Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.697
Filtrar
1.
Stomatologiia (Mosk) ; 98(3): 65-70, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31322598

RESUMO

The aim of the study was to elaborate Diagnostic criteria for the transition from occlusal splints to non-removable orthopedic appliances in patients with TMJ dysfunction with disc disorders. The study involved 95 patients with the clinics of TMJ dysfunction. An examination included electrovibrography and computerized electromyography in order to assess diagnostic value of the methods. Electrovibrography is a method based on arthrophonography, which makes it possible to obtain data on intraarticular noise in the TMJ. Computerized electromyography provides an objective assessment of the bioelectrical activity of the masticatory muscles in occlusive disorders, changes in the height of the lower facial area, and their relationship with the development of musculo-articular dysfunction of the TMJ and allows monitoring the effectiveness of orthopedic treatment. Within the normal function of the jaws the graphic trajectories of mandibular movements are within the limits of norm, and in the case of a violation of the TMP function, the graphic and linear indices are significantly different from the normal values.


Assuntos
Placas Oclusais , Síndrome da Disfunção da Articulação Temporomandibular , Humanos , Mandíbula , Músculos da Mastigação , Articulação Temporomandibular , Síndrome da Disfunção da Articulação Temporomandibular/terapia
2.
Rev. ADM ; 76(2): 109-112, mar.-abr. 2019. ilus
Artigo em Espanhol | LILACS | ID: biblio-1009264

RESUMO

La desprogramación neuromuscular juega un papel importante en el tratamiento de la disfunción temporomandibular, uno de los principales inconvenientes es el periodo prolongado del tratamiento, lo cual influye en la aceptación del paciente o el abandono del tratamiento. El diagnóstico es crucial para planificar el tratamiento ya que cubre una amplia gama de variables para tratarlo, por lo que en este caso es un paciente dolicofacial, con problemas de disfunción temporomandibular de origen muscular, por lo cual se optó por utilizar laserterapia de bajo nivel como coadyuvante de tratamiento, dando como resultado una mejor aceptación y colaboración de la desprogramación del paciente en un periodo de tiempo más corto (AU)


Neuromuscular deprogramming plays an important role in the treatment of temporomandibular dysfunction, one of the main drawbacks is the prolonged period of treatment, which influences the acceptance of the patient or the abandonment of treatment. The diagnosis is crucial to plan the treatment since it covers a wide range of variables to treat it, so in this case it is a dolichofacial patient, with problems of temporomandibular dysfunction of muscular origin, which is why we chose to use low-level laser therapy, level as a coadjutant of treatment, resulting in a better acceptance and collaboration of the deprogramming of the patient in a shorter period of time (AU)


Assuntos
Humanos , Masculino , Adolescente , Síndrome da Disfunção da Articulação Temporomandibular/terapia , Oclusão Dentária Central , Lasers Semicondutores/uso terapêutico , Placas Oclusais , Articuladores Dentários , México
3.
Rev. esp. cir. oral maxilofac ; 41(1): 8-16, ene.-mar. 2019. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-182841

RESUMO

Objetivos: El síndrome de dolor miofascial (SDM) de la musculatura masticatoria (MM) constituye la patología más frecuente dentro de los trastornos temporomandibulares (TTM). En cuanto al tratamiento del SDM de la MM, no existen protocolos estandarizados. Hay evidencia de que la acupuntura es eficaz en el tratamiento del dolor miofascial. El objetivo del presente estudio es analizar la eficacia de la acupuntura en el tratamiento del SDM de la MM en términos de reducción de la intensidad del dolor y la duración de la reducción del dolor en el tiempo. Material y métodos: Se realizó un estudio observacional prospectivo en 30 pacientes diagnosticados de SDM de la MM que fueron tratados mediante 15 sesiones de acupuntura. Las variables del estudio fueron: 1) Porcentaje de pacientes que alcanzan una respuesta clínica relevante a lo largo del seguimiento (disminución del dolor de, al menos, un 50 % en la escala visual analógica con respecto al inicial o bien una reducción total del dolor a < 30 mm en la misma escala). 2) Reducción del dolor muscular orofacial después del tratamiento, expresado en milímetros (mm), dentro de la escala visual analógica (EVA). 3) Máxima apertura oral (MAO) expresada en mm. 4) Estabilidad del efecto terapéutico. Las variables fueron evaluadas antes del tratamiento, a los 3, 6, 9 y 12 meses. Resultados: La mediana de edad fue de 42 años (33-53). Con respecto al sexo, 28 de los 30 pacientes (93 %) fueron mujeres. El seguimiento fue completo para los 30 pacientes. Al final del seguimiento, 20 de los 30 pacientes (67 %, IC 95% 49-81) mantuvieron una reducción del dolor a la categoría leve (EVA < 30 %) o bien una reducción > 50 % del basal. A lo largo del estudio, el porcentaje de pacientes que alcanzó el criterio de respuesta clínica relevante preestablecido se mantuvo estable (67-80 %), no variando significativamente a lo largo del tiempo. Conclusiones: Los resultados del estudio demuestran que la acupuntura es eficaz en el control del dolor del SDM de la MM. Los efectos terapéuticos de la acupuntura son de inicio temprano (< 3 meses), estables y se mantienen hasta el final del seguimiento de un año


Objectives: Myofascial Pain Syndrome (MPS) of the Masticatory Muscles (MM) is one of the most prevalent diseases included in the Temporomandibular Joint Dysfunction Syndrome. Regarding its treatment, there are not standarized protocols. There is some evidence that acupuncture is effective in MPS of the MM treatment. The objective of the present study is to analyze the efficacy of acupuncture for the treatment of MPS of the MM, in terms of pain intensity reduction and duration of the pain reduction along time. Patients and methods: This is an observational prospective study. Thirty patients diagnosed of MPS of the MM were treated with 15 sessions of acupuncture. The variables of the study included were: 1) Percentage of patients that achieved a relevant clinical response (pain reduction of at least 50 % from the initial value, in a visual analogue scale, or a visual analogue scale pain value less than 30 milimeters). 2) Pain reduction after treatment, measured in milimeters in a visual analogue scale (VAS). 3) Maximal mouth opening measured in milimeters. 4) Stability of the pain reduction. The variables were evaluated before treatment and 3, 6, 9 and 12 months after. Results: The median of age was 42 years (33-53). Twenty eight patients were female (93 %). The follow up period lasted one year and all the patients completed it. At the end of the follow up period, 20 of the 30 patients (67 %, IC 95 % 49-81) maintained a pain reduction in a mild category (VAS < 30 %) or a total reduction of > 50 % from de initial pain value. Along the follow-up period, the percentage of patients that achieved a relevant clinical response maintained stable (67-80 %). Conclusions: The results of the study show that acupuncture is effective in the treatment of MPS of the MM. Treatment effects appear early (< 3 months) and maintain stable within the first year


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Analgesia por Acupuntura/métodos , Síndromes da Dor Miofascial/terapia , Músculos da Mastigação/fisiopatologia , Resultado do Tratamento , Síndrome da Disfunção da Articulação Temporomandibular/terapia , Estudos Prospectivos
4.
Int J Mol Sci ; 20(2)2019 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-30641957

RESUMO

BACKGROUND: The aims of this narrative review were to examine up-to-date literature in order to evaluate the effectiveness of arthrocentesis or injections with platelet-rich plasma in temporomandibular affections and to compare them to arthrocentesis alone or with hyaluronic acid (HA) or to hyaluronic acid injections. METHODS: The search of international literature was made on the PMC, PubMed and Cochrane databases, including all full-length text of studies on humans focused on osteoarthritis and disc displacements and their treatment with platelet-rich plasma arthrocentesis or injections. All design studies were included in the review and they were examined for three different outcomes: pain, joint sound and mandibular motion. English papers were only selected. RESULTS: Even though the low number of studies in this field, arthrocentesis with platelet-rich plasma and platelet-rich plasma injections in temporomandibular disorders' management were found to be effective in reducing pain and joint sound as well as in improving mandibular motion in a maximum follow-up of 24 months. CONCLUSION: Comparison to arthrocentesis alone or to HA use in arthrocentesis or by injections provided encouraging results in terms of the effectiveness of platelet-rich plasma use.


Assuntos
Artrocentese/métodos , Plasma Rico em Plaquetas/fisiologia , Síndrome da Disfunção da Articulação Temporomandibular/terapia , Humanos , Ácido Hialurônico/administração & dosagem , Ácido Hialurônico/fisiologia , Injeções , Medição da Dor , Amplitude de Movimento Articular/efeitos dos fármacos , Síndrome da Disfunção da Articulação Temporomandibular/fisiopatologia , Resultado do Tratamento
5.
Rev. inf. cient ; 97(5): 923-933, sep.-oct. 2018. tab
Artigo em Espanhol | CUMED | ID: cum-74017

RESUMO

Introducción: el síndrome de disfunción temporomandibular, es una alteración que comprende un conjunto de signos y síntomas relacionados con las estructuras del sistema estomatognático. Objetivo: determinar la efectividad del tratamiento conjunto de láser y terapia de apoyo medicamentosa, aplicadas a los pacientes con el síndrome dolor disfunción de la articulación temporomandibular. Método: se realizó una intervención terapéutica en 84 pacientes que asistieron a la consulta de prótesis de la Clínica Estomatológica "Julio Antonio Mella" de Guantánamo, en el período comprendido entre septiembre de 2014 al mismo mes de 2015. Se conformaron dos grupos terapéuticos: uno recibió láser y terapia de apoyo medicamentosa y, el otro, terapia de apoyo medicamentosa, cada grupo con 42 pacientes que fueron evaluados a los 5, 10 y 15 días. Se tomaron en cuenta variables generales y clínicas: edad, grado de severidad, comportamiento del dolor y criterios de evaluación. Resultados: la terapia combinada de láser y terapia medicamentosa resultó ser más efectivo que la terapia medicamentosa, al desaparecer la sintomatología en un período de tiempo menor. Conclusiones: se validó que el tratamiento combinado de láser y terapia de apoyo medicamentosa resultó más efectivo al desaparecer progresivamente la sintomatología en un periodo de tiempo menor, en relación a los que se les aplicó el tratamiento convencional y por tanto es factible su aplicación(AU)


Introduction: temporomandibular dysfunction syndrome is an alteration that includes a set of signs and symptoms related to the structures of the stomatognathic system. Objective: to determine the effectiveness of the joint treatment of laser and drug support therapy, applied to patients with pain syndrome temporomandibular joint dysfunction. Method: a therapeutic intervention was carried out in 84 patients who attended the prosthesis consultation of the "Julio Antonio Mella" Stomatology Clinic in Guantánamo, in the period from September 2014 to the same month of 2015. Two therapeutic groups were formed: one received laser and drug support therapy and, the other, drug support therapy, each group with 42 patients who were evaluated at 5, 10 and 15 days. General and clinical variables were taken into account: age, degree of severity, pain behavior and evaluation criteria. Results: the combination therapy of laser and drug therapy proved to be more effective than drug therapy, as the symptoms disappear in a shorter period of time. Conclusions: it was validated that the combined treatment of laser and drug support therapy was more effective as the symptomatology progressively disappeared in a shorter period of time, in relation to those that were treated with conventional treatment and therefore its application is feasible(AU)


Introdução: a síndrome de disfunção temporomandibular é uma alteração que inclui um conjunto de sinais e sintomas relacionados às estruturas do sistema estomatognático. Objetivo: determinar a eficácia do tratamento articular da terapia de suporte a laser e medicamentosa, aplicada a pacientes com disfunção temporomandibular da síndrome da dor. Método: intervenção terapêutica em 84 pacientes atendidos no ambulatório de prótese de Estomatologia "Julio Antonio Mella" Clinic Guantanamo no período de setembro de 2014 para 2015. mês foi realizada foram organizados dois grupos de tratamento: um receberam laser e terapia de suporte medicamentoso e, o outro, terapia de suporte medicamentoso, cada grupo com 42 pacientes que foram avaliados aos 5, 10 e 15 dias. Variáveis gerais e clínicas foram consideradas: idade, grau de severidade, comportamento de dor e critérios de avaliação. Resultados: a terapia combinada de laser e terapia medicamentosa mostrou-se mais eficaz que a terapia medicamentosa, pois os sintomas desaparecem em menor tempo. Conclusões: é validado que o laser de tratamento combinado e terapia de droga foi mais eficaz para apoiar sintomas em fases num curto período de tempo, em relação aos quais foram aplicados o tratamento convencional, e, portanto, a sua aplicação é viável(AU)


Assuntos
Humanos , Síndrome da Disfunção da Articulação Temporomandibular/diagnóstico , Síndrome da Disfunção da Articulação Temporomandibular/terapia , Lasers , Terapia a Laser , Comunidade Terapêutica , Terapêutica
6.
J Med Case Rep ; 12(1): 148, 2018 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-29803229

RESUMO

BACKGROUND: Temporomandibular dysfunction involving anterior disc derangement with or without reduction, secondary to posterior ligament insufficiency is typically managed conservatively with success in a majority of patients. When conservative management fails, the next step in the continuum of care is unclear. Platelet-rich plasma injection combined with a 3-week immobilization period may be effective in treating posterior ligament insufficiency following a period of physical therapy. The result of this case was exceptionally successful, with the patient reporting 100% improvement 6 months post-injection. Prior to this case, we predicted a 20% success rate based on her inability to maintain the effects of conservative management over the long term. CASE PRESENTATION: A 33-year-old white woman presented with temporomandibular dysfunction, which responded to an initial course of physical therapy aimed at restoring the mechanics of her temporomandibular joint, exercise management, and education on self-management strategies. She returned 20 months later and responded well to another course of physical therapy. Despite improvement in pain, range of motion, and mechanics, she continued to present with a reduction click at the end range of opening. The crisp and loud nature of the reduction click indicated a viable posterior ligament and reduction of the anteriorly displaced disc. She opted for platelet-rich plasma injection, provided by a chronic pain specialist with the assistance of a physical therapist. She was immobilized for 3 weeks, followed by a weaning period with reduced posterior support for an additional 5 weeks. Follow-up appointments with a physical therapist occurred at 3 weeks, 8 weeks, and 6 months post-injection. CONCLUSIONS: At 6 months, she reported 100% improvement. Objectively, there was no indication that the disc condyle relationship was disrupted. At 6 months post-platelet-rich plasma injection, preceded by a period of conservative physical therapy management, and followed with appropriate physical therapy follow-up, this individual had complete resolution of her anterior disc derangement with reduction.


Assuntos
Luxações Articulares/terapia , Síndrome da Disfunção da Articulação Temporomandibular/terapia , Articulação Temporomandibular , Adulto , Feminino , Humanos , Imobilização , Placas Oclusais , Modalidades de Fisioterapia , Plasma Rico em Plaquetas , Amplitude de Movimento Articular
7.
Aust J Gen Pract ; 47(4): 212-215, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29621862

RESUMO

BACKGROUND: Orofacial pain is a common presentation in the primary healthcare setting and temporomandibular dysfunction represents one of the major causes. Its aetiology is multifactorial, caused by both masticatory muscle dysfunction and derangement within the temporomandibular joint. OBJECTIVE: The aim of this article is to provide an overview of temporomandibular dysfunction, its management and referral considerations for general practioners. DISCUSSION: Temporomandibular joint dysfunction affects a large number of adults. Conservative management involving non-pharmacological and pharmacological therapies is effective in the majority of cases.


Assuntos
Síndrome da Disfunção da Articulação Temporomandibular/diagnóstico , Síndrome da Disfunção da Articulação Temporomandibular/terapia , Articulação Temporomandibular/anormalidades , Tratamento Conservador/métodos , Diagnóstico Diferencial , Dor Facial/etiologia , Humanos , Imagem por Ressonância Magnética/métodos , Articulação Temporomandibular/fisiopatologia , Síndrome da Disfunção da Articulação Temporomandibular/fisiopatologia
8.
J Craniomaxillofac Surg ; 46(6): 916-922, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29692327

RESUMO

PURPOSE: In temporomandibular disorders (TMDs), unless splints are effective, combined therapies are performed. The aim of this study is to show the effectiveness of the local anaesthethic injections (trigger point injections) to the masticatory muscles. MATERIALS AND METHODS: The study was composed of TMD patients and the predictor variables were therapy combinations including stabilization splint (SS) therapy, SS+trigger point injection therapy (TPI) and arthrocentesis. The primary outcome variables were pain and jaw movements. The follow-ups were done at 1st and 3rd months. 56 patients who were treated for TMD with only SS or combined therapies were included in the study. The effects of additional TPIs were compared to SS therapy alone. Also the effect of arthrocentesis was evaluated too. RESULTS: All groups revealed significant decreases in pain scores. Decreases in mouth openings were observed in some of the patients in the injection groups. CONCLUSION: The combined treatment method in which the injections were applied at shorter time intervals, was a more effective method for decreasing VAS scores in TMD patients in this study but further studies are required.


Assuntos
Artrocentese/métodos , Injeções/métodos , Síndromes da Dor Miofascial/terapia , Placas Oclusais , Pontos-Gatilho , Clonidina/análogos & derivados , Clonidina/uso terapêutico , Terapia Combinada , Humanos , Músculos da Mastigação , Meloxicam/uso terapêutico , Medição da Dor , Transtornos da Articulação Temporomandibular/terapia , Síndrome da Disfunção da Articulação Temporomandibular/terapia , Resultado do Tratamento , Turquia , Escala Visual Analógica
9.
J Oral Facial Pain Headache ; 32(2): 113-122, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29694463

RESUMO

AIMS: To investigate, in individuals with pain-related temporomandibular disorder (TMD), the association of long-term pain intensity with baseline health-related quality of life (HRQoL) and jaw functional limitation. METHODS: Of 513 cases with baseline pain-related TMD (masticatory muscle and/or temporomandibular joint [TMJ] pain), 273 were reevaluated after 8 years, and 258 of them had complete baseline data for Jaw Functional Limitation Scale (JFLS) scores and HRQoL measured by the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the 12-item Short Form Health Survey and follow-up data for Characteristic Pain Intensity (CPI) from the Graded Chronic Pain Scale. Secondary analyses of existing data quantified the effects of primary (PCS, MCS) and secondary (JFLS) predictors on follow-up CPI by using multivariable linear regression. Sensitivity analyses considered differences between the included participants (n = 258) and those who were not included (n = 255) by using inverse probability weighting. Interactions of baseline predictors with age, sex, and baseline CPI were evaluated using multivariable linear regression. RESULTS: The score for baseline PCS, but not MCS or JFLS, was associated with follow-up CPI (P = .012). One standard deviation (SD = 9.0)-higher baseline PCS score predicted an overall 3.2-point-lower follow-up CPI (95% confidence interval -5.8 to -0.7) after adjusting for age, sex, MCS, JFLS, and baseline CPI scores. However, the effect of PCS score was not uniform: the association between PCS and follow-up CPI scores was statistically significant for participants with baseline CPI ≥ 51.3/100 and clinically significant for participants with baseline CPI ≥ 68.7/100. Adjustment for TMD treatments and sensitivity analyses had negligible effect. CONCLUSION: In participants with moderate to severe baseline TMD pain intensity, higher baseline physical HRQoL predicted lower TMD pain intensity at 8 years follow-up. PCS score could contribute to a multifactorial long-term TMD pain prediction model.


Assuntos
Dor Facial/diagnóstico , Medição da Dor/estatística & dados numéricos , Síndrome da Disfunção da Articulação Temporomandibular/diagnóstico , Adolescente , Adulto , Idoso , Dor Facial/psicologia , Dor Facial/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Psicometria/estatística & dados numéricos , Síndrome da Disfunção da Articulação Temporomandibular/psicologia , Síndrome da Disfunção da Articulação Temporomandibular/terapia , Adulto Jovem
10.
Sci. med. (Porto Alegre, Online) ; 28(2): ID29045, abr-jun 2018.
Artigo em Português | LILACS | ID: biblio-909644

RESUMO

OBJETIVOS: Apresentar a transformada wavelet como uma ferramenta alternativa para o processamento dos sinais oriundos da eletromiografia quando utilizada na avaliação da atividade elétrica do músculo masseter de mulheres com disfunção temporomandibular. MÉTODOS: Cinco voluntárias com disfunção temporomandibular passaram por quatro sessões de terapia com diodo emissor de luz (LED, light emitting diode). A eletromiografia do músculo masseter foi realizada bilateralmente antes e após o tratamento, empregando um eletromiógrafo de dois canais. Na análise dos sinais eletromiográficos foi empregada a transformada wavelet na função Morlet. RESULTADOS: Nos escalogramas, observou-se a diminuição da ativação das fibras de alta frequência no protocolo de repouso e seu aumento no protocolo de movimento isométrico. Na análise baseada no sistema de cores RGB, foi possível observar que no protocolo de repouso do músculo masseter direito houve redução dos momentos de máxima intensidades de energia em 82% para frequências de 256-512Hz e em 42% para frequências acima de 512Hz. No músculo masseter esquerdo a redução foi de 42% na banda de frequências de 256-512Hz. CONCLUSÕES: A análise pela transformada wavelet permitiu identificar fatores fisiológicos relacionados não somente à ativação do músculo masseter, mas também à intensidade e à relação tempo/frequência, assim como os principais tipos de fibras ativadas durante os protocolos antes e após a terapia LED em pacientes com disfunção temporomandibular


AIMS: To present the wavelet transform as an alternative tool in the evaluation of the masseter muscle electrical activity in women with temporomandibular disorder after therapy with Light Emitting Diode (LED). METHODS: Five volunteers with temporomandibular disorder underwent four sessions of LED therapy. Electromyography of the masseter muscle was performed bilaterally before and after treatment. For analysing the electromyographic signals, the wavelet transform was applied in the Morlet function. RESULTS: In the scalogram, a decrease in the activation of the high-frequency fibers in the rest protocol and its increase in the isometric movement protocol were observed. In the analysis based on the RGB color system, we observed that in the right masseter muscle resting protocol, the moments of maximum energy intensities were reduced by 82% for frequencies of 256-512Hz and by 42% for frequencies above 512Hz. In the left masseter muscle the reduction was 42% in the frequency band of 256-512Hz. CONCLUSIONS: Analysis by the wavelet transform allowed identification of physiological factors related not only to the activation of the masseter muscle, but also to the intensity and time / frequency relationship, as well as the main types of fibers activated during the protocols before and after LED therapy in patients with dysfunction temporomandibular.


Assuntos
Eletromiografia , Terapia com Luz de Baixa Intensidade , Síndrome da Disfunção da Articulação Temporomandibular/terapia
11.
Physiother Theory Pract ; 34(9): 671-681, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29338489

RESUMO

The purpose of this prospective case series was to observe and describe changes in patients with chronic cervico-craniofacial pain of muscular origin treated with multimodal physiotherapy based on a biobehavioral approach. Nine patients diagnosed with chronic myofascial temporomandibular disorder and neck pain were treated with 6 sessions over the course of 2 weeks including: (1) orthopedic manual physiotherapy (joint mobilizations, neurodynamic mobilization, and dynamic soft tissue mobilizations); (2) therapeutic exercises (motor control and muscular endurance exercises); and (3) patient education. The outcome measures of craniofacial (CF-PDI) and neck disability (NDI), kinesiophobia (TSK-11) and catastrophizing (PCS), and range of cervical and mandibular motion (ROM) and posture were collected at baseline, and at 2 and 14 weeks post-baseline. Compared to baseline, statistically significant (p < 0.01) and clinically meaningful improvements that surpassed the minimal detectable change were observed at 14 weeks in CF-PDI (mean change, 8.11 points; 95% confidence interval (CI): 2.55 to 13.69; d = 1.38), in NDI (mean change, 5 cm; 95% CI: 1.74-8.25; d = 0.98), and in the TSK-11 (mean change, 6.55 cm; 95% CI: 2.79-10.32; d = 1.44). Clinically meaningful improvements in self-reported disability, psychological factors, ROM, and craniocervical posture were observed following a multimodal physiotherapy treatment based on a biobehavioral approach.


Assuntos
Vértebras Cervicais/fisiopatologia , Dor Crônica/terapia , Terapia por Exercício/métodos , Manipulações Musculoesqueléticas/métodos , Cervicalgia/terapia , Educação de Pacientes como Assunto , Síndrome da Disfunção da Articulação Temporomandibular/terapia , Articulação Temporomandibular/fisiopatologia , Adulto , Fenômenos Biomecânicos , Dor Crônica/diagnóstico , Dor Crônica/fisiopatologia , Dor Crônica/psicologia , Terapia Combinada , Avaliação da Deficiência , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Cervicalgia/diagnóstico , Cervicalgia/fisiopatologia , Cervicalgia/psicologia , Medição da Dor , Estudos Prospectivos , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Autocuidado , Síndrome da Disfunção da Articulação Temporomandibular/diagnóstico , Síndrome da Disfunção da Articulação Temporomandibular/fisiopatologia , Síndrome da Disfunção da Articulação Temporomandibular/psicologia , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
12.
Acta Odontol Scand ; 76(3): 175-182, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29124991

RESUMO

OBJECTIVE: To study the outcome of oral appliance treatment in myofascial Temporomandibular disorder (TMD) patients with and without comorbid pain using pain site drawings. MATERIAL AND METHODS: This randomized, controlled multicentre study comprised 65 myofascial TMD patients diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders. Pain-site drawings were filled in at the baseline examination. The patients were treated with oral appliances. Treatment outcome was followed up for 1 year and analysed according to the recommendations by the Initiative on Methods, Measurement and Pain assessment in Clinical Trials (IMMPACT) on an intent-to-treat basis. The data were analysed for two pain profiles, localized pain (face and head, n = 26) versus widespread pain group (pain sites outside the face and head, n = 39). RESULTS: Statistically significant improvement was registered within both groups for all outcome variables (characteristic pain intensity, 30% pain reduction of worst reported pain, graded chronic pain, depression, and somatization scores) during the follow-up with only small differences between the groups. CONCLUSIONS: Oral appliance treatment had a positive effect on all outcome measures during the 1-year follow-up in patients suffering from myofascial TMD pain, regardless of whether the pain was localized or widespread. Multiple pain sites seemed to have surprisingly little influence on the outcome variables. However, some indications of more challenges when treating patients with widespread pain compared to local pain could be observed. Pain-site drawings seem to be useful in the clinical situation and could support the clinicians in decision-making regarding treatment planning.


Assuntos
Dor Facial/terapia , Desenho de Aparelho Ortodôntico , Síndrome da Disfunção da Articulação Temporomandibular/terapia , Adulto , Depressão/etiologia , Dor Facial/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Síndrome da Disfunção da Articulação Temporomandibular/complicações , Fatores de Tempo , Resultado do Tratamento
13.
Rev. inf. cient ; 97(5): i:923-f:933, 2018. tab
Artigo em Espanhol | LILACS | ID: biblio-1005784

RESUMO

Introducción: el síndrome de disfunción temporomandibular, es una alteración que comprende un conjunto de signos y síntomas relacionados con las estructuras del sistema estomatognático. Objetivo: determinar la efectividad del tratamiento conjunto de láser y terapia de apoyo medicamentosa, aplicadas a los pacientes con el síndrome dolor disfunción de la articulación temporomandibular. Método: se realizó una intervención terapéutica en 84 pacientes que asistieron a la consulta de prótesis de la Clínica Estomatológica "Julio Antonio Mella" de Guantánamo, en el período comprendido entre septiembre de 2014 al mismo mes de 2015. Se conformaron dos grupos terapéuticos: uno recibió láser y terapia de apoyo medicamentosa y, el otro, terapia de apoyo medicamentosa, cada grupo con 42 pacientes que fueron evaluados a los 5, 10 y 15 días. Se tomaron en cuenta variables generales y clínicas: edad, grado de severidad, comportamiento del dolor y criterios de evaluación. Resultados: la terapia combinada de láser y terapia medicamentosa resultó ser más efectivo que la terapia medicamentosa, al desaparecer la sintomatología en un período de tiempo menor. Conclusiones: se validó que el tratamiento combinado de láser y terapia de apoyo medicamentosa resultó más efectivo al desaparecer progresivamente la sintomatología en un periodo de tiempo menor, en relación a los que se les aplicó el tratamiento convencional y por tanto es factible su aplicación(AU)


Introduction: temporomandibular dysfunction syndrome is an alteration that includes a set of signs and symptoms related to the structures of the stomatognathic system. Objective: to determine the effectiveness of the joint treatment of laser and drug support therapy, applied to patients with pain syndrome temporomandibular joint dysfunction. Method: a therapeutic intervention was carried out in 84 patients who attended the prosthesis consultation of the "Julio Antonio Mella" Stomatology Clinic in Guantánamo, in the period from September 2014 to the same month of 2015. Two therapeutic groups were formed: one received laser and drug support therapy and, the other, drug support therapy, each group with 42 patients who were evaluated at 5, 10 and 15 days. General and clinical variables were taken into account: age, degree of severity, pain behavior and evaluation criteria. Results: the combination therapy of laser and drug therapy proved to be more effective than drug therapy, as the symptoms disappear in a shorter period of time. Conclusions: it was validated that the combined treatment of laser and drug support therapy was more effective as the symptomatology progressively disappeared in a shorter period of time, in relation to those that were treated with conventional treatment and therefore its application is feasible(AU)


Introdução: a síndrome de disfunção temporomandibular é uma alteração que inclui um conjunto de sinais e sintomas relacionados às estruturas do sistema estomatognático. Objetivo: determinar a eficácia do tratamento articular da terapia de suporte a laser e medicamentosa, aplicada a pacientes com disfunção temporomandibular da síndrome da dor. Método: intervenção terapêutica em 84 pacientes atendidos no ambulatório de prótese de Estomatologia "Julio Antonio Mella" Clinic Guantanamo no período de setembro de 2014 para 2015. mês foi realizada foram organizados dois grupos de tratamento: um receberam laser e terapia de suporte medicamentoso e, o outro, terapia de suporte medicamentoso, cada grupo com 42 pacientes que foram avaliados aos 5, 10 e 15 dias. Variáveis gerais e clínicas foram consideradas: idade, grau de severidade, comportamento de dor e critérios de avaliação. Resultados: a terapia combinada de laser e terapia medicamentosa mostrou-se mais eficaz que a terapia medicamentosa, pois os sintomas desaparecem em menor tempo. Conclusões: é validado que o laser de tratamento combinado e terapia de droga foi mais eficaz para apoiar sintomas em fases num curto período de tempo, em relação aos quais foram aplicados o tratamento convencional, e, portanto, a sua aplicação é viável(AU)


Assuntos
Humanos , Síndrome da Disfunção da Articulação Temporomandibular/diagnóstico , Síndrome da Disfunção da Articulação Temporomandibular/terapia , Terapia a Laser , Comunidade Terapêutica
14.
J Altern Complement Med ; 23(10): 771-777, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29017019

RESUMO

OBJECTIVE: Arthrocentesis and prolotherapy are nonsurgical treatments for temporomandibular joint (TMJ) diseases. This study aimed to evaluate the treatment of hypermobility, pain, and displacement of the TMJ by consecutively performing arthrocentesis and prolotherapy in the same session. MATERIALS AND METHODS: In this study, 10 adults with disc displacement and painful, hypermobile TMJ were selected. Arthrocentesis and prolotherapy were consecutively performed using a 30% dextrose solution that was simultaneously injected into five areas: posterior disc attachment, superior joint space, superior and inferior capsular attachments, and stylomandibular ligament. Paired t-test, McNemar test, and chi-square test were used to assess the maximum mouth opening, clicking sounds, pain, and subluxation of the TMJ. Patients with rheumatoid arthritis and parafunctional habits such as teeth clenching and grinding and biting of the cheeks or any other objects and those who had undergone surgery were excluded from this study. RESULTS: A total of 10 participants (36.20 ± 7.06 years old, 7 women and 3 men) received a single treatment session of combined arthrocentesis and prolotherapy at the same office visit. Subluxation frequency and pain significantly decreased after the first week of treatment (p < 0.05). Subluxation also decreased at the 3-month follow-up (p < 0.05). Clicking sound values did not significantly change at any of the follow-up time points. Maximum mouth opening values decreased at all follow-up time points compared to baseline (p < 0.05). CONCLUSION: A single session of combined arthrocentesis and prolotherapy to treat symptomatic TMJ safely and significantly improved the subluxation and pain after 1 week and subluxation after 3 months compared to baseline status. The maximum mouth opening significantly decreased at all follow-up time points. Future studies assessing multiple treatment sessions are warranted.


Assuntos
Artrocentese , Glucose , Procedimentos Ortopédicos , Síndrome da Disfunção da Articulação Temporomandibular/terapia , Adulto , Feminino , Glucose/administração & dosagem , Glucose/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade
15.
Stomatologiia (Mosk) ; 96(5): 34-36, 2017.
Artigo em Russo | MEDLINE | ID: mdl-29072643

RESUMO

The aim of the study was to evaluate correlation of dental system functional status and emotional stress level in young adults. The study involved 164 patients aged 20-25 years. TMJ dysfunction was diagnosed according to M. Ahlers and H. Jakstat criteria (2000). All patients underwent electromyography (EMG) of mastication muscles at rest and by functional test. Emotional stress and anxiety were assessed by Holmes and Rahe stress scale, Jakhin-Mendeleevich clinical questionnaire and State-Trait Anxiety Inventory. The study revealed correlation between EMG activity of masticatory muscles and emotional stress level highlighting the importance of stress assessment in TMJ dysfunction planning.


Assuntos
Músculos da Mastigação/fisiopatologia , Estresse Psicológico/diagnóstico , Estresse Psicológico/psicologia , Adulto , Ansiedade/diagnóstico , Ansiedade/fisiopatologia , Feminino , Humanos , Masculino , Miografia , Síndrome da Disfunção da Articulação Temporomandibular/fisiopatologia , Síndrome da Disfunção da Articulação Temporomandibular/terapia , Adulto Jovem
17.
Adv Clin Exp Med ; 26(3): 455-460, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28791820

RESUMO

BACKGROUND: Temporomandibular joint dysfunction is often related to excessive load in the stomatognathic system. OBJECTIVES: The objective of the model tests, using numeric calculations, was to assess the articular disc loads in the temporomandibular joints after prosthetic and pharmacological treatment of functional disorders of the masticatory organ. MATERIAL AND METHODS: The study involved 10 patients, aged 21-48 years, of both sexes, randomly selected from a group of 120 patients treated with relaxation occlusal splints (60 patients, group I) and intramuscular injection of botulinum toxin type A (60 patients, group II), suffering from temporomandibular joint dysfunction with the dominant muscle component. In all subjects, a specialized functional examination was carried out. Treatment groups: occlusal splint therapy (group I) and intramuscular injection of botulinum toxin type A (group II). An assessment of the loads of 4 disc zones of the temporomandibular joints was carried out based on the results of clinical studies (phase I of the study), and numeric model tests (phase II). In the representatives of the study groups (5 patients in each group), measurements of occlusal forces and an evaluation of tension of the masseter and temporalis muscle were performed. RESULTS: The results of the average load values for all evaluated zones of the right and left articular disc differ in a statistically significant way in favor of group II, with the exception of the external mid part of the discs. In the case of the anterior of the right disc, the load was lower in patients belonging to group I than in those obtained in group II. CONCLUSIONS: Botulinum toxin type A significantly reduces the loads within the temporomandibular joints, generated by masseter muscle hypertonia.


Assuntos
Disco da Articulação Temporomandibular/fisiopatologia , Transtornos da Articulação Temporomandibular/fisiopatologia , Síndrome da Disfunção da Articulação Temporomandibular/fisiopatologia , Adulto , Toxinas Botulínicas Tipo A/administração & dosagem , Feminino , Humanos , Injeções Intramusculares/métodos , Masculino , Músculo Masseter/efeitos dos fármacos , Músculo Masseter/fisiopatologia , Menisco/efeitos dos fármacos , Menisco/fisiopatologia , Pessoa de Meia-Idade , Placas Oclusais , Medição da Dor/métodos , Disco da Articulação Temporomandibular/efeitos dos fármacos , Transtornos da Articulação Temporomandibular/tratamento farmacológico , Transtornos da Articulação Temporomandibular/terapia , Síndrome da Disfunção da Articulação Temporomandibular/tratamento farmacológico , Síndrome da Disfunção da Articulação Temporomandibular/terapia
18.
Rev. Soc. Esp. Dolor ; 24(4): 201-210, jul.-ago. 2017. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-165185

RESUMO

Introducción: El dolor músculo-esquelético crónico no reumático afecta a un 20 % de la población mundial, con tendencia ascendente. Actualmente, su tratamiento es solamente sintomático, pobremente eficaz y oneroso. El objetivo de este estudio fue caracterizar la enfermedad investigada como dolor fibromiofascial, de evolución inicialmente remitente, recurrente y, luego, migratoria, progresiva y persistente. Resistente al tratamiento sintomático. La hipótesis etiológica es que esta enfermedad es producida por la impregnación de urato monosódico en el tejido conjuntivo del aparato músculo-esquelético y tejido conjuntivo laxo, en forma similar a la fisiopatología de la gota, pero sin inflamación, expresándose solamente dolor y, en algunos casos, edema. Entonces, se plantea la tesis que un tratamiento antigotoso oral será eficaz. La intervención consiste en aplicar a la muestra este tratamiento (no importando la uricemia de cada paciente) y ponderar su efecto en la disminución del dolor y otras molestias. Material y métodos: Se realizó un estudio de seguimiento individual por un año a una cohorte formada por 49 pacientes que acudieron, aleatoria y voluntariamente, en el periodo de un año, a un consultorio de medicina integral, presentando dolor según la definición de caso. El diseño es un estudio de cohorte dinámico, prospectivo, aleatorio, cuasi experimental, sin grupo control. Determinando dos grupos: 1) pacientes ya estudiados y tratados con AINE, analgésicos, fisioterapia o alternativos; y 2) pacientes sin diagnóstico ni tratamientos previos. Tratamiento aplicado: dieta hipopurínica y los fármacos colchicina y alopurinol, vía oral y, eventualmente, lidocaína transdérmica para algún punto gatillo persistente. Se excluyó absolutamente l uso de otros tratamientos analgésicos. Se determinaron las variables que componen y caracterizan el síndrome en estudio. Se evaluó las tasas de recuperación y las probabilidades de recuperación por cada intervalo de tiempo estudiado a través del análisis descriptivo de la recuperación, en conjunto con un análisis de supervivencia. Resultados: De la muestra inicial de 53 personas, 4 de ellas abandonaron el tratamiento el primer día por intolerancia a los fármacos. Permaneciendo en tratamiento y control individual por 1 año la muestra formada por 49 pacientes. De ellos, 17 son hombres (34,7 %) y 32 son mujeres (65,3 %); edad media de 58,5 años (DT = 15,07); duración de la enfermedad: 0 a 27 años, media = 4,08 años (DT = 5,23). La caracterización de la enfermedad se obtuvo de recoger y evaluar la distribución de frecuencias de síntomas y signos del conjunto de la muestra. La hipótesis etiológica se obtuvo de un estudio semiológico-clínico comparativo previo, determinando como agente etiológico el urato monosódico, sal insoluble que estimula los nocipropioreceptores sin producir inflamación. Se aplicó colchicina: 1,5 a 0,5 mg/día, en un periodo máximo de 2 meses cada dosis, obtenida la remisión: 0,5 mg/semana, y alopurinol: 300 mg/día hasta la remisión y, luego, 100 mg/día. Al final de 1 año de tratamiento y seguimiento a cada paciente, todos ellos presentaron 100 % de recuperación, en una mediana de tiempo de 2 meses, lo que se evaluó con un análisis de supervivencia. La adhesión al tratamiento fue del 92,45 %. Un 24,5 % presentó reacciones adversas tolerables. Conclusión: La caracterización semiológica clínica del síndrome de dolor fibromiofascial fue suficientemente sensible para establecer el diagnóstico. La hipótesis etiológica permitió elegir un tratamiento curativo para todas las personas efectivamente tratadas (AU)


Introduction: The chronic non-rheumatic musculoskeletal pain affects 20 % of the world population, with an upward trend. Currently, its treatment is only symptomatic, poorly efficient and onerous. The aim of this study was to characterize the disease researched as fibromyofascial pain, of an initially relapsing-remitting evolution, and then, migratory, progressive and persistent. Resistant to symptomatic treatment. The etiological hypothesis is that this disease is produced by the impregnation of the monosodium urate in the connective tissue of the musculoskeletal system and soft connective tissue; similarly to the physiopathology of gout but without inflammation. Expressing only pain, and in some cases, edema. Therefore, the hypothesis states that an oral treatment for gout will be effective. The intervention consists of applying this treatment to the sample -regardless of the uricemia of each patient- and calculate its effect in decreasing pain and other health problems. Material and methods: An individual follow-up study was held for one year of a 49-patient cohort, who attended, at random and voluntarily, for the period of one year, to an integral medicine center, presenting pain according to the definition of the case. The design is a dynamic, prospective, randomized, quasi-experimental, with no control group, cohort study. Two groups are formed: 1) patients previously studied and treated with NSAIDs, analgesics, corticoids, physiotherapy or alternative treatment; and 2) patients who had not been either diagnosed or treated previously. Treatment: Low-Purine Diet, colchicine and allopurinol, via oral and, eventually, transdermic lidocaine for some persistent trigger point. The use of other analgesic treatments was absolutely excluded. Variables that compose and characterize the syndrome in study were determined. Recovery rates and recovery probabilities were evaluated for each time interval, studied through a descriptive analysis of recovery, and also through a survival analysis. Results: From the initial sample of 53 people, 4 of them quit the treatment on the first day because of intolerance to medicines. As a result, the sample was formed by 49 patients, who continued with the treatment and individual control for 1 year. In this group, 17 are male (34.7 %) and 32 are female (65.3 %); 58.5 years old in average (SD = 15.07); length of disease: 0 to 27 years, means: 4.08 years (DT = 5.23). The characteristics of the disease were obtained by identifying and evaluating the frequency distribution of symptoms and signs of the whole group in the sample. The etiological hypothesis was obtained in a previous semiological and clinical comparative study, in which the monosodium urate was characterized as the etiological agent, that this is an insoluble salt, which stimulates the nocipropioreceptors, without causing inflammation. Treatment: colchicine: 1.5 to 0,5 mg/day, for 2 months at most each dose, remission guaranteed: 0.5 mg/week. Allopurinol: 300 mg/day until remission, and then, 100 mg/day. By the end of the year of treatment and follow-up for each patient, all of them achieved 100 % of recovery, in a median time of 2 months, which was evaluated with a survival analysis. The compliance with the treatment was 92.45 %. 24.5 % presented tolerable adverse reactions: Allopurinol: mucous dryness (1), urinary and vaginal burning (1) erectile dysfunction (1). Colchicine: gastric intolerance (2), persistent diarrhea (4), vomit (1), headache (1), nausea (1). Conclusion: The semiological-clinical characterization of the syndrome of fibromyofascial pain was sensitive enough to establish the diagnosis. The etiological hypothesis allowed to select a curative treatment for all the patients effectively treated (AU)


Assuntos
Humanos , Síndrome da Disfunção da Articulação Temporomandibular/etiologia , Síndrome da Disfunção da Articulação Temporomandibular/terapia , Síndromes da Dor Miofascial/etiologia , Fibromialgia/tratamento farmacológico , Fasciite/tratamento farmacológico , Síndromes da Dor Miofascial/terapia , Adesão à Medicação , Estudos de Coortes , Colchicina/uso terapêutico , Alopurinol/uso terapêutico , Mialgia/complicações , Mialgia/etiologia , Mialgia/terapia
19.
Br Dent J ; 223(2): 90-95, 2017 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-28729573

RESUMO

Background and aim To evaluate the outcome of a group therapy approach in the management of myofascial temporomandibular pain (TMD) through promotion of self-care.Methods A group based interactive session was introduced for those patients who, at initial consultation, were diagnosed with myalgic TMD. Feedback forms and telephone interviews were used to record patient reported outcome measures to assess patient satisfaction with the service.Results Fifty-five patients attended 17 group sessions over ten months. Feedback revealed a high level of satisfaction immediately after the session with 71% (n = 39) of patients opting for discharge, reporting confidence to self-manage in primary care. This effect appears to be sustainable up to 11 months.Conclusions This approach benefits patients with myofascial TMD through promotion of self-management while utilising health care resources efficiently.


Assuntos
Psicoterapia de Grupo , Autocuidado , Síndrome da Disfunção da Articulação Temporomandibular/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
20.
J Oral Facial Pain Headache ; 31(3): 225-232, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28738107

RESUMO

AIMS: To carry out a systematic review of clinical trials published up to 2015 to determine the effectiveness of acupuncture in treating myofascial pain in temporomandibular disorder (TMD) patients. METHODS: The databases used were the Cochrane Library, PubMed, Scopus, and Web of Science; the dates of the articles surveyed ranged from 1990 to May 2015. The inclusion criteria were: (1) publications in English, Portuguese, or Spanish; (2) controlled clinical trials; (3) patients with TMD of muscular origin; and (4) studies that used acupuncture or laser acupuncture only for treatment. Reference lists of the included articles were hand searched. RESULTS: A total of four randomized clinical trials using acupuncture (traditional, trigger point, and laser) for TMD treatment met the eligibility criteria and were included. Although the studies featured small sample sizes and short-term follow-up periods, acupuncture yielded results similar to those observed in groups treated with occlusal splints and were significantly superior than those obtained from placebo acupuncture-treated groups. CONCLUSION: Despite the weak scientific evidence supporting its efficacy, acupuncture treatment appears to relieve the signs and symptoms of pain in myofascial TMD. More controlled and randomized clinical trials with larger sample sizes are needed in this field of research to verify these initial findings.


Assuntos
Terapia por Acupuntura , Síndrome da Disfunção da Articulação Temporomandibular/terapia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA