Orofacial myofunctional disorder, a possible complicating factor in the management of painful temporomandibular disorder. Case report

Abstract

BACKGROUND AND OBJECTIVES:The clinical association between painful temporomandibular disorder and orofacial myofunctional disorders is frequent and requires attention. The objective of this study was to describe a clinical case of painful temporomandibular disorder in association with orofacial myofunctional disorders that evidence the importance of dental and speech therapy approaches involving myofunctional orofacial limits, as well as to discuss whether the presence of orofacial myofunctional disorders can be a comorbidity that hinders the temporomandibular disorder management. CASE REPORT: Female patient, 35 years old, complaining of pain in the orofacial region and joint noises during high amplitude mandibular movements for 17 years. She was diagnosed with myofascial pain and arthralgia (RDC/TMD) and orofacial myofunctional disorders (phonoarticulation with deviations and lingual interposition, atypical swallowing, oromandibular incoordination and mandibular hyperexcursion with eminence noise). Complementary tests (electromyography and electrovibratography) were performed in the pre-and post-treatment moments (1 year after). The treatment consisted of self-management and mindfulness orientations, stabilizing occlusal splint and speech therapy. After the treatment, there was an improvement in pain and mandibular range of motion, with consequent reduction of noise, better electromyographic balance and reduction of orofacial myofunctional disorders scores. CONCLUSION:The case report has suggested that the presence of orofacial myofunctional disorders in association with painful temporomandibular disorder could interfere in the management of pain and the balance of the stomatognathic system because it seems to act as a worsening factor to the temporomandibular Orofacial myofunctional disorder, a possible complicating factor in the management of painful temporomandibular disorder. Case report Distúrbio miofuncional orofacial, um disorder signs and symptoms. In this sense, the importance of dental and speech therapy interventions in patients with orofacial myofunctional disorders as possible comorbidity to painful temporomandibular disorder is highlighted. Keywords: Comorbidity, Speech therapy, Temporomandibular joint dysfunction syndrome. RESUMO JUSTIFICATIVA E OBJETIVOS:A associação clínica da disfunção temporomandibular dolorosa com distúrbios miofuncionais orofaciais é bastante frequente e requer atenção. O objetivo deste estudo foi mostrar um caso de disfunção temporomandibular dolorosa com associação de distúrbios miofuncionais orofaciais que evidenciou a importância do manuseio terapêutico odontológico e fonoaudiológico, com abordagens que envolveram limites miofuncionais orofaciais, bem como discutir se a presença de distúr-bios miofuncionais orofaciais pode ser uma comorbidade que dificulta o manuseio da disfunção temporomandibular. RELATO DO CASO: Paciente do sexo feminino, 35 anos, com queixa de dor na região orofacial e ruídos articulares durante movimentos mandibulares de grande amplitude ...

Validação do protocolo de avaliação miofuncional orofacial MBGR para adultos com disfunção temporomandibular com deslocamento de disco com redução

“…As for the construct evaluation, a statistically significant difference was found between the SG and CG regarding the clinical examination of pain on palpation and mandibular mobility. This result corroborates those of studies that reported changes in mandibular mobility (15,16) and sensitivity to palpation on the masticatory and cervical muscles in individuals with TMD (14,24) .…”

“…Regarding the content evaluation, the MBGR Protocol includes the analysis of the orofacial structures and habitual posture of lips and tongue that may be altered in cases of TMD (16,19,24) ; mobility of the lips and mandible that may be impaired in this population (14)(15)(16)19) ; masticatory function, for which there is consensus among studies of the presence of disorder in this function (5,(14)(15)(16)(17)(18)(19)(20)(21)26) ; deglutition, referred to as atypical or adapted in cases of TMD (14,16,(19)(20)(21)(22)25) ; speech, allowing identification of cases with phonetic and TMJ disorders (14) . Thus, the MBGR Protocol encompasses the Orofacial Myofunctional Disorders (OMD) described in the literature for individuals with TMD.…”

“…They were community individuals who volunteered to participate in the study, but only two of them sought treatment for TMD. Moreover, they had mild, or absence of symptoms and the literature has shown that the severity of TMD has a greater influence on orofacial functions (14,16,19) .…”

“…Fourteen studies were selected after a literature review on functional changes presented by patients with TMD (5,(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) according to the inclusion and exclusion criteria adopted (Chart 1).…”

Toxicological Profile of Biological Environment of Two Elastodontic Devices

“…Thus, by correcting these habits simultaneously with dental alignment by using elastodontic dental appliances, it is gaining more and more ground in orthodontic practice [11]. On the other hand, the other alternative approach to these dental diseases is represented by the use of bracket devices that have the disadvantage number, the most important being the high percentage of recurrence [12]. Two of the most elastodontic orthodontic appliances are Myobrace for Kids from Myofunctional Research Co. (Helensvale, Australia) (MB) and LM TrainerTM 2 (LMD).…”