Non-Cochrane · intervention · PM42930579
Conservative and Minimally Invasive Treatments for Temporomandibular Disorders Versus Inactive Controls: A Systematic Review and Meta-Analysis of Randomized Trials.
Țănculescu Oana, Țarevici Eugenia-Larisa, Bodnar Petronela, et al. · Medical sciences (Basel, Switzerland) · 2026 · PubMed · doi:10.3390/medsci14060660
Findings
27 findings
| Population | ||||
|---|---|---|---|---|
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Inactive control (sham/placebo, no treatment, or waitlist) | Oral-health-related quality of life short term (≤3 months) | SMD -0.17 [-1.04, 0.7] Very low Downgraded: risk of bias, imprecision 3 studies · 104 participants |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Inactive control (sham/placebo, no treatment, or waitlist) | Jaw functional limitation medium term (>3 to ≤6 months) | SMD -0.24 [-3.2, 2.71] Very low Downgraded: risk of bias, imprecision 2 studies · 84 participants |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Inactive control (sham/placebo, no treatment, or waitlist) | Mouth opening short term · Excluding Aroca combined intervention | MD 1.85 [0.18, 3.52] GRADE not reported 24 studies |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Inactive control (sham/placebo, no treatment, or waitlist) | Pain intensity short term · Excluding high-risk results | MD -0.94 [-1.74, -0.15] GRADE not reported 13 studies |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Inactive control (sham/placebo, no treatment, or waitlist) | Oral-health-related quality of life medium term (>3 to ≤6 months) | MD -2.29 [-35.89, 31.3] Very low Downgraded: risk of bias, imprecision 2 studies · 84 participants |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Inactive control (sham/placebo, no treatment, or waitlist) | Mouth opening short term · Excluding change-score effect | MD 1.95 [0.23, 3.66] GRADE not reported 24 studies |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Inactive control (sham/placebo, no treatment, or waitlist) | Jaw functional limitation short term · Excluding Reeve | SMD -0.46 [-1.22, 0.29] GRADE not reported 3 studies |
| Adults with temporomandibular disorders diagnosed by RDC/TMD or DC/TMD | Conservative or minimally invasive treatments pooled (exercise, manual therapy, education, occlusal appliances, photobiomodulation, TENS, acupuncture, dry needling, botulinum toxin, PRP or other injections) | Inactive control (sham/placebo, no treatment or waitlist) | Mouth opening (mm) Short term (up to 3 months) · Outpatient dental, oral medicine, maxillofacial, physiotherapy and rehabilitation settings · Sensitivity: excluding high risk-of-bias results | MD 0.75 [-0.62, 2.12] GRADE not reported 17 studies |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Inactive control (sham/placebo, no treatment, or waitlist) | Pain intensity medium term (>3 to ≤6 months) | MD -1.12 [-2.02, -0.23] Low Downgraded: risk of bias, imprecision 4 studies · 173 participants |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Inactive control (sham/placebo, no treatment, or waitlist) | Mouth opening short term · Excluding largest immediate gain | MD 1.39 [0.3, 2.48] GRADE not reported 24 studies |
| Adults with temporomandibular disorders diagnosed by RDC/TMD or DC/TMD | Conservative or minimally invasive treatments pooled (exercise, manual therapy, education, occlusal appliances, photobiomodulation, TENS, acupuncture, dry needling, botulinum toxin, PRP or other injections) | Inactive control (sham/placebo, no treatment or waitlist) | Jaw functional limitation (MFIQ, MOPDS, JFLS-8) Short term (up to 3 months) · Outpatient dental, oral medicine, maxillofacial, physiotherapy and rehabilitation settings · Sensitivity: excluding high risk-of-bias results | The body of evidence remaining after exclusion of high-risk results contained only two studies and was extremely imprecise (numerical estimate not reported; shown graphically in Figure 5) GRADE not reported 2 studies |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Inactive control (sham/placebo, no treatment, or waitlist) | Mouth opening short term · Excluding converted distributions | MD 1.28 [0.17, 2.39] GRADE not reported 23 studies |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Inactive control (sham/placebo, no treatment, or waitlist) | Pain intensity short term (≤3 months) | MD -1.31 [-2.0, -0.62] Very low Downgraded: risk of bias, imprecision, inconsistency 23 studies · 1221 participants |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Inactive control (sham/placebo, no treatment, or waitlist) | Mouth opening short term · Excluding immediate or ≤48-hour and 2–4 day measurements | MD 1.69 [0.47, 2.92] GRADE not reported 20 studies |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Inactive control (sham/placebo, no treatment, or waitlist) | Mouth opening medium term (>3 to ≤6 months) | MD 2.25 [-1.6, 6.1] Very low Downgraded: risk of bias, imprecision, indirectness 4 studies · 173 participants |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Inactive control (sham/placebo, no treatment, or waitlist) | Pain intensity short term · Excluding graph-derived and distribution-converted effects | MD -0.96 [-1.66, -0.27] GRADE not reported 19 studies |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Inactive control (sham/placebo, no treatment, or waitlist) | Jaw functional limitation short term (≤3 months) | SMD -0.31 [-0.91, 0.29] Very low Downgraded: risk of bias, imprecision, inconsistency 4 studies · 197 participants |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Inactive control (sham/placebo, no treatment, or waitlist) | Mouth opening short term (≤3 months) | MD 1.96 [0.33, 3.6] Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness 25 studies · 1340 participants |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Inactive control (sham/placebo, no treatment, or waitlist) | Pain intensity short term · Excluding immediate or ≤48-hour measurements | MD -1.55 [-2.32, -0.78] GRADE not reported 19 studies |
| Adults with temporomandibular disorders diagnosed by RDC/TMD or DC/TMD | Conservative or minimally invasive treatments pooled (exercise, manual therapy, education, occlusal appliances, photobiomodulation, TENS, acupuncture, dry needling, botulinum toxin, PRP or other injections) | Inactive control (sham/placebo, no treatment or waitlist) | Pain intensity (0 to 10 scale) Medium term (>3 to 6 months) · Outpatient dental, oral medicine, maxillofacial, physiotherapy and rehabilitation settings · Sensitivity: excluding high risk-of-bias results | When the single high-risk result was removed, the estimate became less precise and included no difference (numerical estimate not reported; shown graphically in Figure 5) GRADE not reported 3 studies |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Personalized mandibular repositioning appliance | No treatment | Pain intensity long term (>6 months) | MD -4.35 [-5.17, -3.53] Very low Downgraded: risk of bias, imprecision 1 study · 86 participants |
| Adults with temporomandibular disorders diagnosed by RDC/TMD or DC/TMD | Conservative or minimally invasive treatments pooled (exercise, manual therapy, education, occlusal appliances, photobiomodulation, TENS, acupuncture, dry needling, botulinum toxin, PRP or other injections) | No treatment or waitlist control | Mouth opening (mm) Short term (up to 3 months) · Outpatient dental, oral medicine, maxillofacial, physiotherapy and rehabilitation settings · Comparator stratum: no treatment/waitlist (exploratory) | MD 3.43 [-0.46, 7.33] GRADE not reported 3 studies |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Sham/placebo | Pain intensity short term | MD -1.07 [-1.77, -0.38] GRADE not reported 20 studies |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | Sham/placebo | Mouth opening short term | MD 1.84 [-0.04, 3.71] GRADE not reported 22 studies |
| Adults with myogenous TMD (trials restricted to myogenous TMD), RDC/TMD or DC/TMD | Conservative or minimally invasive treatments pooled (exercise, manual therapy, education, occlusal appliances, photobiomodulation, TENS, acupuncture, dry needling, botulinum toxin, PRP or other injections) | Inactive control (sham/placebo, no treatment or waitlist) | Pain intensity (0 to 10 scale) Short term (up to 3 months) · Outpatient dental, oral medicine, maxillofacial, physiotherapy and rehabilitation settings · Phenotype subgroup: myogenous TMD | MD -2.16 [-3.01, -1.31] GRADE not reported 10 studies · 523 participants |
| Adults with DC/TMD- or RDC/TMD-defined temporomandibular disorders | Conservative or minimally invasive treatment | No treatment or waitlist | Pain intensity short term | MD -2.86 [-7.38, 1.66] GRADE not reported 3 studies |
| Adults with mixed-phenotype TMD, RDC/TMD or DC/TMD | Conservative or minimally invasive treatments pooled (exercise, manual therapy, education, occlusal appliances, photobiomodulation, TENS, acupuncture, dry needling, botulinum toxin, PRP or other injections) | Inactive control (sham/placebo, no treatment or waitlist) | Pain intensity (0 to 10 scale) Short term (up to 3 months) · Outpatient dental, oral medicine, maxillofacial, physiotherapy and rehabilitation settings · Phenotype subgroup: mixed TMD | MD -0.33 [-1.16, 0.50] GRADE not reported 11 studies · 513 participants |
Included primary studies 62
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 2016 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 |
| 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 |
| Aisaiti 2021 Effect of photobiomodulation therapy on painful temporomandibular disorders DOI:10.1038/s41598-021-87265-0 | 2021 | 1 other review | 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 |
| Del Vecchio 2019 Evaluation of the efficacy of a new low-level laser therapy home protocol in the treatment of temporomandibular joint disorder-related… DOI:10.1080/08869634.2019.1599174 | 2019 | 1 other review | not stated | not extracted yet |
| Del Vecchio 2019 Evaluation of the efficacy of a new low-level laser therapy home protocol in the treatment of temporomandibular joint disorder-related… PMID:30999823 | 2021 | 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 |
| Ferreira 2016 Short-term transcutaneous electrical nerve stimulation reduces pain and improves the masticatory muscle activity in temporomandibular… DOI:10.1590/1678-77572016-0173 | 2017 | 1 other review | not stated | not extracted yet |
| Gikic 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 |
| Herpich 2020 Intraoral photobiomodulation diminishes pain and improves functioning in women with temporomandibular disorder: a randomized,… DOI:10.1007/s10103-019-02841-1 | 2019 | 1 other review | not stated | not extracted yet |
| Mathpati 2024 Platelet-Rich Plasma in the Management of Temporomandibular Joint Pain in Young Adults With Temporomandibular Disorder. PMID:38586782 | 2024 | 1 other review | not stated | not extracted yet |
| Monteiro 2020 Effectiveness of Photobiomodulation in Temporomandibular Disorder-Related Pain Using a 635 nm Diode Laser: A Randomized, Blinded, and… DOI:10.1089/photob.2019.4730 | 2020 | 1 other review | not stated | not extracted yet |
| Nitecka-Buchta 2019 Platelet-Rich Plasma Intramuscular Injections - Antinociceptive Therapy in Myofascial Pain Within Masseter Muscles in Temporomandibular… PMID:30941095 | 2019 | 1 other review | not stated | not extracted yet |
| Reeve 2024 Does the Use of Botulinum Toxin in Treatment of Myofascial Pain Disorder of the Masseters and Temporalis Muscles Reduce Pain, Improve… PMID:38228287 | 2024 | 1 other review | not stated | not extracted yet |
| Sancakli 2015 Early results of low-level laser application for masticatory muscle pain: a double-blind randomized clinical study. PMID:26496720 | 2015 | 1 other review | not stated | not extracted yet |
| Zotelli 2017 Acupuncture Effect on Pain, Mouth Opening Limitation and on the Energy Meridians in Patients with Temporomandibular Dysfunction: A… PMID:29078971 | 2017 | 1 other review | 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 DOI:10.1186/s12903-023-02784-8 | 2023 | this review only | not stated | not extracted yet |
| Alajbeg 2020 Effect of occlusal splint on oxidative stress markers and psychological aspects of chronic temporomandibular pain: a randomized controlled… DOI:10.1038/s41598-020-67383-x | 2020 | this review only | not stated | not extracted yet |
| Alajbeg 2020 Effect of occlusal splint on oxidative stress markers and psychological aspects of chronic temporomandibular pain: a randomized controlled… PMID:32620810 | 2020 | this review only | not stated | not extracted yet |
| Aroca 2022 Auricular acupuncture in TMD — A sham-controlled, randomized, clinical trial DOI:10.1016/j.ctcp.2022.101569 | 2022 | this review only | not stated | not extracted yet |
| Aroca 2022 Auricular acupuncture in TMD - A sham-controlled, randomized, clinical trial. PMID:35487130 | 2022 | this review only | 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… DOI:10.1111/joor.12823 | 2019 | this review only | not stated | not extracted yet |
| Benli 2023 A novel treatment modality for myogenous temporomandibular disorders using aromatherapy massage with lavender oil: A randomized controlled… DOI:10.1080/08869634.2020.1819067 | 2020 | this review only | not stated | not extracted yet |
| Calixtre 2019 Effectiveness of mobilisation of the upper cervical region and craniocervical flexor training on orofacial pain, mandibular function and… DOI:10.1111/joor.12733 | 2018 | this review only | not stated | not extracted yet |
| Calixtre 2019 Effectiveness of mobilisation of the upper cervical region and craniocervical flexor training on orofacial pain, mandibular function and… PMID:30307636 | 2019 | this review only | not stated | not extracted yet |
| Carvalho 2023 Photobiomodulation Therapy on the Palliative Care of Temporomandibular Disorder and Orofacial/Cervical Skull Pain: Preliminary Results… PMID:37761771 | 2023 | this review only | not stated | not extracted yet |
| Costa 2017 The analgesic effect of photobiomodulation therapy (830 nm) on the masticatory muscles: a randomized, double-blind study DOI:10.1590/1807-3107bor-2017.vol31.0107 | 2017 | this review only | not stated | not extracted yet |
| Costa 2017 The analgesic effect of photobiomodulation therapy (830 nm) on the masticatory muscles: a randomized, double-blind study. PMID:29267668 | 2017 | this review only | not stated | not extracted yet |
| D'Attilio 2021 Pain Assessment during Gnathological Treatment of Temporomandibular Myofascial Pain through Mandibular Repositioning Splints Designed… DOI:10.3390/app11188303 | 2021 | this review only | not stated | not extracted yet |
| de Oliveira Chami 2022 Rapid LLLT protocol for myofascial pain and mouth opening limitation treatment in the clinical practice: An RCT DOI:10.1080/08869634.2020.1773660 | 2020 | this review only | not stated | not extracted yet |
| de Oliveira Chami 2022 Rapid LLLT protocol for myofascial pain and mouth opening limitation treatment in the clinical practice: An RCT. PMID:32491956 | 2022 | this review only | not stated | not extracted yet |
| de Oliveira-Souza 2024 Effectiveness of an 8-week neck exercise training on pain, jaw function, and oral health-related quality of life in women with chronic… DOI:10.22514/jofph.2024.005 | 2024 | this review only | not stated | not extracted yet |
| de Oliveira-Souza 2024 Effectiveness of an 8-week neck exercise training on pain, jaw function, and oral health-related quality of life in women with chronic… PMID:39788575 | 2024 | this review only | not stated | not extracted yet |
| de Salles-Neto 2020 Acupuncture for pain, mandibular function and oral health‐related quality of life in patients with masticatory myofascial pain: A… DOI:10.1111/joor.13055 | 2020 | this review only | not stated | not extracted yet |
| de Salles-Neto 2020 Acupuncture for pain, mandibular function and oral health-related quality of life in patients with masticatory myofascial pain: A… PMID:32668487 | 2020 | this review only | not stated | not extracted yet |
| de Sousa 2022 Simultaneous red and infrared light-emitting diodes reduced pain in individuals with temporomandibular disorder: a randomized, controlled,… DOI:10.1007/s10103-022-03600-5 | 2022 | this review only | not stated | not extracted yet |
| de Sousa 2022 Simultaneous red and infrared light-emitting diodes reduced pain in individuals with temporomandibular disorder: a randomized, controlled,… PMID:35751005 | 2022 | this review only | not stated | not extracted yet |
| Gikić 2021 Treatment responses in chronic temporomandibular patients depending on the treatment modalities and frequency of parafunctional behaviour DOI:10.1111/joor.13173 | 2021 | this review only | not stated | not extracted yet |
| Giro 2016 Mandibular kinesiographic pattern of women with chronic TMD after management with educational and self-care therapies: A double-blind,… DOI:10.1016/j.prosdent.2016.03.021 | 2016 | this review only | not stated | not extracted yet |
| Giro 2016 Mandibular kinesiographic pattern of women with chronic TMD after management with educational and self-care therapies: A double-blind,… PMID:27236596 | 2016 | this review only | not stated | not extracted yet |
| Herpich 2018 Immediate and short-term effects of phototherapy on pain, muscle activity, and joint mobility in women with temporomandibular disorder: a… DOI:10.1080/09638288.2017.1336648 | 2017 | this review only | not stated | not extracted yet |
| Herpich 2018 Immediate and short-term effects of phototherapy on pain, muscle activity, and joint mobility in women with temporomandibular disorder: a… PMID:28602137 | 2018 | this review only | not stated | not extracted yet |
| Leite 2020 Effects of 4-Week Diacutaneous Fibrolysis on Myalgia, Mouth Opening, and Level of Functional Severity in Women With Temporomandibular… DOI:10.1016/j.jmpt.2020.01.002 | 2020 | this review only | not stated | not extracted yet |
| Leite 2020 Effects of 4-Week Diacutaneous Fibrolysis on Myalgia, Mouth Opening, and Level of Functional Severity in Women With Temporomandibular… PMID:32893024 | 2020 | this review only | not stated | not extracted yet |
| Lindfors 2020 Effect of Therapeutic Jaw Exercises in the Treatment of Masticatory Myofascial Pain: A Randomized Controlled Study DOI:10.11607/ofph.2670 | 2020 | this review only | not stated | not extracted yet |
| Lindfors 2020 Effect of Therapeutic Jaw Exercises in the Treatment of Masticatory Myofascial Pain: A Randomized Controlled Study. PMID:33290442 | 2020 | this review only | not stated | not extracted yet |
| Lopez-Martos 2018 Randomized, double-blind study comparing percutaneous electrolysis and dry needling for the management of temporomandibular myofascial pain. PMID:29924769 | 2018 | this review only | not stated | not extracted yet |
| Marquez-Vera 2024 Immediate Effects of the Mandibular Muscle Energy Technique in Adults with Chronic Temporomandibular Disorder. PMID:39727790 | 2024 | this review only | not stated | not extracted yet |
| Minston 2025 Effect on Pain Following One Session of Botulinum Toxin Type A in Patients With Jaw Myalgia: A Randomised Double‐Blind Controlled… DOI:10.1111/joor.13915 | 2024 | this review only | not stated | not extracted yet |
| Minston 2025 Effect on Pain Following One Session of Botulinum Toxin Type A in Patients With Jaw Myalgia: A Randomised Double-Blind Controlled… PMID:40296202 | 2025 | this review only | not stated | not extracted yet |
| Montes-Carmona 2021 Treatment of Localized and Referred Masticatory Myofascial Pain with Botulinum Toxin Injection. PMID:33374687 | 2020 | this review only | not stated | not extracted yet |
| Packer 2015 Effect of Upper Thoracic Manipulation on Mouth Opening and Electromyographic Activity of Masticatory Muscles in Women With… DOI:10.1016/j.jmpt.2015.04.001 | 2015 | this review only | not stated | not extracted yet |
| Packer 2015 Effect of upper thoracic manipulation on mouth opening and electromyographic activity of masticatory muscles in women with… PMID:25925019 | 2015 | this review only | not stated | not extracted yet |
| Reeve 2024 Does the Use of Botulinum Toxin in Treatment of Myofascial Pain Disorder of the Masseters and Temporalis Muscles Reduce Pain, Improve… DOI:10.1016/j.joms.2023.12.014 | 2024 | this review only | not stated | not extracted yet |
| Sancakli 2015 Early results of low-level laser application for masticatory muscle pain: a double-blind randomized clinical study DOI:10.1186/s12903-015-0116-5 | 2015 | this review only | not stated | not extracted yet |
| Senel Topaloglu 2025 Effect of myofascial release therapy applied to selective muscles on mobility and function in patients with temporomandibular dysfunction… PMID:40859519 | 2025 | this review only | not stated | not extracted yet |
| Şenel Topaloğlu 2025 Effect of myofascial release therapy applied to selective muscles on mobility and function in patients with temporomandibular dysfunction… DOI:10.1097/md.0000000000044086 | 2025 | this review only | not stated | not extracted yet |
| Zotelli 2017 Acupuncture Effect on Pain, Mouth Opening Limitation and on the Energy Meridians in Patients with Temporomandibular Dysfunction: A… DOI:10.1016/j.jams.2017.08.005 | 2017 | 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 aged 18 years or older with muscular, articular or mixed TMD diagnosed using DC/TMD or RDC/TMD | Adults with RDC/TMD- or DC/TMD-defined TMD (myogenous, arthrogenous and mixed) in 35 RCTs; analyzed samples 18 to 145 per study, about 1879 to 1896 participants |
| Intervention | Conservative treatments (education/self-management, exercise, physiotherapy, manual therapy, occlusal appliances, photobiomodulation, TENS, acupuncture) and minimally invasive treatments (dry needling, botulinum toxin, arthrocentesis, intra-articular injections) | Photobiomodulation/LLLT/LED (n=12 electrophysical or light-based), manual therapy, exercise, massage or education (n=10), needling or injections incl. botulinum toxin and PRP (n=7), occlusal splints (n=2), acupuncture (n=2), multi-arm (n=2) |
| Comparison | Inactive controls: sham/placebo, no treatment or waitlist (registered review also covered active comparators) | Sham/placebo (devices, placebo splints, nonpenetrating acupuncture, saline injections) and no treatment/waitlist |
| Outcomes | Pain intensity, mouth opening, jaw functional limitation, oral-health-related quality of life | Pain short term (n=23), medium term (n=4), long term (n=1); mouth opening short term (26 effects/25 studies), medium term (n=4); jaw functional limitation short term (n=4), medium term (n=2); OHRQoL short term (n=3), medium term (n=2) |
| Study designs | English-language peer-reviewed RCTs published 2015 to 2025 | RCTs (n=35) |
| Timing | Short term (up to 3 months), medium term (>3 to 6 months), long term (>6 months) | Short, medium and long term windows; long term pain only from one study |
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 | Yes | Partial Yes | no |
| 3Choice of study designs explained | No | Yes | no |
| 4Comprehensive literature searchcritical | Partial Yes | Yes | no |
| 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 | Yes | no |
| 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 | Yes | Yes | 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 |