Patient-reported outcome measures between digital and conventional splints for bruxism: systematic review

Abstract

Background: The integration of digital workflows in dentistry has raised questions about the effectiveness of digital occlusal stabilizing splints (OSS) in bruxism management. Objective: This systematic review evaluates whether computer-aided design and computer-aided manufacturing (CAD-CAM) OSS provide superior Patient-Reported Outcome Measures (PROMs) compared to conventional splints. Material and Methods: This review was registered in PROSPERO (CRD42024536412). A comprehensive search was conducted in six databases (MEDLINE/PubMed, Scopus, Embase, Web of Science, CENTRAL, and BVS) up to March 2024. Eligible RCTs comparing digital and conventional OSS in PROMs were included. After screening 4,269 records, four studies met the inclusion criteria. Results: Primary outcomes such as comfort, appearance, and quality of life favored digital OSS. Secondary outcomes, including time spent, T-scan analysis, electromyography (EMG) activity, and stability assessed by the operator, also suggested advantages for digital splints. Although, the certainty of evidence of the included studies was assessed as low to very low for several outcomes. Conclusion: Digital OSS appears to improve PROMs in bruxism patients. However, variations in splint materials, thicknesses, and PROM assessments across studies complicate direct comparisons and result clustering, due to the limited and preliminary nature of the evidence. Further standardized research is needed to validate these findings.

KEYWORDS

Bruxism; Computer-aided design and manufacturing; Digital workflows; Occlusal splints; Patient-reported outcome measures.