A systematic review and Meta-Analysis: Exploring the efficacy of self-managed treatments for Temporomandibular Disorders (TMD): The role of home exercise and digital therapies
In brief
Self-managed TMD therapies lower pain by about 0.8 standard deviations
A meta-analysis of randomized trials found that home-exercise, education and digital programs produce a clinically meaningful reduction in temporomandibular disorder pain (effect size ≈ 0.8). The same approaches showed a non-significant trend toward greater mouth opening. These results support adding structured self-care to routine TMD management, though benefits for mobility remain uncertain.
- Journal
- Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery (Q1)
- Published
- 18 August 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Jonathan Mohr, Jannik Ketschau, Alex Grabenhorst, Hannes Singer, Katharina Pippich, Nils Krautkremer, et al.
- PMID
- 42612338
- DOI
- 10.1016/j.jcms.2026.109856
Why clinicians should know about it
- Picked for Otorhinolaryngology (top studies of the week, 23 August 2026): High-quality evidence in a top journal
Abstract
Temporomandibular disorders (TMD) are highly prevalent and frequently associated with chronic pain and functional impairment, forming part of the diagnostic spectrum in cranio-maxillofacial surgery. Scalable, self-managed interventions - including home-exercise programs, psychoeducational strategies, and digitally supported approaches - are increasingly used, yet their pooled effectiveness has not been systematically quantified. A systematic search of PubMed, Scopus, and Cochrane CENTRAL identified randomized controlled trials evaluating predominantly self-managed or remotely delivered interventions for TMD. Eligible studies were qualitatively synthesized, and trials providing sufficient numerical data were meta-analyzed. Standardized mean differences (Hedges' g) were calculated using random-effects models; heterogeneity, prediction intervals, robustness, and publication bias were assessed. Self-managed interventions produced a statistically significant and clinically meaningful reduction in pain (SMD = -0.78; 95% CI -1.33 to -0.24; p = 0.005; I2 = 84%), with robust findings in sensitivity analyses. For maximal mouth opening, the pooled estimate showed a nonsignificant trend toward improved mandibular mobility (SMD = 0.63; 95% CI -0.11 to 1.37; I2 = 91%). These findings support structured self-management strategies as effective components of contemporary TMD care pathways, with direct relevance for evidence-based indication setting and patient counseling in cranio-maxillofacial practice.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.