Abstract
Occlusal splints are widely used as a conservative treatment modality for temporomandibular disorders (TMD). With the increasing integration of digital technologies in dentistry, computer-aided design and manufacturing (CAD/CAM) workflows have emerged. Although digital splints are increasingly adopted in clinical practice, their clinical effectiveness compared with conventionally fabricated splints remains uncertain. Electronic searches were performed in PubMed, Scopus, Web of Science (WOS), and Cochrane Central Register of Controlled Trials (CENTRAL) from database inception to March 2026 to identify randomized controlled trials (RCTs) comparing digital with conventional occlusal splints in patients with TMD. The primary outcome was the mean difference of pain intensity post intervention. Continuous outcomes were analyzed using mean differences (MDs) with 95% confidence intervals (CIs) using a random-effects model. Eight RCTs comprising 390 patients were included. Seven studies reported posttreatment pain scores, showing no significant difference between digital and conventional splints (MD = -0.22; 95% CI = -0.92 to 0.48; p = 0.54; I² = 77.9%). Similarly, no significant differences were observed in limited mouth opening or maximum mouth opening. Patient satisfaction was also comparable between groups. However, digitally fabricated splints were associated with significantly shorter clinical occlusal adjustment time compared with conventional splints (MD = -9.10 minutes; 95% CI = -15.18 to -3.02; p < 0.001). Digital and conventional occlusal splints provide comparable clinical outcomes in patients with TMD with respect to pain relief, mouth opening, and patient satisfaction. However, digitally fabricated splints may offer a practical advantage by reducing clinical adjustment time. Further high-quality trials with standardized outcomes and longer follow-up are warranted.