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口面部肌功能治疗对颞下颌关节紊乱病的影响。

Effects of orofacial myofunctional therapy on temporomandibular disorders.

作者信息

de Felício Cláudia Maria, de Oliveira Melchior Melissa, da Silva Marco Antonio Moreira Rodrigues

机构信息

Faculty of Medicine of Ribeirão Preto, University of São Paulo, Department of Otorhino- laryngology, Ophthalmology and Head and Neck Surgery, Brazil.

出版信息

Cranio. 2010 Oct;28(4):249-59. doi: 10.1179/crn.2010.033.

Abstract

The objectives of the current study were to analyze the effects of orofacial myofunctional therapy (OMT) on the treatment of subjects with associated articular and muscular temporomandibular disorders (TMD). Thirty subjects with associated articular and muscular TMD, according to the Research Diagnostic Criteria (RDC/TMD), were randomly divided into groups: 10 were treated with OMT (T group), 10 with an occlusal splint (OS group), and 10 untreated control group with TMD (SC). Ten subjects without TMD represented the asymptomatic group (AC). All subjects had a clinical examination and were interviewed to determine Helkimo's Indexes (Di and Ai), the frequency and severity of signs and symptoms, and orofacial myofunctional evaluation. During the diagnostic phase, there were significant differences between groups T and AC. There were no significant differences between group T and OC and SC groups. During the final phase, groups T and OS presented significant improvement, however, the group T presented better results and differed significantly from group OS regarding the number of subjects classified as Aill; the severity of muscular pain and TMJ pain; the frequency of headache and the muscles and stomatognathic functions. The group T differed significantly from the SC group but no longer differed significantly from the AC group. OMT favored a significant reduction of pain sensitivity to palpation of all muscles studied but not for the TMJs; an increased measure of mandibular range of motion; reduced Helkimo's Di and Ai scores; reduced frequency and severity of signs and symptoms; and increased scores for orofacial myofunctional conditions.

摘要

本研究的目的是分析口面部肌功能治疗(OMT)对伴有关节和肌肉性颞下颌关节紊乱病(TMD)患者的治疗效果。根据研究诊断标准(RDC/TMD),30名伴有关节和肌肉性TMD的患者被随机分为三组:10名接受OMT治疗(T组),10名佩戴咬合板(OS组),10名未治疗的TMD对照组(SC)。10名无TMD的受试者作为无症状组(AC)。所有受试者均接受临床检查并接受访谈,以确定赫尔基莫指数(Di和Ai)、体征和症状的频率及严重程度,以及口面部肌功能评估。在诊断阶段,T组和AC组之间存在显著差异。T组与OC组和SC组之间无显著差异。在最后阶段,T组和OS组均有显著改善,然而,T组的结果更好,在被归类为Aill的受试者数量、肌肉疼痛和颞下颌关节疼痛的严重程度、头痛频率以及肌肉和口颌系统功能方面与OS组有显著差异。T组与SC组有显著差异,但与AC组不再有显著差异。OMT有助于显著降低对所有研究肌肉触诊的疼痛敏感性,但对颞下颌关节无效;增加下颌运动范围的测量值;降低赫尔基莫的Di和Ai评分;降低体征和症状的频率及严重程度;提高口面部肌功能状况的评分。

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