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Doctoral Thesis
DOI
https://doi.org/10.11606/T.58.2023.tde-23102023-164619
Document
Author
Full name
Paulo Roberto Quiudini Júnior
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2023
Supervisor
Committee
Regalo, Simone Cecilio Hallak (President)
Nepomuceno, Victor Rodrigues
Santos, Daniela Micheline dos
Siessere, Selma
Title in Portuguese
Efeito das técnicas dry needling e liberação miofascial instrumental nos músculos mastigatórios, faciais e cervicais de indivíduos com disfunção temporomandibular muscular
Keywords in Portuguese
Disfunção temporomandibular
Dor
Dry needling
Liberação miofascial
Músculos cervicais
Músculos faciais
Músculos mastigatórios
Abstract in Portuguese
A disfunção temporomandibular (DTM) engloba uma série de alterações clínicas envolvendo musculatura, articulações e estruturas anatômicas associadas que modificam a função do Sistema Cérvico-cranio-mandibular. O objetivo desse estudo foi avaliar a eficácia das terapias Dry Needling (DN) e Liberação Miofascial Instrumental (LMI) no sistema cervico-crânio-mandibular por meio da dor, força molar e distribuição de contatos oclusais de indivíduos com disfunção temporomandibular (DTM) muscular. Trinta indivíduos foram distribuídos em dois grupos: DN (n=15) e LMI (n=15). Eficácia das terapias quanto à percepção e tolerância dolorosa dos músculos mastigatórios, faciais e cervicais, além da força de mordida molar e distribuição dos contatos oclusais, foram analisadas neste estudo de coorte prospectivo experimental autocontrolado no pré/pós-intervenção e pré/pós um mês das intervenções terapêuticas. Os dados foram tabulados e analisados estatisticamente (medidas repetidas e post-hoc de Bonferroni, p < 0,05). Houve diferença estatística na dor entre os grupos na comparação pré e pós-intervenção clínica com efeito no tempo X intervenção na cabeça e pescoço. A percepção e tolerância dolorosa mostrou efeito estatístico do tempo nos músculos temporal, suboccipital, esternocleidomastoideo, mentual (direito e esquerdo); masseter direito e trapézio esquerdo. Houve efeito estatístico da intervenção nos músculos mentual, supraorbital e infraorbital (direito e esquerdo). Houve efeito estatístico da interação no músculo masseter porção superior (direito e esquerdo); temporal porção anterior (esquerdo); suboccipital, esternocleidomastoideo e mentual (esquerdo). Houve aumento na força de mordida molar pós-intervenção nos grupos com efeito estatístico no tempo X intervenção na região direita e esquerda. O contato das forças oclusais na interface maxila/mandíbula demonstrou diferença estatística entre as médias do tempo nos dentes 26 -36 pós X pós 1 mês de intervenção. Os resultados apresentados permitem sugerir que as técnicas DN e LMI são viáveis no tratamento da DTM muscular, entretanto a segunda técnica mostrou ser mais eficaz imediatamente pós-intervenção e depois de um mês.
Title in English
Effect of dry needling and instrumental myofascial release techniques on the masticatory, facial and cervical muscles of individuals with muscle temporomandibular disorder
Keywords in English
Cervical muscles
Dry needling
Facial muscles
Masticatory muscles
Myofascial release
Pain
Temporomandibular disorders
Abstract in English
Temporomandibular disorder (TMD) encompasses a series of clinical alterations involving musculature, joints and associated anatomical structures that modify the function of the Cervico-cranio-mandibular System. The aim of this study was to evaluate the effectiveness of Dry Needling (DN) and Instrumental Myofascial Release (IML) therapies in the cervicocraniomandibular system through pain, molar force and distribution of occlusal contacts in individuals with muscular temporomandibular disorders (TMD). Thirty individuals were divided into two groups: DN (n=15) and LMI (n=15). Efficacy of therapies regarding pain perception and tolerance of masticatory, facial and cervical muscles, in addition to molar bite force and distribution of occlusal contacts, were analyzed in this self-controlled experimental prospective cohort study pre/post-intervention and pre/post one month of therapeutic interventions. Data were tabulated and statistically analyzed (repeated and post-hoc Bonferroni measures, p < 0.05). There was a statistical difference in pain between the groups in the comparison pre and post-clinical intervention with effect on time X intervention in the head and neck. Pain perception and tolerance showed a statistical effect of time on the temporal, suboccipital, sternocleidomastoid, and mental muscles (right and left); right masseter and left trapezius. There was a statistical effect of the intervention on the mentalis, supraorbital and infraorbital muscles (right and left). There was a statistical effect of the interaction on the upper portion of the masseter muscle (right and left); temporal anterior portion (left); suboccipital, sternocleidomastoid and mentalis (left). There was an increase in post-intervention molar bite force in the groups with a statistical effect on time X intervention in the right and left regions. The contact of the occlusal forces at the maxilla/mandible interface demonstrated a statistical difference between the mean times on teeth 26 -36 post X post 1 month of intervention. The results presented suggest that the DN and LMI techniques are viable in the treatment of muscular TMD, however the second technique proved to be more effective immediately after the intervention and after one month.
 
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Publishing Date
2023-11-24
 
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