RESUMO
The application of low-level laser therapy (LLLT) to acupuncture points may produce effects similar to that of needle stimulation in patients with temporomandibular disorders (TMD). This systematic review was conducted according to the Cochrane Collaboration guidelines and aimed to address clinical questions using the following strategy: Patient/Problem, Intervention, Comparison, and Outcome (PICO). A comprehensive literature search was performed upto April 26, 2023, across nine electronic databases (BVS, PubMed, Scopus, Embase, Web of Science, ScienceDirect, Cochrane Library, Latin American and Caribbean Health Sciences Literature (LILACS), and Google Scholar) supplemented with gray literature. The risk of bias in randomized and nonrandomized clinical trials was assessed using two tools: risk-of-bias (RoB) 2 and Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I). Meta-analysis involved the extraction of mean and standard deviation values for spontaneous pain and mouth opening levels. Seven studies were included in this review, all of which used LLLT. The applied wavelengths ranged from 690 to 810 nm without significant variations in light emission patterns. LLLT demonstrated a significant reduction in instantaneous pain levels (standard mean difference [SMD] = 3.85; 95% confidence interval [CI] = 2.09, 5.62; p < 0.003) and an improvement in instantaneous mouth opening ability (mean difference [SMD] = -7.15; 95% CI = -11.73, -2.58; p < 0.002), with low certainty of evidence. LLLT may alleviate symptoms in patients with TMD; however, caution should be exercised when interpreting the results because of protocol variations among studies and the limited number of studies included in the meta-analysis.
Assuntos
Terapia por Acupuntura , Terapia a Laser , Transtornos da Articulação Temporomandibular , Humanos , Terapia por Acupuntura/métodos , Dor/etiologia , Transtornos da Articulação Temporomandibular/radioterapia , LasersRESUMO
O Bruxismo é um comportamento da musculatura mandibular, caracterizado pelo apertamento e/ou rangimento dental, tanto em estado de vigília quanto no sono, que pode acarretar na Disfunção Temporomandibular (DTM). Altamente prevalente em crianças e etiologia multifatorial, destacam-se os aspectos psicossociais, principalmente o estresse e ansiedade. A necessidade de distanciamento social durante a pandemia da COVID-19 trouxe consequências para as crianças e fez surgir novos formatos de ações na Odontologia. Esse estudo avaliou a influência do autocuidado nas manifestações do Bruxismo/DTM em crianças que estavam em tratamento, antes da pandemia, no Serviço de Atendimento de Bruxismo e DTM na Infância (SABDI) da FORP/USP, por meio de intervenções assistidas, implementadas remotamente, de Práticas Integrativas e Complementares (PICs). Previamente às intervenções (T0), os pais responderam o questionário (Q1) sobre a criança (no formato Google Forms, enviado por WhatsApp e e-mail). As práticas propostas foram explicadas em reuniões virtuais (Google Meet) e foram realizadas durante 21 dias, registradas em um "Diário de Controle". Um novo questionário (Q2) foi preenchido para análise comparativa após as intervenções (T1). Das 37 crianças que estavam em tratamento, a amostra final das 18 que concluíram todas as etapas propostas apresentou diferença quantitativa nos itens: "dor na boca/rosto quando mastiga"; "dor ou dificuldade de abrir e fechar a boca"; "acorda com dor no rosto ou dor de cabeça" e, "dor de cabeça durante o dia ou à noite", "range os dentes em vigília"; "frequência que range os dentes em vigília"; "range os dentes enquanto dorme" e, "frequência que range os dentes enquanto dorme", "sono agitado"; "pesadelo" e "insônia". Observou-se evidência de diferença estatística com valor P<0,05, no item "aperta os dentes em vigília" (p=0,0057). Conclui-se que as intervenções propostas influenciaram as manifestações do Bruxismo favorecendo o seu controle.
Bruxism is a behavior of the mandibular muscles, characterized by clenching and/or dental grinding, both in wakefulness and in sleep, which can lead to Temporomandibular Disorders (TMD). Highly prevalent in children and possessing a multifactorial etiology, psychosocial aspects stand out, especially stress and anxiety. The need for social distancing during the COVID-19 pandemic has had consequences for children and has given rise to new formats of actions in Dentistry. This study evaluated the influence of self-care on the manifestations of Bruxism/TMD in children who were undergoing treatment, before the pandemic, Care Center for children with Bruxism and TMD, whose acronyms in Portuguese is SABDI, located in Ribeirão Preto School of Dentistry (FORP-USP), through assisted interventions, implemented remotely, of Complementary and Integrative Therapies (CIT). Prior to the interventions (T0), the parents answered the questionnaire (Q1) about the child (in Google Forms, sent by WhatsApp and e-mail). The proposed practices were explained in virtual meetings (Google Meet) and performed for 21 days and recorded in a "Control Diary". A new questionnaire (Q2) was completed for comparative analysis after the interventions (T1). Of the 37 children who were undergoing treatment, the final sample of 18 who completed all the proposed steps showed a quantitative difference in the items: "pain in the mouth/face when chewing"; "pain or difficulty opening and closing the mouth"; "waking up with pain in the face or headache" and "headache during the day or night"; "grinding teeth while awake"; "frequency grinding teeth while awake"; "grinding teeth while sleeping"; "frequency grinding teeth while sleeping"; "restless sleep"; "nightmare"; and "insomnia". Evidence of statistical difference was observed with a P value <0.05, in the item "clenches teeth while awake" (p=0.0057). It is concluded that the proposed interventions influenced the manifestations of Bruxism, favoring its control.
