title: Efficacy of musculoskeletal manual approach in the treatment of temporomandibular joint disorder: A systematic review with meta-analysis.
abstract: BACKGROUND
  Temporomandibular joint disorder (TMD) requires a complex diagnostic and therapeutic approach, which usually involves a multidisciplinary management. Among these treatments, musculoskeletal manual techniques are used to improve health and healing.
  
  
  OBJECTIVE
  To assess the effectiveness of musculoskeletal manual approach in temporomandibular joint disorder patients.
  
  
  METHODS
  A systematic review with meta-analysis.
  
  
  METHODS
  During August 2014 a systematic review of relevant databases (PubMed, The Cochrane Library, PEDro and ISI web of knowledge) was performed to identify controlled clinical trials without date restriction and restricted to the English language. Clinical outcomes were pain and range of motion focalized in temporomandibular joint. The mean difference (MD) or standard mean difference (SMD) with 95% confidence intervals (CIs) and overall effect size were calculated at every post treatment. The PEDro scale was used to demonstrate the quality of the included studies.
  
  
  RESULTS
  From the 308 articles identified by the search strategy, 8 articles met the inclusion criteria. The meta-analysis showed a significant difference (p < 0.0001) and large effect on active mouth opening (SMD, 0.83; 95% CI, 0.42 to 1.25) and on pain during active mouth opening (MD, 1.69; 95% CI, 1.09 to 2.30) in favor of musculoskeletal manual techniques when compared to other conservative treatments for TMD.
  
  
  CONCLUSIONS
  Musculoskeletal manual approaches are effective for treating TMD. In the short term, there is a larger effect regarding the latter when compared to other conservative treatments for TMD.
authors.affiliation: University of Brasilia, College of Physical Therapy, Brasilia, DF, Brazil. Electronic address: wrmartins@me.com.
authors.forename: Wagner Rodrigues
authors.initials: WR
authors.lastname: Martins
authors.affiliation: Brazilian Institute of Osteopathic, Rio de Janeiro, RJ, Brazil. Electronic address: juscelinocastro@gmail.com.
authors.forename: Juscelino Castro
authors.initials: JC
authors.lastname: Blasczyk
authors.affiliation: Sena Aires College, College of Physical Therapy, Valparaíso, GO, Brazil. Electronic address: micaele-furlan@hotmail.com.
authors.forename: Micaele
authors.initials: M
authors.lastname: Aparecida Furlan de Oliveira
authors.affiliation: Brazilian Institute of Osteopathic, Rio de Janeiro, RJ, Brazil. Electronic address: karinalagoa@gmail.com.
authors.forename: Karina Ferreira
authors.initials: KF
authors.lastname: Lagôa Gonçalves
authors.affiliation: University of Brasilia, College of Physical Therapy, Brasilia, DF, Brazil. Electronic address: anaclara@unb.br.
authors.forename: Ana Clara
authors.initials: AC
authors.lastname: Bonini-Rocha
authors.affiliation: Université Libre de Bruxelles, Faculté des Sciences de la Motricité, Department of Osteopathic Sciences, Research Unit in Osteopathy, Route de Lennik 808, Campus Erasme (CP 640) Bât. N.4.117 - 1070, Bruxelles, Belgique. Electronic address: Pierre-Michel.Dugailly@ulb.ac.be.
authors.forename: Pierre-Michel
authors.initials: PM
authors.lastname: Dugailly
authors.affiliation: University of Brasilia, College of Physical Education, Brasilia, DF, Brazil. Electronic address: rjaco@unb.br.
authors.forename: Ricardo Jacó
authors.initials: RJ
authors.lastname: de Oliveira
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods*; D016059:Range of Motion, Articular; D013704:Temporomandibular Joint / Q000503:physiopathology*; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis* / Q000628:therapy*; D055815:Young Adult
keywords: Manual therapy; Pain; Range of motion; Temporomandibular joint disorder