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Background: A class of musculoskeletal diseases known as temporomandibular disorders (TMD) damage the temporomandibular joint (TMJ) and related structures, resulting in discomfort, reduced jaw function, and a lower standard of living. This study compared the outcomes to those of healthy controls in order to assess craniovertebral and craniomandibular alterations in TMD patients following six months of physiotherapy in addition to occlusal splint therapy.

Methods: A prospective case-control research included 60 participants: 30 TMD sufferers and 30 healthy controls. The control group received no treatment, while the TMD group underwent six months of physiotherapy and occlusal splint therapy. Before and after therapy, lateral cephalograms were collected. We measured vertical (NL/ML angle), sagittal (Wits and ANB angle), craniovertebral, and cervical alignment changes in the mandible. Maximum mouth opening and pain were measured. Statistics were analysed using paired t-tests and Wilcoxon tests, with significance set at p<0.05.

Results: The TMD group showed significant improvements in vertical mandibular position (NL/ML angle decreased by 1.8°), sagittal positioning (ANB angle reduced by 1.3°), and craniovertebral alignment (CVA increased by 3.6°) compared to the control group (p<0.001). Functional spaces between the cranial base and cervical vertebrae also decreased significantly in the TMD group. Pain levels in the TMD group decreased from 2.4 to 0.7 on a 0-3 scale, and maximum mouth opening improved by 6.3 mm. The control group showed no significant changes.

Conclusion: Physiotherapy combined with occlusal splint therapy effectively improved craniovertebral and craniomandibular alignment, reduced pain, and increased mandibular mobility in patients with TMD. These findings support the use of a multimodal approach in the management of TMD.

Recommendations: Future studies should explore the long-term effects of this combined therapy and investigate its efficacy in different subgroups of TMD patients. Additionally, the role of other adjunct therapies such as pharmacological interventions should be evaluated.

Keywords: Temporomandibular Disorders, Occlusal Splint Therapy, Physiotherapy, Craniovertebral Alignment, Mandibular Positioning, Pain Reduction