## 4 Discussion
[PERSON] et al., in their study comparing laser therapy on pain trigger points and the use of stabilization splints, concluded that both can be effective therapeutic treatments for reducing pain symptoms and the clicking sounds associated with TMD in patients with fibromyalgiagia [34]. Additionally, this group showed an improvement in both psychological and physical well-being, as reflected in the scores of the GAD-7, OHIP-14, WHO-5, and PSQI questionnaires. Although some of these tools may assess related domains, each was selected for its validated focus on a distinct construct--such as sleep quality, emotional well-being, or functional limitations--allowing for a more comprehensive interpretation. However, it is important to consider that the intervention also included behavioral recommendations. This raises the possibility that improvements were partially influenced by factors such as sleep hygiene, stress management, and relaxation techniques. Prior research by [PERSON] and [PERSON] (2001) highlighted that patients with widespread pain did not significantly benefit from occlusal splints, whereas those with localized pain did [35]. This contrasts with our findings, which showed improvements even in patients with fibromyalgiagia. One possible explanation is that we used a different splint design, and all patients also received behavioral guidance as part of the treatment. These additional elements, along with differences in patient selection and context, may have contributed to the more favorable outcomes observed in our study. Thus, patient context, differences in methodology, and the multifactorial nature of the intervention may explain the difference in our results from those of previous studies reporting limited effects in similar populations. Secondly, for the SBFB group, the intervention also resulted in significant improvements in TMD-related symptoms, particularly in TMJ pain, mandibular locking, and reductions in JFLS-8 scores. Improvements in GAD-7, OHIP-14, WHO-5, and PSQI scores also reflected enhancements in overall well-being and sleep quality. This is consistent with prior studies, such as [PERSON] et al., which demonstrated that the use of splint therapy in the treatment of sleep bruxism creates a biomechanical balance between the physiological load and that generated by stress [24]. This suggests that such treatment may lead to the stabilization of bruxism by reducing deformations and deviations in the TMJ, thereby decreasing the load on the joint [24]. Patients in the ABG also exhibited significant improvements in mandibular function, as indicated by JFLS-8 scores, along with enhancements in oral health and overall well-being (as measured by OHIP-14 and WHO-5). However, the improvements in anxiety (GAD-7) and sleep quality (PSQI) did not reach statistical significance in this group. This may be partly due to the relatively small sample size in this subgroup. This suggests that while the splint has a positive impact on certain aspects of TMD and overall well-being, the effects may be less pronounced concerning anxiety reduction and sleep improvement in patients with bruxism without fibromyalgiagia. This finding supports studies such as that by [PERSON] et al., which observed that adjustable splints, such as full-occlusion biofeedback splints, were more effective in reducing episodes of sleep bruxism, improving patient-reported symptoms, and enhancing overall well-being [36]. Although our study showed smaller changes in the WHO-5 well-being test, positive post-treatment changes were still observed [36]. In the SBG, the intervention led to significant improvements in JFLS-8, GAD-7, OHIP-14, and PSQI. However, the WHO-5 did not show statistically significant changes. These results suggest that for patients with sleep bruxism, the occlusal splint may be beneficial in alleviating specific TMD symptoms and improving physical aspects, but its impact on overall well-being may be limited in comparison to other groups.