Effectiveness of Physical Therapy Interventions for Temporomandibular Disorders Associated with Tinnitus: A Systematic Review.

Temporomandibular disorders (TMDs) refers to different clinical conditions affecting the temporomandibular joints, masticatory muscles, and adjacent structures. Although TMDs signs and symptoms (e.g., pain and limited mouth opening) are common, otological symptoms, such as tinnitus, might also be present. This study aims to summarize the evidence of the effectiveness of physical therapy interventions in individuals with TMDs associated with tinnitus. Randomized controlled trials investigating the effectiveness of physical therapy in individuals of both genders aged 18 or older with TMDs associated with tinnitus were included. The electronic search was performed in the following databases: MEDLINE, EMBASE, CINAHL, PEDro and CENTRAL. A total of four studies were included. All studies showed that physical therapy reduced the intensity of tinnitus, and two trials showed a decrease in the pain intensity caused by TMDs, an increase in the pressure pain thresholds in the masticatory muscles and an improvement of mandibular function. Two studies presented a low risk of bias. Despite a low certainty of the evidence, this review showed that physical therapy reduces the intensity or severity of tinnitus associated with TMDs. Results may support future research on the topic and evidence-based practice by recommending the best physical therapy approach for patients, clinicians, researchers, and health system managers.