Effectiveness of manual physical therapy and /or mandibular exercises in the treatment of the articular temporomandibular disorder - a systematic review

Anielle Do Nascimento Jácome,Aurigena Antunes De Araújo,Jeanne De Sena Monteiro Sousa,Erika Oliveira De Almeida,Gustavo Augusto Seabra Barbosa,Camila Maria Bastos Machado De Resende

doi:10.33448/rsd-v9i10.8485

Anielle Do Nascimento Jácome, Aurigena Antunes De Araújo + Show 4 more

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https://doi.org/10.33448/rsd-v9i10.8485

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Abstract

Objective: Evaluate the effectiveness of manual therapy and exercises for improving function and/or pain in patients diagnosed with temporomandibular joint dysfunction (TMD) through a systematic review of the literature. Methods: A systematic and manual electronic search of the data was performed in the following databases: MEDLINE-Pubmed, Cochrane Library, Web of Science and Scopus (until 2020). The following descriptors were used: "physiotherapy", "physiotherapy modalities", "physiotherapy specialty", "manual therapy", "massage", "exercise", "temporomandibular joint", "temporomandibular disorder", "temporomandibular joint", "disc "," Previous Disc Displacement "," Randomized Controlled Clinical Trial "," Controlled Clinical Trial "," Effectiveness "," Effect "and" Effectiveness ". As an inclusion, studies should present patients with joint pain diagnosed by the Diagnostic Criteria for Research on TMD (RDC / TMD) and manual therapy as an intervention. Results: Only 1 randomized controlled clinical trial was included in the inclusion criteria. Physical therapy manual exercises, despite promoting significant improvement in all studied variables, did not represent an additional positive effect in relation to the instruction and guidance given to patients with unrestricted articular disc displacement. Manual physical therapy and physical therapy exercises, despite while promoted a significant improvement in all the studied variables, did not represent an additional positive effect in relation to the instruction and orientation given to patients with joint disc displacement without reduction. Conclusions: Weak supporting evidence regarding the use of these approaches in patients with joint TMD was found, revealing the need to conduct new studies with methodologies well delineated and higher level of evidence.

Highlights

The temporamdibular joint (TMJ) can be affected by several disorders, for which this abnormality is called the temporomandibular disorder (TMD) nomenclature, masticatory muscles, and occlusion(Nascimento, et al, 2013; Craane, et al, 2012; Michelotti, et al, 2015; Cuccia et al, 2010)
Biological, anatomical, biomechanical, behavioral, environmental and emotional factors are able to affect the masticatory system, collaborating to the time of symptomatology, due to favoring the appearance of signs and symptoms. This has led to the acceptance of the TMD as a multifactorial pathology (Nascimento, et al, 2013; Craane, et al, 2012; Tuncer, et al, 2012), characterized mainly by pain and restriction of mandibular movements, the symptom most often leads the patient to seek help is pain (Tuncer, et al, 2013; Nicolakis, et al, 2000)
The methodology used for systematic review was chosen because it is a valuable resource that can highlight best practices in the health field and clarify clinical controversies

Summary

Introduction

The temporamdibular joint (TMJ) can be affected by several disorders, for which this abnormality is called the temporomandibular disorder (TMD) nomenclature, masticatory muscles, and occlusion(Nascimento, et al, 2013; Craane, et al, 2012; Michelotti, et al, 2015; Cuccia et al, 2010). Biological, anatomical, biomechanical, behavioral, environmental and emotional factors are able to affect the masticatory system, collaborating to the time of symptomatology, due to favoring the appearance of signs and symptoms. This has led to the acceptance of the TMD as a multifactorial pathology (Nascimento, et al, 2013; Craane, et al, 2012; Tuncer, et al, 2012), characterized mainly by pain and restriction of mandibular movements, the symptom most often leads the patient to seek help is pain (Tuncer, et al, 2013; Nicolakis, et al, 2000). The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) widely used for TMD research since its publication in 1992 (Schiffman, et al, 2014; Workshop I, 1994). Through a series of workshops and symposia, in 2014, specialists in clinical and scientific pain modified the RDC/TMD Axis I algorithms and proposed new Axis II instruments, creating the Diagnostic Criteria Protocol for TMD (DC / TMD) , which demonstrates greater sensitivity and specificity for the diagnosis of pain and joint disorders (Schiffman, et al, 2014; Stegenga, 2010)

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