Effectiveness of manual therapy and home physical therapy in patients with temporomandibular disorders: A randomized controlled trial

Manual therapy was effective in reducing pain immediately after treatment, independent of the professional category.

“Manual therapy was found to be effective in reducing pain immediately after treatment, independent of the professional category (Table 2).”

Myofascial release, performed by physiotherapists, chiropractors and dental nurses, showed significant improvements in both pain and function.

“Myofascial release, performed by physiotherapists, chiropractors and dental nurse, showed significant improvements in both pain and function [22,34,35].”

Physiotherapists consistently achieved significant outcomes in pain reductions and maximum mouth opening improvement.

“Physiotherapists consistently achieved significant outcomes in pain reductions [21–23] and MMO improvement [21,22,26].”

Manual therapy was effective across all professional categories, with significant reductions in pain and improvements in maximum mouth opening.

“Manual therapy was effective across all professional categories, with significant reductions in pain [21–25] and improvements in MMO [21–26].”

In this systematic review, most studies applied Axis I criteria, while a subset incorporated both Axis I and II.

“In this systematic review, most studies applied Axis I criteria [22,25,27,30,35], while a subset incorporated both Axis I and II [21,33] to identify TMD subtypes most responsive to manual therapy.”

Myofascial release targeting masticatory and jaw muscles showed consistent efficacy.

“Similarly, myofascial release targeting masticatory and jaw muscles showed consistent efficacy [22].”

Several studies emphasized that manual therapy was performed by professionals with specialized training, reinforcing the notion that clinical expertise is critical to achieving effective results.

“Several studies [21,22,25,26,29,31,34] emphasized that manual therapy was performed by professionals with specialized training, reinforcing the notion that clinical expertise is critical to achieving effective results.”

Pooling results of 2 studies, MT targeted to the orofacial region or in combination with cervical treatment was better than home exercises for the jaw and neck alone or treatment to cervical spine alone for improving mouth opening.

“Pooling the results of the 2 studies 75,105,106 with similar interventions, outcomes, and diagnoses, we found that MT targeted to the orofacial region or in combination with cervical treatment was better than home exercises for the jaw and neck alone or treatment to cervical spine alone for improving mouth opening.”

Eight of the trials reported no adverse events with the treatments.

“Eight of the trials 57,65,67,74,75,77,87,88 reported no adverse events with the treatments.”

Conservative interventions such as physiotherapy and manual therapy directly affect the muscular system to reduce excessive tension and minimize pain in the temporomandibular joints and chewing muscles.

“These interventions directly affect the muscular system, in order to reduce its excessive tension, and thus minimize pain in the area of the temporomandibular joints, and in muscles involved in the chewing process [1,3,19,20,21,22,23,24,25,26].”