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OBJECTIVE: Temporomandibular disorder (TMD) is a group of heterogeneous pathological conditions that affect the temporomandibular joint (TMJ), mastication muscles, and some associated structures. The aim of this study was to measure the prevalence of signs and symptoms of dysfunction, including knowledge of TMD in a stratum of the population. METHODS: A population extract from Rio de Janeiro subdivided by conglomerates was interviewed through an online form. RESULTS: The results showed that only 19% of the participants had no symptoms related to TMD. CONCLUSION: The results showed that the symptom prevalence is directly related to knowledge and practices about the disorder and that its presence may be under-reported.

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The aim of the present study was to evaluate the effect of intraoral photobiomodulation involving super-pulsed laser (905 nm) combined with red (640 nm) and infrared (875 nm) light-emitting diodes on pain, mandibular range of motion, and functioning in women with myogenous temporomandibular disorder. A randomized, sham-controlled, double-blind clinical trial was conducted involving 30 women with myogenous temporomandibular disorder diagnosed using the Research Diagnostic Criteria for Temporomandibular Disorders. The participants were randomly allocated to two groups (active and sham photobiomodulation). The evaluations involved this use of the visual analog scale, digital calipers, and a functional scale. Photobiomodulation was administered intraorally in the region of the pterygoid muscles, bilaterally, in all participants for a total of six sessions. Evaluations were performed on five occasions: prior to the intervention, immediately after the first session, 24 h and 48 h after the first session, and after the six sessions. Significant differences between groups were found regarding pain (p ≤ 0.01) and functioning (p ≤ 0.04). However, no statistically significant difference was found regarding range of mandibular motion. The findings demonstrate that intraoral photobiomodulation involving super-pulsed laser (905 nm) combined with red (640 nm) and infrared (875 nm) light-emitting diodes diminishes pain and improves functioning but does not exert an influence on mandibular range of motion in women with temporomandibular disorder.Trial registration: NCT02839967.

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O objetivo do presente estudo foi avaliar se as terapias de placa oclusal, fisioterapia e aconselhamento, empregadas para o tratamento da disfunção temporomandibular (DTM), alteram a postura craniocervical e quadro de dor. Trata-se de um ensaio clínico randomizado controlado cego, onde foram incluídos sujeitos previamente diagnosticados com DTM por meio do RDC/TMD (Research diagnostic criteria for temporomandibular disorders). Os pacientes foram sorteados entre quatro grupos de tratamento: placa oclusal (PO, n=17), fisioterapia (F, n= 19), aconselhamento (AC, n=15) e placa associada ao aconselhamento (PAC, n= 14), totalizando 65 indivíduos. Para a análise postural, uma teleradiografia foi realizada no baseline e após 1 mês da aplicação da terapia a fim de observar a distância occiptoatlas (DOA), a relação craniocervical (ACR) e o posicionamento do osso hioide (TH). Os traçados foram realizados nas imagens utilizando-se o Software CorelDraw X6 (2012 Corel Corporation, Canadá). Para análise da variável dor, a escala visual analógica foi aplicada antes e 1 mês após as terapias. Os dados obtidos foram submetidos a diversos testes T pareado (α=5%) e para a variável dor o teste SPANOVA foi aplicado. Com exceção do grupo PAC na variável ACR (p=0,003), os resultados mostraram que não houve diferença estatisticamente significativa para as variáveis analisadas quanto as diferentes terapias ao longo do tempo. Porém pode-se observar que todos os grupos de tratamento possibilitaram uma redução do quadro de dor dos pacientes (p=0.013) ao longo do tempo. Conclui-se que as terapias aplicadas pouco influenciam na postura craniocervical, mas são eficazes para o alivio da sintomatologia dolorosa (AU).

The objective of the present study was to evaluate whether the occlusal plaque, physiotherapy and counseling therapies used in the treatment of temporomandibular disorders (TMD) alter the craniocervical posture and the pain picture. This is a controlled, randomized, blinded study that included individuals previously diagnosed with TMD through the RDC / TMD (Research criteria criteria for temporomandibular disorders). The patients were randomly selected from four treatment groups: occlusal (OP, n = 17), physiotherapy (MT, n = 19), counseling (C, n = 15) and counseling, totaling 65 individuals. For the postural analysis, a teleradiography was performed at the baseline and 1 month after the application of the therapy, in order to observe the occipito-atlas distance (DOA), the craniocervical relationship (ACR) and the positioning of the hyoid bone. Traits were performed on the images using CorelDraw X6 software (2012 Corel Corporation, Canada). To analyze the pain variable, the visual analogue scale was applied before and 1 month after the therapies. The data obtained were submitted to several paired T tests (α = 5%) and for the pain variable the SPANOVA test was applied. With the exception of the PAC group in the ACR variable (p = 0.003), the results showed that there was no statistically significant difference for the analyzed variables regarding the different therapies over time. However, it can be observed that all the treatment groups allowed a reduction of the patients' pain picture (p = 0.013) over time. It's concluded that the therapies applied have little influence on craniocervical posture, but are effective for the relief of painful symptoms (AU).

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ABSTRACT BACKGROUND AND OBJECTIVES: Temporomandibular disorder and Burnout syndrome are influenced by emotional factors. This study aimed at prospectively evaluating Burnout syndrome dimensions and their relationship with temporomandibular disorder signs and symptoms in a sample of dentistry graduating students. METHODS: Sample was made up of dentistry graduating students (23±2.5 years), who have answered the Maslach Burnout Inventory questionnaire, students survey, and the ProDTM-Multi. Questionnaires were answered once a year, considering first, second and third year of the course (2013/2014/2015). Statistical analysis has compared Burnout syndrome dimensions between genders and has tested their correlation with total ProDTMMulti score, as well as variations between scores of this syndrome dimensions along the years by gender. RESULTS: Considering total sample, there has been increase in risk zone frequency for Burnout syndrome as years went by. There has been significant difference between males and females for emotional exhaustion in the three evaluated years (p=0.002, p=0.003, p=0.01, respectively) and also for disbelief in the last year (p=0.02), being higher for females. There has been significant correlation of ProTD-MMulti scores and emotional exhaustion among females in the first and second evaluated years (p=0.0004, p=0.04). CONCLUSION: It seems to be correlation between emotional exhaustion and perception of temporomandibular signs and symptoms among females, and a trend to Burnout syndrome dimensions scores increase as course progressed.

RESUMO JUSTIFICATIVA E OBJETIVOS: A disfunção temporomandibular e a síndrome de Burnout são influenciadas por fatores emocionais. O objetivo deste estudo foi analisar de forma prospectiva as dimensões da síndrome de Burnout, e sua relação com a percepção dos sinais e sintomas de disfunção temporomandibular em uma amostra de estudantes de graduação em Odontologia. MÉTODOS: A amostra foi composta por alunos de graduação em odontologia (23±2.5 anos), os quais responderam aos questionários Inventário de Burnout de Maslach - versão estudantes e o ProDTMMulti. Os questionários foram respondidos anualmente, considerando-se o primeiro, segundo e terceiro ano do curso (2013/2014/2015). A análise estatística comparou as dimensões da síndrome de Burnout entre os gêneros e testou a sua correlação com o escore total do ProDTMMulti, bem como a variação entre os escores das dimensões dessa síndrome ao longo dos anos por gênero. RESULTADOS: Considerando a amostra total houve aumento na frequência da zona de risco para a síndrome de Burnout com o passar dos anos. Observou-se diferença significativa entre homens e mulheres para exaustão emocional nos três anos avaliados (p=0,002, p=0,003, p=0,01, respectivamente) e ainda para a descrença no último ano (p=0,02), sendo mais altos para as mulheres. Houve correlação significativa dos escores do ProDTMMulti com a exaustão emocional nas mulheres no primeiro e segundo ano avaliados (p=0,0004, p=0,04). CONCLUSÃO: Parece existir uma correlação entre a exaustão emocional e a percepção de sinais e sintomas de disfunção temporomandibular no gênero feminino e uma tendência de aumento dos escores das dimensões da síndrome de Burnout com a progressão do curso.

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Los Criterios Diagnósticos para la Investigación de los Trastornos Temporomandibulares (CDI/TTM) ofrecen un sistema estandarizado para evaluar la Disfunción Temporomandibular (DTM). Sin embargo, la validez del diagnóstico clínico obtenido con estos criterios al compararlo con el diagnóstico obtenido de las imágenes de Resonancia Magnética (RM) es controversial. El objetivo fue determinar la concordancia que existe entre la evaluación clínica realizada con los CDI/TTM e imágenes de RM de la articulación temporomandibular (ATM), de pacientes atendidos en la Clínica Integral del Adulto, de la Escuela de Odontología de la Universidad del Valle, en Cali, Colombia. Se evaluó clínicamente a 36 individuos, con edades comprendidas entre 18 y 60 años, utilizando los CDI/TTM y se les realizaron exámenes de RM. Las variables estudiadas fueron sexo, edad, signos y síntomas de la ATM, Posición Normal del Disco (PND), Desplazamiento Discal con Recaptura (DDCR) y Desplazamiento Discal Sin Recaptura (DDSR). Los datos obtenidos fueron sometidos a pruebas estadísticas para determinar el índice Kappa y características operativas de la prueba clínica. El Índice Kappa fue 0,53, con una concordancia entre las evaluaciones clínicas e imagenológicas moderada. De la población estudiada, 91,6% fue del sexo femenino, con 31 años como promedio de edad. El signo hallado con mayor frecuencia fue el ruido articular (77%) y el síntoma más frecuente fue el dolor facial (69%). La sensibilidad de los CDI/TTM para determinar la PND fue 0,52 y la especificidad 0,87; la sensibilidad para el DDCR fue 0,8780 y la especificidad 0,709; la sensibilidad para el DDSR fue 0,5714 y la especificidad 0,948. La DTM se presentó con mayor frecuencia en las mujeres, con edad promedio de 31 años. Los CDI/TTM pueden considerarse confiables, especialmente para el DDCR; sin embargo, tratamientos invasivos, permanentes o quirúrgicos, requerirían confirmación con un diagnóstico imagenológico para evitar falsos positivos.

The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) offer a standardized system to clinically evaluate the most common subtypes of Temporomandibular Disorders (TMD). However, the validity of the clinical diagnose obtained with these criteria when compared with the diagnose obtained from the images of Magnetic Resonance (MR) is controversial. The objective of this study was to determine the concordance existing between the clinical evaluation obtained from the RDC/TMD and that obtained from MR images of the temporomandibular joint (TMJ) of patients attending the Clínica Integral del Adulto ­ Clínica de ATM, of the Escuela de Odontología of the Universidad del Valle, Cali, Colombia. A population of 36 patients of both sexes, with ages between 18 and 60 years, were clinically evaluated with the RDC/TMD and MR. The variables considered were sex, age, signs and symptoms of the TMJ, Normal Disc Position (NDP), Disc Displacement with Reduction (DD-R) and Disc Displacement without Reduction (DD-NR). The data obtained were submitted to statistical tests to determine the Kappa Index and operative characteristics of the clinical evaluation. The Kappa Index obtained was 0.53, which shows that the concordance between the clinical and the imagenological evaluations is moderate. Of the total population studied, 91.6% were females, with 31 years as average age. The most frequent sign found was the joint sound (77%) and the most frequent symptom was facial pain (69%). The sensitivity of the RDC/TMD to determine NDP was 0.52 and the specificity 0.87; the sensitivity for the DD-R was 0.8780 and the specificity 0.709; the sensitivity for the DD-NR was 0.5714 and the specificity 0.948. The TMD were found most frequent in women, with average age of 31 years. The RDC/TMD can be considered reliable, especially for the DD-R; however, invasive, permanent or surgical treatments would require confirmation with imagenological diagnoses to avoid false positives.

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BACKGROUND AND OBJECTIVES: For most cases, temporomandibular disorders should be treated by a non-invasive, interdisciplinary and integrative process. In traditional Chinese medicine, acupuncture is an excellent tool aiming at treating and healing this disease. This study was a critical literature review to observe the efficacy of traditional Chinese acupuncture to treat muscular temporomandibular disorders and to identify primary acupoints. CONTENTS: Pubmed, LILACS, Scielo and Cochrane databases were queried to identify scientific articles relevant for the study. Articles were selected from January 2000 to May 2013. A total of 125 articles were found and 21 were included. Acupuncture treatment alone or as additional therapy, or even compared to other techniques, was superior and effective to improve pain and function of patients with temporomandibular disorders and most commonly used acupoints were IG4, E6, E7 and F3. CONCLUSION: This study has shown that acupuncture is a technique recommended by national and international literature to treat muscular temporomandibular disorders, promoting pain relief and/or total intensity, improvement of joint movements and oral function and decrease of masticatory muscles hyperactivity. .

JUSTIFICATIVA E OBJETIVOS: Na grande maioria dos casos, o tratamento das disfunções temporomandibulares deve ser um processo não invasivo, interdisciplinar e integrativo. Dentro da medicina tradicional chinesa, a acupuntura é uma ótima ferramenta que visa a terapia e cura dessas doenças. O objetivo deste estudo foi conduzir uma revisão crítica da literatura para verificar a eficácia da acupuntura tradicional chinesa no tratamento da disfunção temporomandibular do tipo muscular, bem como identificar os principais acupontos. CONTEÚDO: Foi realizada uma pesquisa nas bases de dados Pubmed, LILACS, Scielo e Cochrane para identificar artigos científicos relevantes para o estudo. Os artigos foram selecionados no período de janeiro de 2000 a maio de 2013. Encontrou-se um total de 125 artigos, sendo que 21 foram incluídos. O tratamento de acupuntura isolado ou como terapia complementar, ou ainda comparado com outras técnicas, se mostrou superior e eficiente na melhora da dor e da função de pacientes com disfunção temporomandibular, e os pontos de acupuntura mais citados foram IG4, E6, E7 e F3. CONCLUSÃO: Este estudo demonstrou que a acupuntura é uma técnica recomendada pela literatura nacional e internacional para o tratamento de disfunções temporomandibulares de origem muscular, promovendo alivio e/ou redução total da intensidade dolorosa, melhora nos movimentos mandibulares e na função oral e diminuição da hiperatividade muscular dos músculos da mastigação. .

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JUSTIFICATIVA E OBJETIVOS: A disfunção temporomandibular (DTM) é o termo genérico para um grande número de distúrbios funcionais do sistema da mastigação, da articulação temporomandibular (ATM) e de estruturas associadas. Fibromialgia (FM) é uma das doenças reumatológicas mais frequentes, cuja característica principal manifesta-se com dor musculoesquelética difusa e crônica. Pelo fato dessas duas condições apresentarem diversas semelhanças, tanto na prevalência quanto nas características clínicas; o objetivo desse estudo foi realizar uma análise e relatar a possível correlação entre ambas. CONTEÚDO: Realizou-se uma revisão da literatura de 1995 a 2008 nas bases de dados Web of Science, Pubmed, MedLine, LILASC e BBO, cruzando-se os descritores fibromialgia, fibrosite, síndrome da dor miofascial difusa, síndrome da disfunção da articulação temporomandibular (DTM), transtornos da articulação temporomandibular e transtornos crânio mandibulares. Os estudos mostraram que a dor muscular oriunda da DTM, embora seja considerada uma condição regional pode, em determinados indivíduos, coexistir com síndromes dolorosas sistêmicas, como a FM. No entanto, indivíduos com FM apresentam, em sua grande maioria, dolorimento na região de cabeça caracterizando um forte indício da presença de possível DTM. O que se observou é que grande parte dos indivíduos com FM apresentam DTM, porém o inverso não é verdadeiro.CONCLUSÃO: Considerando-se o escasso conhecimento sobre a apresentação orofacial da FM, o tratamento da DTM para pacientes com FM deve ser conservador e direcionado aos possíveis fatores de risco

BACKGROUND AND OBJECTIVES: Temporomandibular disorder (TMD) is a generic term for a large number of functional disorders of the chewing system, of the temporomandibular joint (TMJ) and of associated structures. Fibromyalgia (FM) is one of the most frequent rheumatologic diseases, the major characteristic of which is diffuse and chronic musculoskeletal pain. Because these two conditions have several similarities both in prevalence and in clinical characteristics, this study aimed at analyzing and reporting the possible correlation between them.CONTENTS: Literature was reviewed from 1995 to 2008 in Web of Science, PubMed, Medline, LILACS and BBO databases by crossing the keywords fibromyalgia, fibrositis, diffuse myofacial pain syndrome, temporomandibular joint disorder syndrome, temporomandibular joint disorders (TMD) and craniomandibular disorders. Studies have shown that TMD-related muscular pain although being considered a regional condition may, in certain people, coexist with systemic painful syndromes such as FM. However, the vast majority of people with FM have pain in the head, characterizing a strong evidence of the presence of possible TMD. What has been observed was that a large number of people with FM also have TMD, however the opposite is not true. CONCLUSION: Considering the scarce knowledge about orofacial FM presentation, TMD treatment for FM patients should be conservative and oriented toward potential risk factors.