Oral motor rehabilitation for temporomandibular joint disorders: a systematic review

Sassi, Fernanda Chiarion; Silva, Amanda Pagliotto da; Santos, Rayane Kelly Santana; Andrade, Claudia Regina Furquim de

Fernanda Chiarion Sassi

Department of Physiotherapy, Speech-language and Hearing Science and Occupational Therapy, School of Medicine, Universidade de São Paulo - USP - São Paulo (SP), Brazil

Amanda Pagliotto da Silva

Division of Speech-Language and Hearing Sciences, Hospital das Clínicas, School of Medicine, Universidade de São Paulo - USP - São Paulo (SP), Brazil

Rayane Kelly Santana Santos

Division of Speech-Language and Hearing Sciences, Hospital das Clínicas, School of Medicine, Universidade de São Paulo - USP - São Paulo (SP), Brazil

Claudia Regina Furquim de Andrade Corresponding author: Claudia Regina Furquim de Andrade. E-mail: clauan@usp.br

Department of Physiotherapy, Speech-language and Hearing Science and Occupational Therapy, School of Medicine, Universidade de São Paulo - USP - São Paulo (SP), Brazil

Corresponding author: Claudia Regina Furquim de Andrade. E-mail: clauan@usp.br

Conflict of interests: No

Author's contribution:FCS data analysis, writing and revison of the manuscript; APS data collection and analysis, writing of the manuscript; RKSS data collection, writing of the manuscript; CRFA orientation, writing and revison of the manuscript.

Reference	Title	Considerations of the cases	Age	Sex	Main disorder	Study objectives	Used techniques	Result/conclusion
Truelove et al., 2006⁽¹⁴14. Truelove E, Huggins KH, Mancl L, Dworkin SF. The efficacy of traditional, low-cost and nonsplint therapies for temporomandibular disorder: a randomized controlled trial. J Am Dent Assoc. 2006;137(8):1099-107. https://doi.org/10.14219/jada.archive.2006.0348 https://doi.org/10.14219/jada.archive.20... ⁾	The efficacy of traditional, low-cost and nonsplint therapies for temporomandibular disorder: a randomized controlled trial	Conventional treatment: 64 patients Treatment with acrylic splint: 68 patients Treatment with thermoplastic vinyl splint: 68 patients	23-47 years	Both	TMD and myofascial pain	To investigate whether the use of two different types of occlusal splint combined with conventional therapy contributes to pain reduction and TMD symptoms (opening noise, crepitus, tinnitus, daytime and nighttime clenching, alterations of chewing function)	Conventional treatment: mandible relaxation, reduction of parafunctional habits, thermotherapy, and passive stretching of the muscles Treatment with an acrylic splint: conventional treatment combined with the use of an acrylic splint Treatment with a thermoplastic vinyl splint: conventional treatment combined with the use of a thermoplastic splint	There were no differences among the treatments; all were equally effective in reducing pain and TMD symptoms
Gavish et al., 2006⁽¹⁵15. Gavish A, Winocur E, Astandzelov-Nachmias T, Gazit E. Effect of controlled masticatory exercise on pain and muscle performance in myofascial pain patients: a pilot study. Cranio. 2006;24(3):184-90. https://doi.org/10.1179/crn.2006.030 https://doi.org/10.1179/crn.2006.030... ⁾	Effect of controlled masticatory exercise on pain and muscle performance in myofascial pain patients: a pilot study	Conventional treatment: 10 patients Treatment with chewing gum: 10 patients	20-45 years	Female	TMD and myofascial pain	To verify whether controlled chewing exercises improve muscle function and reduce the level of pain in patients with TMD	Conventional treatment: guidance on the TMD and the effects of parafunctional habits Treatment with gum: patients were advised to chew two pieces of sugarless gum three times a day as follows: weeks 1 and 2—10 minutes; weeks 3 and 4—15 minutes; weeks 5 and 6—20 minutes; weeks 7 and 8—30 minutes	Both groups showed a reduction in myofascial pain, and the group treated using chewing gum demonstrated greater pain reduction. No improvement in muscle performance was observed in either group.
Kümbüloğlu et al., 2013⁽¹⁶16. Kümbüloglu Ó, Saracoglu A, Bingol P; Hatipoglu A. Ozcan M. Clinical study on the comparison of masticatory efficiency and jaw movement before and after temporomandibular disorder treatment. Cranio. 2013;31(3):190-201. https://doi.org/10.1179/crn.2013.030 https://doi.org/10.1179/crn.2013.030... ⁾	Clinical study on the comparison of masticatory efficiency and jaw movement before and after temporomandibular disorder treatment	Unilateral muscular alteration: 20 patients Unilateral alteration of articular disk: 20 patients Individuals without alterations: 20 patients	20-55 years	Both	TMD and myofascial pain	To compare pretreatment with post-treatment results in different groups, after therapy with an occlusal splint	The treatment in the patient groups was the full-time use of an occlusal acrylic splint for 6 weeks The group of individuals without alterations was evaluated just once.	The use of an occlusal splint eliminated muscle pain, joint pain, and headaches; it also improved mastication, reduced crepitus and noises, and improved the maximum oral opening in both groups of patients.

Reference	Title	Considerations of the cases	Age	Sex	Main disorder	Study objectives	Used techniques	Result/conclusion
Felicio et al., 2008⁽¹⁷17. Felício CM, Melchior MO, Ferreira CL, Silva MA. Otologic symptoms of temporomandibular disorder and effect of orofacial myofunctional therapy. Cranio. 2008;26(2):118-25. https://doi.org/10.1179/crn.2008.016 https://doi.org/10.1179/crn.2008.016... ⁾	Otologic symptoms of temporomandibular disorder and effect of orofacial myofunctional therapy	TMD: 20 patients—10 treated using orofacial myofunctional therapy and 10 in the control group Asymptomatic group: eight individuals with no signs or symptoms of TMD	Average of 31 years and 46 months	Female	Joint TMD	To investigate the frequency of otologic symptoms, the relationship between these symptoms and orofacial signs and symptoms of TMD, and the effectiveness of orofacial myofunctional therapy on the frequency and seriousness of these symptoms.	Purpose of the orofacial myofunctional therapy: increase local blood circulation and relieve pain, improve mandibular posture and mobility, improve co-ordination of the muscles of the stomatognathic system as well as the balance of stomatognathic functions, between nine and 13 sessions of 45 minutes each, weekly during the first 30 days and every two weeks thereafter. The other groups performed only the evaluations.	TMD groups presented a higher incidence of otologic symptoms, mainly otalgia and tinnitus. These symptoms were related to pain on palpation and with the severity of orofacial signs and symptoms. The group which followed orofacial therapy presented significant improvement of the signs and symptoms of TMD, particularly the otologic symptoms and muscle asymmetry index.
Felício, Oliveira e Silva, 2010⁽¹⁸18. Felício CM, Oliveira MM, Silva MA. Effects of orofacial myofunctional therapy on temporomandibular disorders. Cranio. 2010;28(4):249-9. https://doi.org/10.1179/crn.2010.033 https://doi.org/10.1179/crn.2010.033... ⁾	Effects of orofacial myofunctional therapy on temporomandibular disorders	TMD group: 30 subjects with TMD—10 in the myofunctional therapy group, 10 in the occlusion splint group, and 10 in the symptomatic control group. Group without TMD: 10 individuals	TMD group: 13-43 years for myofunctional therapy, 17-64 years for occlusal splint, and 14-63 years for the symptomatic control Group without TMD: 18-68 years	Female	Long-term muscular and joint TMD: average of 74 months and 4 days	To analyze the effect of myofunctional therapy in individuals with chronic joint and muscular orofacial TMD. Clinical protocols were used to determine whether the therapy promotes remission and/or muscular and joint pain reduction, improvement in mandibular mobility, improvement in the Helkimo index, remission or reduction in the frequency and severity of the symptoms of TMD and myofunctional changes.	TMD group: Objectives— to relieve pain, improve mandibular posture and mobility, promote muscle symmetry, improve muscle co-ordination in the stomatognathic system and balance stomatognathic functions Exercises described in the appendix of the article. 120 days—45 minutes each session, weekly during the first 30 days and every two weeks thereafter; patients were instructed to perform the exercises at home Occlusal splint: continuous use during the first 15 days, followed by nighttime use after this period, for a total treatment time of 45 days	Myofunctional therapy showed positive effects, with significant reduction in the severity of pain on palpation (muscular only), increased mandible mobility, reduction in Helkimo index, reduction in the frequency and severity of TMD signs and symptoms, and improvement in orofacial myofunctional conditions
Richardson et al., 2012⁽¹⁹19. Richardson K, Gonzalez Y, Crow H, Sussman J. The effect of oral motor exercises on patients with myofascial pain of masticatory system. Case series report. N Y State Dent J. 2012;78(1):32-7.⁾	The effect of oral motor exercises on patients with myofascial pain of masticatory system. Case series report	Three patients with TMD	28, 28, and 56 years	Female	Muscular TMD	To present three case studies of patients who reported myofunctional pain and who had received multidisciplinary treatment with a program of oral motor exercises	Three to four oral motor therapy sessions, with the objective of increasing lips, jaw, and tongue mobility, improving the strength and range of motion. The exercises are described in the text.	The therapy was beneficial, with reduction in pain and improvement in the masticatory function.
Melchior et al., 2012⁽²⁰20. Melchior MO, Venezian GC, Machado BCZ, Borges RF, Mazzetto MO. Does low intensity laser therapy reduce pain and change orofacial myofunctional conditions? Cranio. 2012;31(2):133-9. https://doi.org/10.1179/crn.2013.021 https://doi.org/10.1179/crn.2013.021... ⁾	Does low intensity laser therapy reduce pain and change orofacial myofunctional conditions?	12 individuals	18-60 years	Female	Myofascial pain with or without intraarticular TMD	To verify whether the application of low-intensity laser helps decrease pain, to evaluate whether orofacial myofunctional changes occur, and to check whether the remission of pain remains for 30 days after the treatment	Laser: doses of 60 mW over 40 seconds, held twice a week for four weeks.	Laser therapy promoted instant relief from pain; however, it was not effective in the long run. Pain reduction was not enough to introduce orofacial myofunctional changes.
Machado et al., 2016⁽¹²12. Machado BC, Mazzetto MO, Silva MA, Felício CM. Effects of oral motor exercises and laser therapy on chronic temporomandibular disorders: a randomized study with follow-up. Lasers Med Sci. 2016;31(5):945-54. https://doi.org/10.1007/s10103-016-1935-6 https://doi.org/10.1007/s10103-016-1935-... ⁾	Effects of oral motor exercises and laser therapy on chronic temporomandibular disorders: a randomized study with follow-up	82 patients with TMD: 21 in GI (laser + myofunctional therapy), 22 in GII (myofunctional therapy), 21 in GIII (placebo and myofunctional therapy), 18 in GIV (laser therapy) and 20 without TMD in the control group: GC	GC: 21-39 years GI: 23-49 years GII: 21-45 years GIII: 18-46 years GIV: 22-46 years	Both	TMD and pain	To compare a low-intensity laser/ myofunctional therapy combination with the isolated treatments and with a placebo treatment	Laser: 60 mW over 40 seconds; bilateral application on the condyle, masseter, and temporal region Myofunctional therapy: instructions and guidance on TMD, strategies for pain reduction using heat therapy, massage, and relaxation, myofunctional exercises for the tongue, lips, cheeks, and jaw, and orofacial myofunctional training; 45-minute sessions, totaling a maximum of nine sessions, weekly at the beginning and then every 2 weeks after 30 days	The combination of techniques was more effective in TMD rehabilitation than the laser technique alone. However, it was not better than the full myofunctional therapy protocol (exercises associated with strategies such as relaxation, hot compresses, and massage techniques)

Reference	Title	Considerations on the cases	Age	Sex	Main disorder	Study objectives	Used techniques	Result/conclusion
Piekartz, Hall., 2013⁽²¹21. Piekartz HV, Hall T. Orofacial manual therapy improves cervical movement impairment associated with headache and features of temporomandibular dysfunction: a randomized controlled trial. Man Ther. 2013;18(4):345-50. https://doi.org/10.1016/j.math.2012.12.005 https://doi.org/10.1016/j.math.2012.12.0... ⁾	Orofacial manual therapy improves cervical movement impairment associated with headache and features of temporomandibular dysfunction: a randomized controlled trial	43 individuals: 21 in the usual care group and 22 in the orofacial care group	18-65 years	Both	TMD and pain	To determine whether the orofacial treatment associated with manual therapy contributes to the treatment, mainly with regard to cervical mobility.	Manual cervical therapy, regular physiotherapy, and orofacial treatment; six sessions of 30 minutes were held for both groups. Patients were instructed to perform the exercises at home. In the orofacial care group, maneuvers were carried out to eliminate tension, and regular therapy was used.	The combination of orofacial treatment and cervical therapy showed better results, with improvement of cervical mobility.
Ariji et al., 2014⁽²²22. Ariji Y, Nakayama M, Nishiyama W, Ogi N, Sakuma S, Katsumata A et al. Potential clinical application of masseter and temporal muscle massage treatment using an oral rehabilitation robot in temporomandibular disorder patients with myofascial pain. Cranio. 2014;33(4):256-62. https://doi.org/10.1179/2151090314Y.0000000030 https://doi.org/10.1179/2151090314Y.0000... ⁾	Potential clinical application of masseter and temporal muscle massage treatment using an oral rehabilitation robot in temporomandibular disorder patients with myofascial pain	41 subjects received massage.	19-83 years	Both	TMD and pain	To investigate the safety and efficacy of treatment with robot massage of the masseter and temporal muscles	Therapeutic robot massage: patient in a reclined chair, pressure of 10 N on average, with a total time of 16 minutes of massage. Six sessions were held in total, every 2 weeks.	The study confirmed that massage treatment using an oral rehabilitation robot was safe. The massage treatment was effective in reducing pain in 70.3% of the patients.
Ucar et al., 2014⁽²³23. Ucar M, Sarp U, Koca I, Eroglu S, Yetisgin A, Tutoglu A et at. Effectiveness of a home exercise program in combination with ultrasound therapy for temporomandibular joint disorders. J Phys Ther Sci. 2014;26(12):1847-9. https://doi.org/10.1589/jpts.26.1847 https://doi.org/10.1589/jpts.26.1847... ⁾	Effectiveness of a home exercise program in combination with ultrasound therapy for temporomandibular joint disorders	18 individuals were placed in the exercise group, while 20 underwent a combination of exercises and ultrasound	29-40 years	Both	TMD and pain	To compare the effectiveness of exercise alone with that of exercise plus ultrasound for reducing pain on palpation and during oral aperture	Exercises performed twice a day for 4 weeks; the adopted exercises involved reducing muscle activity, passive mandibular movement, and isometric and counterresistance exercises (performed for six seconds with at least repetitions). One of the groups was subjected to ultrasound five times a week for 4 weeks, with 3 minutes of implementation within the region of the TMJ and the masticatory muscles.	The combination of home exercise and ultrasound appeared to be more effective in relieving pain and increasing oral opening.
Gomes, El Hage, Amaral e Politti, 2014⁽²⁴24. Gomes CAFP, El Hage Y, Amaral AP, Politti F, Biasotto-Gonzalez DA. Effects of massage therapy and occlusal splint therapy on electromyographic activity and the intensity of signs and symptoms in individuals with temporomandibular disorder and sleep bruxism: a randomized clinical trial. Chiropr Man Therap.. 2014;22(1):43. https://doi.org/10.1186/s12998-014-0043-6 https://doi.org/10.1186/s12998-014-0043-... ⁾	Effects of massage therapy and occlusal splint therapy on electromyographic activity and the intensity of signs and symptoms in individuals with temporomandibular disorder and sleep bruxism: a randomized clinical trial	60 volunteers divided into four groups: massage group—15 subjects; occlusal splint group—15 subjects; group with traditional occlusal splint + massage—15 subjects; group with silicone splint—15 subjects	18-40 years	Both	TMD and pain	To investigate the effects of massage therapy, therapy with a traditional occlusal splint, and that with silicon splint on the electromyographic activity of the masseter and anterior temporal muscles in patients with TMD and bruxism.	Massage group: 30-minute massages of the masseter and temporal muscles for 12 sessions over 3 weeks; Occlusal splint group: 4 weeks of traditional occlusal splint use during the night; Massage plus occlusal splint group: combination of the treatments of the previous groups; Silicone splint group: 3-mm polyvinyl splint	Therapeutic massage and the use of occlusal splint did not significantly influence the electromyographic activity of the masseter and anterior temporal muscles when used individually. The combination of therapies led to a reduction in the intensity of signs and symptoms.
Kraaijenga et al.,2014⁽²⁵25. Kraaijenga S, Molen, Tinteren H, Hilgers F, Smeele L. Treatment of myogenic temporomandibular disorder: a prospective randomized clinical trial, comparing a mechanical stretching device (TheraBite®) with standard physical therapy exercise. Cranio. 2014;32(3):208-16. https://doi.org/10.1179/0886963413Z.00000000016 https://doi.org/10.1179/0886963413Z.0000... ⁾	Treatment of myogenic temporomandibular disorder: a prospective randomized clinical trial, comparing a mechanical stretching device (TheraBite®) with standard physical therapy exercise	10 individuals in the experimental group and seven in the default group	17-73 years	Both	TMD and pain	To investigate whether passive movement of mandible using the TheraBite® device produces better results than traditional therapy in terms of improving TMD	Traditional therapy: guidance on mandibular operation, relaxed oral opening, tongue and cervical position, parafunctional habits, and exercises comprising masticatory muscle massage, strength and co-ordination exercises (four sessions of 30 minutes, five times a day, at home); Use of the TheraBite®: a guided oral opening session conducted for 30 seconds with five repetitions, five times a day	Both treatment modalities were equally effective in relieving the symptoms of myogenic TMD. The use of the TheraBite® device resulted in significantly greater functional improvement in the first week of treatment.
Navrátil et al.,2014⁽²⁶26. Navrátil L, Navratil V, Hajkova S, Hlinakova P, Dostalova T, Vranová J. Comprehensive treatment of temporomandibular joint disorders. Cranio. 2014;32(1):24-30. https://doi.org/10.1179/0886963413Z.0000000002 https://doi.org/10.1179/0886963413Z.0000... ⁾	Comprehensive treatment of temporomandibular joint disorders	24 patients undergoing TMD treatment	14-38 years	Both	TMD and pain	To evaluate the benefits of physiotherapy and to verify the reduction in temporomandibular alterations	Relaxation, mobilization, distraction, and self-mobilization exercises to improve the cognitive and motor abilities of patients; explanation of the relationship between masticatory musculature and facial movements, mandible muscle relaxation, practice of the exercises at home; Complementary methods: magnetic pulses, non-invasive laser therapy, thermotherapy, and guidance on TMDs and parafunctional habits	Long-term therapy, including physiotherapy and complementary methods, is important. As for the invasive methods, the combination of magnetic pulse with laser proved beneficial.
Godoy et al., 2015⁽²⁷27. Godoy CHL, Motta LJ, Fernandes KPS, Mesquita-Ferraro RA, Deana AM, Bussadori SK. Effect of low-level laser therapy on adolescents with temporomandibular disorder: a blind randomized controlled pilot study. J Oral Maxillofac Surg. 2015;73(4):622-9. https://doi.org/10.1016/j.joms.2014.09.018 https://doi.org/10.1016/j.joms.2014.09.0... ⁾	Effect of low-level laser therapy on adolescents with temporomandibular disorder: a blind randomized controlled pilot study	Five individuals in the group undergoing laser therapy and four in the placebo group	14-23 years	Both	TMD and pain	To evaluate the effect of laser therapy on pain, mandibular movements, and occlusal contacts	Group subjected to laser therapy: two sessions a week for 6 weeks, with three points of application on the masseter and one on the temporal region Placebo group: the appliance was disconnected and a recording of the sounds emitted by the appliance was reproduced.	There was no difference between the treatments.
Oliveira et al., 2015⁽²⁸28. Oliveira LB, Lopes TS, Soares C, Maluf R, Goes BT, Sa NK et al. Transcranial direct current stimulation and exercises for treatment of chronic temporomandibular disorders: a blind randomised-controlled trial. J Oral Rehabil.. 2015;42(10):723-32. 1 https://doi.org/0.1111/joor.12300 https://doi.org/0.1111/joor.12300... ⁾	Transcranial direct current stimulation and exercises for treatment of chronic temporomandibular disorders: a blind randomized-controlled trial	16 individuals in the active group— transcranial stimulation and exercise 16 in the control group—exercises and placebo transcranial stimulation	18-40 years	Both	TMD and pain	To evaluate the effect of transcranial direct current stimulation (tDCS) on the exercises for TMD and chronic pain	Four weeks of exercises were undertaken for 5 consecutive days in the first week: 15 minutes followed by 20 minutes of transcranial stimulation. Subsequently, the patients performed therapeutic sessions twice a week for 3 weeks, with only exercises and stimulation. The exercises involved the cervical region, the face, the oral opening, lateral movements and protrusion of the mandible, contraction of the masseter, and manual manipulation of the neck and TMJ.	There was no difference when the tDCS was added to the therapy.
Packer et al., 2015⁽²⁵25. Kraaijenga S, Molen, Tinteren H, Hilgers F, Smeele L. Treatment of myogenic temporomandibular disorder: a prospective randomized clinical trial, comparing a mechanical stretching device (TheraBite®) with standard physical therapy exercise. Cranio. 2014;32(3):208-16. https://doi.org/10.1179/0886963413Z.00000000016 https://doi.org/10.1179/0886963413Z.0000... ⁾	Effect of upper thoracic manipulation on mouth opening and electromyographic activity of masticatory muscles in women with temporomandibular disorder: a randomized clinical trial	16 individuals in the experimental group and 16 in the placebo group	18-40 years	Female	TMD and pain	To evaluate the effect of upper thoracic manipulation on the oral vertical opening and on the electromyographic activity of the masticatory muscles in women with TMD	Thoracic manipulation was performed at T1 and T2, with joint decompression. The patients were monitored before, as well as on the 2nd and 4th days after recovery. The placebo group received no traction manipulation.	No differences were found between treatments.

Reference	Title	Considerations on the cases	Age	Sex	Main disorder	Study objectives	Used techniques	Result/conclusion
Felicio, Freitas e Bataglion, 2007⁽³⁰30. Felício CM, Freitas RL, Bataglion C. The effects of orofacial myofunctional therapy combined with an occlusal splint on signs and symptoms in a man with TMD-hypermobility: case study. I Int J Orofacial Myology. 2007;33:21-9.⁾	The effects of orofacial myofunctional therapy combined with an occlusal splint on signs and symptoms in a man with TMD-hypermobility: case study	1	49 years	Male	TMD and pain	To describe a patient with TMD and hypermobility treated with orofacial myofunctional therapy and occlusal splint.	Therapy initiated 60 days after the occlusal splint was placed. 50 minutes of therapy every 15 days, including guidelines on TMD and how to perform the exercises at home. The aim of the exercises was: to improve muscle function with training of lips and tongue mobility, and mandibular movements control improving the performance of stomatognathic system functions. The exercises employed are described in the article.	The combination of orofacial myofunctional therapy and the occlusal splint proved effective in improving the stomatognathic system and in treating TMJ hypermobility.
Monteiro et al., 2013⁽³¹31. Monteiro W, Santos RM, Grecco LAC, Neto HP, Oliveira CS. Effectiveness of global postural reeducation in the treatment of temporomandibular disorder: case report. J Bodyw Mov Ther. 2013;17(1):53-8. https://doi.org/10.1016/j.jbmt.2012.05.003 https://doi.org/10.1016/j.jbmt.2012.05.0... ⁾	Effectiveness of global postural reeducation in the treatment of temporomandibular disorder: case report	1	23 years	Male	TMD and pain	To evaluate the effectiveness of global postural re-education in the treatment of TMD	Global posture reeducation: 30-minute sessions three times a week, for eight weeks, totaling 24 sessions. Protocol explained in the article.	Improvements in the postural patterns of the cervical column helped improve the functioning of the masseter muscle, as verified by SEMG.
Yamashita et al., 2014⁽³²32. Yamashita A, Kondo Y, Yamashita J. Thirty-year follow-up of a TMD case treated based on the neuromuscular concept. Cranio. 2014;32(3):224-34. https://doi.org/10.1179/0886963413Z.00000000020 https://doi.org/10.1179/0886963413Z.0000... ⁾	Thirty-year follow-up of a TMD case treated based on the neuromuscular concept	1	19 years	Female	TMD and pain	Following up a case of TMD for 30 years	Occlusal adjustment was carried out with orthopedic appliance, followed by electrostimulation (TENS). A reassessment one and two months after starting treatment. The patient was followed up for 30 years.	The occlusal adjustment performed on the patient was effective and the occlusal function was re-established. At the end of the 30-year period of follow-up, the patient did not show symptoms of TMD.
Ataç et al., 2014⁽³³33. Ataç MS, Çakir M, Yucel E, Gazioglu Ç, Akkaya S. Early treatment of unilateral temporomandibular joint ankylosis: a multidisciplinary approach. J Craniofac Surg. 2014;25(3):213-6. https://doi.org/10.1097/SCS.0000000000000459 https://doi.org/10.1097/SCS.000000000000... ⁾	Early treatment of unilateral temporomandibular joint ankylosis: a multidisciplinary approach	1	10 years	Female	TMD and pain	To investigate the effectiveness of early multidisciplinary treatment in a case of ankylosis.	Use of orthodontic appliance removed only for chewing. The patient follow-up was held for nine months. Passive exercises, which started 10 days after the surgical procedure, were carried out.	The multidisciplinary approach to the treatment of TMJ ankylosis favored the re-establishment of muscle function and promoted stability of the results during the 2-years follow-up.
Rubis et al., 2014⁽³⁴34. Rubis LM, Rubis D, Winchester B. A collaborative approach between chiropractic and dentistry to address temporomandibular dysfunction: a case report. J Chiropr Med. 2014;12(1):55-61. https://doi.org/10.1016/j.jcm.2013.10.003 https://doi.org/10.1016/j.jcm.2013.10.00... ⁾	A collaborative approach between chiropractic and dentistry to address temporomandibular dysfunction: a case report	1	38 years	Female	TMD and pain	To describe the association of chiropractic and traditional therapy in patients with TMD, headache, and myalgia.	Chiropractic including cervical, thoracic, and pelvic spinal manipulation, followed by manual therapy in the face, cervical spine, and shoulder. This was combined with the use of a jaw splint during the night.	The combination of therapies led to increased oral opening, promoted pain reduction, and improved cervical range.

[1] Corresponding author: Claudia Regina Furquim de Andrade. E-mail: clauan@usp.br

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Oral motor rehabilitation for temporomandibular joint disorders: a systematic review

ABSTRACT

Introduction:

Purpose:

Research strategy:

Selection criteria:

Results:

Conclusion: