Agulhamento seco no tratamento da dor miofascial associada a disfunção temporomandibular: uma revisão sistemática

Dor miofascial é um distúrbio muscular que esta frequentemente associada às desordens temporomandibulares, afeta os músculos da mastigação e pode levar a limitações funcionais. Esta revisão sistemática tem como objetivo identificar a literatura científica sobre os efeitos do agulhamento seco superficial e profundo para o tratamento da dor em pacientes com disfunção temporomandibular (DTM) miofascial. Trata-se de uma revisão sistemática buscando estudos primários nas bases de dados PubMed e Biblioteca Virtual em Saúde - BVS (que reúne bases de dados como LILACS - Literatura Latino-americana e do Caribe em Ciências da Saúde, MEDLINE - Medical Literature Analysis and Retrieval System Online, SciELO - Scientific Electronic Library Online, dentre outras) com os descritores “temporomandibular joint disorders dry needling”, or “myofascial temporomandibular dysfunction dry needling”, or “temporomandibular dysfunction dry needling”, assim artigos inglês, português ou espanhol que respondem à questão norteadora de utilização do agulhamento seco no tratamento de DTM miofascial foram incluídos; teses, monografias, associações de tratamentos, artigos que estavam em outras línguas que não as citadas acima e revisões sistemáticas foram excluídas. Nove estudos foram considerados elegíveis. Um estudo comparou o agulhamento seco superficial e profundo. Quatro estudos utilizaram apenas agulhamento seco profundo e outros 4 estudos não especificaram o tipo de agulhamento utilizado. Diante disso, os resultados encontrados sugerem que não há dados suficientes para tirar conclusões sólidas sobre qual tipo de agulhamento seco é melhor para o tratamento da dor miofascial associada à DTM. Ensaios clínicos randomizados de baixo risco de viés são fortemente necessários.

A Research Protocol on Effectiveness of Sub Occipital Myofacial Release on Functional Disability in Temporomandibular Dysfunction with Neck Pain: A Randomized Control Trial

Background: Temporomandibular joint dysfunction is one of commonest joint that gets affected in females, studies shows that the altered posture of cervical spine lead to mandibular retrusion and hence in long term leads to Temporomandibular dysfunction, the tightness of sub-occipital muscle leads to pulling of the ligaments around the joint in course causing retrusion or malocclusion. The common symptoms of temporomandibular joint dysfunction includes clicking, reduced mouth opening, headache. Alteration in the function of TMJ leads to poor quality of life of the individual as this joint is involved in basic activities like talking, eating, laughing and kissing. The sub-occipital muscles are the group of muscle extending from spinous process of C2 vertebrae to inferior nuchal line of occipital bone. Tightness of this muscle lead to extension of upper cervical spine and flexion of lower cervical spine. The common causes of temporomandibular dysfunction includes injury to jaw, overuse, inflammatory condition like arthritis and bruxism. Our aim is to find out the efficacy of sub-occipital Myofacial Release versus conventional physiotherapy on functional disability of TMJ. The clinical trial registry-India (CTRI) registration number for this trial is CTRI/2021/05/033493. Methodology: In this study the total of 60 patients with mild to moderate Temporomandibular dysfunction with neck pain were divided into two group one group received MFR and other group received stretching exercises followed by conventional physiotherapy. The treatment was given for two week 5 session in each week. The assessment was done at day one of treatment and the end of first week and at the end of second week. Discussion: This study was done to find out the effectiveness of suboccipital Myofacial release and stretching exercises in mild to moderate Temporomandibular joint dysfunction with neck pain. Conclusion: Conclusion of the study can be made based on the effect of both technique on functional disability in patient with mild to moderate TMD and opt for more specific treatment for rehabilitation of patient with TMD.

Analysis of the relationship between temporomandibular dysfunction and sleep quality: A cross-sectional study

Considered as a set of disorders, temporomandibular disorder (TMD) involves several anatomical structures such as the temporomandibular joint, masticatory muscles and attached structures. Its etiology is multifactorial, and the psychobehavioral factor, especially sleep disorders, is relevant in this context. This study aimed to assess the prevalence of temporomandibular dysfunction (TMD), sleep quality, and possible associations between these variables, in first to fifth year students of the Dental School. A sample of 182 students participated in this study and a questionnaire proposed by the American Academy of Orofacial Pain and the Pittsburgh Sleep Quality Index questionnaire were used to obtain the data. 75.27% of the students were females and 24.72% males. TMD was observed in 45.60% of students, and 68.13% of the students reported poor sleep quality. However, there was no significant association between the variables (TMD and sleep quality, p=0.114). Regarding the severity of TMD, the mild form was more prevalent (34.61%), being more prevalent in females (79.16%). However, there was no significant association between TMD and sleep quality (p=0.317). There was no association between TMD and sleep quality in the studied population.