Clinical practice guidelines in primary treatment for temporomandibular disorders: The Japanese Society for the Temporomandibular Joint, 2023 edition
Year: 2025
Type: article
Abstract: PURPOSE: This guideline aimed to make evidence-based clinical practice guidelines for the primary treatment of temporomandibular disorders (TMDs) for general practitioners who do not specialize in TMD. REVIEW PROCESS: Following the principles of evidence-based medicine, a systematic review and network meta-analysis (NMA) of multiple treatments was conducted, assessing the certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Randomized controlled trials published between January 2000 and December 2020 were included. Patients diagnosed with TMD according to the Diagnostic Criteria for Temporomandibular Disorders were considered. Myalgia, arthralgia, and maximal mouth opening were selected as outcomes, and 12 treatments were included in the NMA. The modified Delphi method was used to reach a consensus on recommendations during clinical guideline panel meetings of the Japanese Society for the Temporomandibular Joint. RESULTS: Self-administered mouth opening exercises, stabilization-type oral appliances, and low-level laser therapy (LLLT) were recognized as effective primary treatments, although the evidence level was graded as "very low" (Grade 2D). During the clinical guideline panel meetings, decisions were developed based on the NMA results, and recommendations for clinical practice guidelines were finalized following consensus. CONCLUSIONS: This guideline recommends mouth opening exercises and the use of stabilization-type oral appliances as primary treatments for TMD. Additionally, it suggests that LLLT be a conditional recommendation, supplemented with additional considerations.
Authors: Kazuhiro Ooi, Akira Nishiyama, Hidemichi Yuasa, Yoshihiro Yamaguchi, Takahiro Abe, Yasuhiro Ono, Toshihiro Fukazawa, Shinpei Matsuda, Hidehisa Matsumura, Yuki Watanabe, Yoshitaka Suzuki, Miki Kashiwagi, Azuma Kosai, Yuko Fujihara, Hiroyuki Ishiyama, Yoshizo Matsuka
Institutions: Kanazawa University, Institute of Science Tokyo, National Hospital Organization Toyohashi Medical Center, Aichi Gakuin University, Kanagawa Dental University, University of Fukui, Kyushu University, SHOWA Medical University, Tokushima University, University of Tokyo Hospital, The University of Tokyo, Tokyo Teishin Hospital
Language: English
Subfield: Complementary and Manual Therapy
Field: Health Professions
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,000
OpenAlex ID: W4410579593