Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2025 Apr;52(4):521-530.
doi: 10.1111/joor.13792. Epub 2024 Jul 23.

Comparative evaluation of cognitive behavioural therapy versus standard treatment in temporomandibular disorders: A systematic review

Sahana Shivakumar  1 , Nishath Sayed Abdul  2 , Bhuvan Jyoti  3 , Veena Kalburgi  4 , Marco Cicciù  5 , Giuseppe Minervini  6   7
Affiliations
Comparative Study

Comparative evaluation of cognitive behavioural therapy versus standard treatment in temporomandibular disorders: A systematic review

Sahana Shivakumar et al. J Oral Rehabil. 2025 Apr.

Abstract

Background: Temporomandibular disorders (TMDs) are musculoskeletal and neuromuscular conditions affecting the temporomandibular joint and associated structures. Cognitive-behavioural therapy (CBT) has emerged as a potential intervention for TMDs, but its comparative effectiveness against standard treatments remains unclear. This systematic review aimed to evaluate and compare the efficacy of CBT versus standard treatment interventions in managing TMDs.

Methods: A comprehensive search was conducted across multiple databases using MeSH keywords and Boolean operators. Inclusion criteria encompassed clinical trials comparing CBT/CBT in combination with standard treatment interventions or a control group in individuals with TMDs. The primary outcome measured was pain. Secondary outcomes such as disability, depression and jaw function were also looked into. Two reviewers independently assessed for the eligibility of the articles and conducted data extraction. Quality assessments were performed using RoB 2.0 for randomised clinical trials.

Results: The initial search identified 623 articles, of which a total of eight clinical studies met the inclusion criteria and were included in the systematic review. Seven out of eight studies demonstrated improvements in outcomes related to TMD. Pain was significantly decreased in studies that showed a positive outcome. Jaw function, quality of life and psychological well-being were superior among individuals receiving CBT alone or in combination with conventional modalities, as well as hypnotic therapy coupled with CBT-based interventions. The quality of studies assessed showed all articles to be of good quality as per RoB-2 evaluation.

Conclusion: This systematic review highlights the potential benefits of CBT in managing TMDs, suggesting its effectiveness in improving pain outcomes and enhancing overall well-being. The findings indicate that CBT may be a valuable adjunct or alternative to standard treatment interventions for individuals with TMDs. However, further research with larger sample sizes and standardised outcome measures is warranted to establish definitive conclusions regarding the comparative efficacy of CBT versus standard treatments in TMD management.

Keywords: cognitive‐behavioural therapy; pain; temporomandibular disorders.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Graphical representation of the PRISMA guideline utilisation in the review.
FIGURE 2
FIGURE 2
Risk of bias graph of included studies.
FIGURE 3
FIGURE 3
Risk of bias summary of included studies.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Rongo R, Ekberg E, Nilsson I, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for children and adolescents: an international Delphi study—part 1‐development of Axis I. J Oral Rehabil. 2021;48:836‐845. - PMC - PubMed
    1. Paduano S, Bucci R, Rongo R, Silva R, Michelotti A. Prevalence of temporomandibular disorders and oral parafunctions in adolescents from public schools in southern Italy. Cranio. 2020;38:370‐375. - PubMed
    1. Iodice G, Cimino R, Vollaro S, Lobbezoo F, Michelotti A. Prevalence of temporomandibular disorder pain, jaw noises and oral behaviours in an adult Italian population sample. J Oral Rehabil. 2019;joor.12803:691‐698. - PubMed
    1. Gonçalves DA d G, Dal Fabbro AL, Campos JADB, Bigal ME, Speciali JG. Symptoms of temporomandibular disorders in the population: an epidemiological study. J Orofac Pain. 2010;24:270‐278. - PubMed
    1. Haddad C, Sayegh SM, El Zoghbi A, Lawand G, Nasr L. The prevalence and predicting factors of temporomandibular disorders in COVID‐19 infection: a cross‐sectional study. Cureus. 2022;14:e28167. doi:10.7759/cureus.28167 - DOI - PMC - PubMed

MeSH terms