Non-Cochrane · intervention · PM42365270
Comparative effectiveness of nonpharmacological therapies for adult myogenic temporomandibular disorders: a network meta-analysis of randomized trials.
Zhang Lei, Liu Minghe, Li Xiaojing, et al. · BMC oral health · 2026 · PubMed · doi:10.1186/s12903-026-09044-5
Findings
Population Adults (>=18 years) with myogenic temporomandibular disorders
132 findings
| Manual therapy (MT) | Photobiomodulation therapy (PBMT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 2.23 [0.19, 4.28] GRADE not reported Studies not reported |
| Photobiomodulation therapy (PBMT) | Manual therapy (MT) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.27 [-1.14, 0.61] GRADE not reported Studies not reported |
| Photobiomodulation therapy (PBMT) | Combined therapy (COMB) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.45 [-1.48, 0.57] GRADE not reported Studies not reported |
| Combined therapy (COMB) | Photobiomodulation therapy (PBMT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 1.34 [-0.93, 3.62] GRADE not reported Studies not reported |
| Manual therapy (MT) | Combined therapy (COMB) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.19 [-1.20, 0.83] GRADE not reported Studies not reported |
| Manual therapy (MT) | Combined therapy (COMB) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.89 [-1.13, 2.91] GRADE not reported Studies not reported |
| Photobiomodulation therapy (PBMT) | Extracorporeal shock wave therapy (ESWT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.44 [-3.65, 4.53] GRADE not reported Studies not reported |
| Photobiomodulation therapy (PBMT) | Extracorporeal shock wave therapy (ESWT) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.43 [-2.42, 1.56] GRADE not reported Studies not reported |
| Manual therapy (MT) | Extracorporeal shock wave therapy (ESWT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 2.67 [-1.39, 6.73] GRADE not reported Studies not reported |
| Manual therapy (MT) | Extracorporeal shock wave therapy (ESWT) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.17 [-2.19, 1.86] GRADE not reported Studies not reported |
| Combined therapy (COMB) | Extracorporeal shock wave therapy (ESWT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 1.78 [-2.50, 6.07] GRADE not reported Studies not reported |
| Combined therapy (COMB) | Extracorporeal shock wave therapy (ESWT) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.02 [-2.11, 2.15] GRADE not reported Studies not reported |
| Photobiomodulation therapy (PBMT) | Central neuromodulation (CNM) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.68 [-2.78, 1.41] GRADE not reported Studies not reported |
| Central neuromodulation (CNM) | Photobiomodulation therapy (PBMT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.26 [-3.89, 4.41] GRADE not reported Studies not reported |
| Manual therapy (MT) | Central neuromodulation (CNM) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 1.97 [-2.15, 6.09] GRADE not reported Studies not reported |
| Manual therapy (MT) | Central neuromodulation (CNM) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.42 [-2.55, 1.71] GRADE not reported Studies not reported |
| Combined therapy (COMB) | Central neuromodulation (CNM) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.23 [-2.46, 2.00] GRADE not reported Studies not reported |
| Combined therapy (COMB) | Central neuromodulation (CNM) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 1.08 [-3.26, 5.42] GRADE not reported Studies not reported |
| Central neuromodulation (CNM) | Extracorporeal shock wave therapy (ESWT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.70 [-4.70, 6.10] GRADE not reported Studies not reported |
| Extracorporeal shock wave therapy (ESWT) | Central neuromodulation (CNM) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.25 [-3.02, 2.52] GRADE not reported Studies not reported |
| Electrotherapy (ELEC) | Photobiomodulation therapy (PBMT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.81 [-2.11, 3.72] GRADE not reported Studies not reported |
| Photobiomodulation therapy (PBMT) | Electrotherapy (ELEC) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.98 [-2.13, 0.17] GRADE not reported Studies not reported |
| Manual therapy (MT) | Electrotherapy (ELEC) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.71 [-1.74, 0.31] GRADE not reported Studies not reported |
| Manual therapy (MT) | Electrotherapy (ELEC) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 1.42 [-0.85, 3.70] GRADE not reported Studies not reported |
| Combined therapy (COMB) | Electrotherapy (ELEC) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.53 [-1.76, 0.71] GRADE not reported Studies not reported |
| Combined therapy (COMB) | Electrotherapy (ELEC) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.54 [-2.26, 3.33] GRADE not reported Studies not reported |
| Extracorporeal shock wave therapy (ESWT) | Electrotherapy (ELEC) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.55 [-2.71, 1.62] GRADE not reported Studies not reported |
| Electrotherapy (ELEC) | Extracorporeal shock wave therapy (ESWT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 1.25 [-3.33, 5.82] GRADE not reported Studies not reported |
| Electrotherapy (ELEC) | Central neuromodulation (CNM) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.55 [-4.08, 5.17] GRADE not reported Studies not reported |
| Central neuromodulation (CNM) | Electrotherapy (ELEC) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.29 [-2.56, 1.97] GRADE not reported Studies not reported |
| Photobiomodulation therapy (PBMT) | Acupuncture (ACU) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -1.07 [-1.93, -0.21] GRADE not reported Studies not reported |
| Acupuncture (ACU) | Photobiomodulation therapy (PBMT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.22 [-1.88, 2.32] GRADE not reported Studies not reported |
| Manual therapy (MT) | Acupuncture (ACU) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.81 [-1.70, 0.09] GRADE not reported Studies not reported |
| Manual therapy (MT) | Acupuncture (ACU) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 2.01 [0.12, 3.90] GRADE not reported Studies not reported |
| Combined therapy (COMB) | Acupuncture (ACU) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 1.12 [-1.11, 3.35] GRADE not reported Studies not reported |
| Combined therapy (COMB) | Acupuncture (ACU) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.62 [-1.70, 0.46] GRADE not reported Studies not reported |
| Extracorporeal shock wave therapy (ESWT) | Acupuncture (ACU) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.64 [-2.66, 1.38] GRADE not reported Studies not reported |
| Acupuncture (ACU) | Extracorporeal shock wave therapy (ESWT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.66 [-3.42, 4.75] GRADE not reported Studies not reported |
| Central neuromodulation (CNM) | Acupuncture (ACU) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.39 [-2.51, 1.74] GRADE not reported Studies not reported |
| Central neuromodulation (CNM) | Acupuncture (ACU) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.04 [-4.11, 4.18] GRADE not reported Studies not reported |
| Electrotherapy (ELEC) | Acupuncture (ACU) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.58 [-2.22, 3.39] GRADE not reported Studies not reported |
| Electrotherapy (ELEC) | Acupuncture (ACU) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.09 [-1.28, 1.09] GRADE not reported Studies not reported |
| Photobiomodulation therapy (PBMT) | Occlusal splint therapy (OST) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -1.43 [-2.29, -0.56] GRADE not reported Studies not reported |
| Occlusal splint therapy (OST) | Photobiomodulation therapy (PBMT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.18 [-1.99, 2.36] GRADE not reported Studies not reported |
| Manual therapy (MT) | Occlusal splint therapy (OST) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -1.16 [-2.10, -0.22] GRADE not reported Studies not reported |
| Manual therapy (MT) | Occlusal splint therapy (OST) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 2.05 [0.00, 4.10] GRADE not reported Studies not reported |
| Combined therapy (COMB) | Occlusal splint therapy (OST) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 1.16 [-0.79, 3.11] GRADE not reported Studies not reported |
| Combined therapy (COMB) | Occlusal splint therapy (OST) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.97 [-1.91, -0.04] GRADE not reported Studies not reported |
| Occlusal splint therapy (OST) | Extracorporeal shock wave therapy (ESWT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.62 [-3.59, 4.84] GRADE not reported Studies not reported |
| Extracorporeal shock wave therapy (ESWT) | Occlusal splint therapy (OST) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.99 [-3.05, 1.07] GRADE not reported Studies not reported |
| Central neuromodulation (CNM) | Occlusal splint therapy (OST) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.08 [-4.19, 4.35] GRADE not reported Studies not reported |
| Central neuromodulation (CNM) | Occlusal splint therapy (OST) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.74 [-2.90, 1.42] GRADE not reported Studies not reported |
| Electrotherapy (ELEC) | Occlusal splint therapy (OST) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.45 [-1.62, 0.73] GRADE not reported Studies not reported |
| Electrotherapy (ELEC) | Occlusal splint therapy (OST) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.62 [-2.21, 3.46] GRADE not reported Studies not reported |
| Acupuncture (ACU) | Occlusal splint therapy (OST) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.04 [-1.87, 1.95] GRADE not reported Studies not reported |
| Acupuncture (ACU) | Occlusal splint therapy (OST) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.35 [-1.23, 0.52] GRADE not reported Studies not reported |
| Photobiomodulation therapy (PBMT) | Conventional care, placebo or no-treatment control (CON) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -1.49 [-2.07, -0.91] GRADE not reported Studies not reported |
| Photobiomodulation therapy (PBMT) | Conventional care, placebo or no-treatment control (CON) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.56 [-1.00, 2.12] GRADE not reported Studies not reported |
| Manual therapy (MT) | Conventional care, placebo or no-treatment control (CON) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -1.23 [-1.92, -0.54] GRADE not reported Studies not reported |
| Manual therapy (MT) | Conventional care, placebo or no-treatment control (CON) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 2.79 [1.33, 4.26] GRADE not reported Studies not reported |
| Combined therapy (COMB) | Conventional care, placebo or no-treatment control (CON) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 1.91 [-0.10, 3.91] GRADE not reported Studies not reported |
| Combined therapy (COMB) | Conventional care, placebo or no-treatment control (CON) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -1.04 [-2.00, -0.09] GRADE not reported Studies not reported |
| Extracorporeal shock wave therapy (ESWT) | Conventional care, placebo or no-treatment control (CON) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -1.06 [-2.96, 0.84] GRADE not reported Studies not reported |
| Extracorporeal shock wave therapy (ESWT) | Conventional care, placebo or no-treatment control (CON) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.12 [-3.67, 3.91] GRADE not reported Studies not reported |
| Central neuromodulation (CNM) | Conventional care, placebo or no-treatment control (CON) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.82 [-3.03, 4.67] GRADE not reported Studies not reported |
| Central neuromodulation (CNM) | Conventional care, placebo or no-treatment control (CON) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.81 [-2.82, 1.21] GRADE not reported Studies not reported |
| Electrotherapy (ELEC) | Conventional care, placebo or no-treatment control (CON) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 1.37 [-1.20, 3.94] GRADE not reported Studies not reported |
| Electrotherapy (ELEC) | Conventional care, placebo or no-treatment control (CON) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.51 [-1.54, 0.52] GRADE not reported Studies not reported |
| Acupuncture (ACU) | Conventional care, placebo or no-treatment control (CON) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.42 [-1.10, 0.26] GRADE not reported Studies not reported |
| Acupuncture (ACU) | Conventional care, placebo or no-treatment control (CON) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.79 [-0.76, 2.33] GRADE not reported Studies not reported |
| Occlusal splint therapy (OST) | Conventional care, placebo or no-treatment control (CON) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.07 [-0.85, 0.72] GRADE not reported Studies not reported |
| Occlusal splint therapy (OST) | Conventional care, placebo or no-treatment control (CON) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.74 [-1.10, 2.59] GRADE not reported Studies not reported |
| Exercise therapy (EX) | Photobiomodulation therapy (PBMT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.39 [-1.81, 2.59] GRADE not reported Studies not reported |
| Photobiomodulation therapy (PBMT) | Exercise therapy (EX) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -1.64 [-2.55, -0.73] GRADE not reported Studies not reported |
| Manual therapy (MT) | Exercise therapy (EX) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -1.37 [-2.26, -0.49] GRADE not reported Studies not reported |
| Manual therapy (MT) | Exercise therapy (EX) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 1.85 [0.05, 3.64] GRADE not reported Studies not reported |
| Combined therapy (COMB) | Exercise therapy (EX) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -1.19 [-2.05, -0.32] GRADE not reported Studies not reported |
| Combined therapy (COMB) | Exercise therapy (EX) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.96 [-0.76, 2.68] GRADE not reported Studies not reported |
| Extracorporeal shock wave therapy (ESWT) | Exercise therapy (EX) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -1.21 [-3.26, 0.85] GRADE not reported Studies not reported |
| Exercise therapy (EX) | Extracorporeal shock wave therapy (ESWT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.83 [-3.36, 5.02] GRADE not reported Studies not reported |
| Central neuromodulation (CNM) | Exercise therapy (EX) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.12 [-4.37, 4.12] GRADE not reported Studies not reported |
| Central neuromodulation (CNM) | Exercise therapy (EX) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.95 [-3.11, 1.21] GRADE not reported Studies not reported |
| Electrotherapy (ELEC) | Exercise therapy (EX) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.66 [-1.70, 0.38] GRADE not reported Studies not reported |
| Electrotherapy (ELEC) | Exercise therapy (EX) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.42 [-2.08, 2.92] GRADE not reported Studies not reported |
| Acupuncture (ACU) | Exercise therapy (EX) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.57 [-1.51, 0.38] GRADE not reported Studies not reported |
| Exercise therapy (EX) | Acupuncture (ACU) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.16 [-1.89, 2.21] GRADE not reported Studies not reported |
| Occlusal splint therapy (OST) | Exercise therapy (EX) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.21 [-1.03, 0.61] GRADE not reported Studies not reported |
| Exercise therapy (EX) | Occlusal splint therapy (OST) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.20 [-1.66, 2.06] GRADE not reported Studies not reported |
| Conventional care, placebo or no-treatment control (CON) | Exercise therapy (EX) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.15 [-0.93, 0.64] GRADE not reported Studies not reported |
| Exercise therapy (EX) | Conventional care, placebo or no-treatment control (CON) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.95 [-0.85, 2.74] GRADE not reported Studies not reported |
| Photobiomodulation therapy (PBMT) | Cognitive behavioral therapy (CBT) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -2.00 [-2.99, -1.00] GRADE not reported Studies not reported |
| Cognitive behavioral therapy (CBT) | Photobiomodulation therapy (PBMT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.37 [-2.15, 2.88] GRADE not reported Studies not reported |
| Manual therapy (MT) | Cognitive behavioral therapy (CBT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 1.87 [-0.31, 4.05] GRADE not reported Studies not reported |
| Manual therapy (MT) | Cognitive behavioral therapy (CBT) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -1.73 [-2.71, -0.75] GRADE not reported Studies not reported |
| Combined therapy (COMB) | Cognitive behavioral therapy (CBT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.98 [-1.45, 3.41] GRADE not reported Studies not reported |
| Combined therapy (COMB) | Cognitive behavioral therapy (CBT) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -1.55 [-2.61, -0.48] GRADE not reported Studies not reported |
| Extracorporeal shock wave therapy (ESWT) | Cognitive behavioral therapy (CBT) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -1.57 [-3.66, 0.53] GRADE not reported Studies not reported |
| Cognitive behavioral therapy (CBT) | Extracorporeal shock wave therapy (ESWT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.81 [-3.52, 5.14] GRADE not reported Studies not reported |
| Central neuromodulation (CNM) | Cognitive behavioral therapy (CBT) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -1.31 [-3.51, 0.88] GRADE not reported Studies not reported |
| Cognitive behavioral therapy (CBT) | Central neuromodulation (CNM) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.10 [-4.28, 4.49] GRADE not reported Studies not reported |
| Electrotherapy (ELEC) | Cognitive behavioral therapy (CBT) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.44 [-2.50, 3.38] GRADE not reported Studies not reported |
| Electrotherapy (ELEC) | Cognitive behavioral therapy (CBT) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -1.02 [-2.22, 0.18] GRADE not reported Studies not reported |
| Cognitive behavioral therapy (CBT) | Acupuncture (ACU) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.14 [-2.15, 2.43] GRADE not reported Studies not reported |
| Acupuncture (ACU) | Cognitive behavioral therapy (CBT) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.93 [-1.91, 0.06] GRADE not reported Studies not reported |
| Occlusal splint therapy (OST) | Cognitive behavioral therapy (CBT) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.57 [-1.46, 0.31] GRADE not reported Studies not reported |
| Cognitive behavioral therapy (CBT) | Occlusal splint therapy (OST) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.18 [-2.23, 2.59] GRADE not reported Studies not reported |
| Cognitive behavioral therapy (CBT) | Conventional care, placebo or no-treatment control (CON) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD 0.93 [-1.17, 3.03] GRADE not reported Studies not reported |
| Conventional care, placebo or no-treatment control (CON) | Cognitive behavioral therapy (CBT) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.51 [-1.38, 0.37] GRADE not reported Studies not reported |
| Cognitive behavioral therapy (CBT) | Exercise therapy (EX) | Maximum mouth opening (short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.02 [-2.05, 2.01] GRADE not reported Studies not reported |
| Exercise therapy (EX) | Cognitive behavioral therapy (CBT) | Pain intensity (VAS and other scales, short-term) Short-term assessment closest to completion of intervention · Not specified | SMD -0.36 [-1.18, 0.46] GRADE not reported Studies not reported |
| photobiomodulation therapy | All other treatment nodes in the network (ranking) | Pain intensity (mainly VAS) Short-term assessment closest to completion of the intervention | SUCRA 88.9 GRADE not reported Studies not reported |
| photobiomodulation therapy | All other treatment nodes in the network (ranking) | Maximum mouth opening Short-term assessment closest to completion of the intervention | SUCRA 38.1 GRADE not reported Studies not reported |
| manual therapy | All other treatment nodes in the network (ranking) | Pain intensity (mainly VAS) Short-term assessment closest to completion of the intervention | SUCRA 79.9 GRADE not reported Studies not reported |
| manual therapy | All other treatment nodes in the network (ranking) | Maximum mouth opening Short-term assessment closest to completion of the intervention | SUCRA 92.9 GRADE not reported Studies not reported |
| combined therapy | All other treatment nodes in the network (ranking) | Maximum mouth opening Short-term assessment closest to completion of the intervention | SUCRA 75.2 GRADE not reported Studies not reported |
| combined therapy | All other treatment nodes in the network (ranking) | Pain intensity (mainly VAS) Short-term assessment closest to completion of the intervention | SUCRA 72.5 GRADE not reported Studies not reported |
| extracorporeal shock wave therapy | All other treatment nodes in the network (ranking) | Maximum mouth opening Short-term assessment closest to completion of the intervention | SUCRA 33.8 GRADE not reported Studies not reported |
| extracorporeal shock wave therapy | All other treatment nodes in the network (ranking) | Pain intensity (mainly VAS) Short-term assessment closest to completion of the intervention | SUCRA 67.8 GRADE not reported Studies not reported |
| central neuromodulation | All other treatment nodes in the network (ranking) | Pain intensity (mainly VAS) Short-term assessment closest to completion of the intervention | SUCRA 58.8 GRADE not reported Studies not reported |
| central neuromodulation | All other treatment nodes in the network (ranking) | Maximum mouth opening Short-term assessment closest to completion of the intervention | SUCRA 47.9 GRADE not reported Studies not reported |
| electrotherapy | All other treatment nodes in the network (ranking) | Pain intensity (mainly VAS) Short-term assessment closest to completion of the intervention | SUCRA 50.6 GRADE not reported Studies not reported |
| electrotherapy | All other treatment nodes in the network (ranking) | Maximum mouth opening Short-term assessment closest to completion of the intervention | SUCRA 58.7 GRADE not reported Studies not reported |
| acupuncture | All other treatment nodes in the network (ranking) | Maximum mouth opening Short-term assessment closest to completion of the intervention | SUCRA 45.1 GRADE not reported Studies not reported |
| acupuncture | All other treatment nodes in the network (ranking) | Pain intensity (mainly VAS) Short-term assessment closest to completion of the intervention | SUCRA 47.8 GRADE not reported Studies not reported |
| occlusal splint therapy | All other treatment nodes in the network (ranking) | Pain intensity (mainly VAS) Short-term assessment closest to completion of the intervention | SUCRA 30.5 GRADE not reported Studies not reported |
| occlusal splint therapy | All other treatment nodes in the network (ranking) | Maximum mouth opening Short-term assessment closest to completion of the intervention | SUCRA 42.5 GRADE not reported Studies not reported |
| conventional care, placebo or no-treatment control | All other treatment nodes in the network (ranking) | Pain intensity (mainly VAS) Short-term assessment closest to completion of the intervention | SUCRA 25.8 GRADE not reported Studies not reported |
| conventional care, placebo or no-treatment control | All other treatment nodes in the network (ranking) | Maximum mouth opening Short-term assessment closest to completion of the intervention | SUCRA 19.7 GRADE not reported Studies not reported |
| exercise therapy | All other treatment nodes in the network (ranking) | Maximum mouth opening Short-term assessment closest to completion of the intervention | SUCRA 47.7 GRADE not reported Studies not reported |
| exercise therapy | All other treatment nodes in the network (ranking) | Pain intensity (mainly VAS) Short-term assessment closest to completion of the intervention | SUCRA 20.5 GRADE not reported Studies not reported |
| cognitive behavioral therapy | All other treatment nodes in the network (ranking) | Pain intensity (mainly VAS) Short-term assessment closest to completion of the intervention | SUCRA 6.9 GRADE not reported Studies not reported |
| cognitive behavioral therapy | All other treatment nodes in the network (ranking) | Maximum mouth opening Short-term assessment closest to completion of the intervention | SUCRA 48.4 GRADE not reported Studies not reported |
Included primary studies 41
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Monteiro 2020 Effectiveness of Photobiomodulation in Temporomandibular Disorder-Related Pain Using a 635 nm Diode Laser: A Randomized, Blinded, and… PMID:32427553 | 2020 | 4 other reviews | not stated | not extracted yet |
| Barbosa 2019 Effects of 8 weeks of masticatory muscles focused endurance exercises on women with oro-facial pain and temporomandibular disorders: A… PMID:31099036 | 2019 | 3 other reviews | not stated | not extracted yet |
| Ferreira 2017 Short-term transcutaneous electrical nerve stimulation reduces pain and improves the masticatory muscle activity in temporomandibular… PMID:28403351 | 2017 | 3 other reviews | not stated | not extracted yet |
| Aisaiti 2021 Effect of photobiomodulation therapy on painful temporomandibular disorders. PMID:33907210 | 2021 | 2 other reviews | not stated | not extracted yet |
| Dıraçoğlu 2012 Effectiveness of dry needling for the treatment of temporomandibular myofascial pain: a double-blind, randomized, placebo controlled study. PMID:23220812 | 2012 | 2 other reviews | not stated | not extracted yet |
| Herpich 2020 Intraoral photobiomodulation diminishes pain and improves functioning in women with temporomandibular disorder: a randomized,… PMID:31325122 | 2020 | 2 other reviews | not stated | not extracted yet |
| Al-Quisi 2023 The reliability of using light therapy compared with LASER in pain reduction of temporomandibular disorders: a randomized controlled trial. PMID:36782179 | 2023 | 1 other review | not stated | not extracted yet |
| Benli 2023 A novel treatment modality for myogenous temporomandibular disorders using aromatherapy massage with lavender oil: A randomized controlled… PMID:32893748 | 2023 | 1 other review | not stated | not extracted yet |
| Carlson 2001 Physical self-regulation training for the management of temporomandibular disorders. PMID:11889647 | 2001 | 1 other review | not stated | not extracted yet |
| Dib-Zakkour 2022 Evaluation of the Effectiveness of Dry Needling in the Treatment of Myogenous Temporomandibular Joint Disorders. PMID:35208580 | 2022 | 1 other review | not stated | not extracted yet |
| Espejo-Antúnez 2024 Effects of adding electro-massage to manual therapy for the treatment of individuals with myofascial temporomandibular pain: a randomized… PMID:39292112 | 2024 | 1 other review | not stated | not extracted yet |
| Ferreira 2024 Manual therapy and dry needling improve mobility, pain and reduce fear of COVID-19 in temporomandibular disorder patients: Randomized… PMID:39593654 | 2024 | 1 other review | not stated | not extracted yet |
| Gikić 2021 Treatment responses in chronic temporomandibular patients depending on the treatment modalities and frequency of parafunctional behaviour. PMID:33797785 | 2021 | 1 other review | not stated | not extracted yet |
| Law 2025 Safety and Efficacy of Shockwave Therapy for Myogenous Temporomandibular Disorders: Early Post-Treatment Results. PMID:40992027 | 2025 | 1 other review | not stated | not extracted yet |
| Liu 2024 Effect of acupuncture for temporomandibular disorders: a randomized clinical trial. PMID:38710498 | 2024 | 1 other review | not stated | not extracted yet |
| Magri 2018 Non-specific effects and clusters of women with painful TMD responders and non-responders to LLLT: double-blind randomized clinical trial. PMID:29209867 | 2018 | 1 other review | not stated | not extracted yet |
| Magri 2021 Follow-up results of a randomized clinical trial for low-level laser therapy in painful TMD of muscular origins. PMID:31585522 | 2021 | 1 other review | not stated | not extracted yet |
| Özden 2020 Efficacy of dry needling in patients with myofascial temporomandibular disorders related to the masseter muscle. PMID:30296920 | 2020 | 1 other review | not stated | not extracted yet |
| Serrano-Hernanz 2023 Pressure release technique versus placebo applied to cervical and masticatory muscles in patients with chronic painful myofascial… PMID:37163204 | 2023 | 1 other review | not stated | not extracted yet |
| Seyhan 2023 Is core stability training effective in temporomandibular disorder? A randomized controlled trial. PMID:37924356 | 2023 | 1 other review | not stated | not extracted yet |
| Shousha 2021 Effects of low-level laser therapy versus soft occlusive splints on mouth opening and surface electromyography in females with… PMID:34597318 | 2021 | 1 other review | not stated | not extracted yet |
| Smith 2007 The efficacy of acupuncture in the treatment of temporomandibular joint myofascial pain: a randomised controlled trial. PMID:17095133 | 2007 | 1 other review | not stated | not extracted yet |
| Wright 2000 Usefulness of posture training for patients with temporomandibular disorders. PMID:10680388 | 2000 | 1 other review | not stated | not extracted yet |
| Ahrari 2014 The efficacy of low-level laser therapy for the treatment of myogenous temporomandibular joint disorder. PMID:23318917 | 2014 | this review only | not stated | not extracted yet |
| Alves 2021 Effects of photobiomodulation associated with orofacial myofactional therapy on temporomandibular joint dysfunction. PMID:34105614 | 2021 | this review only | not stated | not extracted yet |
| Berguer 2008 Neuro-reflexotherapy for the management of myofascial temporomandibular joint pain: a double-blind, placebo-controlled, randomized… PMID:18634956 | 2008 | this review only | not stated | not extracted yet |
| Cakıcı 2025 Exercise based multisite pain management in temporomandibular dysfunction and chronic low back pain: a randomized controlled trial. PMID:40415287 | 2025 | this review only | not stated | not extracted yet |
| Cho 2025 Effectiveness and cost-effectiveness of Chuna manual therapy for temporomandibular disorder: A randomized clinical trial. PMID:40333834 | 2025 | this review only | not stated | not extracted yet |
| Conti 2012 Behavioural changes and occlusal splints are effective in the management of masticatory myofascial pain: a short-term evaluation. PMID:22672361 | 2012 | this review only | not stated | not extracted yet |
| Donnell 2015 High-Definition and Non-invasive Brain Modulation of Pain and Motor Dysfunction in Chronic TMD. PMID:26226938 | 2015 | this review only | not stated | not extracted yet |
| Gębska 2023 Evaluation of the efficacy of manual soft tissue therapy and therapeutic exercises in patients with pain and limited mobility TMJ: a… PMID:37684652 | 2023 | this review only | not stated | not extracted yet |
| Giannakopoulos 2018 Comparison of device-supported sensorimotor training and splint intervention for myofascial temporomandibular disorder pain patients. PMID:29855069 | 2018 | this review only | not stated | not extracted yet |
| Grillo 2015 Could Acupuncture Be Useful in the Treatment of Temporomandibular Dysfunction? PMID:26276455 | 2015 | this review only | not stated | not extracted yet |
| Itoh 2012 Effects of trigger point acupuncture treatment on temporomandibular disorders: a preliminary randomized clinical trial. PMID:22483183 | 2012 | this review only | not stated | not extracted yet |
| Kalamir 2012 Intraoral myofascial therapy for chronic myogenous temporomandibular disorder: a randomized controlled trial. PMID:22079052 | 2012 | this review only | not stated | not extracted yet |
| Kraaijenga 2014 Treatment of myogenic temporomandibular disorder: a prospective randomized clinical trial, comparing a mechanical stretching device… PMID:25000163 | 2014 | this review only | not stated | not extracted yet |
| Madani 2020 A randomized clinical trial comparing the efficacy of low-level laser therapy (LLLT) and laser acupuncture therapy (LAT) in patients with… PMID:31396794 | 2020 | this review only | not stated | not extracted yet |
| Reynolds 2020 Effectiveness of Cervical Spine High-Velocity, Low-Amplitude Thrust Added to Behavioral Education, Soft Tissue Mobilization, and Exercise… PMID:31905097 | 2020 | this review only | not stated | not extracted yet |
| Siqueira 2025 Laser treatment for temporomandibular disorder: a randomized controlled clinical trial. PMID:40643712 | 2025 | this review only | not stated | not extracted yet |
| Vicente-Barrero 2012 The efficacy of acupuncture and decompression splints in the treatment of temporomandibular joint pain-dysfunction syndrome. PMID:22549668 | 2012 | this review only | not stated | not extracted yet |
| Yıldız 2025 Comparison of the effectiveness of three different conservative methods in myogenous temporomandibular disorders. PMID:40638472 | 2025 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults (>=18 years) with myogenic temporomandibular disorders | Adults with myogenic TMD (n=2021; 41 RCTs); mean age 21.7 to 46.9 years |
| Intervention | Acupuncture, central neuromodulation, combined therapy, electrotherapy, exercise therapy, extracorporeal shock wave therapy, manual therapy, occlusal splint therapy, photobiomodulation therapy, cognitive behavioral therapy | ACU (9 studies), PBMT (10), EX (10), MT (9), COMB (6), OST (9), CNM (1), ELEC (4), ESWT (1), CBT (6) |
| Comparison | Sham or placebo, usual care or no treatment (control node), or another predefined active nonpharmacological modality | Conventional care, placebo or no treatment (CON) in 24 studies; active comparators |
| Outcomes | Pain (primary); maximum mouth opening (primary) | Pain (41 studies; 2021 participants); maximum mouth opening (31 studies; 1463 participants) |
| Study designs | Published randomized controlled trials | 41 RCTs (20 single-blind, 14 double-blind, 7 open-label; 8 three-arm, 33 two-arm) |
| Timing | Short-term assessment closest to completion of the intervention | Short-term outcome closest to the end of the intervention |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Low | yes |