Multimodal physiotherapeutic approach: effects on the temporomandibular disorder diagnosis and severity

Abstract

Multimodal physiotherapeutic approach: effects on the temporomandibular disorder diagnosis and severity [I] Abordagem fi sioterapêutica multimodal: efeitos sobre o diagnóstico e a gravidade da disfunção temporomandibular [A] Ariane Bôlla Freire [a] , Angélica Trevisan De Nardi [b] , Jalusa Boufleur [c] , Laís Chiodelli [d] , Fernanda Pasinato [e] , Eliane Castilhos Rodrigues Corrêa [f] [a] Undergraduate Student, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS -Brazil, e-mail:aribfreire@hotmail.com [b] Undergraduate Student, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS -Brazil, e-mail:angelica_denardi@hotmail.com [c] Abstract Introduction: The temporomandibular disorder (TMD) consists of a set of signs and symptoms that affect the masticatory structures, which may cause joint and/or muscular pain. The physiotherapy approach aims at the pain relief and the functional recovery by means of several modalities. Objective: To investigate the effects, short and medium-term, of a multimodal physiotherapeutic approach on TMD diagnosis and severity. Methodology: Individuals with diagnosis of TMD, confirmed by the Axis I of the RDC/TMD, took part in the study. From this evaluation, the Temporomandibular Index (TMI) and its sub-indices were calculated. The participants were treated during ten sessions of physiotherapy, which included therapeutic ultrasound, thermotherapy, manual therapy, stretching and neuromuscular exercises, as well as self-care and home exercises instructions. Assessments were carried out before treatment (AV1), immediately after treatmentFisioter Mov. 2014 abr/jun;27(2):219-27Freire AB, De Nardi AT, Boufleur J, Chiodelli L, Pasinato F, Corrêa ECR. 220 (AV2) and two months after the end of the treatment (AV3). The values of indices and the diagnosis prevalence were compared between the different periods by the t paired test (p < 0.05). Results: The number of diagnoses reduced in all the subgroups and 41.7% of the 24 participants presented no diagnosis after the treatment. A significant decrease in the TMI was observed between AV1 and AV2 (p = 0.000). There was no difference between AV2 and AV3 (p = 0.204) in 13 participants assessed two months after the end of the treatment. Conclusion: The multimodal physiotherapeutic approach resulted in positive effects, short and medium-term, on the symptoms and clinical signs, with deletion of the dysfunction or reduction of its severity in treated patients.[

Photobiomodulation with simultaneous use of red and infrared light emitting diodes in the treatment of temporomandibular disorder: study protocol for a randomized, controlled and double-blind clinical trial

“…The complexity of TMDs encouraged the search for treatment of a multidisciplinary team and the use of different forms of therapy, [12] among them, myorelaxant splints, [13] massotherapy resources and mobilizations, [14,15] as well as low level laser photobiomodulation. [16,17] The low-level laser therapy (LLLT) is able to penetrate the tissues by influencing the synthesis, release and metabolism of substances involved in analgesia, [18] stimulating blood flow, promoting anti-inflammatory action, [19] and stands out for its easy application, with the minimum of contraindications and the possibility of shorter treatments.…”

Atuação fonoaudiológica em disfunção temporomandibular em dois casos: análise comparativa dos efeitos da terapia tradicional e o uso da bandagem terapêutica associada

“…São necessários estudos com desenho metodológico mais rígido, maior número de sujeitos estudados e aplicação de indicadores quantitativos para comprovação da eficiência da aplicação da bandagem elástica nas DTMs. com a Academia Americana de Dor Orofacial, que aponta uma prevalência de DTM entre a segunda e quarta década de vida 2,11,18,19 . Com relação aos sintomas das DTMs investigados pelo questionário de anamnese desenvolvido pelos autores, estudos relatam que os mais frequentemente encontrados são a cefaleia 10,20 , os sintomas otológicos 11 , o ruído articular e limitação de amplitude de movimentos articulares 6,9,17 .…”