The DOI matches its Crossref record; 121 of the 124 references it cites were found in a registry or an index; 26 of the 190 sources its claims cite were checked for support.
Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis
Open accessAbstract
Background: Manual therapy (MT) and exercise have been extensively used to treat people with musculoskeletal conditions such as temporomandibular disorders (TMD). The evidence regarding their effectiveness provided by early systematic reviews is outdated. Purpose: The aim of this study was to summarize evidence from and evaluate the methodological quality of randomized controlled trials that examined the effectiveness of MT and therapeutic exercise interventions compared with other active interventions or standard care for treatment of TMD. Data Sources: Electronic data searches of 6 databases were performed, in addition to a manual search. Study Selection: Randomized controlled trials involving adults with TMD that compared any type of MT intervention (eg, mobilization, manipulation) or exercise therapy with a placebo intervention, controlled comparison intervention, or standard care were included. The main outcomes of this systematic review were pain, range of motion, and oral function. Forty-eight studies met the inclusion criteria and were analyzed. Data Extraction: Data were extracted in duplicate on specific study characteristics. Data Synthesis: The overall evidence for this systematic review was considered low. The trials included in this review had unclear or high risk of bias. Thus, the evidence was generally downgraded based on assessments of risk of bias. Most of the effect sizes were low to moderate, with no clear indication of superiority of exercises versus other conservative treatments for TMD. However, MT alone or in combination with exercises at the jaw or cervical level showed promising effects. Limitations: Quality of the evidence and heterogeneity of the studies were limitations of the study. Conclusions: No high-quality evidence was found, indicating that there is great uncertainty about the effectiveness of exercise and MT for treatment of TMD.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This systematic review and meta-analysis of 48 randomized controlled trials found no high-quality evidence and generally low certainty about the effectiveness of manual therapy and therapeutic exercise for temporomandibular disorders (TMD). Manual therapy alone or combined with exercise showed promising effects, while exercise was not clearly superior to other conservative treatments.
Key findings
- The overall evidence was considered low; none of the 48 included studies was rated low risk of bias, with 58.4% classified as unclear risk and 41.6% as high risk.
- Postural training for myogenous TMD significantly increased maximum pain-free mouth opening (MD = 5.54 mm, 95% CI = 2.93, 8.15) and reduced disturbance with daily life (SMD = 1.13, 95% CI = 0.48, 1.78).
- Manual therapy plus exercises for arthrogenous TMD significantly reduced pain (SMD = 0.40, 95% CI = 0.13, 0.68) and increased active mouth opening (MD = 3.58 mm, 95% CI = 1.46, 5.70); for mixed TMD, manual therapy plus exercises improved mouth opening (MD = 6.10 mm, 95% CI = 1.11, 11.09).
- General jaw exercises in mixed TMD were not superior to other treatments for pain (SMD = −0.06, 95% CI = −0.50, 0.38) or mouth opening (MD = −0.25 mm, 95% CI = −2.08, 1.57).
Methods
- Systematic review and meta-analysis reported according to PRISMA and registered in PROSPERO (CRD42013005628); 6 electronic databases were searched through April 7, 2015, plus a manual search.
- Inclusion criteria were randomized controlled trials of adults (>18 years) with TMD comparing any manual therapy or exercise therapy with placebo, controlled comparison intervention, or standard care; primary outcomes were pain, range of motion, and oral function, with pressure pain threshold as a secondary outcome.
- The search yielded 3,549 articles; 48 studies were included in the final analysis. Data were extracted in duplicate, risk of bias was assessed by 2 independent reviewers using a compiled tool, GRADE was used to assess evidence quality, and meta-analyses used MD or SMD with 95% CI and random-effects models when clinical heterogeneity was present.
Limitations
- Stated by the paper: quality of evidence and heterogeneity were limitations; a small proportion of studies in other languages could not be translated; heterogeneity existed in TMD diagnosis, study intervention, and control/comparison intervention; many studies included exercise or manual therapy as part of a general treatment program, making isolated effects difficult to evaluate; only 21 of 48 studies used a valid, reliable, and reproducible diagnostic tool for TMD.
- Evident from the text: no study was classified as low risk of bias, which precluded sensitivity analyses by quality; only 20 studies reported appropriate randomization, 4 reported allocation concealment, 12 used blinded outcome assessment, and 16 used intention-to-treat analysis; adverse events were reported in only 10 of 48 trials.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
26 of 190 cited sources checked · 16 supported · 0 flagged · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The minimal clinically important difference for pain has been reported to range from 1.5 to 3.2 points.30 -34”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Outcomes
What the sources say
- Not checked — no full text of the sourcecites [30] Kovacs, 2007, Minimal clinically important change for pain intensity and disability in patients with nonspecific low back pain, Spine (Phila Pa 1976) source
- Not checked — no full text of the sourcecites [31] Farrar, 2001, Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale, Pain source
- Not checked — no full text of the sourcecites [32] van der Roer, 2006, Minimal clinically important change for pain intensity, functional status, and general health status in patients with nonspecific low back pain, Spine (Phila Pa 1976) source
- Partly supportedcites [33] Maughan, 2010, Outcome measures in chronic low back pain, Eur Spine J sourceExperimental — accuracy not yet measured
The Discussion reports a minimal clinically important change of 4 points on the pain numerical rating scale, while the Abstract also gives a method-dependent estimate of 2.4 points. The paper therefore supports the existence of a point-based pain threshold, but not the claimed range of 1.5–3.2 points; its 4-point estimate falls outside it. (LLM, conf=0.87)
- Not checked — no full text of the sourcecites [34] Dworkin, 2008, Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations, J Pain source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Measurements of PPT have been shown to have good or excellent interrater and intrarater reliability.36 -38”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Outcomes
What the sources say
- Not checked — no full text of the sourcecites [36] Nussbaum, 1998, Reliability of clinical pressure-pain algometric measurements obtained on consecutive days, Phys Ther source
- Not checked — no full text of the sourcecites [37] Ylinen, 2005, Effect of long-term neck muscle training on pressure pain threshold: a randomized controlled trial, Eur J Pain source
- Supportedcites [38] Cathcart, 2006, Reliability of pain threshold measurement in young adults, J Headache Pain source
The Introduction reports that previous studies demonstrated high intra- and inter-rater reliability for PPT assessment in clinical and healthy subjects. The paper's own measurements used one rater, but its report of prior inter-rater findings supports the citing sentence. (LLM, conf=0.90)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“When pooling the results of the studies investigating the effectiveness of exercise alone or in combination with other conservative therapies on pain intensity, 58,61,68,86 we found that there was no statistically significant difference in pain between exercise and control groups.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Jaw and Neck Exercises Alone or as Part of a Conservative Regimen in Arthrogenous TMD
What the sources say
- Not checked — no full text of the sourcecites [58] Maloney, 2002, Effect of a passive jaw motion device on pain and range of motion in TMD patients not responding to flat plane intraoral appliances, Cranio source
- Could not verifycites [61] Craane, 2012, Randomized controlled trial on physical therapy for TMJ closed lock, J Dent Res sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.
- Not checked — no full text of the sourcecites [68] de Felicio, 2008, Otologic symptoms of temporomandibular disorder and effect of orofacial myofunctional therapy, Cranio source
- Not checked — no full text of the sourcecites [86] Yuasa, 2001, Randomized clinical trial of primary treatment for temporomandibular joint disk displacement without reduction and without osseous changes: a combination of NSAIDs and mouth-opening exercise versus no treatment, Oral Surg Oral Med Oral Pathol Oral Radiol Endod source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesThe sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Four studies 64,65,77,81 looked at MT techniques, such as facial manipulation versus botulinum toxin 81 or intraoral myofascial therapy versus waiting list, and self-care education and exercises for people with myogenous TMD.64,65,77”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Manual Therapy Targeted to the Orofacial Region in Myogenous TMD
What the sources say
- Supportedcites [64] Kalamir, 2013, Intra-oral myofascial therapy versus education and self-care in the treatment of chronic, myogenous temporomandibular disorder: a randomised, clinical trial, Chiropr Man Therap source
The Abstract Methods passage identifies this paper as a trial of intra-oral myofascial therapy in people with chronic myogenous TMD, compared with education and supervised self-care exercises. It therefore supports its inclusion as one of the four cited studies; the paper is not being cited to establish the count on its own. (LLM, conf=0.92)
- Supportedcites [65] Kalamir, 2010, Intra-oral myofascial therapy for chronic myogenous temporomandibular disorders: a randomized, controlled pilot study, J Man Manip Ther source
The Abstract identifies this as a pilot study of intra-oral myofascial therapy in people with chronic myogenous TMD. It compares therapy alone, therapy plus education and self-care, and a non-treated wait-list group, matching the study for which this source is cited. The claim's count of four refers to the citing paper's group of studies, not to a finding attributed to this individual source. (LLM, conf=0.93)
- Not checked — no full text of the sourcecites [77] Kalamir, 2012, Intraoral myofascial therapy for chronic myogenous temporomandibular disorder: a randomized controlled trial, J Manipulative Physiol Ther source
- Not checked — no full text of the sourcecites [81] Guarda-Nardini, 2012, Myofascial pain of the jaw muscles: comparison of short-term effectiveness of botulinum toxin injections and fascial manipulation technique, Cranio source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“However, one study 61 did not find that exercises were superior to a control group involving general physical therapy treatment.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Jaw and Neck Exercises Alone or as Part of a Conservative Regimen in Arthrogenous TMD
What the sources say
- Could not verifycites [61] Craane, 2012, Randomized controlled trial on physical therapy for TMJ closed lock, J Dent Res sourceExperimental — accuracy not yet measured
The available passages, labeled Abstract with no page number, contain bibliographic information and keywords but no description of the treatment groups or results. Searches for exercise superiority and the control-group comparison returned no outcome passage, so our copy cannot verify the claimed finding. (LLM, conf=0.73)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Could not verify
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“Regarding active mouth opening, a nonsignificant effect was found between general jaw exercises and education, splint therapy, or a control group when pooling 3 studies.58,61,86”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Jaw and Neck Exercises Alone or as Part of a Conservative Regimen in Arthrogenous TMD
What the sources say
- Not checked — no full text of the sourcecites [58] Maloney, 2002, Effect of a passive jaw motion device on pain and range of motion in TMD patients not responding to flat plane intraoral appliances, Cranio source
- Could not verifycites [61] Craane, 2012, Randomized controlled trial on physical therapy for TMJ closed lock, J Dent Res sourceExperimental — accuracy not yet measured
The available passages identify Craane et al. as a randomized trial of physical therapy for TMJ closed lock, but provide no trial methods or results. Searches for active mouth opening, jaw exercises, comparators, and a nonsignificant effect found no passage establishing that this trial contributed to the stated three-study pooled result. (LLM, conf=0.72)
- Not checked — no full text of the sourcecites [86] Yuasa, 2001, Randomized clinical trial of primary treatment for temporomandibular joint disk displacement without reduction and without osseous changes: a combination of NSAIDs and mouth-opening exercise versus no treatment, Oral Surg Oral Med Oral Pathol Oral Radiol Endod source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesThe sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“When pooling the results from 3 of these studies based on similar outcomes and diagnoses and comparing similar interventions regarding MT, 64,65,81 we found that MT significantly reduced pain at 4 to 6 weeks of treatment compared with botulinum toxin or waiting list, approaching a clinically relevant value.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Manual Therapy Targeted to the Orofacial Region in Myogenous TMD
What the sources say
- Supportedcites [64] Kalamir, 2013, Intra-oral myofascial therapy versus education and self-care in the treatment of chronic, myogenous temporomandibular disorder: a randomised, clinical trial, Chiropr Man Therap source
The citation identifies this paper as one of the studies the citing authors pooled; the pooled result is expressly presented as what ‘we found,’ not as this paper’s own finding. The Methods (Outcome measures) and Results (Primary outcomes) describe an intra-oral myofascial therapy trial measuring pain at six weeks. Its comparator was education and self-care, rather than botulinum toxin or a waiting list. (LLM, conf=0.88)
- Supportedcites [65] Kalamir, 2010, Intra-oral myofascial therapy for chronic myogenous temporomandibular disorders: a randomized, controlled pilot study, J Man Manip Ther source
The Interventions and Abstract identify this as a myofascial-therapy trial with a wait-list control, making it an appropriate citation for one of the studies the citing authors pooled. The Results table reports significantly lower pain on clenching at six weeks in the treatment groups than in the control group. The pooling and its comparison with botulinum toxin are explicitly the citing authors’ own finding, not a result attributed to this individual trial. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [81] Guarda-Nardini, 2012, Myofascial pain of the jaw muscles: comparison of short-term effectiveness of botulinum toxin injections and fascial manipulation technique, Cranio source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- The authors state this as an assumption: There is interstudy variability in the included studies.
- The authors state this as an assumption: There is clinical heterogeneity in the study population or intervention.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“However, compared with other forms of active treatments, such as splints, a global postural re-education program, or acupuncture, [72][73][74]95,95,98,99 no significant differences between these treatments were found.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > General Jaw Exercise Program in Mixed TMD
What the sources say
- Supportedcites [72] Ficnar, 2013, Evaluation of the effectiveness of a semi-finished occlusal appliance: a randomized, controlled clinical trial, Head Face Med source
The Methods describe conservative therapy alone versus conservative therapy with either of two occlusal appliances. The Results and Discussion report no significant differences in therapeutic effectiveness between the three groups, supporting the splint comparison for which this source is cited. (LLM, conf=0.90)
- Not checked — no full text of the sourcecites [73] Niemela, 2012, Efficacy of stabilisation splint treatment on temporomandibular disorders, J Oral Rehabil source
- Not checked — no full text of the sourcecites [74] Truelove, 2006, The efficacy of traditional, low-cost and nonsplint therapies for temporomandibular disorder: a randomized controlled trial, J Am Dent Assoc source
- Not checked — no full text of the sourcecites [95] Klobas, 2006, Effect of therapeutic jaw exercise on temporomandibular disorders in individuals with chronic whiplash-associated disorders, Acta Odontol Scand source
- Not checked — no full text of the sourcecites [98] Tavera, 2012, Approaching temporomandibular disorders from a new direction: a randomized controlled clinical trial of the TMDes ear system, Cranio source
- Not checked — no full text of the sourcecites [99] Raustia, 1986, Acupuncture compared with stomatognathic treatment for TMJ dysfunction, part III: effect of treatment on mobility, J Prosthet Dent source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“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.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Manual Therapy Plus Exercises for Mixed TMD
What the sources say
- Not checked — no full text of the sourcecites [75] Tuncer, 2013, Effectiveness of manual therapy and home physical therapy in patients with temporomandibular disorders: a randomized controlled trial, J Bodyw Mov Ther source
- Partly supportedcites [105] von Piekartz, 2013, Orofacial manual therapy improves cervical movement impairment associated with headache and features of temporomandibular dysfunction: a randomized controlled trial, Man Ther sourceExperimental — accuracy not yet measured
The Intervention section confirms that this trial compared orofacial treatment, usually combined with cervical treatment, against cervical treatment alone. But the Results section reports improvement in cervical movement, while restricted mouth opening is described as a baseline sign; our copy does not report improvement in mouth opening. The pooling result is the citing authors’ own finding, not a finding attributed to this trial alone. (LLM, conf=0.85)
- Not checked — no full text of the sourcecites [106] von Piekartz, 2011, Effect of treatment of temporomandibular disorders (TMD) in patients with cervicogenic headache: a single-blind, randomized controlled study, Cranio source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesThe sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Eight of the trials 57,65,67,74,75,77,87,88 reported no adverse events with the treatments.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Adverse Events
What the sources say
- Not matchedcites [57] Mulet, 2007, A randomized clinical trial assessing the efficacy of adding 6 × 6 exercises to self-care for the treatment of masticatory myofascial pain, J Orofac Pain
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Supportedcites [65] Kalamir, 2010, Intra-oral myofascial therapy for chronic myogenous temporomandibular disorders: a randomized, controlled pilot study, J Man Manip Ther source
The Conclusion states that no participant had an adverse reaction during this trial. That supports citing this paper as one of the trials reporting no adverse events; it does not itself establish the count of eight trials. (LLM, conf=0.93)
- Not checked — no full text of the sourcecites [67] La Touche, 2013, Does mobilization of the upper cervical spine affect pain sensitivity and autonomic nervous system function in patients with cervico-craniofacial pain: a randomized-controlled trial, Clin J Pain source
- Not checked — no full text of the sourcecites [74] Truelove, 2006, The efficacy of traditional, low-cost and nonsplint therapies for temporomandibular disorder: a randomized controlled trial, J Am Dent Assoc source
- Not checked — no full text of the sourcecites [75] Tuncer, 2013, Effectiveness of manual therapy and home physical therapy in patients with temporomandibular disorders: a randomized controlled trial, J Bodyw Mov Ther source
- Not checked — no full text of the sourcecites [77] Kalamir, 2012, Intraoral myofascial therapy for chronic myogenous temporomandibular disorder: a randomized controlled trial, J Manipulative Physiol Ther source
- Not checked — no full text of the sourcecites [87] Carmeli, 2001, Comparative study of repositioning splint therapy and passive manual range of motion techniques for anterior displaced temporomandibular discs with unstable excursive reduction, Physiotherapy source
- Not checked — no full text of the sourcecites [88] Haketa, 2010, Randomized clinical trial of treatment for TMJ disc displacement, J Dent Res source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Not matched
- Probably not a substantial claim. 38
- It may state two separate claims as one. 34
- The quote only partly states this claim. 1
Every source the paper cites for this claim was checked and supports it.
In the paper
“however, we developed specific decision rules to make decisions as described elsewhere.43”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Quality Assessment (Risk of Bias)
What the sources say
- Supportedcites [43] Armijo-Olivo, 2014, Poor reliability between Cochrane reviewers and blinded external reviewers when applying the Cochrane risk of bias tool in physical therapy trials, PloS One source
The Methods section (“RoB assessments procedure”) explicitly says the authors developed specific decision rules for their risk-of-bias assessments, in addition to following Cochrane guidelines. This directly supports the citing sentence. (LLM, conf=0.95)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Twenty-one of the studies 57-76 used the RDC/TMD established by Dworkin and LeResche 27 to classify the patients as having TMD.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Diagnosis
What the sources say
- Not matchedcites [57] Mulet, 2007, A randomized clinical trial assessing the efficacy of adding 6 × 6 exercises to self-care for the treatment of masticatory myofascial pain, J Orofac Pain
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [58] Maloney, 2002, Effect of a passive jaw motion device on pain and range of motion in TMD patients not responding to flat plane intraoral appliances, Cranio source
- Not checked — no full text of the sourcecites [59] Komiyama, 1999, Posture correction as part of behavioural therapy in treatment of myofascial pain with limited opening, J Oral Rehabil source
- Not checked — no full text of the sourcecites [60] Wright, 2000, Usefulness of posture training for patients with temporomandibular disorders, J Am Dent Assoc source
- Could not verifycites [61] Craane, 2012, Randomized controlled trial on physical therapy for TMJ closed lock, J Dent Res sourceExperimental — accuracy not yet measured
The available passages identify Craane et al. as a trial on TMJ closed lock, but do not describe how its patients were classified. Searches for RDC/TMD, Dworkin and LeResche, and diagnostic criteria found no passage establishing that this trial used RDC/TMD; the paper also cannot establish the citing document’s count of 21 studies. (LLM, conf=0.72)
- Not checked — no full text of the sourcecites [62] Craane, 2012, One-year evaluation of the effect of physical therapy for masticatory muscle pain: a randomized controlled trial, Eur J Pain source
- Not checked — no full text of the sourcecites [63] Gavish, 2006, Effect of controlled masticatory exercise on pain and muscle performance in myofascial pain patients: a pilot study, Cranio source
- Supportedcites [64] Kalamir, 2013, Intra-oral myofascial therapy versus education and self-care in the treatment of chronic, myogenous temporomandibular disorder: a randomised, clinical trial, Chiropr Man Therap source
The Methods (Subjects) say the RDC assessment was used to establish a myogenous TMD diagnosis for inclusion, and Methods (Study team) say the assessor was trained to administer the RDC for TMD. This supports citing the trial as one of the studies that used the RDC/TMD to classify patients; the total of twenty-one is a count across the citing paper’s studies, not a finding attributed to this trial alone. (LLM, conf=0.92)
- Supportedcites [65] Kalamir, 2010, Intra-oral myofascial therapy for chronic myogenous temporomandibular disorders: a randomized, controlled pilot study, J Man Manip Ther source
The Subjects section says participants were assessed using the RDC and that it was used to identify myogenous TMD sufferers for inclusion. Reference 31 identifies the criteria as those of Dworkin and LeResche. This paper supports its inclusion among the studies counted by the citing authors; it does not itself establish the aggregate count of twenty-one. (LLM, conf=0.91)
- Not matchedcites [66] Michelotti, 2004, The additional value of a home physical therapy regimen versus patient education only for the treatment of myofascial pain of the jaw muscles: short-term results of a randomized clinical trial [erratum in: J Orofac Pain. 2006;20:106], J Orofac Pain
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
Every source the paper cites for this claim was checked and supports it.
In the paper
“The quality of the body of the evidence was assessed using the GRADE approach.49”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Data synthesis.
What the sources say
- Supportedcites [49] Guyatt, 2008, GRADE: an emerging consensus on rating quality of evidence and strength of recommendations, BMJ source
The Summary Points identify GRADE as a system for rating the quality of evidence, and the section on classifying evidence describes its four quality levels. This supports the citation as identifying the approach used; the source does not independently document the citing authors’ assessment. (LLM, conf=0.93)
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In general, we found that MT plus exercises reduced symptoms and increased ROM for patients with arthrogenous TMD, particularly for those with reduced ROM due to disk displacements without reduction (”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Manual Therapy Plus Jaw Exercises in Arthrogenous TMD
What the sources say
- Not checked — no full text of the sourcecites [69] Ismail, 2007, Short-term efficacy of physical therapy compared to splint therapy in treatment of arthrogenous TMD, J Oral Rehabil source
- Partly supportedcites [70] Nascimento, 2013, Physical therapy and anesthetic blockage for treating temporomandibular disorders: a clinical trial, Med Oral Patol Oral Cir Bucal sourceExperimental — accuracy not yet measured
The Discussion reports improved mouth opening and jaw protrusion in both groups, and reduced pain in the group receiving anesthetic blockage plus physical therapy. It reports increased mouth opening for one patient with disc displacement without reduction, but does not establish that manual therapy plus exercises alone is particularly effective for patients with closed lock; that patient also received anesthetic blockage. Page numbers are unavailable in our copy. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [78] Schiffman, 2007, Randomized effectiveness study of four therapeutic strategies for TMJ closed lock [erratum in: J Dent Res. 2013;92:98], J Dent Res source
- Not checked — no full text of the sourcecites [87] Carmeli, 2001, Comparative study of repositioning splint therapy and passive manual range of motion techniques for anterior displaced temporomandibular discs with unstable excursive reduction, Physiotherapy source
- Not checked — no full text of the sourcecites [88] Haketa, 2010, Randomized clinical trial of treatment for TMJ disc displacement, J Dent Res source
- Not checked — no full text of the sourcecites [89] Minakuchi, 2004, Self-reported remission, difficulty, and satisfaction with nonsurgical therapy used to treat anterior disc displacement without reduction, Oral Surg Oral Med Oral Pathol Oral Rad Endod source
- Not checked — no full text of the sourcecites [90] Minakuchi, 2001, Randomized controlled evaluation of non-surgical treatments for temporomandibular joint anterior disk displacement without reduction, J Dent Res source
- Not checked — no full text of the sourcecites [91] Yoshida, 2005, Simple manipulation therapy for temporomandibular joint internal derangement with closed lock, Asian J Oral Maxillofac Surg source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“0.44% (1/224) had hematoma”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Adverse Events
What the sources say
- Supportedcites [70] Nascimento, 2013, Physical therapy and anesthetic blockage for treating temporomandibular disorders: a clinical trial, Med Oral Patol Oral Cir Bucal source
The Discussion explicitly reports 0.44% (1/224) hematoma as a complication in this study. It also states that 224 auriculotemporal nerve blockages were performed, providing the denominator. (LLM, conf=0.95)
Strength:plain· not yet calibratedSingle caseTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“2.23% (5/224) had positive aspirations.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Adverse Events
What the sources say
- Supportedcites [70] Nascimento, 2013, Physical therapy and anesthetic blockage for treating temporomandibular disorders: a clinical trial, Med Oral Patol Oral Cir Bucal source
The Discussion reports 2.23% (5/224) positive aspirations as complications in this study. It also states that the study performed 224 auriculotemporal nerve blockages. (LLM, conf=0.95)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Nascimento et al 70 reported some adverse events due to the anesthetic blockages procedure.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Adverse Events
What the sources say
- Supportedcites [70] Nascimento, 2013, Physical therapy and anesthetic blockage for treating temporomandibular disorders: a clinical trial, Med Oral Patol Oral Cir Bucal source
The Results section reports complications due to injection, including temporary facial nerve anesthesia and hematoma at the injection site. The Discussion also identifies temporary facial nerve paralysis, hematoma, and positive aspirations as complications of the procedure in this study. (LLM, conf=0.94)
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Effect sizes from trials that excluded participants in their analysis or that used a modified ITT protocol tended to be more beneficial than those from trials without exclusions, demonstrating that the ITT principle is important to preserve the benefits of randomization and keep unbiased estimates when the objective of the trial is to investigate effectiveness.110”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Methodological Elements and Overall Quality of the Evidence Affecting Observed Effect
What the sources say
- Partly supportedcites [110] Nuesch, 2009, The effects of excluding patients from the analysis in randomised controlled trials: meta-epidemiological study, BMJ sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Partly supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Fourteen of the studies examined the effectiveness of the exercise or MT interventions in muscular TMD (myogenous TMD)”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Diagnosis
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The agreement between reviewers to select the articles for this review was kappaϭ0.98 (95% CIϭ0.977, 0.99).”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Results
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“In addition, 3 studies 55-57 were obtained through a manual search.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Results
What the sources say
- Not checked — no full text of the sourcecites [55] Burgess, 1988, Short-term effect of two therapeutic methods on myofascial pain and dysfunction of the masticatory system, J Prosthetic Dent source
- Not checked yetcites [56] Magnusson, 1999, Therapeutic jaw exercises and interocclusal appliance therapy: a comparison between two common treatments of temporomandibular disorders, Swed Dent J
- Not checked yetcites [57] Mulet, 2007, A randomized clinical trial assessing the efficacy of adding 6 × 6 exercises to self-care for the treatment of masticatory myofascial pain, J Orofac Pain
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The search of the literature resulted in a total of 3,549 published articles.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Results
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Of the 3,549 published articles, 106 were considered to be potentially relevant.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Results
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“There were 5 articles in other languages 50 -54 that were not possible to translate by our study team and were not included in the final analysis.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Results
What the sources say
- Not checked — no full text of the sourcecites [50] Fink, 2007, The use of physcial therapy for the treatment of craniomandibular disorders: a prospective, randomised clinical trial [article in German], Manuelle Medizin Issue source
- Not checked yetcites [51] Lalabonova, 2008, Physical and medicinal treatment of TMJ arthrosis [article in Russian], Stomatologiia (Mosk)
- Not checked — no full text of the sourcecites [52] Petz, 1974, Therapy of restricted jaw movements [article in German], Z Arztl Fortbild (Jena)
- Not checked — no full text of the sourcecites [53] van der Glas, 2000, Vergelijking tussen behandelingsvormen bij myogene temporomandibulaire dysfunctie [Comparison of treatment options for myogenous temporomandibular dysfunction], Ned Tijdschr Tandheelkd
- Not checked — no full text of the sourcecites [54] Xue, 2007, Clinical observation on warming needle moxibustion plus exercise for treatment of temporomandibular joint dysfunction syndrome [article in Chinese], Zhongguo Zhen Jiu
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“based on a preliminary search performed by our team, it was realized that this review missed important RCTs in the area (included only 5 studies).”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Abstract
What the sources say
- Not checked — no full text of the sourcecites [25] Brantingham, 2013, Manipulative and multimodal therapy for upper extremity and temporomandibular disorders: a systematic review, J Manipulative Physiol Ther source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“One study looked at both myogenous and arthrogenous TMD.58”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Diagnosis
What the sources say
- Not checked — no full text of the sourcecites [58] Maloney, 2002, Effect of a passive jaw motion device on pain and range of motion in TMD patients not responding to flat plane intraoral appliances, Cranio source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Moreover, the authors did not report intrarater or inter-rater reliability of the assessors who performed outcome measurements.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Only a few studies reported these items (11, 17, and 3 studies, respectively).”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The remaining 27 studies used their own diagnostic criteria, based on signs and symptoms of the patients.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Diagnosis
Strength:plain· not yet calibratedn = 27Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The SMD for pain intensity at 4 weeks to 3 months was 0.40 (95% CIϭ0.13, 0.68), with a moderate effect size according to Cohen's guidelines 48”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Manual Therapy Plus Jaw Exercises in Arthrogenous TMD
What the sources say
- Not matchedcites [48] Cohen, 1988, The concepts of power analysis
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Not matched
In the paper
“The SMD for pain intensity was 0.68 (95% CIϭϪ0.04,1.40), with a moderate effect size according to Cohen's guidelines.48”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Jaw and Neck Exercises Alone or as Part of a Conservative Regimen in Arthrogenous TMD
What the sources say
- Not matchedcites [48] Cohen, 1988, The concepts of power analysis
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Not matched
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“When pooling was focused on those studies including only a control group, 68,86 similar results were found, although the SMD increased (SMDϭ1.11;95% CIϭϪ0.73,2.94).”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Jaw and Neck Exercises Alone or as Part of a Conservative Regimen in Arthrogenous TMD
What the sources say
- Not checked — no full text of the sourcecites [68] de Felicio, 2008, Otologic symptoms of temporomandibular disorder and effect of orofacial myofunctional therapy, Cranio source
- Not checked — no full text of the sourcecites [86] Yuasa, 2001, Randomized clinical trial of primary treatment for temporomandibular joint disk displacement without reduction and without osseous changes: a combination of NSAIDs and mouth-opening exercise versus no treatment, Oral Surg Oral Med Oral Pathol Oral Radiol Endod source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although the results for the intraoral myofascial therapy and exercise groups were superior to the results for the waiting-list control group, there was no statistically significant difference between them.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Manual Therapy Targeted to the Orofacial Region in Myogenous TMD
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, at 3 months after treatment, facial manipulation was slightly superior in reducing subjective pain perception, and botulinum toxin injections were slightly superior in increasing ROM.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Manual Therapy Targeted to the Orofacial Region in Myogenous TMD
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although the quality of the evidence is mostly uncertain and low, the results of our systematic review showed positive results when using postural exercises and jaw exercises to treat both myogenous and arthrogenous TMD disorders.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Main Results
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, most of these exercise programs were part of a general conservative treatment regimen including other therapies and did not provide clear information regarding dosage, frequency, or adherence, so the isolated effect of exercise to treat TMD and the optimal regimen are uncertain at this time.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Effect of Exercise for Treating TMD
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“In general, exercises for mixed TMD compared with control groups had better results for decreasing pain and improving function and pain sensitivity of the masticatory muscles.55, 71,96,97”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > General Jaw Exercise Program in Mixed TMD
What the sources say
- Not checked — no full text of the sourcecites [55] Burgess, 1988, Short-term effect of two therapeutic methods on myofascial pain and dysfunction of the masticatory system, J Prosthetic Dent source
- Not checked — no full text of the sourcecites [71] de Felicio, 2010, Effects of orofacial myofunctional therapy on temporomandibular disorders, Cranio source
- Not checked — no full text of the sourcecites [96] Tegelberg, 1988, Short-term effect of physical training on temporomandibular joint disorder in individuals with rheumatoid arthritis and ankylosing spondylitis, Acta Odontol Scand source
- Not checked — no full text of the sourcecites [97] Tegelberg, 1996, A 3-year follow-up of temporomandibular disorders in rheumatoid arthritis and ankylosing spondylitis, Acta Odontol Scand source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“The SMD for pain intensity was Ϫ0.06 (95% CIϭϪ0.50, 0.38), with a very small effect size according to Cohen's guidelines.48”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > General Jaw Exercise Program in Mixed TMD
What the sources say
- Not matchedcites [48] Cohen, 1988, The concepts of power analysis
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Not matched
None of the sources cited for this claim have been checked yet.
In the paper
“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.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Manual Therapy and Mixed TMD
What the sources say
- Not checked — no full text of the sourcecites [100] Cuccia, 2010, Osteopathic manual therapy versus conventional conservative therapy in the treatment of temporomandibular disorders: a randomized controlled trial, J Bodyw Mov Ther source
- Not checked yetcites [102] O'Reilly, 1996, TMJ pain and chiropractic adjustment: a pilot study, Chiropractic J Aust
- Not checked — no full text of the sourcecites [76] Packer, 2014, Effects of upper thoracic manipulation on pressure pain sensitivity in women with temporomandibular disorder: a randomized, double-blind, clinical trial, Am J Phys Med Rehabil source
- Not checked — no full text of the sourcecites [104] Gomes, 2014, Effects of massage therapy and occlusal splint therapy on mandibular range of motion in individuals with temporomandibular disorder: a randomized clinical trial, J Manipulative Physiol Ther source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Manual therapy targeted to the cervical spine decreased pain and increased mouth ROM in patients with myogenous TMD.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Main Results
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“The studies by Mansilla-Ferragud et al 101 and Otano and Legal 103 showed positive results at improving mouth ROM and increasing PPT in the orofacial region when comparing mobilization of the atlantoaxial joint versus placebo.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Manual Therapy and Mixed TMD
What the sources say
- Not checked — no full text of the sourcecites [101] Mansilla-Ferragud, 2008, Efecto de la manipulacion de la charnela occipito-atlo-axoidea en la apertura de la boca [Effect of upper cervical spine manipulation on mouth opening], Osteopatia Cientifica source
- Not checked — no full text of the sourcecites [103] Otano, 2010, Modificaciones radiologicas del espacio entre el occipucio y el cuerpo del atlas tras una manipulacion global (OAA) de Fryette [Radiological changes in the atlanto-occipital space after Fryette global manipulation (OAA)], Osteopatia Cientifica source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No high-quality evidence was found, indicating that there is great uncertainty about the effectiveness of exercise and manual MT for TMD.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Research Implications
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We did not perform sensitivity analyses based on quality because the risk of bias of the analyzed studies was either unclear or high, with no study being classified as low risk.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Subgroup and sensitivity analysis.
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“That review included several types of designs and did not focus on RCTs, which are the best evidence when looking at interventions.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Abstract
What the sources say
- Not checked — no full text of the sourcecites [25] Brantingham, 2013, Manipulative and multimodal therapy for upper extremity and temporomandibular disorders: a systematic review, J Manipulative Physiol Ther source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Assessments of quality (risk of bias) were completed by 2 independent reviewers (any 2 members of the research team).”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Quality Assessment (Risk of Bias)
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“The reporting of this systematic review is based on the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines.26”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Method
What the sources say
- Not checked — no full text of the sourcecites [26] Moher, 2009, Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement, Ann Intern Med source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“According to Byrt's criteria, 41 the agreement between reviewers was excellent.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Results
What the sources say
- Not checked — no full text of the sourcecites [41] Byrt, 1996, How good is that agreement?, Epidemiology source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In addition, the risk of bias tool was used with the main outcome of each study to make the assessments.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Quality Assessment (Risk of Bias)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“For each part of the review, data extraction was carried out independently by 2 reviewers.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Data Extraction
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Any disagreements on data extraction were resolved by consensus.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Data Extraction
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The funding bodies had no input in the design, collection, analysis, or interpretation of data; writing of the manuscript; or the decision to submit the manuscript for publication.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Role of the Funding Source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Two independent investigators screened the titles of publications found in the databases and, if available, the abstract of the publication.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Data Screening
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Disagreements between reviewers on inclusion were resolved by consensus.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Disagreements between reviewers on inclusion were resolved by consensus.
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We followed the guidelines established by the Cochrane Collaboration to perform assessments of risk of bias”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Quality Assessment (Risk of Bias)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Any discrepancies in quality ratings were resolved by discussion.If consensus could not be reached, a third member of the review team with expertise in quality assessments (S.A-O.)acted as an arbitrator and made a final decision.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Quality Assessment (Risk of Bias)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“However, 2 reviews 19,23 were conducted 9 years previously and included few randomized controlled trials (RCTs).”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Abstract
What the sources say
- Not checked — no full text of the sourcecites [19] Medlicott, 2006, A systematic review of the effectiveness of exercise, manual therapy, electrotherapy, relaxation training, and biofeedback in the management of temporomandibular disorder, Phys Ther source
- Not checked — no full text of the sourcecites [23] McNeely, 2006, A systematic review of physical therapy intervention for temporomandibular disorders, Phys Ther source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“This systematic review was registered in PROSPERO (CRD42013005628).”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Method
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“which was clinically significant in favor of postural training.35”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Effectiveness of Intervention by TMD Diagnoses: Posture Correction Exercises in Myogenous TMD
What the sources say
- Not checked — no full text of the sourcecites [35] Kropmans, 1999, Smallest detectable difference in outcome variables related to painful restriction of the temporomandibular joint, J Dent Res source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesThe quote only partly states this claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The results of these studies support the use of MT to treat myogenous TMD, as people treated with all of these approaches had improved mouth opening and reduced jaw pain from baseline.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Manual Therapy Targeted to the Orofacial Region in Myogenous TMD
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The results indicate noninvasive procedures as a first line of treatment.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“implying that conservative treatment plus exercises is appropriate to treat disk displacement without reduction or when patients have restricted mandibular movement.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The effect sizes found in this study for pain intensity (28.75 points; 95% CIϭ21.65,35.85) and PPT (1.12 kg/cm 2 ; 95% CIϭ0.96, 1.29) were considered clinically relevant.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Manual Therapy Mobilization of the Cervical Spine and Myogenous TMD
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“General aerobic exercises have been shown to improve muscle strength, flexibility, and functional capacity and could induce analgesia.107”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Effect of Exercise for Treating TMD
What the sources say
- Not checked — no full text of the sourcecites [107] Sharma, 2010, Aerobic exercise alters analgesia and neurotrophin-3 synthesis in an animal model of chronic widespread pain, Phys Ther source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“with conservative treatments as a first line of treatment.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Main Results
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Selection bias could have existed, as only 20 trials reported appropriate randomization and only 4 reported concealment of allocation.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Methodological Elements and Overall Quality of the Evidence Affecting Observed Effect
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“There was a small proportion of studies in other languages that our team could not translate.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Limitations
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Many studies included the use of exercises or MT as part of a general treatment program, which made the evaluation of these treatments in isolation dif-ficult.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Limitations
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“As with any systematic review, there is the potential for selection bias, yet our group used a comprehensive search strategy and included databases as well as manual search.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Limitations
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Based on the results of this systematic review, MT shows promising results for treatment of myogenous, arthrogenous, and mixed TMD, although the evidence is limited and low.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Effect of Manual Therapy for Treating TMD
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Despite this lack of standardized diagnosis, the study populations in all trials appeared to be representative of patients seen in clinical practice.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Limitations
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
- Rests on an assumption: The study populations in the included trials are representative of patients seen in clinical practice.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“exercises and MT are safe and simple interventions”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Clinical Implications
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The present study used a compilation of items from all of the scales used in the reviewed physical therapy literature in addition to the risk of bias tool.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Methodological Elements and Overall Quality of the Evidence Affecting Observed Effect
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“Other systematic reviews have shown similar results.24”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Effect of Manual Therapy for Treating TMD
What the sources say
- Not checked — no full text of the sourcecites [24] Miller, 2010, Manual therapy and exercise for neck pain: a systematic review, Man Ther source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The findings of this review are specific to TMD (nonsurgical) and to exercise and MT.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Limitations
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In addition, they did not control for cointerventions and did not have adequate adherence to treatment.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Methodological Elements and Overall Quality of the Evidence Affecting Observed Effect
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Active and passive exercise for the jaw, postural exercises, and neck exercises appear to have favorable effects for patients with TMD.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Clinical Implications
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, we believe that most of the representative studies were included in the final analysis of this systematic review.”
§ Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis > Limitations
Strength:hedged· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
The authors state this as an assumption.
There is interstudy variability in the included studies.
“based on the assumption of the presence of interstudy variability to provide a more conservative estimate of the true effect.”
The authors state this as an assumption.
There is clinical heterogeneity in the study population or intervention.
“In the presence of clinical heterogeneity in the study population or intervention, the DerSimonian and Laird random-effects model of pooling was used based on the assumption of the presence of interstudy variability to provide a more conservative estimate of the true effect.”
The paper relies on this without support.
The study populations in the included trials are representative of patients seen in clinical practice.
“Despite this lack of standardized diagnosis, the study populations in all trials appeared to be representative of patients seen in clinical practice.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“This diversity contributes to heterogeneity in the literature, as treatment outcomes are shaped by differences in clinical approach [15,16], underlying etiology, and involvement of structures such as joints (TMJ or spine), muscles, and neuropathic components – factors that complicate differential diagnosis [17,18].”
From Efficacy of manual therapy by different healthcare professionals on pain and function in temporomandibular disorders: a systematic review of randomized controlled trials (2026) · cites this paper as [16]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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 [5]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Other systematic reviews have investigated the efficacy of various cervical MT techniques on TMJ dysfunction,5,19,23,24 such as myofascial release to the masticatory and cervical muscles, mobilization/manipulation to the cervical and thoracic spine, and interventions combining the two.5,19”
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 [5]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“These reviews suggest that MT combined with other interventions improves outcomes for those with TMJ dysfunction.5,19,23”
The cited source says what the claim attributes to it.
In the citing paper
“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”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Risk-of-bias classification rule conflicts with reported classifications
MinorThe stated rule classifies a trial with an unclear overall risk-of-bias assessment as low risk. The results instead report that no study was low risk and that 58.4% were classified as unclear.
“a trial was considered at low risk of bias if it was rated as low risk in all individual domains, if the rating was unclear in at least one domain and the other domains were unclear or low, or if the overall assessment of risk of bias was unclear.”
“none of the studies was considered as low risk of bias.Most of them were classified as either unclear (58.4%) or high risk of bias (41.6%).”
Intervention-description percentage does not match the study count
MinorThe review included 48 studies. Thirty of 48 is 62.5%, not 64.6%.
Reported 64.6 · recomputed 62.5
“only 64.6% (nϭ30) of the studies described the main intervention to be tested.”
Two upper confidence limits are reported for the same mouth-opening estimate
MinorThe results text gives an upper 95% confidence limit of 45.06 mm, while the GRADE table gives 45.08 mm for the same estimate.
“the MD in mouth opening between control and MT groups was 17.33 mm (95% CIϭϪ10.39,45.06).”
“MDϭ17.33 mm [Ϫ10.39,45.08]”
Citations
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3 of the 124 references couldn’t be matched to a known paper.
Research works printed but not linked: 7
- McNeill, 1993, Epidemiology, 19
- Armijo, 2001, Clinic and teleradiographic alterations in patients with anterior disc displacement with reduction, Kinesiologia, 64, 82
- Higgins, 2006, Cochrane Handbook for Systematic Reviews of Interventions, Version 4.2.6
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Cited by
Sorted by citations
Items 301–400 of 413
Tharmo, K. (2022) · Preprints.org · doi:10.20944/preprints202211.0219.v1
Vera, M. A. M. (2023) · doi:10.14201/gredos.153246 · Cited by 1
Moharamzadeh, K. (2018) · doi:10.1002/9781119312093.ch49 · Cited by 1
Chiaramonte, R., Ferrillo, M., de Sire, A., & Vecchio, M. (2026) · Journal of Manual & Manipulative Therapy · doi:10.1080/10669817.2026.2629282
“This diversity contributes to heterogeneity in the literature, as treatment outcomes are shaped by differences in clinical approach [15,16], underlying etiology, and involvement of structures such as joints (TMJ or spine), muscles, and neuropathic components – factors that complicate differential…”
Schmerzen vor dem Ohr – ist die Ursache immer das Kiefergelenk? Ein Fallbericht
Hoffmann, M., & Trouw, M. (2017) · manuelletherapie · doi:10.1055/s-0043-121550
Surface electromyography in manual therapy - categorization of purpose and quality of reporting
Santiago, R. J., Baptista, J. S., & Costa, J. T. (2018) · International Journal of Occupational and Environmental Safety · doi:10.24840/2184-0954_002.002_0007
“Armijo-Olivo et al. (2016) described some of the intentions of MT application to restore normal range-of-motion (ROM), reduce local ischemia, stimulate proprioception, break fibrous adhesions, stimulate synovial fluid production and reduce pain.”
BackgroundManagement of temporomandibular joint conditions
Spencer, C. J., & Neary, J. P. (2018) · Clinical Dentistry Reviewed · doi:10.1007/s41894-018-0038-0
Adjunctive Therapies for Temporomandibular Disorders
Fernández‐de‐las‐Peñas, C., & Bensen, K. (2019) · Springer eBooks · doi:10.1007/978-3-319-99912-8_7
Reynolds, B. (2019) · NSUWorks (Nova Southeastern University)
Asadi, M. R., & Hajvalie, G. (2019) · مجله پزشکی بالینی ابن سینا · doi:10.29252/ajcm.26.2.125
Feurer, I. (2019) · ZWR - Das Deutsche Zahnärzteblatt · doi:10.1055/a-1026-2346
“Bruxismus wird als beitragender oder unterhaltender Faktor bei der Entstehung der CMD diskutiert [7].”
BackgroundImbriglio, T. V. (2019) · TSpace (University of Toronto)
Santiago, R. J., Baptista, J. S., Magalhães, A., & Costa, J. T. (2020) · International Journal of Occupational and Environmental Safety · doi:10.24840/2184-0954_004.001_0008
Modern therapeutic management of temporomandibular disorders: A review
Lăzărescu, H., Forna, D. A., Topoliceanu, C., et al. (2019) · Romanian Journal of Stomatology · doi:10.37897/rjs.2019.3.1
Atuação da fisioterapia no trismo secundário ao câncer de glândula salivar
de Moraes, A. M., Rosa, K. Y. A., da Silva, L. L. D. S., et al. (2020) · Fisioterapia Brasil · doi:10.33233/fb.v21i2.2841
Hedya, W. M. (2019) · International Journal of Sports Science and Arts · doi:10.21608/eijssa.2019.87514
“Chiropractic and manual therapies, 23(1):1.”
MethodInfluentialIlyin, A. A., Fazylova, T. A., Olesova, V. N., et al. (2019) · Clinical Dentistry (Russia) · doi:10.37988/1811-153x_2019_4_93
Evaluation of Oral Splint in Treatment of Tempromandibular Disorders in Class I Malocclusion
Al-Khalifa, H. N. (2020) · Egyptian Dental Journal /Egyptian Dental Journal · doi:10.21608/edj.2020.41077.1235
“This will relax the elevator and positioning muscles.(20-24) In regard to pain all groups showed improvement gradually from the first month till the six months of treatment with varying degree of improvement from patient with hard splint to soft splint to dual splint with the highest degree of significance with dual l…”
BackgroundVeloso, É. M., do Nascimento, E. L. P., Barbosa, M. A., et al. (2020) · HU Revista · doi:10.34019/1982-8047.2020.v46.30307
Pain Management in Temporomandibular Disorders: A Review of the Literature
Melek, L. N. F., & Renton, T. F. (2020) · Saudi Journal of Oral and Dental Research · doi:10.36348/sjodr.2020.v05i11.005
“TMD’s are considered a major source of nondental orofacial pain interfering with normal daily activities and affecting the quality of life [3, 4].”
BackgroundDesai, M. (2021) · Indian Journal of Physiotherapy and Occupational Therapy - An International Journal · doi:10.37506/ijpot.v15i1.13350
Patientenmanagement bei fazialer Umstellungsosteotomie
Toferer, A., & Taxer, B. (2021) · Der Schmerzpatient · doi:10.1055/a-1345-2262
“[26] Armijo-Olivo S, Pitance L, Singh V, et al.”
dos Santos, E. P., Sampaio, R. R., Mourão, C. R., da Rocha, I. S., de Farias, M. A. S. L., dos Santos, C. B. A., Maciel, M. J. P., dos Santos, T. B., de Oliveira, V. S., da Costa, A. S. D. S. P., et al. (2021) · doi:10.22533/at.ed.94321220416
EFEITOS ALUCINÓGENOS E RISCOS DA DOSAGEM EXCESSIVA (INCLUSIVE DE CAUSAR DEPENDÊNCIA)
de Almeida, M. Z. T., de Souza, C. D. F. D. O. B. A., de Almeida, T. T., Lima, W. L. F., Quarto, L. C., Tiradentes, J. F. V. N., & Manhães, F. C. (2021) · doi:10.22533/at.ed.94321220414
Campello, C., de Lima, E. L. S., Fernandes, R. S. M., Dellalibera, E., & Muniz, M. T. C. (2021) · doi:10.22533/at.ed.94321220413
Liu, H., Suh, H., Jung, Y.-E., et al. (2020) · doi:10.21203/rs.3.rs-31981/v2
“Most importantly, patients are more receptive of a more conservative approach [22, 23, 24].”
BackgroundRole Of Rehabilitation In The Treatment Of Temporomandibular Disorders: Scientific Evidence
Chafii, A., salwa, L., Maftouh, B., et al. (2021) · Journal of Emerging Technologies and Innovative Research
Franck, R., Anjos, T. D., Chaufferin, G., & Philippe, G. (2021) · Research Square · doi:10.21203/rs.3.rs-695766/v1
“These include acupuncture, internal medicine, naturopathy, neurology, osteopathy, physical and massage therapy, psychology, rheumatology, and traditional Chinese medicine (Armijo-Olivo et al., 2016; Greene and Obrez, 2015).”
BackgroundCoutinho, A. D. D. F., de Oliveira‐Souza, A. I. S., Sales, L. R. D. V., et al. (2021) · Headache Medicine/Revista Headache Medicine · doi:10.48208/headachemed.2021.18
Postrehabilitation Considerations for Individuals With Temporomandibular Disorders
Olivencia, O., Kaplan, K. B., Dreger, M., Veloz, M., Kais, A., & Marlowe, K. (2021) · Strength and conditioning journal · doi:10.1519/ssc.0000000000000685
“Although the evidence is limited, the benefits of manual therapy on the cervical spine and TMJ seem encouraging (9).”
BackgroundAnalysis of splint weaning in temporomandibular disorder patients
Kim, B. E., Min, K. R., Kim, H. T., et al. (2021) · Journal of Dental Rehabilitation and Applied Science · doi:10.14368/jdras.2021.37.4.225
“Treatment options for TMD include occlusal splint therapy, manual therapy, physical therapy, medication, and surgery.(11,12) Among these, occlusion splint therapy is most commonly used as it decreases TMD symptoms ranging from internal derangements to myofascial pain.”
Fabbro, C. D., & Lavigne, G. J. (2021) · Springer eBooks · doi:10.1007/978-3-030-85074-6_12
Weden, A. (2022) · Journal of Dentistry and Oral Epidemiology · doi:10.54289/jdoe2200101
Lucena, L. D. O., Nascimento, C. M. M., Asano, N. M. J., Coriolano, M. D. G. W. D. S., & Lins, C. C. D. S. A. (2022) · Revista CEFAC · doi:10.1590/1982-0216/20222419721s
Liu, H., Suh, H., Jung, Y.-E., et al. (2020) · doi:10.21203/rs.3.rs-31981/v1
“Most importantly, patients are more receptive of a more conservative approach [20, 21, 22].”
BackgroundFonseca, F. F., Politti, F., da Cunha, T. A., Leonardis, M. N., Carvalho, L., Gomes, C. A. F. D. P., & Biasotto‐Gonzalez, D. A. (2022) · CRANIO® · doi:10.1080/08869634.2022.2091099
“Characterized by muscle and/or joint pain, range of motion dysfunction, joint noises, and changes in movement patterns [4], which may interfere with the activities of daily living, it is an important public health problem [5,6].”
Gebhart, G. F., & Schmidt, R. F. (2013) · Springer eBooks · doi:10.1007/978-3-642-28753-4_102289
Konservative Therapie der kraniomandibulären Dysfunktion
Weber, D., & Neff, A. (2022) · Die MKG-Chirurgie · doi:10.1007/s12285-022-00383-0
“Wissenschaftlich nachgewiesen sind schmerzund entzündungsreduzierende Effekte im muskuloskelettalen System, die Linderung von CMD-Symptomen sowie die Optimierung und Koordinierung der Kiefer- und Halsmotorik in akuten, subakuten und chronischen Stadien [4, 5].”
BackgroundSantiago, J. A., Vieira, M. D. A., Ribeiro, A. F. M., et al. (2022) · Conjecturas · doi:10.53660/conj-1740-2k06
A Plastic Surgeons Guide to the Temporomandibular Joint: Part III, Treatment
Mantilla‐Rivas, E., Crowder, H. R., Nasser, J. S., et al. (2023) · FACE · doi:10.1177/27325016221149171
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POLITICAS PÚBLICAS RELACIONADAS AO HIV/AIDS NO BRASIL: CENTRO DE TESTAGEM E ACONSELHAMENTO
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Metadata
- Authors
- Armijo-Olivo, S., Pitance, L., Singh, V., Neto, F., Thie, N., & Michelotti, A.
- Affiliations
- University of Alberta (CA)
- Cliniques Universitaires Saint-Luc (BE)
- F. Neto, PT, FisioNeto–Terapia Manual Ortopédica and Pilates Clínico, Póvoa de Varzim, Portugal.
- N. Thie, BSc, MSc, MMSc, DDS, School of Dentistry, Faculty of Medicine and Dentistry, TMD/Orofacial Pain Graduate Program, Edmonton Clinic Health Academy, Edmonton, Alberta, Canada.
- Federico II University Hospital (IT)
- Corresponding author
- Armijo-Olivo, Susan
- Venue
- Physical Therapy
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-01-01
- Volume
- 96
- Issue
- 1
- Pages
- 9-25
- ISSN
- 0031-9023 (ISSN-L)
- 1538-6724
- PMC
- PMC4706597
- OpenAlex
- W2180651192
- Cited by
- 413
- References
- 124
- Citations by year
- 2026: 30 · 2025: 40 · 2024: 58 · 2023: 63 · 2022: 54 · 2021: 50 · 2020: 46 · 2019: 27 · 2018: 24 · 2017: 15 · 2016: 3
- FWCI
- 5.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Physical Therapy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (submittedVersion)
- Digital Access to Libraries (submittedVersion)
- Funders
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Dentistry › Oral Surgery › Temporomandibular Joint Disorders
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Myofascial pain diagnosis and treatment
- Keywords
- temporomandibular disorders, manual therapy, exercise therapy, manipulation, pain, range of motion, oral function, conservative treatment, risk of bias
- MeSH terms
- Exercise Therapy, Humans, Pain Measurement, Temporomandibular Joint Disorders, Range of Motion, Articular, Musculoskeletal Manipulations
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