficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT yuxinshi efficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT yiyanghou efficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT xiaoxuanli efficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis
AT jingguo efficacyofanteriorrepositioningsplintsinthemanagementoftemporomandibulardiscdisplacementasystematicreviewandmetaanalysis