The effectiveness of physical therapy for temporomandibular disorder: A systematic review [version 1; peer review: awaiting peer review]

Background Temporomandibular disorders (TMD) are diseases of the stomatognathic system characterized by various signs and symptoms. TMD treatment must be multidisciplinary because its causes are multifactorial. Noninvasive conservative treatment strategies should be carried out before considering invasive treatment options that may lead to irreparable damage. Physical therapy is an effective noninvasive therapy for managing the signs and symptoms of TMD. To date, the most effective therapeutic approach for managing TMD pain remains controversial. Therefore, this study aimed to evaluate the most effective physical therapy for pain management, symptom control, and quality of life improvement in patients with TMD. Methods Data search was performed using the PubMed, SCOPUS, and Web of Sciences databases. The results are reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for systematic reviews. Interventions based on physical therapy, including physical exercise, manual therapy, myofacial muscle manipulation, and postural therapy, with pain relief, increased mouth opening, or improved quality of life as primary outcomes, were examined. Results Twenty eligible articles were analyzed. Most interventions demonstrated statistically significant improvements as measured by the study outcomes. Conclusions Most types of physical therapy demonstrated positive effects on patients with TMD. Furthermore, physical therapy for both cervical and regional TMJ manipulation can be an alternative long-term treatment for TMD.