Non-Cochrane · intervention · PM42494855
Extracorporeal shock wave therapy for temporomandibular disorders: efficacy on pain, maximal mouth opening, and dysfunction-a meta-analysis of randomized controlled trials.
Chen Li, Luo Yuan, Zhang Liyue, et al. · Frontiers in rehabilitation sciences · 2026 · PubMed · doi:10.3389/fresc.2026.1883205
Findings
Population Patients with temporomandibular disorders
9 findings
| Extracorporeal shock wave therapy (ESWT), alone or combined with other therapies | Control: conventional physical therapy, pharmacotherapy, sham ESWT or no specific intervention | Pain intensity (VAS/NRS) Post-intervention · Mostly single-center trials in China · Number of shocks: <=1,500 | SMD -0.97 [-1.80, -0.13] GRADE not reported 6 studies · 403 participants |
| Extracorporeal shock wave therapy (ESWT), alone or combined with other therapies | Control: conventional physical therapy, pharmacotherapy, sham ESWT or no specific intervention | Maximal mouth opening (MMO) Post-intervention · Mostly single-center trials in China | MD 3.76 [1.52, 5.99] GRADE not reported 12 studies · 823 participants |
| Extracorporeal shock wave therapy (ESWT), alone or combined with other therapies | Control: conventional physical therapy, pharmacotherapy, sham ESWT or no specific intervention | Pain intensity (VAS/NRS) Post-intervention · Mostly single-center trials in China · Gender: female > male | SMD -0.82 [-1.28, -0.36] GRADE not reported 7 studies · 461 participants |
| Extracorporeal shock wave therapy (ESWT), alone or combined with other therapies | Control: conventional physical therapy, pharmacotherapy, sham ESWT or no specific intervention | Pain intensity (VAS/NRS) Post-intervention · Mostly single-center trials in China · Treatment period: >=4 weeks | SMD -1.79 [-2.09, -1.49] GRADE not reported 3 studies · 130 participants |
| Extracorporeal shock wave therapy (ESWT), alone or combined with other therapies | Control: conventional physical therapy, pharmacotherapy, sham ESWT or no specific intervention | Pain intensity (VAS/NRS) Post-intervention · Mostly single-center trials in China · Gender: male > female | SMD -0.97 [-1.94, 0.00] GRADE not reported 10 studies · 575 participants |
| Extracorporeal shock wave therapy (ESWT), alone or combined with other therapies | Control: conventional physical therapy, pharmacotherapy, sham ESWT or no specific intervention | Pain intensity (VAS/NRS) Post-intervention · Mostly single-center trials in China | SMD -1.28 [-1.96, -0.61] GRADE not reported 17 studies · 1036 participants |
| Extracorporeal shock wave therapy (ESWT), alone or combined with other therapies | Control: conventional physical therapy, pharmacotherapy, sham ESWT or no specific intervention | Pain intensity (VAS/NRS) Post-intervention · Mostly single-center trials in China · Treatment period: <=2 weeks | SMD -0.79 [-1.38, -0.20] GRADE not reported 14 studies · 906 participants |
| Extracorporeal shock wave therapy (ESWT), alone or combined with other therapies | Control: conventional physical therapy, pharmacotherapy, sham ESWT or no specific intervention | Pain intensity (VAS/NRS) Post-intervention · Mostly single-center trials in China · Number of shocks: >1,500 | SMD -1.07 [-1.46, -0.69] GRADE not reported 8 studies · 501 participants |
| Extracorporeal shock wave therapy (ESWT), alone or combined with other therapies | Control: conventional physical therapy, pharmacotherapy, sham ESWT or no specific intervention | Temporomandibular joint dysfunction index (DI) Post-intervention · Mostly single-center trials in China | MD -0.05 [-0.13, 0.03] GRADE not reported 13 studies · 850 participants |
Included primary studies 23
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Keskin Tunc 2024 Can extracorporeal shock wave therapy be effective in temporomandibular joint disorder?: A pilot study DOI:10.1097/md.0000000000040052 | 2024 | 1 other review | not stated | not extracted yet |
| Keskin Tunc 2024 Can extracorporeal shock wave therapy be effective in temporomandibular joint disorder?: A pilot study. PMID:39470554 | 2024 | 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 |
| Li 2020 Treatment of Temporomandibular Joint Disorders by Ultrashort Wave and Extracorporeal Shock Wave: A Comparative Study DOI:10.12659/msm.923461 | 2020 | 1 other review | not stated | not extracted yet |
| Li 2020 Treatment of Temporomandibular Joint Disorders by Ultrashort Wave and Extracorporeal Shock Wave: A Comparative Study. PMID:32564051 | 2020 | 1 other review | not stated | not extracted yet |
| Han 2018 DOI:10.19787/j.issn.1008-1879.2018.06.012 | NR | this review only | not stated | not extracted yet |
| Han 2021 DOI:10.3969/j.issn.1004-437x.2021.14.012 | NR | this review only | not stated | not extracted yet |
| Hu 2023 DOI:10.3969/j.issn.1005-8982.2023.13.014 | NR | this review only | not stated | not extracted yet |
| Law 2025 Safety and Efficacy of Shockwave Therapy for Myogenous Temporomandibular Disorders: Early Post-Treatment Results DOI:10.1016/j.identj.2025.103923 | 2025 | this review only | not stated | not extracted yet |
| Lei 2023 DOI:10.3969/j.issn.1002-1256.2023.07.004 | NR | this review only | not stated | not extracted yet |
| Lei 2024 DOI:10.16833/j.cnki.jbmc.2024.07.016 | NR | this review only | not stated | not extracted yet |
| Liu 2021 DOI:10.3969/j.issn.1003-1634.2021.01.012 | NR | this review only | not stated | not extracted yet |
| Mao 2019 DOI:10.16047/j.cnki.cn14-1300/r.2019.10.012 | NR | this review only | not stated | not extracted yet |
| Marotta 2022 Effects of Radial Extracorporeal Shock Wave Therapy in Reducing Pain in Patients with Temporomandibular Disorders: A Pilot Randomized… DOI:10.3390/app12083821 | 2022 | this review only | not stated | not extracted yet |
| Wang 2020 DOI:10.3969/j.issn.1671-7651.2020.03.001 | NR | this review only | not stated | not extracted yet |
| Wang 2023 DOI:10.19335/j.cnki.2096-1219.2023.20.046 | NR | this review only | not stated | not extracted yet |
| Wang 2024 DOI:10.13591/j.cnki.kqyx.2024.11.011 | NR | this review only | not stated | not extracted yet |
| Wei 2024 Effect of Extracorporeal Shock Wave on IGF-1, TNF-α, and IL-1in Joint Fluid of Patients with Temporomandibular Joint Disorder Syndrome DOI:10.1007/s12013-024-01517-0 | 2024 | this review only | not stated | not extracted yet |
| Wei 2024 Effect of Extracorporeal Shock Wave on IGF-1, TNF-α, and IL-1in Joint Fluid of Patients with Temporomandibular Joint Disorder Syndrome. PMID:39259406 | 2025 | this review only | not stated | not extracted yet |
| Wu 2024 DOI:10.13638/j.issn.1671-4040.2024.21.025 | NR | this review only | not stated | not extracted yet |
| Xu 2016 DOI:10.3969/j.issn.1009-7147.2016.06.059 | NR | this review only | not stated | not extracted yet |
| Zhang 2025 Pilot randomized controlled trial of extracorporeal shock wave therapy for temporomandibular joint disorders DOI:10.1177/10538127241309240 | 2025 | this review only | not stated | not extracted yet |
| Zhang 2025 Pilot randomized controlled trial of extracorporeal shock wave therapy for temporomandibular joint disorders. PMID:39973094 | 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 | Participants with a confirmed diagnosis of TMD irrespective of age, gender, duration or severity | Patients with TMD (n=1,150; 18 RCTs) |
| Intervention | ESWT as monotherapy or combined with other therapeutic modalities | ESWT alone (5 RCTs) or combined with physical therapy (8), pharmacotherapy (3) or traditional Chinese medicine (2) |
| Comparison | Conventional physical therapy, pharmacological therapy, sham ESWT, or no specific intervention | Rehabilitation, sham therapy, medication, or no treatment |
| Outcomes | VAS pain intensity, maximal mouth opening (MMO), temporomandibular joint dysfunction index (DI) | Pain VAS (17 studies, n=1,036), MMO (12 studies, n=823), DI (13 studies, n=850) |
| Study designs | Randomized controlled trials | RCTs (n=18) |
| Timing | Not specified | Post-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 | No | No | 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 | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | NRSI: N/A · RCT: Yes | RCT: Yes · NRSI: N/A | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | RCT: Yes · NRSI: N/A | yes |
| 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 | Critically Low | Critically Low | yes |