Vieira e Silva Carolina A, da Silva Marco Antônio M Rodrigues, Melchior Melissa de Oliveira, de Felício Cláudia Maria, Sforza Chiarella, Tartaglia Gianluca M
Cranio. 2012 Jul;30(3):218-26. doi: 10.1179/crn.2012.033.
The purpose of this study was to apply Functional Anatomy Research Center (FARC) Protocol of TMD treatment, which includes the use of a specific type of mandibular occlusal splint, adjusted based on the electromyographic index, in a group of 15 patients with disc displacement, classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and then analyzing the results compared with the control group. The clinical evaluations were completed both before and after the treatment. Electromyographic (EMG) data was collected and recorded on the day the splint was inserted (visit 1), after one week (visit 2) and after five weeks of treatment (visit 3). The control group consisted of 15 asymptomatic subjects, according to the same diagnostic criteria (RDC/TMD), who were submitted to the same evaluations with the same interval periods as the treatment group. Immediately after splint adjustment, masseter muscle symmetry and total muscular activity were significantly different with than without the splint (p < 0.05), showing an increased neuromuscular coordination. After treatment, significant variations (p < .05) were found in mouth opening and in pain remission. There were no significant differences among the three sessions, either with or without the splint. There were significant differences between the TMD and control groups for all analyzed indices of muscular symmetry, activity and torque, with the exception of total muscular activity. The use of the splint promoted balance of the EMG activities during its use, relieving symptoms. EMG parameters identified neuromuscular imbalance, and allowed an objective analysis of different phases of TMD treatment, differentiating individuals with TMD from the asymptomatic subjects.
本研究的目的是应用颞下颌关节紊乱病（TMD）治疗的功能解剖研究中心（FARC）方案，该方案包括使用一种特定类型的下颌咬合板，并根据肌电图指标进行调整。研究对象为15名根据颞下颌关节紊乱病研究诊断标准（RDC/TMD）分类为盘移位的患者，然后将结果与对照组进行分析比较。治疗前后均完成了临床评估。在插入咬合板当天（就诊1）、一周后（就诊2）和治疗五周后（就诊3）收集并记录肌电图（EMG）数据。对照组由15名无症状受试者组成，根据相同的诊断标准（RDC/TMD），他们接受了与治疗组相同间隔期的相同评估。在咬合板调整后立即发现，有咬合板时与无咬合板时相比，咬肌对称性和总肌肉活动有显著差异（p<0.05），表明神经肌肉协调性增加。治疗后，张口度和疼痛缓解方面出现了显著变化（p<0.05）。无论有无咬合板，三个时间段之间均无显著差异。除总肌肉活动外，TMD组和对照组在肌肉对称性、活动和扭矩的所有分析指标上均存在显著差异。使用咬合板在其使用过程中促进了肌电图活动的平衡，缓解了症状。肌电图参数识别出神经肌肉失衡，并允许对TMD治疗的不同阶段进行客观分析，从而区分TMD患者和无症状受试者。
