The effect of behavioral cognitive alteration and the stretching of jaw elevating muscles on the treatment of orofacial pains of muscle-skeletal origin
Keywords:
Temporomandibular joint disorder, Cognitive therapy, Muscle stretching exercisesAbstract
The aim of this study was to establish a clinical protocol for the treatment of Temporomandibular Disorder (TMD) of muscular origin through behavioral cognitive alteration. A sample of 144 patients was assessed over eight weeks, with an average attendance of 75 (52%). All patients were diagnosed as suffering from Temporomandibular Disorder of muscular origin, based on the evaluation protocol established by the Research Diagnostic Criteria for Temporomandibular Disorders. The superficial masseter (insertion, body, and origin), the deep masseter, and the anterior temporalis were analyzed by palpation, using the Visual Analogue Scale (VAS) for quantification of sensitivity. The patients were accompanied over an eight-week period and evaluated weekly by one sole researcher. Upon each evaluation, the patients were stimulated as to the recognition of oral habits, change in sleeping position, and stretching of the jaw elevating muscles. As of the second week, after the first examination, a statistically significant reduction in the sensitivity to palpation of the analyzed muscles could be observed, regardless of the side analyzed (p<0.05). In 68% of the patients, the symptoms associated with muscular pains, such as headache, earache, and pain in the cervical area, disappeared. The therapeutic protocol described herein can be recommended as an initial treatment for patients with Temporomandibular Disorder of muscular origin. The results have also shown that a precise diagnosis is necessary for the optimization of the protocol used.
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