Effect of mandibular exercises in the control of signs and symptoms of temporomandibular disorders: a randomized controlled clinical trial.

Abstract

Objective: To evaluate the effectiveness of mandibular exercises (ME) in patients with temporomandibular disorders (TMD) diagnosed by Research Diagnostic Criteria for TMD (RDC/TMD).

Material and methods: Thirty-two patients seeking clinical treatment for TMD were randomly assigned to groups based on the treatment modality: conservative therapy (CT), including occlusal splint therapy and counseling; and ME. Muscle and joint pain were assessed using a 4-point scale (0 = no pain, 1 = mild pain, 2 = moderate pain, and 3 = severe pain). The maximum unassisted mouth opening (MUMO) was measured in millimeters, both with and pain-free. Outcomes were evaluated at baseline (T0) and after a 3-months intervention period (T1).

Results: Both treatments significantly reduced muscle and joint pain intensity at most assessed sites. The reduction in pain with ME compared to CT was statistically significant at the right lateral pole of the temporomandibular joint (TMJ) (p = 0.048; rrb = 0.348). After three months, ME resulted in greater pain-free MUMO (T0 vs. T1; p = 0.004; rrb = 0.594), and the increase in MUMO was greater than that observed with CT (p < 0.001; rrb = 0.742).

Conclusion: ME and CT similarly reduced palpatory pain, with ME showing greater clinical impact at the right lateral pole. Both treatments led to significant improvements in the masseter and TMJ pole. ME also provided superior, clinically meaningful gains in pain-free MUMO, positioning it as a preferred option when enhancing jaw mobility is a primary goal in TMD management.