Therapeutic approach to patients with chronic orofacial pain with temporomandibular disturbed

Adolpho Marlon Antoniol Moura,Horácio Pompei Filho,Saulo Machado Moreira De Sousa,Bruna Marquezini Matos

doi:10.52600/2763-583x.bjcr.2022.2.2.3-11

Adolpho Marlon Antoniol Moura, Horácio Pompei Filho + Show 2 more

Open Access

https://doi.org/10.52600/2763-583x.bjcr.2022.2.2.3-11

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Abstract

Temporomandibular disorder (TMD) is a term that encompasses a series of dysfunctions and disorders that affect the temporomandibular joint (TMJ), masticatory muscles and associated structures. These disorders are characterized by a set of signs and symptoms that may include joint noises, such as clicking and crackling, tooth wear, limited mandibular movement, accompanied or not by facial, cranial and periauricular pain. Here, we reported the clinical conduct of a patient with muscle TMD. Patient with chronic pain complaint in the cervico-craniofacial region, signs of bruxism, mouth opening limitation and masseteric hypertonia. The diagnosis was TMD of bilateral masseteric muscle origin, without trigger points. Heat thermotherapy was prescribed, myofacial and myofunctional physiotherapy, rigid Michigan stabilizer plate making, postural correction, and cognitive-behavioral therapy. The patient presented a gradual evolution of the clinical condition and after 90 days reported remission of approximately 95% of the symptomatological complaints, such as an improvement in the quality of sleep at night, without medication assistance, reduction in pain crises, and full mouth opening (44mm). It is concluded that the correct diagnosis and full patient adherence to the treatment proposed in this study provided relief in painful symptoms and biopsychosocial aspects.

Highlights

Temporomandibular disorder (TMD) is a term that encompasses a series of dysfunctions and disorders that affect the temporomandibular joint (TMJ), masticatory muscles and associated structures [1]
Epidemiological studies show the presence of signs and symptoms of TMD in all age groups, and its incidence generally increases with age [3]
Entities dedicated to the study of TMD were created, with new scientific studies emerging that attributed multifactoriality to temporomandibular disorders, involving anatomical factors such as occlusion and TMJ, neuromuscular factors such as muscle hyperactivity, deviations posture, psychological factors, trauma and parafunctional habits [5]

Summary

Introduction

Temporomandibular disorder (TMD) is a term that encompasses a series of dysfunctions and disorders that affect the temporomandibular joint (TMJ), masticatory muscles and associated structures [1]. Epidemiological studies show the presence of signs and symptoms of TMD in all age groups, and its incidence generally increases with age [3]. Such studies show that a large portion of the population presents signs and/or symptoms of dysfunction at subclinical or clinical levels, finding a high prevalence of dysfunction in individuals considered non-patients, that is, those who do not seek treatment [4]. Some theories have been proposed to explain the etiology of TMD. These theories generally considered a single factor to cause such dysfunctions. Entities dedicated to the study of TMD were created, with new scientific studies emerging that attributed multifactoriality to temporomandibular disorders, involving anatomical factors such as occlusion and TMJ, neuromuscular factors such as muscle hyperactivity, deviations posture, psychological factors (anxiety, stress and depression), trauma and parafunctional habits [5]

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