Unlocking the jaw: The examination and treatment of temporomandibular dysfunction - A literature review

Absztrakt

Objective and Methods: This review evaluates the effectiveness of noninvasive physiotherapy treatments in reducing myofascial TMJD symptoms, with a focus on electrotherapy, manual therapy, and exercise therapy. A literature search was conducted using PubMed and the University of Szeged Klebelsberg Library. Only English-language clinical trials published between 2015 and 2025 were included. Ten high-quality studies (9 randomized controlled trials and 1 quasi-randomized trial) were analyzed using the PRISMA 2020 framework and quality assessment tools, including Scimago rankings and CEBM evidence levels. Across all studies, 653 participants (predominantly female), ranging from young to middle-aged adults, were diagnosed with myofascial TMJD and included in these trials.

Results: All modalities showed significant pain reduction (p<0.05). For overall symptom improvement, including mainly pain and maximal mouth opening, low-level laser therapy (LLLT) and electro-massage generally outperformed TENS and therapeutic ultrasound. Manual therapies such as Kinesio taping, myofascial release, post-isometric relaxation, and trigger point release were all effective in reducing muscle tension and pain. Massage therapy, especially when combined with exercise, led to faster, near-complete pain relief.

Conclusion: Multimodal noninvasive approaches are more effective than single therapies. Combining manual massage with electro-massage or LLLT, along with jaw opening exercises, improves pain, flexibility, and muscle function more rapidly. Addressing limitations in study design and standardization could further improve long-term patient outcomes.