Effects of therapies for temporomandibular disorder on the craniocervical posture: A randomized clinical trial
Keywords:Temporomandibular disorders, Temporomandibular Joint, posture, pain, radiography.; Temporomandibular disorders; Temporomandibular Joint; Posture; Pain; Radiography.
Objective: The present study searched evaluate whether the occlusal splint, physiotherapy and counseling therapies used in the treatment of temporomandibular disorders (TMD) alter the craniocervical posture and pain. Methods: Controlled, randomized, blinded study that included individuals previously diagnosed with TMD through the RDC/TMD (Research criteria for temporomandibular disorders). The patients were randomly selected from four treatment groups: occlusal splint (OS, n = 17), physiotherapy (P, n = 19), counseling (C, n = 15) and occlusal splint associated with counseling (OSC = 14), 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 occiput-atlas distance (OAD), the craniocervical angle (CCA) and the positioning of the hyoid triangle (HT). CorelDraw X6 software (2012 Corel Corporation, Canada) was used in the images. The data obtained was submitted to several paired T tests (α = 5%) and for the pain variable the SPANOVA test was applied. Results: Except for the OSC group in the CCA 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 (p = 0.013) over time. Conclusion: It is concluded that the therapies applied have little influence on craniocervical posture but are effective for the relief of painful symptoms.
Armijo-Olivo S, Rappoport K, Fuentes J, Gadotti IC, Major PW, Warren S, et al. Head and Cervical posture in pacients with temporomandibular disorders. J Orofac Pain 2011; 25: 199-209.
Câmara-Souza MB, Figueredo OMC, Maia PRL, Dantas IS, Barbosa GAS. Cervical posture analysis in dental students and its correlation with temporomandibular disorder. CRANIO 2017; 36: 85-90.
Chaves TC, Turci AM, Pinheiro CF, Sousa LM, Grossi DB. Static body postural misalignment in individuals with temporomandibular disorders: a systematic review. Braz J Phys Ther 2014; 18: 481-501.
Conti PC, de Alencar EN, da Mota Corrêa AS, Lauris JR, Porporatti AL, Costa YM. Behavioural changes and oclusal splints are effective in the manegement of mastigatory myofascical pain: a short term evaluation. J. Oral Rehabil. 2012b; 39: 754-760.
Cooper BC, Kleinberg I. Examination of a large patient population for the presence of symptoms and signs of temporomandibular disorders. Cranio 2007; 25: 114-126.
Costa LMR, et al. Effect of the Pilates method on women with temporomandibular disorders: a study protocol for a randomized controlled trial. J Bodyw Mov Ther 2016; 20:110-114.
Dworkin SF, Le Resche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 1992; 6:301-55.
de Oliveira SB, de Siqueira SR, Sanvovski AR, do Amaral LM, de Siqueira JT. Temporomandibular disorder in brazilian portuguese patients: a preliminar study. J.Clin.Phychol.Med.Settings 2008; 15: p.338-343.
Faulin EF, Guedes CG, Feltrin PP, Joffiley CMMSC. Association between temporomandibular disorders and abnormal head postures. Braz Oral Res 2015; 29: 1-6.
Gauer RL, Semidey, MJ. Diagnosis and treatment of temporomandibular disorders. Am.Fam.Physician 2015;91:378-386.
Luther F. TMD and occlusion part II. Damned if we don’t? Functional occlusal problems: TMD epidemiology in a wider context. Br Dent J 2007; 202: 38-9.
Maluf SA, Moreno BGD, Alfredo PP, Marques AP, Rodrigues G. Therapeutic exercises in temporomandibular disorders: a literature review. Fisioterapia e Pesquisa 2008; 15: 408-15.
Mcneill C. Management of temporomandibular disorders: concepts and controversies. J Prosthet Dent 1997; 77: 510-22.
Michelotti A, de Wijer A, Steenks M., Farella M. Evaluation of the short-term effectiveness of education versus oclusal Splint for the treatment of myofascial pain of the jaw muscles. J. Am. Dent. Assoc. 2012; 143: 47-53.
Minghelli B, Kiselova L, Pereira C. Association between temporomandibular dysfunction symptoms with psychological factors and modifications in the cervical column among students of the Jean Piaget-Algarve Health School. Rev Port Saúde Pública 2011; 29: 140-147.
Monteiro MDC. Association between postural alterations and pacients with oclusion problems with signals and simpthoms of TMD. Rev Pesqui Fisioterapia 2011; 1: 29-44.
Nassif NJ, Al Saleeh, Al- Admawi M. The prevalence and treatment needs of symptoms and signs of temporomandibular disorders among young adult males. J Oral Rehabil 2003; 30: 944-950.
Okeson JP. Tratamento das desordens temporomandibulares e oclusão. 7ª ed. São Paulo: Editora elsevier ltda; 2013.
Qvintus V, Souminen Al, Huttunen J, Raustia A, Yeostalo P, Spilea K. Efficacy of stabilisation splint treatment on facial pain – 1 year follow-up. Journal of Oral Reabilitation 2015; 439-446.
Reiter S, Emodi-Perlman A, Goldsmith C, Friedman-Rubin P, Winocur E. Comorbity between depression and anxiety in patients with temporomandibular disorders aconding to the Rearch Diagnostic Criteria for Temporomandibular Disorders. J Oral Facial Pain Headache 2015; 29:135-143.
Rocabado M. Biomechanical relationship of the cranial, cervical, and hyoid regions. J Craniomandibular Pract 1983; 1: 61-6.
Rocha CP, Croci CS, Caria PHF. Is there relationship between temporomandibular disorders and head and cervical posture? A systematic review. J Oral Rehabil 2013; 40: 875-881.
Souchard PE. Reeducação postural global. 6. ed. São Paulo: Ícone; 1986.
Souza JA, Pasinato F, Corrêa EC, da Silva AM.Global Body Posture and plantar pressure distribuition in individuals with and without temporomandibular disorder: a preliminar study. J Manipulative Physiol Ther 2014; 36: 407-414.
Stohler CS, Zarb GA. On the management of temporomandibular disorders: a plea for a low-tech, high-prudence therapeutic approach. J Orofac Pain 1999; 13: 255-61.
Suniven TI, Reade PC, Hanes KR, Kononen M, Kemppainen P. Temporomandibular disorder subtypes according to self- reported physical and psychosocial variables in female patients: a re-evaluation. J Oral Rehabil 2005; 32: 166-73.
Tuncer AB, Ergun N, Tuncer AH, Karahan S. Effectiveness of manual therapy and home physical therapy in patients with temporomandibular disorders: A randomized controlled trial. J. Bodyw Mov Ther 2013; 17: 302-308.
Viana MO, Lima EICBMF, Menezes JNR, Olegario. Evaluation signs and symptoms of temporomandibular dysfunction and its relation to cervical posture. Rev Odontol UNESP 2015; 44: 125-130.
How to Cite
Copyright (c) 2021 Myla Marilana Freire da Cunha; Karen Oliveira Peixoto ; Camila Maria Bastos Machado de Resende ; Micaella Pollyana Silva do Nascimento da Costa ; Ana Louise Oliveira de Carvalho; Rafaela Albuquerque Melo; Erika Oliveira de Almeida; Gustavo Augusto Seabra Barbosa
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.