Multimodal physical therapy approach for the management of patients with temporomandibular disorder: Randomized control trial

Abstract

Background

Temporomandibular disorders (TMD) are musculoskeletal disorders frequently seen in physiotherapy and dental practices, affecting the temporomandibular joint (TMJ) and central nervous system. A multimodal treatment could be more beneficial with limitations of traditional treatment.

Objective

The purpose of this research was to compare the outcomes of cranio-mandibular stabilisation exercises and a structured manual therapy protocol on pain reduction in TMD patients. A secondary purpose was to quantify improvements in mechanical tenderness and active mouth function.

Methods

This single-blind, randomized trial recruited 146 participants (95 women, 51 men) aged 18–50 years with TMD. Participants were randomly allocated into two groups to maintain allocation concealment. The intervention was standardized, administered by skilled physical therapists. Validated instruments measured outcomes, namely pain intensity, mechanical tenderness and active mouth function tests.

Results

Participants receiving cranio-mandibular stabilisation and manual therapy had significantly greater improvements in pain (P = 0.001, 95 %), mechanical tenderness (P = 0.001, 95 %) and active mouth function (P = 0.001, 95 %) compared to controls.

Conclusions

Findings suggest that a multimodal treatment of cranio-mandibular stabilisation and structured manual therapy significantly decreases pain and improves mechanical tenderness and active mouth function in TMD patients. Future research should include long-term follow-up to assess effect sustainability and optimize treatment protocols for maximum benefits.