Aspectos clínicos e psicossociais avaliados por critérios de diagnóstico para disfunção temporomandibular

Abstract

Purpose: to analyze the association between the classification of clinical diagnoses classification (myofascial pain, disc and joint disorder) and the chronic pain graduation, depression and nonspecific physical symptoms in subjects with temporomandibular disorder.

Cervical spine range of motion, posture and electromyographic activity of masticatory muscles in temporomandibular disorders

“…Temporomandibular disorder (TMD) is an umbrella term that covers a set of clinical signs and symptoms involving the temporomandibular joint (TMJ), masticatory (chewing) muscles and associated structures [1][2][3][4][5][6].…”

“…The physiopathology of this disorder is unclear and its etiology multifactorial, including joint trauma, occlusal discrepancies, joint hypermobility, skeletal problems, bruxism (teeth grinding), internal TMJ disorders, parafunctional habits, psychosocial factors and emotional stress [4,6]. It often overlaps with other pain disorders [5] and, except for dental pain, is the most common cause of orofacial pain [1,3].…”

Use of non-invasive neuromodulation in the treatment of pain in temporomandibular dysfunction: preliminary study

“…Neuroimaging studies revealed the presence of chemical pain mediation through opioidergic, glutamatergic, GABAergic and serotonergic neurotransmissions 21,32,33 . Pain due to muscular TMD is believed to be strongly related to emotional distress [9][10][11][12][13][14][15][16]56 . And the DLPF cortex is the fulcrum of several brain networks involved in the cognitive, affective and sensory processing, which stimulation probably mediates the analgesic effects through the modulation of affective-emotional networks related to pain 13,38,39 .…”

“…This mechanism is characterized by maladaptive neuroplasticity but can be reversed with treatment [6][7][8] . Chronic TMD pain is a complex and multidimensional phenomenon that is often associated with an altered emotional state [9][10][11][12][13][14][15][16] , requiring a multidisciplinary treatment that involves different therapies. Some aim to treat the muscles, others act on dental occlusion or joint structures, and there are those whose main focus is the psychoemotional factor 1,[17][18][19] .…”

“…Some aim to treat the muscles, others act on dental occlusion or joint structures, and there are those whose main focus is the psychoemotional factor 1,[17][18][19] . It is believed that this neuronal modification, coupled with the emotional imbalance present in many patients with this disorder, leads to an unsatisfactory response to traditional therapies such as patient education in relation to self-care, pharmacotherapy, acupuncture, stabilizing occlusal splint, biofeedback, ultrasound, transcutaneous electrical nerve stimulation (TENS), cognitive-behavioral therapy, among others 1,6,9,12,17,18 . Given this context, it is evident the need for a therapy that acts directly on the CNS.…”