Tratamento miofuncional orofacial em indivíduos com disfunção temporomandibular: ensaio clínico randomizado, cego

Abstract

Temporomandibular dysfunction presents prevailing pain symptomatology in the chewing muscles, negatively affecting the functionality of the stomatognathic system. Conservative treatments are the most indicated, run by different professionals and techniques that act in the muscular alterations at the peripheral level. Music is used extensively in muscle changes, but there is no evidence in reducing electrical muscle activity. In the literature, there are no studies that associate the possibility of relaxation at the central level in tense muscles. The aim of this thesis is evidence the activation of the cervical vestibular reflex by modified musical stimuli using the physiology of vestibular evoked myogenic potential, posteriorly associate it with the orofacial myofunctional treatment for the individuals with temporomandibular dysfunction and painful symptomatology to analyse the benefits in the orofacial myofunctional therapy. This reflex temporarily relaxes, at the central level, the musculature of the body. Initially, a cross-sectional, observational and analytical study was carried out, that investigated the decrease in muscular electrical activity in sternocleidomastoid muscle. Selected 30 individuals, 60 ears per convenience, randomly divided into three groups: A, received tone burst stimulus at 95 dB at 500 Hz; B, musical stimulus at 95 dB, and C, musical stimulus at 60 dB. Subsequently, a randomised blinded clinical trial. It hás selected 30 individuals with the temporomandibular disorder, randomly divided into four groups: 1, orofacial myofunctional treatment and musical acoustic stimulus in 95 dB; 2, orofacial myofunctional treatment and musical acoustic stimulus in 60 dB; 3, only orofacial myofunctional therapy. Evaluated by surface electromyographic analysis, Helkimo index, AMIOFE-A, analogue visual analogue scale - EVA, and palpation pain. The results showed that the musical acoustic stimulus in 95dB reduces the lower electrical muscle activity. At the randomised clinical trial, electromyographic activity in the 30-second analysis in group 1 presented lower electromyographic activity. All groups 1, 2 and 3 got better after the orofacial myofunctional treatment, with statistically significant values. The study concluded that the modified musical acoustic stimulus in 95 dB intensity, activates the cervical vestibular reflex, and associate