This study aims to investigate the effectiveness of the Maitland joint mobilization technique in alleviating symptoms related to (temporomandibular disorders) TMD and to investigate its influence on patient clinical outcomes, including pain intensity, TMJ range of motion (ROM), functional limitations, disability, and oral behaviors.

Physiotherapeutic procedures for TMD aim to reduce pain, enhance neuromuscular coordination and strength, and promote joint range of motion (ROM), mastication, mouth opening, and general mobility. The literature highlights a variety of physiotherapy techniques used to treat TMD, including manual therapy, stretching, active and passive exercises, as well as modalities like thermotherapy, ultrasound, electrotherapy, iontophoresis, laser therapy, shockwave therapy, infrared therapy, kinesiology taping, and dry needling. Clinical research supports the efficacy of physiotherapy as a conservative treatment for TMD, effectively addressing pain, muscular dysfunctions, and psychosocial factors. Optimal results are achieved through a combination of therapeutic exercises and manual therapy, which is considered one of the most effective approaches.

The Maitland joint mobilization technique is a key physiotherapeutic procedure for managing TMD. This technique involves passive, rhythmic joint mobilizations aimed at restoring joint functionality and alleviating pain. The technique employs five grades of mobility, each designed for specific therapeutic goals. Grades I and II are used to reduce pain and relax soft tissues, while Grades III, IV, and V focus on addressing joint hypomobility by stretching soft tissues and improving joint mobility. The technique enhances both osteokinematic and arthrokinematic movements, with osteokinematic referring to voluntary joint motion, and arthrokinematic to the small, involuntary movements that occur during normal joint ROM. Maitland joint mobilization utilizes controlled forces in specific directions, based on Kaltenborn's concave-convex rule, to optimize both movements and improve joint function. This research is essential for providing further evidence that supports enhanced physiotherapeutic techniques, resulting in enhancing patient clinical outcomes and enhancing professional practices for the optimal management of TMD.

Inclusion Criteria:

• Diagnosis: individuals diagnosed with TMD, whether it is unilateral or bilateral.
• Myofascial pain and myo-spasm.
• Anterior disk displacement with reduction and anterior disk displacement without reduction.
• Craniofacial and craniomandibular pain.
• Myofascial pain with or without limited mouth opening.

Exclusion Criteria:

• Patients with a documented history of surgical procedures involving the TMJ.
• Patients with a confirmed diagnosis of systemic diseases (e.g., rheumatic and metabolic diseases).
• Patients with congenital or developmental craniofacial anomalies, including conditions like as ankylosis.
• Patients with diagnosed cancer.
• Patients with mental, physical disorders and language difficulties.
• Patients with diagnosed neuropathic and dental pain.
• Patients with diagnosed general myopathy (e.g., fibromyalgia).

De-identified individual participant data (IPD) will be shared for research purposes.

Data will be available starting 6 months after publication of the main results, for a period of 3 years

IPD and supporting documents (such as the study protocol and statistical analysis plan) will be made available to qualified researchers upon reasonable request. Requests must include a clear research purpose and be approved by an independent ethics committee or institutional review board. Requests can be submitted by email to Dr. Mohammad Al-Talahma at [mtalahma@ppu.edu], and approved data will be shared via secure electronic transfer.