## 4 Discussion
Our findings align closely with those reported by [PERSON] et al. [27], who investigated the effectiveness of massage therapy versus occlusal splint therapy on mandibular range of motion (ROM) in patients with TMD. Both treatment approaches successfully enhanced the maximum active mouth opening and both right and left excursion. Similarly, [PERSON] et al. [28] noted an improvement in mouth opening ROM after the applied intraoral myofascali therapy. [PERSON] et al. [29] applied cross-friction massage and joint mobilization to eight patients with TMJ disorders. Manual therapy was performed three times a week for two weeks. After the study, the average mouth opening range improved by 9 mm. Some studies have confirmed links between the cranial area, TMJ, and cervical spine. [PERSON] et al. [30] demonstrated a correlation between reduced TMJ mobility and limited mobility in the cervical spine segment in individuals with bruxism. [PERSON] et al. [31] showed that individuals with TMJ pain complaints have a reduced range of rotation in the cervical spine compared to healthy individuals. They also observed that individuals with TMJ pain complaints, who also complained of headaches, had restricted mobility in the cervical spine sagittal plane. The results of [PERSON] et al. [32] demonstrated a significant relationship between treating TMJ dysfunction and reducing neck pain, while simultaneously improving cervical spine mobility. A similar relationship was observed by [PERSON] et al. [33] in a randomized study involving 61 women with TMJ complaints. The researchers assessed the effect of cervical spine mobilization and motor control and cervical spine stabilization exercises on reducing orofacial pain. A statistically significant reduction in TMJ pain complaints was observed in the group undergoing therapeutic intervention. Furthermore, [PERSON] and [PERSON] [34] confirmed the hypothesis that changes in cervical spine posture affect the muscles of the stomatognathic system and lead to TMJ dysfunction. Current research suggests that manual therapy targeting the cervical spine can positively affect women with TMJ symptoms, showing significant improvements in TMJ range of motion and reductions in orofacial pain. These findings highlight that interventions applied in one area--such as the cervical spine--can have beneficial effects in distant, related structures, such as the TMJ, underscoring the interconnectivity of musculoskeletal regions and the potential for comprehensive therapeutic approaches [18]. [PERSON] et al. conducted a study aimed at evaluating the effectiveness of a physiotherapy program for TMJ dysfunctions and the relationship with the cervical spine. A three-month program of therapeutic exercises for jaw and neck muscles, combined with pharmacotherapy, was found to be more effective than pharmacotherapy alone. After therapy, both groups experienced reduced pain, but the combination approach achieved more significant improvements. The average percentage values of the Neck Disability Index and the Jaw Functional Limitation Scale 8 decreased significantly in both groups, but especially in the group that received physiotherapy [19]. Research by [PERSON] et al. indicates that neck motor control training is effective in improving orofacial pain in women with TMD. However, no significant effect on jaw mobility was observed. The authors suggest that the orofacial pain relief after neck-targeted exercises might have occurred due to the neuroanatomical connections between these areas. Specifically, stimulation of descending inhibitory pathways through the neck may reduce pain in the trigeminal nerve region. It is expected that therapies targeting both the neck and jaw areas may be more effective in improving the range of motion of the mandible and the function of the masticatory muscles [17]. [PERSON] and [PERSON] investigated the effectiveness of manual therapy and cervical spine stretching exercises for pain and disability in patients with myofascali TMD accompanied by headaches.