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Multimodal approaches in the management of temporomandibular disorders: a narrative review
Dabkowska I, Sobiech L, Czepinska A, Beben A, Turzanska K, Gawda P
Journal of Clinical Medicine 2025 Jun;14(12):4326
systematic review

BACKGROUND/OBJECTIVES: Temporomandibular disorders (TMDs) are the most common cause of non-dental pain in the orofacial region. Due to the complex and multifactorial nature of TMD a multidisciplinary approach is often required. The objective of this narrative review is to evaluate the effectiveness of multimodal therapies in the management of TMD. METHODS: A literature search was performed using a combination of keywords: TMD, TMJ, disorders, manual therapy, physical therapy, dry needling, botulinum toxin, Botox, splint, and psychotherapy. The search was conducted in the PubMed, Google Scholar, and Scopus databases, focusing on studies involving human subjects. RESULTS: The included studies reported that the use of multimodal approaches-such as physiotherapy, botulinum toxin injections, occlusal splints, and/or psychotherapy-led to symptom improvement or complete resolution in patients with TMD. CONCLUSIONS: Temporomandibular disorders are complex conditions with a multifactorial etiology involving both somatic and psychological components. Given the wide range of symptoms and the functional connections of the temporomandibular joint with the nervous, muscular, and skeletal systems-including the cervical spine-effective treatment of TMD requires a multidisciplinary strategy.

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