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Postoperative physiotherapy31712or its attachment can be seen as well as degenerative changes to the hard tissues. The patient will also complain of a limitation in joint mobility and articular pain.(22) Another tool that can be used to assess the severity of a TMD is the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). This tool was first presented in 1992 and has been frequently updated since. The most recent improvements were presented in 2014.(24) The Axis I protocol can be used to evaluate the pain and joint, through a questionnaire for the patient’s pain history and diagnostic criteria for differentiating the most-common TMD, whereas the Axis II protocol can be used to determine psychosocial factors such as distress and pain disability.(24,25) Depending on how the patient scores on these tools, treatment options will vary from less to more invasive. In more than 80% of all TMDs, a more conservative approach, such as a combination of anti-inflammatory therapy, an occlusal splint, and physiotherapy, combined with oral reeducation will suffice.(14,26–28) However, when these noninvasive treatments fail to provide resolution, a more invasive approach might be needed, ranging from minimally invasive intra-articular injections to open joint surgery.(27)The importance of physiotherapy after TMJ surgery is not a recent discovery. Studies included in this systematic review date from 1987 when Braun(13) first conducted a retrospective study of patients who were surgically treated due to internal derangement of the TMJ. Despite her conclusion that patients could greatly benefit from early onset of physiotherapy, only a few objective studies assessing the effects of physiotherapy on postoperative patients are available to this day.(12) Furthermore, although nearly all the included studies concluded that early onset and rigorous physiotherapy over a prolonged is needed to achieve optimal postoperative results, these studies failed to highlight the importance of individual exercises.(7,12–16) In this systematic review, the authors aimed to provide the reader with an overview and analysis of the available qualitative literature on postoperative physiotherapy after open TMJ surgery and to ascertain its value. Although the amount of comparative literature on this topic is clearly insufficient, it was concluded that postoperative physiotherapy plays an important role in achieving a good MMO and decreasing pain.Nikolas de Meurechy NW.indd 317 05-06-2024 10:15