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Algorithm for Temporomandibular Disorders With Osteopathic Manipulative Therapy: An Expert Consensus
Llanos De-La-Iglesia1,2, Cristina Bravo1,3,4, Cristian Justribó-Manion5,6,7
1Department of Nursing and Physiotherapy, Universidad de Lleida, Lleida, España.
Journal of Chiropractic Medicine
|May 19, 2026
Summary
This study developed a consensus algorithm for diagnosing and treating temporomandibular dysfunction using osteopathic manipulative therapy. The flowchart guides practitioners through patient assessment and treatment steps.
Area of Science:
- Osteopathic medicine
- Neuromusculoskeletal medicine
Background:
- Temporomandibular dysfunction (TMD) presents complex diagnostic and treatment challenges.
- An osteopathic approach to TMD requires a structured methodology for effective patient management.
Purpose of the Study:
- To establish a consensus-driven algorithm for the osteopathic approach to temporomandibular dysfunction (TMD).
- To provide a standardized flowchart for the diagnosis and treatment of TMD using osteopathic manipulative therapy.
Main Methods:
- A modified Delphi method involving a panel of experts was employed.
- Multiple rounds of questionnaires were administered to achieve consensus on the algorithm's components.
Main Results:
- Consensus was reached on 182 items (70.54%) of the proposed algorithm.
- The algorithm features a numerical and color-coded system for clarity in diagnosis and treatment pathways.
- Key categories include psychological aspects, exclusion criteria, physical findings, and other considerations.
Conclusions:
- An evidence-based algorithm for the osteopathic management of TMD has been successfully created.
- This algorithm offers a structured framework to enhance the consistency and effectiveness of osteopathic care for TMD patients.
