Clinical Effectiveness of Acupressure Combined With Rehabilitation Therapy in The Treatment of Temporomandibular Disorders: Evidence From A Provincial Hospital In Vietnam
Abstract
This study aimed to evaluate the effectiveness of acupressure massage combined with rehabilitation therapy in the treatment of patients with temporomandibular disorders at Thanh Hoa General Hospital, Vietnam. A total of 33 patients diagnosed with temporomandibular disorder (TMD) according to the American Academy of Orofacial Pain (AAOP) 2018 criteria were included in the study. Patients underwent a treatment program consisting of temporomandibular joint exercises, acupressure massage of the head, face, and neck regions, together with therapeutic ultrasound. Treatment outcomes were assessed using the Visual Analog Scale (VAS) at hospital admission, discharge, and follow-up after treatment. The results demonstrated that the mean VAS pain score significantly decreased from 5.61 ± 1.62 at admission to 0.24 ± 0.64 at discharge (p < 0.001). Complete pain relief was achieved in 84.8% of patients at discharge and 100% after a two-week follow-up period, with no recurrence or treatment-related complications observed. These findings suggest that acupressure massage combined with rehabilitation therapy is a safe and effective therapeutic approach for reducing pain, improving temporomandibular joint function, and enhancing the quality of life of patients with TMD.
Keywords:
Temporomandibular disorders, acupressure massage, rehabilitation therapy, Visual Analog Scale (VAS), non-pharmacological treatment.
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References
1. Labanca M, Gianò M, Franco C, Rezzani R. Orofacial pain and dentistry management: guidelines for a more comprehensive evidence-based approach. Diagnostics. 2023;13(17):2854. https://doi.org/10.3390/diagnostics13172854
2. Armijo-Olivo S, Pitance L, Singh V, Neto F, Thie N, Michelotti A. Effectiveness of manual therapy and therapeutic exercise for temporomandibular disorders: systematic review and meta-analysis. Phys Ther. 2016;96(1):9-25. https://doi.org/10.2522/ptj.20140548
3. Alqutaibi AY, Alhammadi MS, Hamadallah HH, Altarjami AA, Malosh OT, Aloufi AM, et al. Global prevalence of temporomandibular disorders: a systematic review and meta-analysis. J Oral Facial Pain Headache. 2025;39(2):48-65. https://doi.org/10.22514/jofph.2025.025
4. Calixtre LB, Moreira RFC, Franchini GH, Alburquerque-Sendín F, Oliveira AB. Manual therapy for the management of pain and limited range of motion in subjects with signs and symptoms of temporomandibular disorder: a systematic review of randomised controlled trials. J Oral Rehabil. 2015;42(11):847-861.
https://doi.org/10.1111/joor.12321
5. Da-Cas CD, Valesan LF, do Nascimento LP, Denardin ACS, Januzzi E, Fernandes G, et al. Risk factors for temporomandibular disorders: a systematic review of cohort studies. Oral Surg Oral Med Oral Pathol Oral Radiol. 2024;138(4):502-515. https://doi.org/10.1016/j.oooo.2024.06.007
6. Vieira LS, Pestana PRM, Miranda JP, Soares LA, Silva F, Alcantara MA, et al. The efficacy of manual therapy approaches on pain, maximum mouth opening and disability in temporomandibular disorders: a systematic review of randomised controlled trials. Life. 2023;13(2):292. https://doi.org/10.3390/life13020292
7. de Melo LA, Bezerra de Medeiros AK, Campos MFTP, Bastos Machado de Resende CM, Barbosa GAS, de Almeida EO. Manual therapy in the treatment of myofascial pain related to temporomandibular disorders: a systematic review. J Oral Facial Pain Headache. 2020;34(2):141-148.
8. Trang PT, Mai TTT, Linh NT, Thuy PTH. Effectiveness of MAGO splint therapy in the treatment of temporomandibular disorders. Vietnam Medical Journal. 2023;529(2).
9. Phan AC, Luong TN. Evaluation of treatment outcomes of temporomandibular disorders at Ho Chi Minh City Hospital of Odonto-Stomatology. Journal of Medicine and Pharmacy – Hue University of Medicine and Pharmacy. 2021;11(2):77–85.
10. Ooi K, Aihara M, Matsumura H, Matsuda S, Watanabe Y, Yuasa H, et al. 10. Therapy outcome measures in temporomandibular disorder: a scoping review. BMJ Open. 2022;12(8):e061387. http://dx.doi.org/10.1136/bmjopen-2022-061387
11. Tung DD, Thanh DT, Nghia NV. Evaluation of pain reduction using the Visual Analog Scale (VAS) following computed tomography-guided percutaneous ozone therapy for lumbar disc herniation. Vietnam Medical Journal. 2025;551(1).https://tapchiyhocvietnam.vn/index.php/vmj/article/view/14522/12464
12. Robinson JL, Johnson PM, Kister K, Yin MT, Chen J, Wadhwa S. Estrogen signaling impacts temporomandibular joint and periodontal disease pathology. Odontology. 2020;108(2):153-165. doi:10.1007/s10266-019-00439-1
13. Tashiro A, Bereiter DA. The effects of estrogen on temporomandibular joint pain as influenced by trigeminal caudalis neurons. J Oral Sci. 2020;62(2):150-155. https://doi.org/10.2334/josnusd.19-0405
[14] Zieliński G, Pająk-Zielińska B, Ginszt M. A meta-analysis of the global prevalence of temporomandibular disorders. J Clin Med. 2024;13(5):1365.
https://doi.org/10.3390/jcm13051365
15. Qin H, Guo S, Chen X, Liu Y, Lu L, Zhang M, et al. Clinical profile in relation to age and gender of patients with temporomandibular disorders: a retrospective study. BMC Oral Health. 2024;24(1):955.
https://doi.org/10.1186/s12903-024-04736-2
16. Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache. 2014;28(1):6-27.
https://pmc.ncbi.nlm.nih.gov/articles/PMC4478082/pdf/nihms-695420.pdf
17. Toh AQJ, Chan JLH, Leung YY. Mandibular asymmetry as a possible etiopathologic factor in temporomandibular disorder: a prospective cohort of 134 patients. Clin Oral Investig. 2021;25:4445-4450.
https://doi.org/10.1007/s00784-020-03756-w
18. Yap AUJ, Chua EK, Hoe JKE. Clinical TMD, pain-related disability and psychological status of TMD patients. J Oral Rehabil. 2002;29(4):374-380.
19. Manfredini D, Guarda-Nardini L, Winocur E, Piccotti F, Ahlberg J, Lobbezoo F. Research diagnostic criteria for temporomandibular disorders: a systematic review of axis I epidemiologic findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(4):453-462.
https://doi.org/10.1016/j.tripleo.2011.04.021
20. Slade GD, Ohrbach R, Greenspan JD, Fillingim RB, Bair E, Sanders AE, et al. Painful temporomandibular disorder: decade of discovery from OPPERA studies. J Dent Res. 2016;95(10):1084-1092. doi:10.1177/0022034516653743
21. Cade WT. Diabetes-related microvascular and macrovascular diseases in the physical therapy setting. Phys Ther. 2008;88(11):1322-1335.
https://doi.org/10.2522/ptj.20080008
22. Intengan HD, Schiffrin EL. Vascular remodeling in hypertension: roles of apoptosis, inflammation, and fibrosis. Hypertension. 2001;38(3):581-587.
https://www.ahajournals.org/doi/pdf/10.1161/hy09t1.096249
23. Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B. Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet. 2007;370(9590):851-858.
24. Tanaka E, Detamore MS, Mercuri LG. Degenerative disorders of the temporomandibular joint: etiology, diagnosis, and treatment. J Dent Res. 2008;87(4):296-307. https://doi.org/10.1177/154405910808700421
25. Gauer RL, Semidey MJ. Diagnosis and treatment of temporomandibular disorders. Am Fam Physician. 2015;91(6):378-386.
2. Armijo-Olivo S, Pitance L, Singh V, Neto F, Thie N, Michelotti A. Effectiveness of manual therapy and therapeutic exercise for temporomandibular disorders: systematic review and meta-analysis. Phys Ther. 2016;96(1):9-25. https://doi.org/10.2522/ptj.20140548
3. Alqutaibi AY, Alhammadi MS, Hamadallah HH, Altarjami AA, Malosh OT, Aloufi AM, et al. Global prevalence of temporomandibular disorders: a systematic review and meta-analysis. J Oral Facial Pain Headache. 2025;39(2):48-65. https://doi.org/10.22514/jofph.2025.025
4. Calixtre LB, Moreira RFC, Franchini GH, Alburquerque-Sendín F, Oliveira AB. Manual therapy for the management of pain and limited range of motion in subjects with signs and symptoms of temporomandibular disorder: a systematic review of randomised controlled trials. J Oral Rehabil. 2015;42(11):847-861.
https://doi.org/10.1111/joor.12321
5. Da-Cas CD, Valesan LF, do Nascimento LP, Denardin ACS, Januzzi E, Fernandes G, et al. Risk factors for temporomandibular disorders: a systematic review of cohort studies. Oral Surg Oral Med Oral Pathol Oral Radiol. 2024;138(4):502-515. https://doi.org/10.1016/j.oooo.2024.06.007
6. Vieira LS, Pestana PRM, Miranda JP, Soares LA, Silva F, Alcantara MA, et al. The efficacy of manual therapy approaches on pain, maximum mouth opening and disability in temporomandibular disorders: a systematic review of randomised controlled trials. Life. 2023;13(2):292. https://doi.org/10.3390/life13020292
7. de Melo LA, Bezerra de Medeiros AK, Campos MFTP, Bastos Machado de Resende CM, Barbosa GAS, de Almeida EO. Manual therapy in the treatment of myofascial pain related to temporomandibular disorders: a systematic review. J Oral Facial Pain Headache. 2020;34(2):141-148.
8. Trang PT, Mai TTT, Linh NT, Thuy PTH. Effectiveness of MAGO splint therapy in the treatment of temporomandibular disorders. Vietnam Medical Journal. 2023;529(2).
9. Phan AC, Luong TN. Evaluation of treatment outcomes of temporomandibular disorders at Ho Chi Minh City Hospital of Odonto-Stomatology. Journal of Medicine and Pharmacy – Hue University of Medicine and Pharmacy. 2021;11(2):77–85.
10. Ooi K, Aihara M, Matsumura H, Matsuda S, Watanabe Y, Yuasa H, et al. 10. Therapy outcome measures in temporomandibular disorder: a scoping review. BMJ Open. 2022;12(8):e061387. http://dx.doi.org/10.1136/bmjopen-2022-061387
11. Tung DD, Thanh DT, Nghia NV. Evaluation of pain reduction using the Visual Analog Scale (VAS) following computed tomography-guided percutaneous ozone therapy for lumbar disc herniation. Vietnam Medical Journal. 2025;551(1).https://tapchiyhocvietnam.vn/index.php/vmj/article/view/14522/12464
12. Robinson JL, Johnson PM, Kister K, Yin MT, Chen J, Wadhwa S. Estrogen signaling impacts temporomandibular joint and periodontal disease pathology. Odontology. 2020;108(2):153-165. doi:10.1007/s10266-019-00439-1
13. Tashiro A, Bereiter DA. The effects of estrogen on temporomandibular joint pain as influenced by trigeminal caudalis neurons. J Oral Sci. 2020;62(2):150-155. https://doi.org/10.2334/josnusd.19-0405
[14] Zieliński G, Pająk-Zielińska B, Ginszt M. A meta-analysis of the global prevalence of temporomandibular disorders. J Clin Med. 2024;13(5):1365.
https://doi.org/10.3390/jcm13051365
15. Qin H, Guo S, Chen X, Liu Y, Lu L, Zhang M, et al. Clinical profile in relation to age and gender of patients with temporomandibular disorders: a retrospective study. BMC Oral Health. 2024;24(1):955.
https://doi.org/10.1186/s12903-024-04736-2
16. Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache. 2014;28(1):6-27.
https://pmc.ncbi.nlm.nih.gov/articles/PMC4478082/pdf/nihms-695420.pdf
17. Toh AQJ, Chan JLH, Leung YY. Mandibular asymmetry as a possible etiopathologic factor in temporomandibular disorder: a prospective cohort of 134 patients. Clin Oral Investig. 2021;25:4445-4450.
https://doi.org/10.1007/s00784-020-03756-w
18. Yap AUJ, Chua EK, Hoe JKE. Clinical TMD, pain-related disability and psychological status of TMD patients. J Oral Rehabil. 2002;29(4):374-380.
19. Manfredini D, Guarda-Nardini L, Winocur E, Piccotti F, Ahlberg J, Lobbezoo F. Research diagnostic criteria for temporomandibular disorders: a systematic review of axis I epidemiologic findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(4):453-462.
https://doi.org/10.1016/j.tripleo.2011.04.021
20. Slade GD, Ohrbach R, Greenspan JD, Fillingim RB, Bair E, Sanders AE, et al. Painful temporomandibular disorder: decade of discovery from OPPERA studies. J Dent Res. 2016;95(10):1084-1092. doi:10.1177/0022034516653743
21. Cade WT. Diabetes-related microvascular and macrovascular diseases in the physical therapy setting. Phys Ther. 2008;88(11):1322-1335.
https://doi.org/10.2522/ptj.20080008
22. Intengan HD, Schiffrin EL. Vascular remodeling in hypertension: roles of apoptosis, inflammation, and fibrosis. Hypertension. 2001;38(3):581-587.
https://www.ahajournals.org/doi/pdf/10.1161/hy09t1.096249
23. Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B. Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet. 2007;370(9590):851-858.
24. Tanaka E, Detamore MS, Mercuri LG. Degenerative disorders of the temporomandibular joint: etiology, diagnosis, and treatment. J Dent Res. 2008;87(4):296-307. https://doi.org/10.1177/154405910808700421
25. Gauer RL, Semidey MJ. Diagnosis and treatment of temporomandibular disorders. Am Fam Physician. 2015;91(6):378-386.
Published
30/08/2026
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Trinh Van, T. “Clinical Effectiveness of Acupressure Combined With Rehabilitation Therapy in The Treatment of Temporomandibular Disorders: Evidence From A Provincial Hospital In Vietnam”. International Journal of Alternative and Complementary Medicine, Vol. 7, no. 2, Aug. 2026, https://saapjournals.org/index.php/ijacm/article/view/923.
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