Efeito da alteração comportamental cognitiva e do alongamento dos músculos elevadores da mandíbula no tratamento das dores orofaciais de origem músculo-esquelética

Abstract

The aim of this clinical trial was to evaluate and quantify the effect of stretching of the elevating muscles of the mandible, behavioral-cognitive modification of oral habits and sleeping position alteration on the muscular sensitivity of patients with temporomandibular disorders and standardize a clinical protocol for those with temporomandibular disorders of muscular origin. Such research was motivated by the lack of studies that would evaluate the effect of a reversible, non-invasive and conservative therapy in patients with temporomandibular disorder of muscle origin. The sample was made up of 144 patients with temporomandibular disorder of muscle origin who sought treatment at the Orofacial Pain Clinic of the Dental School of the Federal University of Minas Gerais, Brazil, in 2004. An assessment protocol based on the Research Diagnostic Criteria was used for diagnosis and patients followed up through eight weeks, at which end was observed an improvement of the muscular sensitivity on palpation in the anterior temporal muscle, superficial masseter in its insertion, body and origin and deep masseter. The visual analog scale (VAS), which was used in this work, demonstrated to be effective in quantifying the muscular sensitivity. The stimulation to oral habits cognition, sleep posture modification and stretching of the elevating muscles of the mandible resulted in statistically significant decreasing of muscular sensitivity on palpation of the assessed muscles indicating implicitly that such protocol may be recommended as initial treatment of patients with temporomandibular disorder of muscular origin. The results demonstrated also that it is essential a precise diagnosis in order to optimize the protocol.