How does a splint work? A systematic review

Objective: The mechanisms of action of interocclusal devices have not yet been thoroughly studied, and their true effectiveness remains controversial. A systematic review was conducted to determine how the function of interocclusal devices works in dentate or partially dentate subjects with TMD, with or without associated bruxism. Method: The review followed the structure required by the guidelines reported in the PRISMA statement. PubMed, EBSCO, SCOPUS, and Web of Science databases were included. The quality of the evidence was evaluated using the GRADE scale. Results: 881 articles were identified, and 203 duplicates were removed. 49 articles were finally analyzed in this systematic review. 21 of them were controlled clinical trials, and 28 were clinical trials. The studies included aspects of systemic and neurophysiological responses and biomechanical activity. They also assessed the activity of mandibular advancement devices in patients with apnea. After defining the quality of evidence, all studies were analyzed. Conclusion: The use of interocclusal splints is highly recommended for all patients suffering from any temporomandibular pathology, bruxism, or mild sleep disorders.