Abstract
INTRODUCTION: Kinesio taping (KT) is used after mandibular third-molar surgery, yet its benefits and time course remain uncertain. We evaluated whether KT reduces pain, swelling, and trismus versus no tape. METHODS: PRISMA-2020–conform systematic review and meta-analysis (PROSPERO CRD420251072421). Seven databases (PubMed, Embase.com, Scopus, Web of Science Core Collection, CENTRAL, ScienceDirect, Cochrane Library) plus grey literature were searched from inception to 19 May 2025. Eligible studies were adult randomized trials (parallel or split-mouth) under local anaesthesia; KT (≥10% stretch) was applied within 1 h of closure. Outcomes were pain on VAS immediately and days 2–7; swelling; maximum inter-incisal opening; rescue-analgesic intake; skin reactions; and global improvement. Effects were pooled as mean differences (MD) or Hedges g standardized mean differences (SMD) using REML random-effects with inverse-variance weighting and Hartung–Knapp; heterogeneity used I². Risk of bias used RoB-2. Publication bias used a 24-h funnel plot, Egger’s test (α=0.10), and trim-and-fill. Sensitivity analyses were leave-one-out. Certainty used GRADE. RESULTS: Thirteen randomized trials (2019–2025; n=646) were included; overall risk of bias was high. Pain favoured KT early: SMD −0.88 (95% CI −1.11 to −0.65) at 24 h and −0.91 (−1.33 to −0.50) at 48 h; at day 4 the reduction was uniform (I²=0%) with MD −1.94 (−2.56 to −1.32). By day 7, pain was small and uncertain: SMD −0.66 (−1.48 to 0.15; I²=93%). Swelling showed a small week-one benefit: SMD −0.42 (−0.75 to −0.09; I²=46%). Trismus improved mid-week in single studies (day-4 MD 13.60 mm [10.46 to 16.74]; day-5 MD 5.00 mm [2.56 to 7.44]); pooled day-7 SMD 0.42 (−0.19 to 1.02; I²=83%). Egger’s tests were non-significant except trismus at 2 days (p=0.0003); trim-and-fill imputed zero studies. Early pain findings were robust to leave-one-out. GRADE rated day-7 pain, swelling, and trismus as very low certainty. DISCUSSION: KT yields large early analgesia, a small week-one swelling reduction, and mid-week opening gains chiefly from single studies; interpretation is limited by high bias risk, heterogeneity, variable measurement, and ≤7-day follow-up. CONCLUSIONS: KT may be offered as an adjunct for early symptom control after third-molar extraction; by day 7 effects are small and uncertain. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13005-026-00603-3.