Effects of manual therapy in the treatment of temporomandibular dysfunction—a review of the literature
Open accessAbstract
Background: The term temporomandibular dysfunction (TMD) applies to functional changes related to temporomandibular joint (TMJ) and it is associated to masticatory structures. The main symptoms are pain in the TMJ region and / or the masticatory musculature. Objective: to perform a systematic review on the effects of manual therapy in the treatment of TMD. Methods: We analyzed 231 articles from the databases of Bireme, BVS, Lilacs, MedLine, PEDro, Pubmed and, Scielo. Of these, only 30 were selected for the elaboration of the article and 6 were used for the qualitative synthesis. Studies of controlled clinical trials of high methodological quality and high clinical relevance on the PEDro scale were included, which used the same evaluation measures, VAS (visual analogic scale), PPT (pressure pain threshold) and maximum mouth opening (MMO), and only one treatment technique comparing the control group with placebo. Result: The studies presented positive results for pain in VAS, PPT and MMO; however, there are significant differences depending on the technique. Myofascial release has a strong efficacy in reducing the symptoms of acute pain in the long term, but does not show clinically significant changes in mouth opening amplitude and MMO. Mobilization / manipulation presents significant changes in MMO, significantly improving the efficacy of mouth range of motion in the treatment of the short-term pain symptom, however does not sustain in the long term. Conclusion: The tool for the individual treatment of patients is based on the symptoms addressed, significantly improving the effectiveness of the range of motion of the mouth in the treatment of joint mobilization / manipulation, and treatment of pain by myofascial release.
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Limitations with those reviews and their supporting evidence make it difficult to determine the efficacy of cervical spine joint mobilizations or manipulations.
“However, limitations with those reviews and their supporting evidence makes it difficult to determine the efficacy of cervical spine joint mobilizations or manipulations.”
From The Effect of Upper Cervical Mobilization/Manipulation on Temporomandibular Joint Pain, Maximal Mouth Opening, and Pressure Pain Thresholds: A Systematic Review and Meta-Analysis (2023) · cites this paper as [24]
The Discussion and Conclusion (pages unavailable) report improved mouth opening with cervical mobilization or manipulation and conclude that the technique is effective for improving joint mobility. The Conclusion notes a lack of direct comparisons with myofascial release, but does not say that limitations make its efficacy difficult to determine. (LLM, conf=0.82)
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Experimental — accuracy not yet measuredDetails about specific manual therapy techniques used were not consistently provided, and manual therapy techniques were variable.
“Details about specific MT techniques used were not consistently provided, and MT techniques were variable, including soft tissue release, joint mobilizations, and joint manipulations performed to the cervical spine and/or TMJ.5,19,23,24”
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Research works printed but not linked: 26
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Lam, A. C., Liddle, L. J., & MacLellan, C. L. (2023) · Archives of Rehabilitation Research and Clinical Translation · doi:10.1016/j.arrct.2022.100242 · Cited by 14 · see citing works
“In 1 review, cervical MT consisted of muscle and nerve tissue techniques,(23) and another included trials that considered myofascial therapy, TMJ mobilizations, soft tissue mobilization muscles, and muscle stretching exercises.(24) Our review is the first to specifically examine the efficacy of upper cervical articula…”
BackgroundMethod
- Authors
- Castro, M. E. B. D., Silva, R. M. V. D., & Basilio, F. B.
- Venue
- Manual Therapy, Posturology & Rehabilitation Journal
- Publisher
- Pro Ciencia Periodicos Cientificos
- Published
- 2017-12-28
- Pages
- 1-7
- ISSN
- 1677-5937 (ISSN-L)
- 2236-5435
- OpenAlex
- W3110729234
- Cited by
- 11
- References
- 0
- Citations by year
- 2026: 2 · 2025: 4 · 2023: 2 · 2022: 3
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Manual Therapy Posturology & Rehabilitation Journal (publishedVersion)
- Topics
- Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Myofascial pain diagnosis and treatment
- Health Sciences › Dentistry › Orthodontics › Orthodontics and Dentofacial Orthopedics
- Keywords
- temporomandibular disorders, manual therapy, myofascial release, joint mobilization, joint manipulation, temporomandibular joint pain, masticatory muscle pain, pressure pain threshold, acute pain
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