Evidence map›Paper›PMID 41135079›Full record

Trial reportJournal of medical Internet research2025

Evaluating the Efficacy of a Digital Therapeutic Intervention for Temporomandibular Disorders: Multicenter, Randomized, Sham-Controlled Trial.

Sang-Yoon Park, Sung-Woon On, Sangmin Yi, Sung-Ah Che, Bongju Kim, Soo-Hwan Byun, Byoung-Eun Yang

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Journal of medical Internet research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

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

  1. Pooled it
  2. Trial
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

7 authors.

Sang-Yoon Park *Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.ORCID https://orcid.org/0000-0001-7624-3373
Sung-Woon On *Division of Oral and Maxillofacial Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea.ORCID https://orcid.org/0000-0001-6192-1530
Sangmin YiDepartment of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.ORCID https://orcid.org/0000-0002-3659-8572
Sung-Ah CheDepartment of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.ORCID https://orcid.org/0009-0001-8587-5134
Bongju KimDental Life Science Research Institute, Seoul National University Dental Hospital, Seoul, Republic of Korea.ORCID https://orcid.org/0000-0001-7309-5977
Soo-Hwan ByunDepartment of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.ORCID https://orcid.org/0000-0003-0739-7971
Byoung-Eun YangDepartment of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.ORCID https://orcid.org/0000-0002-4446-6772

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTemporomandibular disorders (TMDs) are common chronic musculoskeletal conditions associated with pain, jaw dysfunction, and impaired quality of life and influenced by behavioral and psychological factors. Digital therapeutics (DTx) may improve access to standardized behavioral interventions, but their clinical efficacy for TMD has not been adequately established.

objectiveThis study aimed to investigate the efficacy of a mobile-based DTx intervention (Clickless DTx TMD-01) compared with a sham app in reducing pain and improving functional and psychological outcomes in patients with TMD.

methodsWe conducted a multicenter, double-blind, randomized, sham-controlled trial at 2 university hospitals in South Korea. Adults aged between 19 and 65 years with a diagnosis of TMD according to the diagnostic criteria for TMD were randomly assigned (1:1) to the intervention group or sham control. The intervention was delivered via the DTx mobile app and included TMD-related disease education, guided jaw exercises, behavioral habit tracking, psychoeducational content, guided meditation, and data-driven feedback. The sham app provided only symptom recording without therapeutic content. Participants were instructed to use the assigned app daily for 6 weeks. The primary outcome was change in pain intensity measured by a 100-mm visual analog scale. Secondary outcomes included maximum mouth opening and scores on the Jaw Functional Limitation Scale-20, Oral Behaviors Checklist, and Patient Health Questionnaire-4.

resultsA total of 102 participants were randomly assigned (DTx group: n=50, 49%; sham group: n=52, 51%). For the per-protocol analysis, 44 (88%) of the 50 participants in the DTx group and 49 (94%) of the 52 participants in the sham group were included. At 6 weeks, the DTx group showed a significantly greater reduction in pain on the visual analog scale compared with the sham group (-33.64 vs -9.86; between-group difference -23.78, 95% CI -34.15 to -13.41; P<.001). Secondary outcomes also favored the DTx group, with improvements in maximum mouth opening (between-group difference 4.36 mm, 95% CI 1.92-6.81 mm; P<.001), Jaw Functional Limitation Scale-20 scores (-1.02, 95% CI -1.63 to -0.42; P=.005), and Oral Behaviors Checklist scores (-5.84, 95% CI -10.18 to -1.50; P=.009). No significant between-group difference was observed in Patient Health Questionnaire-4 scores. Adherence was acceptable, as all participants included in the final analysis met the use threshold of at least 66.7%. No serious adverse events were reported.

conclusionsThis randomized, sham-controlled trial demonstrated that a mobile-based DTx intervention led to significant improvement in pain at 6 weeks compared with sham control, with additional benefits in jaw function and oral behaviors, although no significant between-group difference was observed in psychological distress. These findings suggest that DTx interventions may serve as a promising and scalable adjunct to conventional care for patients with TMD.

trial registrationClinical Research Information Service KCT0009493; https://tinyurl.com/567fexbj.

Indexed as

Mobile ApplicationsTemporomandibular Joint DisordersAdultAgedDouble-Blind MethodFemaleHumansMaleMiddle AgedQuality of LifeRepublic of KoreaTreatment OutcomeYoung Adultcognitive behavioral therapydigital healthdigital therapeuticsmobile appsrandomized controlled trialtemporomandibular joint disorders

Identifiers

PMID41135079
PMCPMC12595392

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.