O uso do laser de baixa intensidade nas disfunções temporomandibulares: estudo clínico randomizado
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Data
2019-04-09
Autores
Rocha, Thaís de Oliveira [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O desequilíbrio no Sistema Estomatognático pode levar a alterações em funções vitais, como a mastigação, deglutição e fonação. Essa ultrapassagem da tolerância fisiológica do indivíduo, pode desenvolver uma patologia conhecida como Disfunção Temporomandibular (DTM). O paciente pode apresentar dor nos músculos da mastigação e/ou nas articulações temporomandibulares (ATM) e pode estar associado a outras estruturas. A DTM é a principal causa de dor não dental na região orofacial, sendo esse sintoma a principal busca pelo tratamento, que abrange um grande número de recursos, incluindo fármacos, psicoterapia, eletroterapia, mobilização articular, entre outros. Mas uma técnica que tem ganhado destaque é o laser de baixa intensidade (LBI). Pois possuí efeitos antinflamatórios e antiálgicos. O objetivo deste estudo foi avaliar a eficácia do LBI em pacientes com DTM muscular. Para tal, uma amostra de 139 pacientes foi recrutada para a avaliação dos critérios de elegibilidade. A amostra final foi composta por 21 pacientes, os quais obedeceram aos critérios de inclusão e foram randomicamente alocados nos grupos de tratamento laser e placebo. Os pacientes foram tratados com o laser AsGaAl pontual de 808nm (100 mW/ 8 segundos – 30 J/cm²) com a aplicação sobre os pontos gatilhos dos músculos masseter e temporal anterior, em 8 sessões (2 vezes por semana). Os testes de Friedman, teste de Dunn e teste de Mann-Whitney com nível de significância de 5% (p<0.05) foram considerados. Os resultados obtidos mostraram que houve uma diferença estatisticamente significativa (p<0.05) ao avaliar a EVA (Escala Visual Analógica) pré e pós tratamento em ambos os grupos de tratamento, mas na comparação LBI com o placebo não houve diferença estatística significativa. Pode-se concluir que o tratamento a laser não é superior ao placebo.
Imbalance in the Stomatognathic System can lead to changes in vital functions such as chewing, swallowing and phonation. This overcoming of the individual's physiological tolerance may develop a condition known as Temporomandibular Dysfunction (TMD). The patient may present pain in the chewing muscles and / or in the temporomandibular joints (TMJ) and may be associated with other structures. TMD is the main cause of non-dental pain in the orofacial region, and this symptom is the main search for treatment, which covers a large number of resources, including drugs, psychotherapy, electrotherapy, joint mobilization, among others. But one technique that has gained prominence is the low intensity laser (LBI). Because it has antiinflammatory and analgesic effects. The aim of this study was to evaluate the efficacy of LBI in patients with muscular TMD. To that end, a sample of 139 patients was recruited for the evaluation of the eligibility criteria. The final sample consisted of 21 patients, who met the inclusion criteria and were randomly assigned to the laser and placebo treatment groups. Patients were treated with the 808nm spot laser (100 mW / 8 seconds - 30J / cm²) with application on the trigger points of the masseter and anterior temporal muscles, in 8 sessions (2 times per week). Friedman's tests, Dunn's test and Mann-Whitney test with significance level of 5% (p <0.05) were considered. The results showed that there was a statistically significant difference (p <0.05) when evaluating VAS (Visual Analogue Scale) before and after treatment in both treatment groups, but in LBI comparison with placebo there was no significant statistical difference. It can be concluded that the laser treatment is not superior to placebo.
Imbalance in the Stomatognathic System can lead to changes in vital functions such as chewing, swallowing and phonation. This overcoming of the individual's physiological tolerance may develop a condition known as Temporomandibular Dysfunction (TMD). The patient may present pain in the chewing muscles and / or in the temporomandibular joints (TMJ) and may be associated with other structures. TMD is the main cause of non-dental pain in the orofacial region, and this symptom is the main search for treatment, which covers a large number of resources, including drugs, psychotherapy, electrotherapy, joint mobilization, among others. But one technique that has gained prominence is the low intensity laser (LBI). Because it has antiinflammatory and analgesic effects. The aim of this study was to evaluate the efficacy of LBI in patients with muscular TMD. To that end, a sample of 139 patients was recruited for the evaluation of the eligibility criteria. The final sample consisted of 21 patients, who met the inclusion criteria and were randomly assigned to the laser and placebo treatment groups. Patients were treated with the 808nm spot laser (100 mW / 8 seconds - 30J / cm²) with application on the trigger points of the masseter and anterior temporal muscles, in 8 sessions (2 times per week). Friedman's tests, Dunn's test and Mann-Whitney test with significance level of 5% (p <0.05) were considered. The results showed that there was a statistically significant difference (p <0.05) when evaluating VAS (Visual Analogue Scale) before and after treatment in both treatment groups, but in LBI comparison with placebo there was no significant statistical difference. It can be concluded that the laser treatment is not superior to placebo.
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Palavras-chave
Disfunção temporomandibular, Laser de baixa intensidade, Dor miofascial, Placebo, Temporomandibular dysfunction, Low intensity laser, Placebo