dal Bello F, Borilli FWFC’S 10th Biennial Congress. International Conference of Chiropractic Research Montreal, CanadaApr 30 – May 2, 2009: 287-8


 

Introduction: Temporo Mandibular Joint (TMJ) is considered the most complex joint in the human body [1].  Due to this joint, daily vital functions are possible such as: speaking, smiling and crying, kissing, yawning, and mainly eating which without it the human being would not be able to survive. When the harmony of the normal fit of the TMJ is not perfect it will provoke the individual’s adaptation, causing clinical discomfort and functional deficiencies to the system, leading to muscles spasms, clacking, neck pain, cephalgia, deficiencies on the opening and closing movements of the jaw and pain which interferes in the individuals daily activities and well-being, and also enables the normal development of vital functions [1,2].  Malocclusion is the second cause related to TMJ pain Complaints [3], due to the functional imbalance between the TMJ and the neuromuscular system of the jaw caused by unstable and not simultaneous dental contact. Orthodontics is the usual approach for these cases, although not always effective and it suggests the use of therapies that focus on the recovery of TMJ and muscles spasms in order to assist the orthodontic treatment4. The interrelation between joint, muscles and nerves lead us to believe that malocclusion has its effects on TMJ symptoms [2,5] and so on to the whole body, as the purpose of this study is to approach the individual as a whole.

Methods: The study is characterized as an almost experimental study because establishes comparisons between two non equivalent groups. The research had the participation of 6 individuals which had an orthodontics´ diagnosis of malocclusion, TMJ pain and were between 10 to 45 years old. The individuals were divided consecutively into two different groups of treatment. The first group was treated with Cervical Manual Adjustment and the second group with the basic protocol of the SOT Technique. After physical evaluation and patient’s historical being collected it was made in each visit: in the first group, the palpation of subluxations and then the manual adjustment of the cervical segment involved, in the second group, the categorization and treatment with the basic protocol of the SOT Technique. The treatment was made in 4 visits during a month. To evaluate the pain of the participant it was used an informative questionnaire, and to measure the pain it was used the Visual Analogical Scale (VAS). Both were used in the first and in the last visit to evaluate the treatment’s effects.

Results: The research showed that in 83,33% of the cases there were TMJ pain decrease in individuals with malocclusion, nevertheless in 16,66% of the cases the results of the chiropractic treatment for the pain were negative. The Manual Cervical Adjustment group obtained 100% of TMJ pain decrease, being asymptomatic after treatment. The SOT Technique group obtained a gradual improvement of TMJ pain in 66,66% of the cases, however 33,33% obtained a negative result presenting increase of TMJ pain. Both treatments had shown to be effective for the TMJ symptoms, not only for pain, but joint clacking, cephalgia, neck pain, muscles tension, enhance of the opening and closing movements of the jaw and the region’s sensitivity.

Conclusion: The results of this research showed the chiropractic treatment as being effective to the TMJ symptoms in individuals with malocclusion, and not only relating to pain, but also for cephalgia, neck pain, muscles tension, enhance of the opening and closing movements of the jaw and joint clacking, giving the individual a better life quality and well-being.

References:

  1. Maciel R.N. Oclusão e ATM: procedimentos clínicos. 1ed. Editora Livraria Santos Comp. Imp. Ltda. 1998. São Paulo.
  2. Howat J.M.P. Chiropractic: Anatomy and Physiology of Sacro Occipital Technique. Cranial Communication Systems. 1999. Oxford.
  3. Tosa H., Imai T., Watannabe F., Sumori M., Tsuchida T., Matsuno I., Nakamura S. The clinical study on occurrence of TMJ dysfunction in orthodontic patients. Nippon Kyosei Shika Gakkai Zasshi. August, 1990 (Vol. 49, Issue 4, Pages 341-51).
  4. Viazis A.D. Atlas de Orthodontia – Princípios e Aplicações Clínicas. 1ed. Livraria Santos Editora Com. Imp. Ltda. 1996. São Paulo.
  5. Mongini F. ATM e Músculos Craniocervicofaciais – Fisiopatologia e Tratamento. 1ed. Livraria Santos Editora Com. Imp. Ltda. 1996. São Paulo.

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