Intervenções fisioterapêuticas no tratamento de disfunções temporomandibulares

Abstract

Introduction: Temporomandibular joint dysfunctions (TMD) are a highly prevalent and disabling condition to which noninvasive interventions have shown potentially effective results, and most of such interventions may be used by Brazilian physiotherapists. This study aimed to conduct a review of the available evidence of the physiotherapeutic interventions that propose to treat TMD. Methods: This study was executed as a narrative review. A search was conducted on PEDro and MEDLINE databases with the terms *Temporomandibular joint*, *temporomandibular joint dysfunction*, and *temporomandibular joint disorder* paired with the terms *exercise therapy*, *manual therapy*, *physical therapy*, *physiotherapy*, *dry needling* and *acupuncture*. Only systematic reviews and randomized clinical trials (RCTs) were included. Data extraction was made manually and is presented written on the results section. Results: 72 systematic reviews were found in the search, only 16 remained after the eligibility criteria were applied. Then, it was conducted a search for RCTs, in which 6 were found, totalizing 22 studies. The articles found were about the following interventions: (i) manual therapy; (ii) therapeutic exercise; (iii) low-level laser therapy as a treatment modality; (iv) acupuncture and dry needling; (v) transcranial direct current stimulation (tDCS); (vi) and a recording and reminding system that aimed to limit daytime non-functional habits. There was a lack of agreement between studies, but it is still possible to identify some points in common about the positive effects of: (i) manual therapy techniques; (ii) use of the low-level laser therapy; (iii) acupuncture; (iv) and of the recording and reminding system. However, all the systematic reviews in this study highlighted the low methodological quality of the vast majority of the included RCT. Conclusion: There is a low level of evidence supporting the use of the interventions mentioned in this study, and more high-quality trials are needed to better understand the treatment of the different types of TMD.