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Comparison 1 Occlusal splint versus palatal splint, Outcome 1 Number of bruxism episodes per hour of sleep (Epi/h).
Figuras y tablas -
Analysis 1.1

Comparison 1 Occlusal splint versus palatal splint, Outcome 1 Number of bruxism episodes per hour of sleep (Epi/h).

Comparison 1 Occlusal splint versus palatal splint, Outcome 2 Arousal index.
Figuras y tablas -
Analysis 1.2

Comparison 1 Occlusal splint versus palatal splint, Outcome 2 Arousal index.

Comparison 1 Occlusal splint versus palatal splint, Outcome 3 Total sleep time (min).
Figuras y tablas -
Analysis 1.3

Comparison 1 Occlusal splint versus palatal splint, Outcome 3 Total sleep time (min).

Comparison 1 Occlusal splint versus palatal splint, Outcome 4 Episodes with grinding noise.
Figuras y tablas -
Analysis 1.4

Comparison 1 Occlusal splint versus palatal splint, Outcome 4 Episodes with grinding noise.

Comparison 1 Occlusal splint versus palatal splint, Outcome 5 Awakenings/hr.
Figuras y tablas -
Analysis 1.5

Comparison 1 Occlusal splint versus palatal splint, Outcome 5 Awakenings/hr.

Comparison 1 Occlusal splint versus palatal splint, Outcome 6 Sleep efficiency (%).
Figuras y tablas -
Analysis 1.6

Comparison 1 Occlusal splint versus palatal splint, Outcome 6 Sleep efficiency (%).

Comparison 2 Occusal splint and TENS, Outcome 1 Headaches.
Figuras y tablas -
Analysis 2.1

Comparison 2 Occusal splint and TENS, Outcome 1 Headaches.

Comparison 2 Occusal splint and TENS, Outcome 2 Pain in TMJ.
Figuras y tablas -
Analysis 2.2

Comparison 2 Occusal splint and TENS, Outcome 2 Pain in TMJ.

Comparison 2 Occusal splint and TENS, Outcome 3 Clicks TMJ oral opening and closing.
Figuras y tablas -
Analysis 2.3

Comparison 2 Occusal splint and TENS, Outcome 3 Clicks TMJ oral opening and closing.

Comparison 2 Occusal splint and TENS, Outcome 4 Clicks TMJ oral opening or closing.
Figuras y tablas -
Analysis 2.4

Comparison 2 Occusal splint and TENS, Outcome 4 Clicks TMJ oral opening or closing.

Comparison 3 Occlusal splint versus no treatment, Outcome 1 Increase in the size of wear facets (canine teeth).
Figuras y tablas -
Analysis 3.1

Comparison 3 Occlusal splint versus no treatment, Outcome 1 Increase in the size of wear facets (canine teeth).

Comparison 3 Occlusal splint versus no treatment, Outcome 2 Increase in the size of wear facets (canine teeth) 6 months of follow up.
Figuras y tablas -
Analysis 3.2

Comparison 3 Occlusal splint versus no treatment, Outcome 2 Increase in the size of wear facets (canine teeth) 6 months of follow up.

Table 1. Appliances description

Authors

Appliances

Alvarez‐Arenal

Occlusal splint was a mandibular transparent thermopolymerising acrylic that was prepared via classical technique (fitting of models in a semiadjustable articulator). The occlusal surface was smooth and levelled with point form contacts, in centric relation, of the functional and non‐functional antagonist cuspids of the posterior teeth. In the anterior sector of the splint the contacts of the anterior teeth were less pronounced, and the inclined planes for the canine and protrusive guides were well defined to provide immediate disocclusion of the posterior teeth during mandibular eccentric movements.

Dube

Occlusal splint was a hard acrylic U‐shaped occlusal splint. Maxillary and mandibular arch impressions were made with alginate and models were cast in artificial stone. The centric tooth relation was taken with a blue wax waffle. A face bow was used to mount the models on a semiadjustable articulator. The splint was made on the maxillary models and then inserted and adjusted. The adjustment was made in centric relation with the use of a 32‐µm articulation paper. Only the points corresponding to contact between the lower buccal cusp and the splint were preserved. Adjustment of lateral guidance and protrusion was done by eliminating any contact other than with the canine in lateral or incisor in anterior‐posterior mandibular movements.

Dube

Palatal splint (can be called palatal control device) was active control made on the maxillary models and then inserted and adjusted. The device did not interfere with the occlusion in any mandibular movements and it was adjusted for maximum tooth intercuspation, and any tooth contact upon mandibular movement was eliminated.

Hachmann

Occlusal splint (called Michigan type bite plate) was a thermopolymerised colourness acrylic resin, worn in the maxilla, without palatal coverage. Maxillary and mandibular arch impressions were made with condensation silicone (Optosil ‐Xantopren ®) and models were cast in dental stone (Velmix ®). A face bow was used to mount the models on a semiadjustable articulator. The plate was built in wax (double layer of pink wax) being adapted over the maxillary arch teeth. The plate was1 to 3 mm in thickness, contact of all teeth in centric relation, disclusion of posterior teeth in lateral and in protusive movements, avoiding balancing side interferences through the anterior guidance.

Landry

Occlusal splint upper standard single was a classic hard acrylic resin. Dental impressions were made with irreversible hydrocolloid, and the working casts were poured with artificial stone (type III). A facebow was used to mount the models on a semiadjustable articulator. The central relation was registered with a rigid blue wax.

Landry

Mandibular advancement device free (MAD free) without pin between arches, which allowed freedom of movement.

Landry

Mandibular advancement device in 25% lower arch advancement position (MAD min).

Landry

Mandibular advancement device in 75% lower arch advancement position (MAD max).

Van der Zaag

Occlusal splint was a hard acrylic stabilisation type of splint, worn in the maxilla, with full coverage of the occlusal surfaces. It was 1 mm in thickness at the level of the first molar.

Van der Zaag

Palatal splint was hard acrylic resine with palatal coverage only.

Figuras y tablas -
Table 1. Appliances description
Comparison 1. Occlusal splint versus palatal splint

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Number of bruxism episodes per hour of sleep (Epi/h) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

2 Arousal index Show forest plot

2

39

Mean Difference (IV, Fixed, 95% CI)

1.22 [‐3.61, 6.05]

2.1 Parallel study

1

21

Mean Difference (IV, Fixed, 95% CI)

12.90 [‐5.93, 31.73]

2.2 Cross‐over study

1

18

Mean Difference (IV, Fixed, 95% CI)

0.40 [‐4.60, 5.40]

3 Total sleep time (min) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

4 Episodes with grinding noise Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

5 Awakenings/hr Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

6 Sleep efficiency (%) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

Figuras y tablas -
Comparison 1. Occlusal splint versus palatal splint
Comparison 2. Occusal splint and TENS

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Headaches Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2 Pain in TMJ Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3 Clicks TMJ oral opening and closing Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4 Clicks TMJ oral opening or closing Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

Figuras y tablas -
Comparison 2. Occusal splint and TENS
Comparison 3. Occlusal splint versus no treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Increase in the size of wear facets (canine teeth) Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2 Increase in the size of wear facets (canine teeth) 6 months of follow up Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

Figuras y tablas -
Comparison 3. Occlusal splint versus no treatment