Effects of Massage Therapy and Occlusal Splint Therapy on Mandibular Range of Motion in Individuals With Temporomandibular Disorder: A Randomized Clinical Trial
Abstract
Objective The purpose of this study was to investigate the effects of massage therapy compared with occlusal splint therapy on mandibular range of motion (ROM) in individuals with temporomandibular disorder (TMD) and compare the results with ROM obtained in a group of individuals without this disorder. Methods A blinded randomized clinical trial was conducted. Twenty-eight volunteers with TMD were randomly distributed into either a massage therapy group or an occlusal splint group. Both treatments were provided for 4 weeks. Fourteen individuals without TMD were consecutively allocated to a comparison group. Fonseca anamnestic index was used to characterize TMD and allocate the volunteers to either of the intervention groups or asymptomatic comparison group. Mandibular ROM was evaluated before and after treatment using a digital caliper. Two-way repeated-measures analysis of variance with a post hoc Bonferroni testing was used for intergroup and intragroup comparisons (level of significance was set to 5%). Cohen d was used to calculate the effect size. Results In the intragroup analysis, significant increases in ROM were found for all measures in both the massage and occlusal splint groups (P Conclusion Massage therapy on the masticatory muscles and the use of an occlusal splint lead to an increase in mandibular ROM similar to that of the asymptomatic comparison group with regard to maximum active mouth opening and both right and left excursion in individuals with TMD.
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Comparator groups varied widely, including sham or no-treatment control, standard care, splint therapy, and pharmacological treatments.
“Comparator groups varied widely, including sham or no-treatment control [23,27], standard care [21], splint therapy [25,29,32] and pharmacological treatments [38].”
Fascial manipulations and massage, administered by physiotherapists, demonstrated efficacy in reducing myogenic temporomandibular disorder symptoms.
“Fascial Manipulations and massage, administered by physiotherapists, demonstrated efficacy in reducing myogenic TMD symptoms [28,30,32,33].”
No statistical differences were found between MT targeted to the jaw and jaw exercises plus splint therapy, between cervical chiropractic adjustment and cervical trigger point therapy, upper thoracic manipulation and placebo, or masticatory muscle massage and splint for improving symptoms of patients with mixed TMD.
“However, no statistical differences were found between MT targeted to the jaw and jaw exercises plus splint therapy, 100 between cervical chiropractic adjustment and cervical trigger point therapy, 102 upper thoracic manipulation and placebo, 76 or masticatory muscle mas- sage and splint 104 for improving symptoms of patients with mixed TMD.”
From Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis (2016) · cites this paper as [104]
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Armijo-Olivo, S., Pitance, L., Singh, V., Neto, F., Thie, N., & Michelotti, A. (2016) · Physical Therapy · doi:10.2522/ptj.20140548 · Cited by 413 · see citing works
Chiaramonte, R., Ferrillo, M., de Sire, A., & Vecchio, M. (2026) · Journal of Manual & Manipulative Therapy · doi:10.1080/10669817.2026.2629282
“Fascial Manipulations and massage, administered by physiotherapists, demonstrated efficacy in reducing myogenic TMD symptoms [28,30,32,33].”
- Authors
- Gomes, C. A. F. D. P., Politti, F., Andrade, D. V., de Sousa, D. F. M., Herpich, C. M., Dibai-Filho, A. V., Gonzalez, T. D. O., & Biasotto-Gonzalez, D. A.
- Affiliations
- Universidade Nove de Julho (BR)
- ORCID
- Venue
- Journal of Manipulative and Physiological Therapeutics
- Published
- 2014-03
- Volume
- 37
- Issue
- 3
- Pages
- 164-169
- ISSN
- 0161-4754 (ISSN-L)
- OpenAlex
- W2002119091
- Cited by
- 77
- References
- 0
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 8 · 2023: 6 · 2022: 7 · 2021: 10 · 2020: 11 · 2019: 6 · 2018: 3 · 2017: 8 · 2016: 5 · 2015: 4 · 2014: 1
- FWCI
- 10.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Manipulative and Physiological Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
- Health Sciences › Dentistry › Orthodontics › Orthodontics and Dentofacial Orthopedics
- Health Sciences › Health Professions › Medical Laboratory Technology › Occupational health in dentistry
- Keywords
- temporomandibular disorders, massage, occlusal splint, mandibular range of motion, masticatory muscles, lateral excursion, maximum mouth opening, Fonseca Anamnestic Index
- MeSH terms
- Adolescent, Adult, Female, Humans, Male, Mandible, Massage, Temporomandibular Joint Disorders, Single-Blind Method, Range of Motion, Articular, Occlusal Splints, Young Adult
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