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NCT Number: NCT07328269

Effects of Mulligan Mobilization in Comparison With Maitland Mobilization in Temporomandibular Joint Dysfunction.

The temporomandibular joint dysfunction is the second most common musculoskeletal pain after back pain, causing jaw pain, restricted movement, and joint sounds. NPRS and millimeter ruler will be used for the assessment of patient. This study will compare the effects of Mulligan and Maitland mobilization, commonly used treatment, on pain and Temporomandibular joint mobility through a randomized controlled trial, involving 30 participants divided into two groups for treatment.

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Key information

Conditions

Temporomandibular Joint Dysfunction Craniomandibular Disorders Jaw Diseases Joint Diseases Mandibular Diseases Muscular Diseases Musculoskeletal Diseases Stomatognathic Diseases Temporomandibular Joint Disorders

Age range

19 year–44 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Foundation University College of Physical Therapy

Islamabad, Punjab Province, Pakistan

Location status: Recruiting

Location contact

Mah Noor, DPT

CONTACT

[email protected]

+92310-5351360

About this study

The temporomandibular joint connects the mandible to the temporal bone near the ear's tragus and plays a key role in mastication. It involves joint or muscle pain, jaw movement limitation, and joint popping sound Risk factors include trauma, bruxism, arthritis, stress, and poor posture, while diagnosis is commonly made using the DC/TMD criteria, focusing on pain and intra-articular dysfunction. Manual therapy techniques widely used to restore joint function and reduce pain.

Among these, Mulligan's Mobilization combines therapist-applied glides with active patient movement, while Maitland mobilization uses graded oscillatory techniques to relieve pain and improve mobility.

This study aims to compare the effects of Mulligan and Maitland mobilization on pain reduction and TMJ hypomobility in adults with TMD.

A randomized controlled trial will be conducted over one year. 30 participants will be selected through purposive sampling and randomly divided into two groups.

The intervention will last two weeks, comprising 06 treatment sessions. Assessments will be conducted at baseline, after the third session, and at the end of the second week.

Treatment will include lateral, anterior, medial, and distraction glides, combined with Rocabado's 6x6 exercises to improve functional movement. Myofascial release for the temporalis and masseter muscles will also be applied.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age 19-44 years.
  • Both Genders (Male and Female).
  • Patients diagnosed with TMJ hypomobility using the Manual Functional Analysis questionnaire based on DC/TMD criteria.
  • Individuals with myofascial pain, scoring above 5 on the NRS and pain upon palpation of at least two of eight masticatory and neck muscles.
  • Subjects with acute TMD and myofascial pain unrelated to active inflammation, infection, or recent trauma for at least six months.

Exclusion criteria

  • Hypermobility of TMJs.
  • Pregnancy.
  • History of rheumatic and inflammatory diseases.
  • A history of temporomandibular disorders treatment within last three months.
  • Acute trauma or injuries of face, head or cervical spine, neurological disorders, taking medication that could affect the musculoskeletal system.

Treatment and study plan

Mulligan Mobilization

Procedure

Both Mulligan and Maitland mobilization techniques with Myofascial release of temporalis and masseter and Rocabado 6*6 exercise program are applied over a two-week period with six sessions in total, focusing on improving TMJ mobility and reducing pain.

Group A Mulligan mobilization emphasizes active patient involvement combined with therapist-applied glides, including lateral, anterior, medial, and distraction glides performed for 5-10 seconds with 3-5 repetitions per session.

These techniques enhance mouth opening, lateral deviation, protrusion, and joint space while reducing stiffness and pain. And baseline treatment of myofascial release of temporalis and masseter muscle and Rocabado's 6*6 exercise program

Maitland Mobilization

Procedure

Group B-Maitland mobilization relies on graded oscillatory movements (Grades I-III) for 5-10 seconds with 3-5 oscillations, targeting pain relief and mobility in the pain-free range. Lower grades (I-II) are used for acute pain with gentle oscillations, while higher grades (II-III) provide moderate mobilization to improve protrusion, lateral deviation, and joint capsule mobility.

And baseline treatment of myofascial release of temporalis and masseter muscle and Rocabado's 6*6 exercise program.

Primary outcomes

  1. Pain intensity

    Time frame: 2 weeks

    Pain will be measured through Numeric Pain Rating Scale. The scoring for NPRS involves a scale from 0 to 10, where 0 indicates no pain. The interpretation of scores is as follows: 0 to 3 for mild pain, 4 to 6 for moderate pain, and 7 to 10 for severe pain.

  2. Temporomandibular joint Hypomobility

    Time frame: 2 weeks

    Mandibular movements were assessed using a millimeter ruler to measure depression (50-60 mm), protrusion (5 mm), and lateral deviation (12-15 mm). Any "click" sounds or deviations during movement were recorded. Jaw movements maintained upper and lower teeth contact.

Study contacts

Contact information is provided by the study sponsor or research team.

Anam Rehman, MS-OMPT

CONTACT

[email protected]

+923355082299

Mah Noor

CONTACT

[email protected]

+92310-5351360

Sponsors and collaborators

Lead sponsor

Foundation University Islamabad

Other

Registry information

Official study title

Effects of Mulligan Mobilization in Comparison With Maitland Mobilization in Temporomandibular Joint Dysfunction

Important dates

Study start
2025
Primary completion
2025
Study completion
2026
First posted
Jan 9, 2026
Registry last updated
Jan 9, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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