ABSTRACT
Background: Initial management of temporomandibular disorders (TMD) based on self-management (SM) is strongly recommended by literature, nevertheless, research is needed to investigate the efficacy of different types of interventions under each component of SM against each other for the management of particular subtypes of TMD. The present study aimed to compare the clinical effectiveness of SM and SM with additional mandibular home exercises for the management of myalgia of masticatory muscles. Material and Methods: A clinical trial was conducted with 54 subjects with a diagnosis of myalgia according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), which were randomised into two groups: treated with SM (SM group) and treated with SM and mandibular home exercises (SM+EX group). Follow-ups were carried out at 2, 6, and 10 weeks, where it was evaluated: pain in the masticatory muscles, jaw opening range of motion, and mandibular functional limitation. Data were analysed using Wilcoxon signed-rank test for comparisons between periods (baseline, and weeks 2, 6, and 10) and Wilcoxon rank-sum test for comparison between groups (p=0.05). Results: All the variables showed significant improvement (p<0.05) from baseline to the first follow-up and were maintained later, i.e. both groups were able to reduce pain, increase the jaw opening range of motion, and improve the mandibular functional limitation, although no significant differences were found between groups (p>0.05). Conclusions: The self-management program was able to reduce pain intensity, increase the jaw opening range of motion and improve functional limitation, but the addition of mandibular home exercises do not have a significant impact on myalgia of the masticatory muscles in the short-term. Key words:Myalgia, Self-care, Self-management, Temporomandibular joint disorders.
ABSTRACT
PURPOSE: To perform a scoping review to identify the available evidence regarding osteochondritis dissecans (OCD) of the temporomandibular joint (TMJ). METHODS: An electronic search of the PubMed, Web of Science and Scopus databases was performed using the following terms: 'Temporomandibular Joint Disorders', 'Osteochondritis Dissecans', 'Joint Loose Bodies' and 'Temporomandibular Joint'. Full-text articles were obtained from the records after applying the inclusion/exclusion criteria. RESULTS: Ten articles were included in the analysis - six case reports, one case series, one retrospective study, one comparative study and one correlational study - with a total of 39 patients. The most frequently reported clinical presentation involved TMJ pain, locked jaw and articular noises (clicking and crepitus). The imaging methods used to identify OCD were radiographs, tomography, arthrography and magnetic resonance imaging. The reported imaging findings varied widely, but the most frequent were (single or multiple) calcified intra-articular loose bodies, signs of degenerative osseous changes, disc displacements, widening of the joint space and alterations in condylar morphology. Seven articles reported treatments (surgical or conservative), but the treatment outcome was not reported in all of the articles, which makes it difficult to make comparisons. CONCLUSION: OCD of the TMJ may present various non-specific clinical characteristics, and given the heterogeneous imaging findings, multiplanar images are required for an accurate diagnosis. Finally, the results do not allow recommending a standard treatment for OCD of the TMJ.