| Brochado et al., 201829
|
51 participants/ 21-77 years old |
To compare the effectiveness of photobiomodulation and manual therapy, both alone and in combination, to treat the pain, limited movements, psychosocial disorders, and anxiety symptoms in people with TMD. |
Pain, limited mandibular movement, psychosocial disorders, and anxiety symptoms. |
Photobiomodulation Group: The GaAlAs diode laser was used in the following parameters: 808-nm wavelength, punctual mode, 100-MW power, 40 s, and 4-J total energy per point. The laser was applied 12 times (3 times per week, for 4 consecutive weeks). Manual Therapy Group: Three 21-minute weekly sessions in the masticatory muscles and TMJ for 4 consecutive weeks. Combined Therapy Group: The group was submitted to both protocols for 4 consecutive weeks. |
The protocols tested eased the pain and improved the mandibular movements, reducing the negative effects of the psychosocial aspects and anxiety symptoms. However, the combined therapy did not potentialize the effect of either therapy alone. |
| Tuncer et al., 201330
|
40 participants/ 18-72 years old |
To determine the effectiveness of treatments for pain intensity and maximum mouth opening without pain in patients with TMD. |
Pain and maximum mouth opening without pain. |
Home Physical Therapy Group: Education on the pain, ergonomic instructions, respiratory exercises, relaxation techniques, postural correction exercises, and mandibular exercises, stretching, mouth opening and closure, and resisted exercises. Home Physical Therapy + Manual Therapy Group: Home physical therapy protocol combined with manual therapy: soft tissue mobilization (intra- and extraoral massage), TMJ mobilization (caudal, ventral-caudal, ventral, and mediolateral traction), TMJ stabilization, coordination exercises, cervical mobilization, and post-isometric relaxation and stretching techniques for the masticatory and neck muscles. The interventions lasted 30 minutes, 3 times a week, for 4 weeks. |
The manual therapy in combination with home physical therapy was more effective to treat TMD than physical therapy alone, concerning eased pain and maximum mouth opening without pain. |
| Von Piekartz & Hall, 201331
|
43 participants/ 18-65 years old |
To investigate whether orofacial physical therapy treatment brings any benefits in comparison with usual care to improve from impaired cervical movement in people with headache and mixed characteristics of cervicogenic headache and TMD signs. |
Pain and cervical mobility. |
Orofacial Care Group: The objective was to approach masticatory trigger points, TMJ restriction, and, when necessary, techniques to desensitize the cranial tissue, and home exercises. In the analysis of this group, the therapist provided and additional treatment for the cervical region to approach the cervical components of the disorder. Usual Care Group: Received only individualized cervical manual therapy, with cervical mobilization and, if necessary, high-speed techniques, stretching, strengthening, and other home exercises involving the cervical region. Both groups received a total of six 30-minute sessions, for 3 to 6 weeks. |
Orofacial treatment besides usual care with manual therapy focused on the cervical spine was more effective to improve impaired cervical movement than usual care alone in people who suffer from headaches with cervical impairment and TMD signs. |
| Guarda-Nardini et al., 201232
|
30 participants/ 23-69 years old |
To verify and compare the effectiveness of two approaches: fascial manipulation techniques and botulinum toxin injections for 3 months in patients with myofascial pain in the mandibular muscles. |
Pain and amplitude of mandibular movement. |
Protocol A: Botulinum toxin - the patients were submitted to a single session with multiple injections of botulinum toxin in the masseter and temporal muscles. Protocol B: Fascial manipulation techniques - the patients were submitted to a fascial manipulation session, involving deep finger pressure on the muscle of the temporal, frontal, sternocleidomastoid, and trapezius regions. The interventions comprised three 50-minute sessions a week with fascial manipulation, for 2 to 4 weeks. |
Both treatments improved the pretreatment levels of pain. In the short run (3 months), both treatments seemed to be almost equally effective - fascial manipulation was slightly superior in decreasing the subjective perception of pain, while the botulinum toxin injections were slightly superior in increasing the amplitude of mandibular movement. |
| Barriere et al., 200933
|
15 participants/ 15-64 years old |
To assess the Cyriax deep transverse massage technique in people with the pain-dysfunction syndrome in the masticatory system. |
Pain, mouth opening, and TMJ crepitation. |
For the Cyriax massage, the patients remained seated. It was performed for 30 seconds on the most tense region of the lateral pterygoid muscle, as observed in the clinical examination. |
It was verified that the Cyriax massage was more positive in patients with severe joint blockage. |
| De Laat, Stappaerts, & Papy, 200334
|
26 participants/ 16-66 years old |
To prospectively assess the effectiveness of a treatment involving instructions and physical therapy in a group of patients with myofascial pain in the masticatory system and investigate whether the duration of the physical therapy (4 vs. 6 weeks) would influence the treatment results. |
Pain and mandibular movement. |
Instruction: All patients received information on their pain etiology and instructions on how to relax the masticatory muscles. Physical therapy: continuous ultrasound for 5 minutes, massage on the masseter and temporal muscles for 10 minutes, stretching of the masseter muscle for 5 minutes, repeat the massage for another 5 minutes, instruct the patient to perform the massage twice a day and apply hot compression for 20 minutes in the evening. Group I: 4 weeks Group II: 6 weeks. |
After 4 and 6 weeks of combined treatment, a sharp improvement was observed in both groups, confirming the effectiveness of the conservative treatment for myofascial pain in the masticatory muscles. |
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