***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Temporom and ibular pain has multiple etiologies and a range of therapeutic options . In this pilot study , the authors assessed the feasibility of conducting a larger trial to evaluate chiropractic treatment of temporom and ibular disorders ( TMDs ) . METHODS The authors assigned 80 participants r and omly into one of the following four groups , all of which included a comprehensive self-care program : reversible interocclusal splint therapy ( RIST ) , Activator Method Chiropractic Technique ( AMCT ) ( Activator Methods International , Phoenix ) , sham AMCT and self-care only . They made assessment s at baseline and at month 2 and month 6 , including use of the Research Diagnostic Criteria for Temporom and ibular Disorders . RESULTS The authors screened 721 potential participants and enrolled 80 people ; 52 participants completed the six-month assessment . The adjusted mean change in current pain over six months , as assessed on the 11-point numerical rating scale , was 2.0 ( 95 percent confidence interval , 1.1 - 3.0 ) for RIST , 1.7 ( 0.9 - 2.5 ) for self-care only , 1.5 ( 0.7 - 2.4 ) for AMCT and 1.6 ( 0.7 - 2.5 ) for sham AMCT . The authors also assessed bothersomeness and functionality . CONCLUSIONS The authors found the study design and methodology to be manageable . They gained substantial knowledge to aid in conducting a larger study . AMCT , RIST and self-care should be evaluated in a future comparative effectiveness study . PRACTICAL IMPLICATION S This pilot study was a necessary step to prepare for a larger study that will provide clinicians with information that should be helpful when discussing treatment options for patients with TMD The aim of this study was to compare the effectiveness of three treatment methods for unilateral temporom and ibular joint ( TMJ ) disc displacement without reduction ( DDwoR ) . One hundred and twenty patients with unilateral TMJ DDwoR were assigned r and omly to one of three treatment groups ( 40 patients in each ) : group 1 received arthrocentesis , group 2 received stabilization splint therapy following arthrocentesis , and group 3 received splint therapy only . The groups were compared in terms of pain ( visual analogue scale ) , joint function ( maximum mouth opening and laterotrusive movements ) , disability and psychological status ( vali date d question naire ) , and success rates . These were recorded before treatment and during follow-up after treatment ( 1 , 3 , and 6 months ) . The between-group and within-group differences in the data were analyzed statistically . The baseline characteristics were similar in all groups ( P>0.05 ) . Significant improvements were noted in all parameters compared to baseline values in all groups ( all P<0.01 ) . Groups 1 and 2 showed comparable outcomes that were superior to those of group 3 .  Arthrocentesis reduces pain and functional impairment more rapidly and effectively than splint therapy . Simultaneous splint application has no additional effect on the effectiveness of arthrocentesis for the treatment of unilateral PURPOSE The aim of the present study was to investigate the effects of massage therapy on the masticatory muscles and occlusal splint usage on quality of life and pain in individuals with sleep bruxism . METHOD A r and omized , controlled , blinded , clinical trial was conducted involving 78 volunteers aged 18 to 40 years with sleep bruxism .  Quality of life and pain assessment s were performed . RESULTS Significant differences ( p < 0.05 ) were found on the physical functioning , general health state , vitality , role emotional and mental health subscales . A large effect size was found for all treatment protocol s with regard to pain . The largest effect was found in the combined treatment group . CONCLUSIONS The findings of the present study reveal that the occlusal splint usage alone led to improvements in components of quality of life among individuals with sleep bruxism . Moreover , both treatments ( occlusal splint usage and massage therapy on the masticatory muscles ) led to a reduction in pain The evidence supporting the use of stabilisation splints in the treatment of temporom and ibular disorders ( TMD ) is scarce and a need for well-controlled studies exists . The aim of this r and omised , controlled trial study was to assess the efficacy of stabilisation splint treatment on TMD . The sample consisted of 80 consecutive referred patients who were r and omly assigned to the splint group ( n = 39 ) and the control group ( n = 41 ) . Subjects in the splint group were treated with a stabilisation splint , whereas subjects in the control group did not receive any treatment except counselling and instructions for masticatory muscle exercises which were given also to the subjects in the splint group . Outcomes were visual analogue scale ( VAS ) on facial pain intensity and clinical findings for TMD which were measured at baseline and after 1-month follow-up . The differences in change between the groups were analysed using regression models . Facial pain decreased and most of the clinical TMD findings resolved in both of the groups . The differences in changes in VAS or clinical TMD findings between the groups were not statistically significant . The findings of this study did not show that stabilisation splint treatment in combination with counselling and masticatory muscle exercises has additional benefit in relieving facial pain and increasing the mobility of the m and ible than counselling and masticatory muscle exercises alone in a short time-interval Sixty-three patients with an arthrographic diagnosis of disk displacement with reduction were r and omly assigned to three treatment groups : ( I ) onlays to maintain disk repositioning , ( II ) flat occlusal splint , or ( III ) untreated controls .  Guidance for construction of the disk-repositioning onlays was established during arthrography to obtain a recaptured disk position relative to the condyle . The onlays were cemented to the teeth and maintained the new intercuspal position anteriorly and inferiorly . The flat occlusal splint was used at night only and was adjusted to maintain a maximal occlusal contact in centric relation and centric occlusion . Clinical examinations were performed before and after 6 months of treatment . The disk-repositioning onlays  improved joint function and reduced joint and muscle pain when compared with the flat occlusal splint and with nontreatment . The signs and symptoms in the flat occlusal splint group were no different from those in the control group . It is concluded that disk-repositioning onlays are effective in reducing pain and dysfunction associated with disk displacement with reduction in patients in whom the disk can be maintained in a normal relationship to the condyle with the aid of such onlays . The symptoms , however , returned when the onlays were removed after 6 months ; this raises the question of whether a permanent change in the intercuspal position is necessary for long-term success Forty-five individuals with long-st and ing facial pain or headache of muscular origin were r and omly allocated into three groups . The first group was treated with acupuncture , the second group received an occlusal splint , and the third group served as controls . Both acupuncture and occlusal splint therapy significantly reduced subjective symptoms and clinical signs from the stomatognathic system . No differences between these two groups were found with regard to treatment effects . It is concluded that acupuncture is an alternative method to conventional stomatognathic treatment for individuals with craniom and ibular disorders of muscular origin BACKGROUND Treatment recommendations for patients with painful temporom and ibular disorders ( TMDs ) range from conservative treatments such as physiotherapy to aggressive and irreversible treatments such as restorative reconstruction and joint surgery . METHODS The authors r and omized 200 subjects diagnosed with TMD into three groups : usual conservative , dentist-prescribed self-care treatment without any intraoral splint appliance ( UT ) ; UT plus a conventional flat-plane hard acrylic splint ( HS ) ; and UT plus a soft vinyl ( a low-cost athletic mouth guard ) splint ( SS ) . Subjects completed question naires and clinical examinations at three , six and 12 months . RESULTS The authors observed no significant differences among the groups in TMD-related pain levels or other common signs and symptoms of TMD at baseline ( BL ) or at any follow-up . The changes from BL were comparable for all three groups . The authors did not note any significant differences at any follow-up for compliance with study protocol s or for occurrences of adverse effects from either splint type . For HS versus SS , there were significant differences in rates of splint use , but these differences were not accompanied by differences in either self-reported symptoms or in clinical findings . CONCLUSIONS All patients improved over time , and traditional splint therapy offered no benefit over the SS splint therapy . Neither splint therapy provided a greater benefit than did self-care treatment without splint therapy . CLINICAL IMPLICATION S These findings suggest that clinicians who treat patients with TMD should consider prescribing low-cost nonsplint self-care therapy for most patients Objective The benefit of the use of some intraoral devices in arthrogenous temporom and ibular disorders ( TMD ) patients is still unknown . This study assessed the effectiveness of the partial use of intraoral devices and counseling in the management of patients with disc displacement with reduction ( DDWR ) and arthralgia . Material s and Methods A total of 60 DDWR and arthralgia patients were r and omly divided into three groups : group I ( n=20 ) wore anterior repositioning occlusal splints ( ARS ) ; group II ( n=20 ) wore the Nociceptive Trigeminal Inhibition Clenching Suppression System devices ( NTI-tss ) ; and group III ( n=20 ) only received counseling for behavioral changes and self-care ( the control group ) . The first two groups also received counseling . Follow-ups were performed after 2 weeks , 6 weeks and 3 months . In these sessions , patients were evaluated by means of a visual analogue scale , pressure pain threshold ( PPT ) of the temporom and ibular joint ( TMJ ) , maximum range of motion and TMJ sounds . Possible adverse effects were also recorded , such as discomfort while using the device and occlusal changes . The results were analyzed with ANOVA , Tukey ’s and Fisher Exact Test , with a significance level of 5 % . Results Groups I and II showed improvement in pain intensity at the first follow-up . This progress was recorded only after 3 months in Group III . Group II showed an increased in joint sounds frequency . The PPT values , m and ibular range of motion and the number of occlusal contacts did not change significantly . Conclusion The simultaneous use of intraoral devices ( partial time ) plus behavioral modifications seems to produce a more rapid pain improvement in patients with painful DDWR . The use of NTI-tss could increase TMJ sounds . Although intraoral devices with additional counseling should be considered for the management of painful DDWR , dentists should be aware of the possible side effects of the intraoral device ’s design Introduction Painful temporom and ibular disorders ( TMDs ) are usually treated with physiotherapy , self-exercises , medication-based therapy and splint therapy . For splint therapy different types of splints are available . Therefore this r and omized controlled study compared the effectiveness of a semi-finished occlusal appliance ( SB ) with a laboratory-made occlusal appliance ( SS ) in myofascial pain patients . Method The trial subjects allocated to the experimental groups with the ( SB ) occlusal appliance and those provided with a laboratory-made occlusal appliance ( SS ) did , in addition , receive conservative treatment ( self-exercises , drug-based and manual therapy ) . The control group was given conservative therapy ( CO ) only . Overall , a total of 63 patients participated in the study with each group consisting of 21 subjects . Results When the first follow-up examination took place ( 14 days after splint insertion ) mouth opening within the SB group was significantly enlarged . When the second examination was conducted ( 2.5 months after splint insertion ) mouth opening was significantly enlarged in both splint groups when compared with the initial value . In the control group , no significant enlargement of mouth opening was detected . At no point there was a significant reduction in the number of pressure-sensitive areas of the TMJ . On palpation of the masticatory muscles however , a significant reduction in the number of pressure-sensitive areas could be observed within the CO group and the SS group after 2.5 months . When comparing pain reduction ( muscle/joint pain ) and mouth opening , no significant differences could be detected between the treatments . Conclusion The results suggest that TMD should be treated conservatively . In cases of restricted mouth opening , the additional use of occlusal appliances can eliminate the patient ’s discomfort more quickly . In this context , the tested , semi-finished occlusal appliance appears to offer an immediately available , temporary alternative to laboratory-made splints Introduction Temporom and ibular disorder ( TDM ) is the most common source of orofacial pain of a non-dental origin . Sleep bruxism is characterized by clenching and /or grinding the teeth during sleep and is involved in the perpetuation of TMD . The aim of the present study was to investigate the effects of massage therapy , conventional occlusal splint therapy and silicone occlusal splint therapy on electromyographic activity in the masseter and anterior temporal muscles and the intensity of signs and symptoms in individuals with severe TMD and sleep bruxism . Methods Sixty individuals with severe TMD and sleep bruxism were r and omly distributed into four treatment groups : 1 ) massage group , 2 ) conventional occlusal splint group , 3 ) massage + conventional occlusal splint group and 4 ) silicone occlusal splint group . Block r and omization was employed and sealed opaque envelopes were used to conceal the allocation . Groups 2 , 3 and 4 wore an occlusal splint for four weeks . Groups 1 and 3 received three weekly massage sessions for four weeks . All groups were evaluated before and after treatment through electromyographic analysis of the masseter and anterior temporal muscles and the Fonseca Patient History Index . The Wilcoxon test was used to compare the 
    Output:
    
There was no evidence that any other outcomes improved when using splints .
There was no evidence of adverse events associated with splints , but reporting was poor regarding this outcome .
No trials measured tooth wear in patients with bruxism .
Sensitivity analyses based on these factors did not indicate a reduction in pain .
Conclusions The very low-certainty evidence identified did not demonstrate that splints reduced pain in TMD as a group of conditions .
There is insufficient evidence to determine whether splints reduce tooth wear in patients with bruxism