Tratamento para disfunções temporomandibulares: uma revisão sistemática

Effects of athletic tape on orofacial pain and jaw movements after 24 hours of use: a randomized clinical trial

PURPOSE

To analyze the sensation of pain and the range of mandibular movements of adult individuals with temporomandibular disorder, before and after the application of the athletic tape.

METHOD

This is a double-blind randomized clinical trial, in which 22 adults with temporomandibular disorder participated, randomly allocated into two groups, with group A comprising 10 women and one man (mean age 28.2±8.3 years) and group B comprising nine women and two men (mean age 26.2±3.9 years). Group A was submitted to the application of the athletic tape on the masseter with 40% stretch and the group B to the application of the athletic tape on the masseter without stretching. All participants underwent the application of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Pain threshold assessment was performed using an algometer to apply pressure to measurement points. The measurement of mandibular movements was performed using a caliper. The athletic tape was glued using the I technique, with a fixed point over the insertion and a movable point over the origin of the masseter muscle. Participants remained with the athletic tape for 24 hours and were re-evaluated.

RESULTS

There was pain relief in the group A in the temporomandibular joint on the right and at the origin of the masseter on the left. The group B showed a reduction in pain in the left anterior temporal region. No differences were found in mandibular movements after intervention, as well as no difference was found in the comparison by groups.

CONCLUSION

The use of the athletic tape over the masseter muscle, with stretching, for 24 hours produced relief from the sensation of pain, on the origin of the right masseter and in the right temporomandibular joint, and, without stretching, in the left anterior temporal muscle. There was no difference in the range of mandibular movements.

The efficacy of orofacial myofunctional therapy in oral dysphagia accompanying temporomandibular dysfunction

OBJECTIVE

Patients with temporomandibular dysfunction (TMD) may develop oral-stage dysphagia (OD) in the chronic phase.

METHODS

This study investigated the effect of orofacial myofunctional therapy (OMT) in individuals with TMD-related OD. Fifty-one patients aged 18-65 years with TMD-related OD were separated into three groups using a simple randomization method: the control group (n = 12) underwent patient education and a home-exercise program; additionally, to an exercise program the manual therapy (MT) group (n = 19) received MT; and the OMT group (n = 20) received the OMT program. MT and OMT were applied in two sessions per week for 10 weeks. The patients were re-evaluated after treatment and at 3 months.

RESULTS

The OMT group showed the most improvement in jaw functionality, swallowing-related quality of life, pain, and dysphagia (p < .05).

DISCUSSION

OMT was superior to MT and exercises alone in reducing dysphagia and improving the swallowing-related quality of life.

Effects of photobiomodulation combined with orofacial myofunctional therapy on the quality of life of individuals with temporomandibular disorder

PURPOSE

To analyze the impact of photobiomodulation combined with orofacial myofunctional therapy (OMT) on the oral health quality of life (OHQOL) of individuals with temporomandibular disorder, before and after the treatment.

METHODS

Blind, controlled, randomized clinical trial with 34 volunteers randomly distributed into two groups: G1, who received OMT combined with photobiomodulation, and G2, treated with OMT combined with inactive laser. The subjects were first assessed with a visual analog scale (VAS) to classify them according to the degree of orofacial pain and with the Oral Health Impact Profile - Short Form (OHIP-14) regarding the impact on the OHQOL. The resulting data were statistically analyzed. The significance level was set at 0.05 (95%).

RESULTS

"Physical pain", "psychological discomfort", "physical disability", and "psychological disability" were the aspects with the greatest impact on the OHQOL. The G1 subjects responded positively to their treatment, as well as G2 to theirs. There was a strong positive correlation between VAS and total OHIP-14 score in both groups after the treatment. However, the functional recovery in the control group individuals (G2) was the most perceived positive change in the OHQOL in comparison with the experimental group (G1).

CONCLUSION

The people who received photobiomodulation combined with OMT perceived an improvement in the OHQOL, as well as those treated with placebo laser. There was a strong positive correlation in both groups in the improvement of the degree of pain and self-perception of the OHQOL.

Isotonic exercises and relaxing techniques in individuals with temporomandibular dysfunction

Objective: The present study aimed to compare the clinical characteristics of volunteers with temporomandibular dysfunction before and after performing exercises with those of volunteers who only followed self-care guidelines.Methods: A parallel randomized controlled trial was performed. Individuals included underwent the intervention twice a week for one month, while the control group only followed self-care guidelines.Results: Twenty-three volunteers participated; however, during the study, four dropped out. At the end of the study, the degree of depression decreased in the volunteers in the intervention group.Conclusion: The level of pain decreased, but the improvement was not statistically significant and, therefore, could not be attributed to the intervention. It can be concluded that the strategies used to reduce pain in this study were not sufficient for clinical improvement in volunteers with temporomandibular dysfunction.

Reabilitação motora orofacial em queimaduras em cabeça e pescoço: uma revisão sistemática de literatura

RESUMO Objetivos Investigar estudos sobre o tratamento das queimaduras em cabeça e pescoço, nas diversas áreas da saúde envolvidas na assistência a queimados (médica, enfermagem, fonoaudiologia, fisioterapia e terapia ocupacional), avaliando a eficácia das técnicas empregadas, principalmente no que se refere à reabilitação da funcionalidade da musculatura em cabeça e pescoço. Estratégia de pesquisa Os artigos foram selecionados por meio da base de dados PubMed, utilizando os descritores “burn and face and speech-language pathology”, “burn and face and speech language”, “burn and face and rehabilitation”, “burn and face and myofunctional rehabilitation”, “burn and face and myofunctional therapy”, “nonsurgical and scar and management”, “burn and face and nonsurgical” e “burn and face and scar and management”. Critérios de seleção Foram incluídos artigos que investigaram os tratamentos das queimaduras em cabeça e pescoço, associados à reabilitação da funcionalidade da musculatura em cabeça e pescoço, utilizando exercícios musculares e/ou terapias manuais. Resultados A maioria dos tratamentos descritos apresentou efeitos benéficos para pacientes com queimaduras. Foi observada grande variabilidade da metodologia adotada para a aplicação e verificação dos efeitos dos tratamentos. Conclusão Apesar do crescente número de pesquisas, ainda não existe consenso quanto à melhor técnica terapêutica e ao real benefício de cada uma delas. Existe uma grande diversidade nos protocolos de tratamento, sendo que um número pequeno de estudos de tratamento visa a funcionalidade do sistema miofuncional orofacial. A maioria dos estudos tem, como foco, atividades motoras isoladas, que visam à mobilidade mandibular.