Among adults with myogenic temporomandibular disorders, photobiomodulation therapy offers the best short-term pain relief, while manual therapy best improves maximum mouth opening.
The study compared the effectiveness of different nonpharmacological treatments for adult myogenic temporomandibular disorders using a random-effects network meta-analysis. Online databases were scoured for relevant randomized controlled trials involving adults who underwent various predefined nonpharmacological treatments. These treatments included photobiomodulation therapy, manual therapy, exercise therapy, occlusal splint therapy, acupuncture, electrotherapy, combined therapy, cognitive behavioral therapy, central neuromodulation, and extracorporeal shock wave therapy. Trials were included if they compared at least one of the predefined treatments to a control group, or another predefined intervention. Primary outcomes considered were pain and maximum mouth opening.
The study involved 41 trials with a total of 2021 participants. It was found that photobiomodulation therapy was ranked as the most effective treatment for pain, whereas manual therapy had the highest ranking for improving maximum mouth opening. Some therapies, such as manual therapy and combined therapy, also showed significant advantages in terms of pain relief in comparison to other treatments. It was also noted that there was inconsistency in pain outcomes for the comparison between electrotherapy and manual therapy, but no significant inconsistencies were observed for maximum mouth opening.
