Efeito da alteração comportamental cognitiva e do alongamento dos músculos elevadores da mandíbula no tratamento das dores orofaciais de origem músculo esquelética
Palavras-chave:
Transtornos da articulação temporomandibular, Terapia cognitiva, Exercícios de alongamento muscularResumo
O objetivo deste trabalho foi estabelecer protocolo clínico para tratamento de disfunção temporomandibular de origem muscular pela alteração comportamental cognitiva. A amostra de 144 indivíduos, diagnosticados como portadores de disfunção temporomandibular de origem muscular segundo o protocolo de avaliação do Research Diagnostic Criteria for Temporomandibular Disorders, foi avaliada por um período de oito semanas. A média de comparecimento às consultas, durante este período, foi de 75 (52%). Os músculos masseter superficial (insserção, corpo e origem), masseter profundo e temporal anterior foram avaliados por palpação, utilizando-se a escala visual análoga para quantificação da sensibilidade. A cada avaliação semanal realizada pelo pesquisador, os pacientes foram estimulados à cognição dos hábitos bucais, alteração da posição de dormir e alongamento dos músculos elevadores da mandíbula. Houve diminuição estatisticamente significativa da sensibilidade à palpação dos músculos avaliados a partir da segunda semana após o primeiro exame, independentemente do lado avaliado (p<0,05). Em 68% dos pacientes houve o desaparecimento de sintomas associados à dor muscular, tais como dor de cabeça, dor de ouvido, dor na região cervical. O protocolo terapêutico descrito pode ser recomendado como tratamento inicial de pacientes portadores de disfunção temporomandibular de origem muscular. Os resultados também demonstraram ser imprescindível um diagnóstico preciso para a otimização do protocolo utilizado.
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