Movimentos mandibulares na fala: interferência das disfunções temporomandibulares segundo índices de dor

Abstract

Background: temporomandibular disorders can cause general alterations of the mandibular movements due to modification in the condition of muscles and articulations. Electrognathography, a computerized exam used to complement the diagnosis of these disorders, allows the objective delineation and record of the mandibular movements, determining their amplitude and speed. Aim: to verify the characteristics of mandibular movements of individuals with temporomandibular dysfunction and in asymptomatic individuals during speech, through computerized electrognathography, analyzing possible interferences of this dysfunction and severity implications regarding pain indexes. Method: 135 adults were divided in four groups based on their pain indexes, using a numeric scale: zero for pain absence, one for mild pain, two for moderate pain and three for severe pain. Mandibular movements were observed during the sequential naming of balanced pictures taking in consideration the occurrence of phonemes in the Brazilian Portuguese language. Records were obtained using computerized electrognathography (BioEGN -BioPak system). Results: the analysis of the results point that differences indicated as significant for mandibular opening amplitude and mandibular closing speed occurred between index zero and all of the other pain indexes. Regarding mandibular opening speed during speech, statistically significant differences were obtained between index zero and index three. It was observed that mandibular movements in speech are discreet, with an anteroposterior component and deviations in laterality. Conclusion: the presence of temporomandibular dysfunctions causes reduction in the values of maximum mandibular opening and a reduction in both mandibular opening speed and mandibular closing speed during speech The different pain indexes: mild, moderate and severe do not seem to determine larger reduction of these values. Key Words: Temporomandibular Joint Disorders; Arthralgia; Kinesiology Applied; Speech, Language and Hearing Sciences. ResumoTema: as disfunções temporomandibulares podem acarretar alterações gerais nos movimentos mandibulares devido à modificação nas condições musculares e articulares. A eletrognatografia, exame computadorizado utilizado para complementar o diagnóstico dessas disfunções, permite delinear e registrar de maneira objetiva os movimentos mandibulares, determinando sua amplitude e velocidade. Objetivo: verificar as características do movimento mandibular na fala em indivíduos com disfunções temporomandibulares e em assintomáticos, por meio de eletrognatografia computadorizada, analisando possíveis interferências dessas disfunções e as implicações de severidade quanto ao índice de dor. Método: 135 participantes adultos foram divididos em quatro grupos com base nos graus de dor, utilizando-se escala numérica, sendo: zero para ausência de dor, um para dor leve, dois para dor moderada e três para dor grave. Os movimentos mandibulares foram observados na nomeação seqüencial de figuras balanceadas quanto à ocorr...

Mandibular range of motion in patients with idiopathic peripheral facial palsy

“…The evaluation of the mandibular range of motion is usually part of protocols which assess TMJ's integrity and functionality. Muscle and structural adaptations arising from numerous disorders of different etiologies may be responsible for the reduction in muscle elongation, which in its turn will impact mandible movement (opening, protrusion and lateralization) [19][20][21][31][32][33][34] . Mandibular movement limitations may be caused by muscle disorders.…”

“…When there is muscle pain, the patient tends to reduce activity in the muscles involved 19 . This reduction in muscle function may cause changes to them, such as atrophy because of lack of use, thus bringing about strength reduction, restriction in opening movements and shifts 21 . More specifically, and according with the literature, the limitation in mandible opening may have many causing factors: muscle contraction for protection and spasm arising from the increase in metabolic degrading products caused by changed muscle activity, both situations aim at avoiding a feeling of discomfort (pain) 34 .…”

“…The TMJs are important structures of the stomatognathic system, since they enable mandibular movements and functions such as suction, swallowing, chewing and speech 18 . Literature states that the range of mandibular motion is associated with TMJ integrity and the action of skeletal muscles [19][20][21] . The TMJ needs to support and accommodate occlusal, muscular and neck adaptations.…”

“…When the demand for functional adaptations exceeds the TMJ functional and structural tolerance, the patient may develop signs and symptoms of temporomandibular disorders (TMd) [22][23][24] , causing changes to mandibular movements and to the stomatognathic functions associated with them 19 . These changes to the mandibular movements often cause complaints of pain, which causes reduction in range of motion, thus affecting speech articulation 21 . Concerning mouth opening, we notice its reduction in individuals who have TMJ disorders 22 .…”

Voz e disfunção temporomandibular em professores

“…Importante lembrar que esses distúrbios são resultantes ainda, do desequilíbrio da musculatura orofacial, cervical, supralaríngea e da modulação dos mecanismos neuromusculares periféricos e centrais, conforme comprovado em diferentes trabalhos [12][13][14][15][16] . As DTMs são caracterizadas por uma série de sinais e sintomas clínicos que se manifestam, como: dores musculares, cefaleia, estalidos na articulação temporomandibular (ATM), dificuldades em realizar movimentos mandibulares e redução dos movimentos mandibulares durante a fala [17][18][19][20][21][22][23][24] . Na presença de DTM, o principal sintoma é dor na ATM, tanto na posição em repouso como no movimento de abertura mandibular 25 .…”