Evolution and Clinical Impact of Prosthodontic Appliances: A Narrative Review of Splints, Stents, and Oral Appliances.

Splints, stents, and oral appliances play an important supportive role in modern prosthodontic practice, contributing to diagnosis, treatment stabilization, surgical accuracy, and functional rehabilitation. Over time, these appliances have evolved from largely empirical devices into precision-based therapeutic tools guided by biomechanical principles and digital technologies. Recent developments in computer-aided design and manufacturing (CAD/CAM), three-dimensional printing, and evidence-based appliance therapy have improved their accuracy, consistency, and clinical predictability. Occlusal splints continue to be widely used as conservative, reversible treatment options for temporomandibular disorders and bruxism. Digital fabrication techniques have demonstrated improved fit and reproducibility when compared with conventional fabrication methods. Surgical and radiotherapeutic stents have expanded the role of prosthodontists in interdisciplinary implant and oncologic rehabilitation by improving procedural precision and protecting surrounding tissues. In addition, oral appliance therapy has gained increasing acceptance in the management of obstructive sleep apnea, particularly in patients who are intolerant of continuous positive airway pressure therapy. Despite their widespread use, considerable variation remains in appliance design, material selection, and clinical protocols, which may influence treatment outcomes. Recent literature highlights the importance of individualized appliance therapy, digital workflow integration, and a deeper understanding of neuromuscular and biomechanical mechanisms. This narrative review summarizes the current evidence on the evolution, mechanisms of action, clinical applications, and technological advancements of prosthodontic appliances, with particular emphasis on splints, stents, oral appliance therapy, and digital technologies. It aims to provide clinicians and postgraduate students with a comprehensive overview of the expanding role of these appliances in contemporary prosthodontic practice.