{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T19:08:10Z","timestamp":1788894490809,"version":"build-2803163510"},"reference-count":15,"publisher":"FapUNIFESP (SciELO)","issue":"6","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVE: The aim of this study was to compare the effectiveness of exercise, transcutaneous electrical nerve stimulation, and manual therapy on pain intensity, maximum mouth opening, and masticatory muscle activity-during chewing of the masseter and temporalis anterior in myogenous temporomandibular disorders.  METHODS: A total of 51 myogenous temporomandibular disorders patients were randomly assigned to three groups: exercise group, transcutaneous electrical nerve stimulation group, and manual therapy group. For 6 weeks, exercise group received exercise only, transcutaneous electrical nerve stimulation group received exercise+transcutaneous electrical nerve stimulation, and manual therapy group received exercise+manual therapy. At baseline and after 6-week treatment, pain intensity was assessed using a visual analog scale, maximum mouth opening using a millimeter ruler, and masticatory muscle activity-during chewing of the masseter and temporalis anterior using surface electromyography.  RESULTS: After treatment, significant improvements in pain intensity, maximum mouth opening, and masticatory muscle activity-during chewing values were found in all the three groups. The greatest improvements were seen in manual therapy group. The decreases in pain intensity and increases in masticatory muscle activity-during chewing values were statistically significantly higher in transcutaneous electrical nerve stimulation group than in exercise group (p&lt;0.05). The increases in maximum mouth opening were similar in transcutaneous electrical nerve stimulation group and exercise group.  CONCLUSION: Exercise is an effective method for improving pain intensity, maximum mouth opening, and masticatory muscle activity-during chewing in myogenous temporomandibular disorders. Combining exercise with manual therapy may provide the highest therapeutic effect on these parameters. Combining exercise with transcutaneous electrical nerve stimulation may also lead to further improvements in pain intensity and masticatory muscle activity-during chewing.<\/jats:p>","DOI":"10.1590\/1806-9282.20242102","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T13:59:58Z","timestamp":1751983198000},"source":"Crossref","is-referenced-by-count":3,"title":["Comparison of the effectiveness of three different conservative methods in myogenous temporomandibular disorders"],"prefix":"10.1590","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2404-2884","authenticated-orcid":false,"given":"Naz\u0131m Tolgahan","family":"Y\u0131ld\u0131z","sequence":"first","affiliation":[{"name":"Karamanoglu Mehmetbey University,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5112-4754","authenticated-orcid":false,"given":"Zafer","family":"Erden","sequence":"additional","affiliation":[{"name":"Hacettepe University,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4169-266X","authenticated-orcid":false,"given":"G\u00fcrsoy","family":"Co\u015fkun","sequence":"additional","affiliation":[{"name":"Hacettepe University,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0641-9956","authenticated-orcid":false,"given":"Filiz","family":"Can","sequence":"additional","affiliation":[{"name":"Hacettepe University,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3883-2406","authenticated-orcid":false,"given":"Hakan H\u0131fz\u0131","family":"T\u00fcz","sequence":"additional","affiliation":[{"name":"Hacettepe University,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2025]]},"reference":[{"issue":"6","key":"ref1","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1097\/GME.0000000000001962","article-title":"Does temporomandibular disorder correlate with menopausal symptoms?","volume":"29","author":"Galhardo APM","year":"2022","journal-title":"Menopause"},{"issue":"8","key":"ref2","article-title":"Cross-sectional study of self-reported pain related to temporomandibular disorders and emotional state of medical school faculty and students: post-COVID-19 pandemic","volume":"19","author":"Galhardo APM","year":"2024","journal-title":"PLoS One"},{"issue":"11","key":"ref3","doi-asserted-by":"crossref","first-page":"6547","DOI":"10.1007\/s00784-023-05260-3","article-title":"Predictors of the masticatory muscle activity during chewing in patients with myogenous temporomandibular disorder","volume":"27","author":"Y\u0131ld\u0131z NT","year":"2023","journal-title":"Clin Oral Investig"},{"issue":"1","key":"ref4","doi-asserted-by":"crossref","first-page":"18403","DOI":"10.1038\/s41598-019-54774-y","article-title":"Influence of age and gender on sex steroid receptors in rat masticatory muscles","volume":"9","author":"Galhardo APM","year":"2019","journal-title":"Sci Rep"},{"issue":"3","key":"ref5","doi-asserted-by":"crossref","first-page":"920","DOI":"10.3390\/jcm13030920","article-title":"Use of surface electromyography to evaluate effects of therapeutic methods on masticatory muscle activity in patients with temporomandibular disorders: a narrative review","volume":"13","author":"Dorosz T","year":"2024","journal-title":"J Clin Med"},{"issue":"12","key":"ref6","doi-asserted-by":"crossref","first-page":"4156","DOI":"10.3390\/jcm12124156","article-title":"Temporomandibular joint dysfunctions: a systematic review of treatment 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meta-meta-analysis","volume":"12","author":"Arribas-Pascual M","year":"2023","journal-title":"J Clin Med"},{"issue":"3","key":"ref10","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1179\/crn.2006.030","article-title":"Effect of controlled masticatory exercise on pain and muscle performance in myofascial pain patients: a pilot study","volume":"24","author":"Gavish A","year":"2006","journal-title":"Cranio"},{"issue":"2","key":"ref11","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1590\/1678-77572016-0173","article-title":"Short-term transcutaneous electrical nerve stimulation reduces pain and improves the masticatory muscle activity in temporomandibular disorder patients: a randomized controlled trial","volume":"25","author":"Ferreira AP","year":"2017","journal-title":"J Appl Oral Sci"},{"issue":"9","key":"ref12","doi-asserted-by":"crossref","first-page":"3250","DOI":"10.3390\/ijerph17093250","article-title":"Evaluation of the stomatognathic system before and after 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