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Occlusion and temporomandibular joint disorders: a meta-analysis of psychosocial outcomes Cover

Occlusion and temporomandibular joint disorders: a meta-analysis of psychosocial outcomes

Australasian Orthodontic Journal
Volume 41 (2025): Issue 1 (January 2025)
By:
Open Access
|Oct 2025

Figures & Tables

Figure 1.

Study selection process.
Study selection process.

Figure 2.

Risk of bias graph.
Risk of bias graph.

Figure 3.

Risk of bias summary.
Risk of bias summary.

Figure 4.

Occlusal splint therapy effect on anxiety.
Occlusal splint therapy effect on anxiety.

Figure 5.

Occlusal splint therapy effect on depression.
Occlusal splint therapy effect on depression.

Figure 6.

Occlusal splint therapy effect on oral health-related quality of life.
Occlusal splint therapy effect on oral health-related quality of life.

Figure 7.

Occlusal splint therapy effect on sleep quality.
Occlusal splint therapy effect on sleep quality.

Characteristics of the included studies

Study ID [reference]Study CharacteristicsPopulation characteristicsIntervention DetailsControl GroupOutcomes measuredTool / Instrument Used
Authors, Year of Publication & CountryStudy design & Sample sizeAge MeanGender distributionNo of participantsType of interventionDuration of interventionNo of participantsType of intervention
Aksakali 21512Aksakalli S. et al., 2015, TurkeyRCT 4031 years.34 (75%) females & 6(25%) males20Stabilization splint3 months20Nociceptive trigeminal inhibition-tension suppression systemPain, Oral health related quality of life & Change in patient complaintsFonseca’s questionnaire, the Oral Health QoL-UK and visual analog scale.
Alajbeg 202013Alajbeg IZ. Et al., 2020, CroatiaRCT 3436.l ± 11.95 yearsxxxxx19Stabilization splint6 months15Placebo splintPain variables, Generalized anxiety & Depression,Graded Chronic Pain Scale, Generalized anxiety disorder-7 questionnaire, Patient health questionnaire-9
DeResend 201914Machado de Resende CM. et al., 2019, BrazilRCT, 8928 ± 9.34 years72 (80.9%) females & 17 (19.1%) males24 in occlusal splint & 21 in manual therapy group & 25 in oral splint and counselling groupOcclusal splint1 month19CounsellingPain, Sleep quality, Quality of life & Oral health related quality of life.Visual analog scale, Pittsburgh Sleep Quality Index questionnaire, World health organization quality of life questionnaire-BREF, The Oral Health Impact Profile-14
Giancarlo 202115Canales GD. et al., 2021, BrazilRCT, 10036.8 ± 5.6 years100% females20 in Oral splint group & 60 in botulinum toxin groupStabilization splint6 months20Normal saline injectionPain intensity & DepressionThe Graded Chronic Pain Scale, The Symptoms Checklist-9OR (SCL-DEP)
Guadalupe 201616Molina-Torres G. et al., 2016 SpainRCT 5851 ± 8 years94% females & 6% males29Stabilization splint12 weeks29Laser therapyIntensity of pain, Severity of symptoms & Sleep qualityVisual analog scale, Symptom Severity Scale, Pittsburgh Sleep Quality Index Questionnaire
Hutela 202017Huhtela OS. et al. 2020, FinlandRCT 4026 years,85% females & 15% males22Stabilization splint12 months18Applied relaxation methodPain, Non-specific physical symptoms & DepressionVisual analog scale, Axis II questionnaire,
Kokkola 201818Kokkola O. et al., 2018, FinlandRCT 8044.4 + 12.6 years82.5% females & 17.5% males39Stabilization splint12 months41CounsellingOral health related quality of lifeThe Oral Health Impact Profile-14
Layza 202419Oppitz LR. et al., 2024, Brazil.RCT 4334.8 ± 10.29 years32 (74.4%) females & 11(25.6%) males23Rigid stabilization splint12 months20Mixed splintOrofacial pain, Quality of life. Anxiety & DepressionVisual analog scale, World health organization quality of life questionnaire-BREF, Hospital Anxiety and Depression Scale
Marijana 202120Gikic M. et al. 2021, CroatiaRCT 3036.44 ± 10.51 years100% females10Stabilization splints6 months10Received thin thermoforming foil (Erkodent 0.5 mm)Spontaneous pain, Pain intensity, Oral health related quality of life & AnxietyVisual analog scale, Composite pain index Score, The Oral Health Impact Profile-14, Generalized anxiety disorder-7 questionnaire
Melo 202021Melo RA. et al., 2020, BrazilRCT, 8528 ± 9.34 years82% females & 18% males25 in oral splint and counselling group, 22 in Occlusal splint & 21 in manual therapy groupOcclusal splint30 days17CounsellingPain & AnxietyVisual analog scale, Hospital Anxiety and Depression Scale, The Beck Anxiety Inventory, The State-Trait Anxiety Inventory (STAI) questionnaire
Omer 202222Ekici O. et al., 2022, Turkey.RCT 132Intervention group 28.58 ± 14.46 years Control group 29.47 ± 10.49 years31 (23.5%) males & 101 (76.5%) females34Occlusal splint12 weeks34No active treatment, Counselling.Pain, Range of motion of the jaw, Disability & Quality of lifeVisual analog scale, The Oral Health Impact Profile-14, Jaw Functional Limitation Scale.
Oz 2010 23Oz S. et al., 2010, TurkeyRCT, 4032.84 ± 10.70 years34 (85%) females & 6 (15%) males20Occlusal splints3 months20Low dose laser therapyPain, Pressure pain threshold & DepressionVisual analog scale, RDC/TMD) Axis II criteria
Peixoto 202124Peixoto KO. et al., 2021, BrazilRCT, 6018-65 yearsxxxx15 in occlusal splint, 15 in scalp Acupuncture & and 15 in manual therapy groupocclusal splint30 days15CounsellingPain, Sleep & Quality of lifeVisual analog scale, Pittsburgh Sleep Quality Index Questionnaire, World health organization quality of life questionnaire
Rodrigeus 201925Rodrigeus MF. et al., 2019 BrazilRCT, 21Average age in intervention group 43.63 years & 47.5 years in control group100% females11Occlusal splints6 months10Low-power laser auriculotherapyPain, Degree of jaw functioning, Depression & Nonspecific physical symptomsAmerican Academy of Orofacial Pain questionnaire, Symptoms Checklist-90 (SCL-90) Depression Scale
Rossana 202426Izzetti R. et al., 2024, ItalyRCT, 1 20Intervention group 40.71 ± 15.85 years Control group 42.76 ± 16.94 years66 (55%) females & 54 (45%) males60Stabilization splint & physio-kinesiotherapy6 months60No interventionPain, Depression, Anxiety & Oral health related quality of life.Pressure pain threshold scores, The Oral Health Impact Profile-14, Patient health questionnaire-9, Generalized anxiety disorder-7 questionnaire
Verbanovic 201927Vrbanovic E. et al., 2019 CroatiaRCT, 30Intervention group 38.89 ± 11.79 years Control group 32.66 ± 11.48 years100% females17Stabilization splint6 months13Placebo splintPain & Quality of lifeVisual analog scale, The Oral Health Impact Profile-14
Wanman 202028Wanman A. et al., 2020, SwedenRCT, 9039.2 ± 15.2 years63 (70%) females & 27 (30%) males30 in Bite splint and 30 in supervised exercise program.Biite splint3 months30Home exercise therapyPain, Neck disability & SomatisationJaw function limitation scale-20, Neck Disability Index, Numeric pain rating scale 0-10

Summary of the findings

Sr. No.OutcomeEffect sizeP-valueHeterogeneityEvidence Certainty (GRADE)
1Anxiety0.05 (-0.49 to 0.60)0.8574% (Moderate)Low
2Depression-0.42 (-0.81 to -0.04)0.0370% (Moderate)Moderate
3Oral Health-Related QoL-0.14 (-0.78 to 0.50)0.6788% (High)Low
4Sleep Quality-0.54 (-1.22 to 0.14)0.1271% (High)Low
5Overall QoL (General Component)-0.07 (-0.59 to 0.46)0.8048% (Moderate)Moderate
6Overall QoL (Physical Component)0.24 (-0.12 to 0.60)0.200% (Low)Moderate
7Overall QoL (Psychological Component)-0.18 (-0.53 to 0.18)0.330% (Low)Moderate
8Overall QoL (Social Component)0.16 (-0.23 to 0.55)0.4310% (Low)Moderate
9Overall QoL (Environmental Component)-0.05 (-0.50 to 0.40)0.8235% (Moderate)Moderate
DOI: https://doi.org/10.2478/aoj-2025-0018 | Journal eISSN: 2207-7480 | Journal ISSN: 2207-7472
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Language: English
Page range: 301 - 319
Submitted on: Jan 1, 2025
Accepted on: May 1, 2025
Published on: Oct 22, 2025
Published by: Australian Society of Orthodontists Inc.
In partnership with: Paradigm Publishing Services
Publication frequency: 1 times per year
Related subjects:
Medicine,
Basic medical science,
Basic medical science, other

© 2025 Rongguang Liu, Ran Huang, Hui Jia, Qi Yang, Xiaqing Liu, Saba Kousar, Ying Li, published by Australian Society of Orthodontists Inc.
This work is licensed under the Creative Commons Attribution 4.0 License.

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