Oral splints for orofacial symptoms: an evidence synthesis

Oral splints for orofacial symptoms:  an evidence synthesis

Oral splints are placed by dentists working in the NHS for patients with orofacial signs of symptoms. It is unclear if oral splints are effective or cost-effective, and if they are, which type of splint is the most cost-effective (cheaper pre-fabricated splints or more expensive custom made ones). 

This project developed a Markov decision analysis model alongside a systematic review of the clinical effectiveness literature on the use of oral splints for temporomandibular disease (TMD).

Standard reporting methods were used to illustrate uncertainty in findings (deterministic and probabilistic sensitivity analysis). There was a dearth of high quality evidence to populate the model, particularly over the longer time period. An expected value of perfect information (EVPI) analysis explored the value for money of conducting additional research to resolve uncertainty in the cost-effectiveness evidence. Expected value of partial perfect information (EVPPI) analysis was used to identify the most important model parameters on which to obtain future data. The results of these analyses can help to prioritise key areas of future research from a cost-effectiveness view-point.

Outcome and Translation

Results of the trial are currently under submission to journals. 

HERU researchers involved in this research project: Dwayne Boyers and Elisabet Jacobsen

External collaborators: Worthington, H., Glenny, A-M. Riley, P. (University of Manchester); Robertson, C. (HSRU, University of Aberdeen).

A self-contained Appendix to the report is available. This Appendix is not part of the main report but informs the findings.

Appendix: Custom-made vs. Prefabricated splints vs. none (Economic evaluation results), including VOI results.

Publications

Riley, P., Glenny, A.M., Worthington, H., Jacobsen, E., Robertson, C., Durham, J., Davies, S., Petersen, H. and Boyers, D. (2018) Oral splints for patients with temporomandibular disorders or bruxism: a systematic review and economic evaluation. Final report submitted to NIHR Health Technology Assessment Programme (Project number: 16/146).

Riley, P., Glenny, A.-M., Worthington, H.V., Jacobsen, E., Robertson, C., Durham, J., Davies, S., Petersen, H. and Boyers, D. (2020) 'Oral splints for temporomandibular disorder or bruxism: a systematic review', British Dental Journal, 228(3), 191-197.

Riley, P., Glenny, A.-M., Worthington, H.V., Jacobsen, E., Robertson, C., Durham, J., Davies, S., Petersen, H. and Boyers, D. (2020) 'Oral splints for patients with temporomandibular disorders or bruxism: a systematic review and economic evaluation', Health Technology Assessment, 24(7).

Presentations

Jacobsen, E.Boyers, D., Durham, J., Riley, P., Glenny, A.M., Petersen, H., Davies, S., Robertson, C. and Worthington, H. (2019) 'Cost-effectiveness of oral splints for TMD', International Association for Dental Research (IADR) General Session, Vancouver Convention Centre, Vancouver, Canada, 19-22 June 2019.

Riley, P., Glenny, A.M., Worthington, H., Jacobsen, E., Robertson, C., Durham, J., Davies, S., Petersen, H. and Boyers, D. (2019) 'Oral splints For TMD or bruxism: a systematic review [Poster]', International Association for Dental Research (IADR) General Session, Vancouver Convention Centre, Vancouver, Canada, 19-22 June 2019.