Evidence map›Paper›PMID 41089095›Full record

ReviewCureus2025

Conservative and Minimally Invasive Interventions for Temporomandibular Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Alberto A Iturbe Cordero, Arturo P Jaramillo, Nelly M Omana Bautista, Karen Nathaly Munoz Armijos, Doris E Cooley, Heliette Emperatriz E Delgado Castromonte

Abstract readReview
In one paragraph

Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Alberto A Iturbe CorderoGeneral Dentistry, Universidad Central de Venezuela, Caracas, VEN.
Arturo P JaramilloGeneral Practice, Universidad Estatal de Guayaquil, Machala, ECU.
Nelly M Omana BautistaGeneral Dentistry, Universidad Antonio Nariño (UAN), Bogota, COL.
Karen Nathaly Munoz ArmijosMedicine, Zaporizhzhia State Medical University, Zaporizhzhia, UKR.
Doris E CooleyGeneral Dentistry, Universidad Catolica de Santiago de Guayaquil, Guayaquil, ECU.
Heliette Emperatriz E Delgado CastromonteDentistry, Universidad Gran Mariscal de Ayacucho, Anzoategui, VEN.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Temporomandibular disorders (TMD) are managed with interventions ranging from conservative physiotherapy to minimally invasive procedures, but their comparative effectiveness is unclear. We conducted a systematic review and meta-analysis of randomized trials to quantify treatment effects on pain and function. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we included randomized/quasi-randomized TMD trials reporting pre-/post-procedure and between-group outcomes. Ten trials (~500 participants) were pooled. Pain (Visual Analog Score (VAS) and Numerical Rating Scale (NRS)) was the primary outcome while maximal mouth opening (MMO) was the secondary outcome. Medians, interquartile ranges (IQRs) and standard errors (SEs) were converted to mean/standard deviation (SD) where needed. RevMan 5.4 (inverse-variance, random-effects) was used for statistical analysis. Subgroups contrasted minimally invasive (arthrocentesis/lavage±injectates) versus conservative/physical therapy (manual therapy, low-level laser therapy (LLLT) vs transcutaneous electrical nerve stimulation (TENS), ultrasound vs splints). Small-study effects were explored using funnel plots. Active interventions improved pain more than controls. In conservative care, adding manual therapy enhanced exercise/education, photobiomodulation outperformed TENS, and ultrasound gave modest early benefit. Invasive protocols (arthrocentesis) yielded faster pain relief than non-surgical comparators, with small differences across lavage agents/volumes. Both strategies produced clinically meaningful pooled benefits, with slightly greater effects for minimally invasive care. Heterogeneity was moderate; funnel plot symmetry suggested little publication bias. Excluding the retracted sodium 2-mercaptoethanesulfonate (MESNA) trial did not change the findings. Both conservative and minimally invasive approaches yield meaningful short-term pain reductions in TMD. Benefits are greatest with multimodal conservative programs and arthrocentesis as escalation. Publication bias was limited. Future randomized controlled trials (RCTs) should standardize outcomes and clarify escalation criteria.

Indexed as

arthrocentesistemporomandibular disorder (tmd)tenstmd pain managementtmd symptoms

Identifiers

PMID41089095
PMCPMC12516169

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.