Subtypes of temporomandibular disorders in patients diagnosed with otalgia: observational study / Subtipos de desordem temporomandibular em pacientes diagnosticados com otalgia: estudo observacional

ABSTRACT BACKGROUND AND OBJECTIVES: Temporomandibular disorder (TMD) has complex symptoms that involve the orofacial region, such as otalgia. Considering the difficult differential diagnoses for associating otological symptoms with TMD. The aim of this study was to verify the diagnosis of TMD in patients with otalgia. METHODS: This is a cross-sectional and descriptive study, where 75 patients diagnosed with otalgia were evaluated. The European Academy of Craniomandibular Disorders's (EACD) screening questionnaire was initially applied, and those who answered affirmatively to at least one question were evaluated by the Research Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), with a final sample of 50 patients. Data were tabulated and ANOVA verified whether there was a statistical difference between TMD subtypes classified by DC/TMD, considering confidence intervals with 95% significance. RESULTS: The mean age of the participants was 39.9±14.1 years, with a predominance of females (76%) (p<0.0001). Among those diagnosed with TMD, females also predominated, with a higher percentage in all evaluated subtypes, with emphasis on arthralgia (82%) and myofascial pain with limited opening (81.8%), followed by myofascial pain (74%) and disc displacement with reduction (72.7%). When observing the distribution of TMD subtypes between genders, there was a predominance of myofascial pain in males (75%) and females (68%), but no statistical significance was observed in this variable and in the others studied. CONCLUSION: Patients with otalgia had one or more TMD subtypes, and the myofascial subtype TMD was the most prevalent among study participants.

RESUMO JUSTIFICATIVA E OBJETIVOS: A disfunção temporomandibular (DTM) possui sintomas complexos que envolvem a região orofacial, como a otalgia. Considerando os difíceis diagnósticos diferenciais para associar sintomas otológicos com DTM. O objetivo deste estudo foi verificar o diagnóstico de DTM em pacientes com otalgia. MÉTODOS: Este é um estudo transversal e descritivo, com uma avaliação de 75 pacientes diagnosticados com otalgia. O questionário de triagem da Academia Europeia de Disfunções Craniomandibulares (EACD) foi aplicado inicialmente, e aqueles que responderam afirmativamente a pelo menos uma questão foram avaliados pelo Critério Diagnóstico de Pesquisa para Disfunções Temporomandibulares (DC/TMD), com amostra final de 50 pacientes. Os dados foram tabulados e por meio da ANOVA foi verificado se havia diferença estatística entre os subtipos de DTM classificados pelo DC/TMD, considerando intervalos de confiança com 95% de significância. RESULTADOS: A idade média dos participantes foi de 39,9±14,1 anos. Além disso, predominou-se o sexo feminino (76%) (p<0,0001), com maior percentual em todos os subtipos avaliados, destacando-se a artralgia (82%) e a dor miofascial com limitação de abertura (81,8%), seguida da dor miofascial (74%) e deslocamento de disco com redução (72,7%). Quando observada a distribuição dos subtipos de DTM entre os sexos, notou-se predominância de dor miofascial no sexo masculino (75%) e feminino (68%), mas não foi observada significância estatística nessa variável e nas demais estudadas. CONCLUSÃO: Os pacientes com otalgia manifestaram mais de um dos subtipos de DTM, sendo o subtipo de dor miofascial o mais prevalente entre os participantes do estudo.

Therapies used for the management of myofascial temporomandibular disorders: bibliometric analysis / Terapias utilizadas para o manejo da disfunção temporomandibular de origem miofascial: análise bibliométrica

ABSTRACT BACKGROUND AND OBJECTIVES: Temporomandibular disorder (TMD) is the term used to describe a set of painful and functional conditions that can affect the temporomandibular joint (TMJ), the masticatory muscles and/or their associated structures. For myofascial TMD, conservative therapies, including drugs, physical therapy, occlusal splint and pain self-management show the best benefits to the patient. The objective of this study was to carry out, through a bibliometric analysis, a review of the existing knowledge regarding the treatments used in myofascial TMD. CONTENTS: The search was conducted in the Web of Science (WOS) and SCOPUS databases in July and updated in December 2023, through the MeSh descriptors "Temporomandibular Joint Dysfunction Syndrome" and "Therapeutics". Moreover, bibliometric mapping was performed using the VOSviewer software. For the analysis, data on the terms of the title and abstract, type of document, number of citations, name of journals, most cited article and year of publication were included. Besides these, the country of the corresponding author, type of treatment, type of study and the results were included in the analysis. Of the 760 articles identified, 63 were selected to compose this review. Of these, most were original articles, clinical trials and were published in 2012. The most frequent treatments were: occlusal splint, laser, manual therapy, botulinum toxin and dry needling. Of the 15 countries analyzed, Brazil was the country with the highest number of publications. CONCLUSION: There was an increase in articles published on the topic, with Brazil being the country with the highest number of publications. Finally, the most used treatments were occlusal splint and laser.

RESUMO JUSTIFICATIVA E OBJETIVOS: Disfunção temporomandibular (DTM) é um termo utilizado para descrever um conjunto de condições dolorosas e funcionais que podem afetar a articulação temporomandibular (ATM), os músculos mastigatórios e/ou suas estruturas associadas. Para DTM miofascial, terapias conservadoras, incluindo fármacos (analgésicos e/ou anti-inflamatórios), fisioterapia, placa oclusal e autogestão da dor apresentam os melhores benefícios para o paciente. O objetivo deste estudo foi abordar, através de uma análise bibliométrica, o conhecimento existente sobre os tratamentos utilizados na DTM de origem miofascial. CONTEÚDO: A busca foi realizada na base de dados Web of Science (WOS) e SCOPUS, em julho e atualização em dezembro de 2023, por meio dos descritores do MeSh "Temporomandibular Joint Dysfunction Syndrome" e "Therapeutics". Além disso, um mapeamento bibliométrico foi realizado no software VOSviewer. Para análise, foram incluídos dados sobre os termos do título e do resumo, tipo de documento, número de citações, nome dos periódicos, artigo mais citado e ano de publicação e, além destes, o país do autor correspondente, tipo de tratamento, tipo de estudo e resultados. Dos 760 artigos identificados, 63 foram selecionados para compor esta revisão. Destes, a maioria era artigos originais, ensaios clínicos e foram publicados em 2012. Os tratamentos mais frequentes foram: placa oclusal, laser, terapia manual, toxina botulínica e agulhamento a seco. Dos 15 países analisados, o Brasil foi o país com maior número de publicações. CONCLUSÃO: Houve um aumento de artigos sobre a temática publicados, sendo o Brasil o país com mais publicações e os tratamentos mais utilizados foram placa oclusal e laser.

Efeitos da bandagem elástica na dor orofacial e nos movimentos mandibulares após 24 horas de uso: ensaio clínico randomizado / Effects of athletic tape on orofacial pain and jaw movements after 24 hours of use: a randomized clinical trial

RESUMO Objetivo Analisar a sensação de dor e amplitude dos movimentos mandibulares de indivíduos adultos com disfunção temporomandibular, antes e após aplicação da bandagem elástica por 24 horas. Método Trata-se de um ensaio clínico randomizado duplo-cego, do qual participaram 22 sujeitos adultos com disfunção temporomandibular, alocados aleatoriamente em dois grupos, sendo grupo A composto por 10 mulheres e um homem (média de idade de 28,2±8,3 anos) e grupo B por nove mulheres e dois homens (média de idade de 26,2±3,9 anos). Todos os participantes foram submetidos à aplicação do Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Foi realizada a avaliação do limiar da dor, com uso de um algômetro, para aplicação da pressão no masseter e temporal e medição dos movimentos mandibulares, com paquímetro. O grupo A foi submetido à aplicação da bandagem sobre o músculo masseter com estiramento de 40% e o grupo B sem estiramento. A colagem da bandagem foi realizada, com corte em "I", com ponto fixo sobre a inserção e ponto móvel sobre a origem do músculo masseter. Os participantes permaneceram com a bandagem por 24 horas e foram reavaliados. Resultados Houve alívio da dor no grupo A na articulação temporomandibular à direita e na origem do masseter à esquerda. O grupo B apresentou redução da dor em região de temporal anterior à esquerda. Não foram encontradas diferenças nos movimentos mandibulares após intervenção, bem como não houve diferença na comparação entre os grupos. Conclusão O uso da bandagem sobre o masseter, por 24 horas, com estiramento, produziu alívio da dor na origem do masseter direito e na região da articulação temporomandibular direita e, sem estiramento, no temporal anterior esquerdo. Não houve diferença na amplitude de movimentos mandibulares.

ABSTRACT Purpose To analyze the sensation of pain and the range of mandibular movements of adult individuals with temporomandibular disorder, before and after the application of the athletic tape. Method This is a double-blind randomized clinical trial, in which 22 adults with temporomandibular disorder participated, randomly allocated into two groups, with group A comprising 10 women and one man (mean age 28.2±8.3 years) and group B comprising nine women and two men (mean age 26.2±3.9 years). Group A was submitted to the application of the athletic tape on the masseter with 40% stretch and the group B to the application of the athletic tape on the masseter without stretching. All participants underwent the application of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Pain threshold assessment was performed using an algometer to apply pressure to measurement points. The measurement of mandibular movements was performed using a caliper. The athletic tape was glued using the I technique, with a fixed point over the insertion and a movable point over the origin of the masseter muscle. Participants remained with the athletic tape for 24 hours and were re-evaluated. Results There was pain relief in the group A in the temporomandibular joint on the right and at the origin of the masseter on the left. The group B showed a reduction in pain in the left anterior temporal region. No differences were found in mandibular movements after intervention, as well as no difference was found in the comparison by groups. Conclusion The use of the athletic tape over the masseter muscle, with stretching, for 24 hours produced relief from the sensation of pain, on the origin of the right masseter and in the right temporomandibular joint, and, without stretching, in the left anterior temporal muscle. There was no difference in the range of mandibular movements.

Facial representation of paroxysmal hemicrania and associated temporomandibular disorder: a case report / Hemicrania paroxística com representação na face e associação com disfunção temporomandibular: relato de caso

ABSTRACT Paroxysmal Hemicrania is a trigeminal autonomic cephalalgia described as a severe and strictly unilateral pain, which occurs in paroxysms at orbital, supraorbital and/ or temporal region. A 45-year-old woman presented to an orofacial pain specialist reporting severe, burning, throbbing, strictly right-sided headache associated to ipsilateral autonomic symptoms and orofacial pain. The pain was perceived on the maxillary region followed by pain spread to the head. Interdisciplinary evaluation, along with absolute responsiveness to indomethacin and normal Brain Magnetic Resonance imaging, led to the diagnosis of primary Episodic paroxysmal hemicrania with facial representation and myofascial pain of masticatory muscles. Dentists should be aware of paroxysmal hemicrania with facial representation and the possibility of temporomandibular disorder coexistence, in order to avoid misdiagnosis and inadequate management. Paroxysmal hemicrania may be first perceived on the face and may be associated with interparoxysmal pain. In these cases, efficient anamnesis and clinical evaluation followed by interdisciplinary approach is needed.

RESUMO A Hemicrania Paroxística é uma cefalalgia autonômica trigeminal descrita como uma dor severa e estritamente unilateral, que ocorre em paroxismos na região orbital, supraorbital e/ou temporal. Uma mulher de 45 anos de idade apresentou-se a um especialista em dor orofacial, referindo uma cefaleia intensa, ardente, latejante, estritamente do lado direito, associada a sintomas autonómicos ipsilaterais e dor orofacial. A dor era sentida na região maxilar, seguida de dor que se estendia à cabeça. A avaliação interdisciplinar, aliada à resposta absoluta à indometacina e à normalidade em ressonância magnética cerebral, levou ao diagnóstico de hemicrania paroxística episódica primária com representação facial e dor miofascial dos músculos mastigatórios. Os médicos dentistas devem estar atentos à hemicrania paroxística com representação facial e à possibilidade de coexistência de Disfunção Temporomandibular, de modo a evitar diagnósticos incorretos e um tratamento inadequado. A hemicrania paroxística pode ser percebida inicialmente na face e pode estar associada à dor interparoxística. Nesses casos, é necessária uma anamnese e avaliação clínica eficientes, seguidas de abordagem interdisciplinar.

Beliefs and concerns about pain were associated with craniofacial pain experienced within 24 hours: cross-sectional study / Crenças e preocupações sobre a dor têm associação à dor craniofacial experimentada nas últimas 24 horas: estudo transversal

ABSTRACT BACKGROUND AND OBJECTIVES: Although craniofacial pain has been associated with negative psychological aspects, how the patient's perception of their own illness could influence craniofacial pain is not elucidated yet. Therefore, this study aims to identify the main factors and beliefs about the illness that could influence pain intensity and pain duration in people who experienced craniofacial pain in the last 24 hours. METHODS: This cross-sectional study comprised undergraduate students, aged between 18 and 40 years old, who experienced self-reported craniofacial pain in the last 24 hours. Participants answered questions regarding body functions, activities and participation, and personal factors based on the International Classification of Functioning (ICF); In addition, questions from the Brief Illness Perceptual Questionnaire (Brief IPQ) were applied. The analysis was carried out with a single and multiple regression model. RESULTS: The sample comprised 87 volunteers. Pain intensity and duration experienced in the last 24 hours were associate by concerns about the presence of an illness and the need for treatment. Pain intensity was specifically associated with the importance of treatment and the extent to which the patient is concerned about their pain (R2=0.108). Pain duration was associated with how much the individual is worried about their illness (R2=0.1459). CONCLUSION: Both pain intensity and duration experienced in the last 24 hours are associated with concerns regarding the presence of an illness and beliefs related to such illness treatment, which reinforces the influence of psychosocial aspects on pain perception.

RESUMO JUSTIFICATIVA E OBJETIVOS: Embora a dor craniofacial seja associada a aspectos psicológicos negativos, ainda não está totalmente elucidado como a percepção do paciente sobre sua própria doença pode influenciá-la. Portanto, este estudo teve como objetivo identificar os principais fatores e as crenças sobre a doença que podem influenciar a intensidade e a duração da dor em pessoas que sentiram dor craniofacial nas últimas 24 horas. MÉTODOS: Estudo transversal composto por universitários, com idade entre 18 e 40 anos, que relataram dor craniofacial nas últimas 24 horas. Os voluntários responderam a perguntas sobre funções corporais, atividades e participação e fatores pessoais com base na classificação da Classificação Internacional de Funcionalidades (CIF). Além disso, foram aplicadas questões do Questionário de Percepção de Doenças Versão Breve (Brief IPQ). A análise foi realizada com um modelo de regressão simples e múltiplo. RESULTADOS: A amostra foi composta por 87 voluntários. A intensidade e a duração da dor sentida nas últimas 24 horas foram influenciadas pela preocupação com a presença de doença e com a necessidade de tratamento. A intensidade da dor foi associada à importância do tratamento e à preocupação do paciente com sua dor (R2=0,108). A duração da dor associou-se à preocupação do indivíduo com sua doença (R2=0,1459). CONCLUSÃO: Tanto a intensidade quanto a duração da dor vivenciadas nas últimas 24 horas são influenciadas pela preocupação com a presença de doença e crenças relacionadas ao seu tratamento, o que reforça a influência dos aspectos psicossociais na percepção da dor.

Characterization of Salivary Gland Pain: A Review of the Literature / Caracterización del Dolor de Glándulas Salivales: Revisión de la Literatura

SUMMARY: The salivary glands in pathological conditions produce countless different clinical presentations, and due to their complex neuroanatomy, their pain symptoms vary widely. However, in the literature to date, few studies characterize salivary gland pain. The aim of this study was to conduct a literature review concerning the clinical characteristics of pain in various salivary gland pathologies. A literature review was done through a systematic search of scientific articles in the Web of Science (WoS), MEDLINE, Scopus, and Elton B. Stephens Company (EBSCO) databases. The free terms "salivary gland", "parotid gland", "submaxillary gland", "sublingual gland", and "pain" were used along with the Boolean operators OR and AND. The search yielded a total of 1896 articles, of which 60 fulfilled the inclusion criteria and were ultimately included in this review. It is described that pain is a nonspecific symptom of a glandular pathology and is characterized mainly by the location of the pain, which is correlated with the anatomical location of the affected salivary gland. Among the painful salivary gland pathologies, we found inflammatory disorders, including infections, obstructions, disorders secondary to hyposalivation; systemic autoimmune diseases; neoplasms, and neuropathic pain disorders. The diagnosis and management of salivary gland pain require knowledge of the causes and mechanisms of the pain, and it is to recognize the signs and symptoms of salivary gland disorders to be able to diagnose and treat them.

Las glándulas salivales en condiciones patológicas producen un sinfín de presentaciones clínicas diferentes, y debido a su compleja neuroanatomía generan variaciones en su sintomatología dolorosa. Sin embargo, en la literatura hasta ahora son escasos los estudios que caracterizan el dolor de glándulas salivales. El objetivo de este estudio fue realizar una revisión de la literatura respecto a las características clínicas del dolor en diversas patologías de glándulas salivales. Se realizó una revisión de la literatura, a través de la búsqueda sistemática de artículos científicos en las bases de datos Web of Science (WoS), MEDLINE, Scopus y Elton B. Stephens Company (EBSCO). A través de los términos libres: "salivary gland", "parotid gland", "submaxillary gland", "sublingual gland", "pain", junto con los operadores booleanos OR y AND. La búsqueda arrojó un total de 1896 artículos, de los cuales 60 cumplieron los criterios de inclusión y fueron finalmente incluidos en esta revisión. Se describe que el dolor es un síntoma poco específico para la patología glandular y está caracterizado principalmente por la localización del dolor, el cual se correlaciona con la ubicación anatómica de la glándula salival afectada. Dentro de las patologías dolorosas de glándulas salivales encontramos los trastornos inflamatorios, incluidas infecciones, obstrucciones, trastornos secundarios a hiposalivación; enfermedades sistémicas autoinmunes; neoplasias y trastornos de dolor neuropático. El diagnóstico y manejo del dolor de glándulas salivales requiere del conocimiento de las causas y mecanismos del dolor, siendo necesario reconocer los signos y síntomas de los trastornos de glándulas salivales para ser capaces de diagnosticarlos y tratarlos.

Knowledge, Attitudes, and Practices on New Treatment Modalities for Temporomandibular Dysfunctions and Orofacial Pain / Conocimientos, Actitudes y Prácticas sobre Nuevas Nodalidades de Tratamiento de las Disfunciones Tempomanibulares y el Dolor Orofacial

The present study proposed to describe, through a literature review, the use of new therapeutic management which allows for offering a better quality of life to individuals affected by these pathologies. A bibliographic search was conducted in the main health databases PUBMED (www.pubmed.gov) and Scholar Google (www.scholar.google.com.br), in which studies published from 1987 to 2023 were collected. In the first stage, the list of retrieved articles was examined by reading the titles and abstracts. In the second stage, the studies were selected by reading the full contents. Two authors (JDMM and DAQ) performed stages 1 and 2. Experimental, clinical, case-control, randomized controlled, and laboratory cohort studies, case reports, systematic reviews, and literature reviews, which were developed in living individuals, were included. Therefore, articles that did not deal with the subject in question, letters to the editor, opinion articles, duplicated literature in databases, and literature that did not address the variables under study, we re excluded. Contemporary dentistry uses alternative treatments capable of improving the patient's condition since a cure is not always possible. Therefore, the possibility of improving the quality of life becomes an important point to be reached. Evidence-based healthcare has made great advances in recent decades, especially in the areas of orofacial pain, TMD, and occlusion, especially related to orthodontic, prosthetic, and restorative care.

En el presente estudio se propuso describir, a través de una revisión bibliográfica, el uso de nuevos manejos terapéuticos que permitan brindar una mejor calidad de vida a los individuos afectados por estas patologías. Se realizó una búsqueda bibliográfica en las principales bases de datos de salud PUBMED (www.pubmed.gov) y Scholar Google (www.scholar.google.com.br), en las que se recopilaron estudios publicados entre 1987 y 2023. En la primera etapa, se examinó la lista de artículos recuperados mediante la lectura de los títulos y resúmenes. En la segunda etapa, los estudios fueron seleccionados mediante la lectura del contenido completo. Dos autores (JDMM y DAQ) realizaron las etapas 1 y 2. Se incluyeron estudios de cohortes experimentales, clínicos, de casos y controles, controlados aleatorios y de laboratorio, informes de casos, revisiones sistemáticas y revisiones de la literatura, que se desarrollaron en individuos vivos. Por lo tanto, se excluyeron artículos que no trataran el tema en cuestión, cartas al editor, artículos de opinión, literatura duplicada en bases de datos y literatura que no abordara las variables en estudio. La odontología contemporánea utiliza tratamientos alternativos capaces de mejorar el estado del paciente, ya que no siempre es posible la curación. Por lo tanto, la posibilidad de mejorar la calidad de vida se convierte en un objetivo importante. La atención médica basada en la evidencia ha logrado grandes avances en las últimas décadas, especialmente en las áreas de dolor orofacial, TMD y oclusión, especialmente en relación con la atención de ortodoncia, prótesis y restauración.

Temporomandibular Disorders Treatments and Its Effects on Headaches: Systematic Review and Meta-analysis of Randomized Controlled Trials / Tratamentos das Disfunções Temporomandibulares e seus Efeitos nas Cefaleias: Revisão Sistemática e Metanálise de Ensaios Controlados Randomizados

Objective: temporomandibular Disorders (TMD) are the most common causes of chronic orofacial pain and, along with primary headaches, are considered Chronic Overlapping Pain Conditions (COPCs). The aim of this study is to evaluate TMD treatment effects in individuals with comorbid headaches. Methods: a systematic review was conducted over a search in the database up to October 2020. Selected studies were randomized clinical trials with individuals diagnosed with TMD and comorbid headaches compared to a control group after treatments for TMD. All included studies were evaluated for their methodological quality through the Cochrane Collaboration tool for assessing the risk of bias. Results: seven studies fulfilled the inclusion criteria and were applied in the review, with a total of 432 participants. Four studies were included in a meta-analysis. There was no significative mean difference in the frequency of headache after TMD treatment, nor for a reduction in pain, after TMD intervention for less than 12 weeks. Although for an individual with a TMD intervention period higher than 12 weeks, there was a significant reduction in pain. Conclusion: there is moderate evidence that painful TMD therapies for 12 weeks or higher reduce headache intensity in individuals with painful TMD and headaches. Simultaneous management of TMD and headache must be prioritized for more effective results on both conditions.

Objetivo: as Disfunções Temporomandibulares (DTM) são as causas mais comuns de dor orofacial crônica e, junto com as cefaleias primárias, são consideradas Condições de Dor Sobrepostas Crônicas (CPOCs). O objetivo deste estudo é avaliar os efeitos do tratamento das DTMs em indivíduos com cefaleia comórbida. Métodos: foi realizada uma revisão sistemática por meio de uma busca em banco de dados até outubro de 2020. Os estudos selecionados foram ensaios clínicos randomizados com indivíduos diagnosticados com DTM e cefaleia comórbida em comparação com um grupo controle após tratamentos para DTM. Todos os estudos incluídos foram avaliados quanto à sua qualidade metodológica por meio da ferramenta Cochrane Collaboration para avaliar o risco de viés. Resultados: sete estudos preencheram os critérios de inclusão e foram incluídos na revisão, totalizando 432 participantes. Quatro estudos foram incluídos em uma meta-análise. Não houve diferença média significativa na frequência de cefaleia após tratamento para DTM, nem para redução da dor, após intervenção para DTM por menos de 12 semanas. Para indivíduos com DTM, o tempo de intervenção maior que 12 semanas resultou em uma redução significativa da dor. Conclusão: há evidências moderadas de que terapias para DTM dolorosa por períodos de 12 semanas ou mais reduzem a intensidade da cefaleia em indivíduos com DTM dolorosa e cefaleia. O manejo simultâneo de DTM e cefaleia deve ser priorizado para resultados mais efetivos em ambas as condições.

Frequency of symptoms of temporomandibular dysfunction in homeless people: cross-sectional study / Frequência de sintomas de disfunção temporomandibular em pessoas em situação de rua: estudo transversal

ABSTRACT BACKGROUND AND OBJECTIVES: Homeless people live a reality of social vulnerability, poverty and exclusion and are considerably more affected by long-term pain (chronic pain) than the general population. The objective of this study was to evaluate the presence of symptoms of temporomandibular disorder (TMD) in homeless people who attended a reception center for this population (POP Center) in the city of Juazeiro do Norte-CE. METHODS: This is an observational, cross-sectional, descriptive-exploratory study, whit a quantitative approach and a convenience sample. For this, the TMD-Pain Screener was applied to measure TMD frequency in 100 individuals who were divided into two groups, group 1 (G1, n=50) composed of residents who were assisted by the center and group 2 (G2, n=50) individuals who worked in the center. The TMD Pain Screener instrument was used and the data were paired according to gender and age group. The Qui-square test was applied to verify associations between the variables, considering a level of significance of 5% (p≤0.05). RESULTS: It was observed that homeless people had fewer TMD symptoms than the control group and this difference was statistically significant (p=0,045). The symptom of pain in the lateral region of the head was the most commonly found, being reported by 20% of the homeless population and by 48% of the control group 48% (p=0.03). CONCLUSION: The homeless population presented TMD symptoms, which should be taken into account by the health authorities, however, in a smaller proportion than the control group, requiring further studies to identify these differences.

RESUMO JUSTIFICATIVA E OBJETIVOS: As pessoas em situação de rua vivem uma realidade de vulnerabilidade social, pobreza e exclusão e são consideravelmente mais afetadas pela dor de longa duração (dor crônica) do que a população em geral. O objetivo deste estudo foi avaliar a presença de sintomas de disfunção temporomandibular (DTM) em moradores de rua que frequentam o centro especializado de assistência à população de rua (Centro POP) da cidade de Juazeiro do Norte-CE. MÉTODOS: Este é um estudo observacional do tipo transversal, descritivo-exploratório, com abordagem quantitativa e amostra por conveniência. Para isso, foi aplicado o TMD-Pain Screener para medir a frequência de DTM em 100 indivíduos que foram divididos em dois grupos, grupo 1 (G1, n=50) composto de residentes que foram assistidos pelo centro e grupo 2 (G2, n=50) indivíduos que trabalhavam no mesmo local. O instrumento TMD Pain Screener foi utilizado e os dados foram emparelhados de acordo com o sexo e a faixa etária. O teste Qui-quadrado foi aplicado para verificar associações entre as variáveis, considerando um nível de significância de 5% (p≤0.05). RESULTADOS: Foi observado que as pessoas em situação de rua apresentaram menos sintomas de DTM do que o grupo controle (p=0,045). O sintoma de dor na região lateral da cabeça foi o mais relatado, sendo reportado por 20% da população em situação de rua e por 48% dos indivíduos do grupo controle 48% (p=0,03). CONCLUSÃO: A população em situação de rua apresenta sintomas de DTM, o que deve ser levado em consideração pelas autoridades sanitárias, contudo, em menor proporção do que a população em geral, sendo necessários mais estudos para a elucidação dessa desproporcionalidade.

Divergence between confidence and knowledge of endodontists regarding non-odontogenic pain

Abstract This study aimed to assess the self-reported levels of confidence and knowledge related to non-odontogenic pain among a group of Brazilian endodontists. Methodology A total of one hundred and forty-six endodontists affiliated with the Brazilian Society of Endodontics participated in the survey. The questionnaire, distributed via email or WhatsApp, contained inquiries designed to gauge self-perceived confidence and knowledge concerning non-odontogenic pain. The practitioners were categorized into four groups based on their self-reported familiarity with various orofacial pain types, classified as either sufficient or insufficient, and on their engagement in ongoing educational programs related to orofacial pain. Data were analyzed by Chi-Square Test and Fischer's exact test (p<0.05). Results Overall, self-reported confidence about non-odontogenic pain was high, especially for endodontists who considered their knowledge about orofacial pain sufficient, regardless of whether they had (71.1% - 97.8%) or not (35.7% - 96.4%) been continuously involved in education courses on orofacial pain. In general, self-reported knowledge about non-odontogenic pain was insufficient (0% - 42%), except in the question about how they would act in cases of pain that persists beyond the normal healing time after an endodontic procedure (70.6% - 81.9%). In general, endodontists are confident in their diagnosis and treatment of non-odontogenic pain. Nonetheless, this confidence did not correlate with a commensurate knowledge depth of. Thus, specialization courses in endodontics should highly consider training and qualifying these professionals in the diagnosis of non-odontogenic pain.

Fotobiomodulação no tratamento do trismo em pacientes tratados por câncer de boca ou orofaringe: um ensaio clínico controlado randomizado / Photobiomodulation in the treatment of trismus in patients treated for oral or oropharyngeal cancer: a randomized controlled clinical trial

RESUMO Objetivo investigar a eficácia da associação entre a fotobiomodulação de baixa frequência e a terapia fonoaudiológica tradicional no tratamento do trismo, em pacientes tratados por câncer de boca ou orofaringe. Métodos ensaio clínico controlado, randomizado, longitudinal e prospectivo, realizado de acordo as normas da declaração CONSORT 2010. Para a coleta de dados, foi utilizado o questionário sociodemográfico, a avaliação clínica, a mensuração da abertura de boca por paquímetro, o protocolo de dor McGuill e o protocolo de qualidade de vida WHOQOL-Bref. A amostra foi composta por 30 participantes, de ambos os gêneros na faixa etária de 35-75 anos, divididos em dois grupos, controle e experimental, de forma controlada, mediante sorteio igualitário no que tange aos critérios de inclusão e exclusão. Resultados por meio dos dados analisados, observou-se que houve aumento da amplitude vertical de mandíbula em ambos os grupos, GC: p<0,005 e GE: p<0,001. Não houve correlação estatística entre os grupos na comparação da abertura de boca, p>0,19, assim como em relação à dor orofacial e à qualidade de vida, p= 0,72, ambas as avaliações após a intervenção fonoaudiológica, porém, com melhores resultados para o GE, p<0,001. Conclusão Conclui-se pela eficácia da intervenção fonoaudiológica tradicional e a associação com a fotobiomodulação de baixa frequência no tratamento do trismo. Para a dor orofacial e qualidade de vida, o tratamento associado é mais benéfico.

ABSTRACT Purpose to investigate the effectiveness of the association between low-frequency photobiomodulation and traditional speech therapy in the treatment of trismus in patients treated for oral or oropharyngeal cancer. Methods controlled, randomized, longitudinal and prospective clinical trial, carried out in accordance with the norms of the CONSORT 2010 declaration. For data collection, a sociodemographic questionnaire, clinical evaluation, measurement of mouth opening by caliper, the protocol of McGuill pain and the WHOQOL-Bref quality of life protocol. The sample consisted of 30 participants, of both genders, aged between 35-75 years, divided into two groups, control and experimental, in a controlled manner, through an equal draw with regard to the inclusion and exclusion criteria. Results through the analyzed data, it was observed that there was an increase in the vertical amplitude of the mandible in both groups, CG: p0.19, as well as in relation to orofacial pain and quality of life, p= 0.72, both assessments after the speech therapy intervention, however, with better results for the EG, p<0.001. Conclusion It is concluded that the traditional speech therapy intervention and its association with low-frequency photobiomodulation are effective in the treatment of trismus. For orofacial pain and quality of life, associated treatment is more beneficial.

Self-Medication for Toothache in Children: A Cross-Sectional Study

ABSTRACT Objective: To construct, validate, and apply a questionnaire to assess and characterize the practice of self-medication performed by parents or children's guardians undergoing dental care. Material and Methods: A questionnaire was constructed, validated, and applied through personal interviews in the teaching clinics of two higher education institutions in the Federal District. Absolute and relative frequencies of categorical variables were calculated using descriptive statistics. Quantitative data were presented as mean and standard deviation. The chi-square test measured the association between the studied variables and self-medication. Results: One hundred and five participants were interviewed between August 2019 and November 2020. The average age of the participants was 37 (± 9) years, and most were mothers of the children who attended (78%) and users of the public health system (94.2%). The average family income was 1.88 minimum wage, and the most prevalent educational level was complete high school (40%). Conclusion: Despite the high level of knowledge about medication safety in children, self-medication was practiced in 50% of them. Difficulty in accessing dental treatment was mentioned by most as a justification. Self-medication was associated with dental pain, continuous medication use, and family self-medication habits.

Actualización sobre el síndrome de Eagle y sus complicaciones neurocardiológicas: casos clínicos / An update on Eagle´s syndrome and its neuro-cardiological complications: clinical cases

El síndrome de Eagle o síndrome estilohioideo o sín-drome de la arteria carótida es un trastorno que se origina por la mineralización y elongación del pro-ceso estiloides. Factores traumáticos agudos y cró-nicos, así como otras teorías, han sido propuestos para explicar la etiología y patogenia de esta altera-ción. El conjunto de síntomas puede incluir: dolor fa-ríngeo, odinofagia, disfagia, cefalea, con irradiación a oreja y zona cervical. Si bien existen varias clasifi-caciones, de manera universal se acepta que existen principalmente dos formas de presentación de esta patología: el tipo I o clásico, generalmente asociado a un trauma faríngeo y acompañado de dolor en la zona faríngea y cervical, y el tipo II o carotídeo, que sue-le presentar molestia cervical, cefalea y alteración de la presión arterial, con riesgo de daño de la ac-tividad cardíaca. La identificación de este síndrome suele ser confusa dada la similitud de los síntomas con otras afecciones. El diagnóstico debe realizarse en base a los síntomas y a los estudios por imágenes específicos. El tratamiento puede ser conservador y actuar simplemente sobre los síntomas, o bien, qui-rúrgico. El objetivo del presente trabajo es realizar una revisión actualizada de la literatura sobre el sín-drome de Eagle y presentar tres casos clínicos con distintas manifestaciones (AU)

Eagle's syndrome or styloid syndrome or stylo-carotid artery syndrome is a disease caused by mineralization and elongation of the styloid process. Acute and chronic traumatic factors, along with other hypothesis, have been proposed to explain the aetiology and pathogenesis of this condition. Symptoms can include: pharynx pain, odynophagia, dysphagia, headache, with radiating pain to the ear and neck. Despite there are several classifications, it is universally accepted that this pathology can present in two forms: the type I or classic, generally associated to tonsillar trauma and characterized by pharyngeal and neck pain, and the type II or carotid artery type, which frequently presents with neck pain, headache, blood pressure variation, with risk of damage to cardiac function. Identifying of Eagle's syndrome is often confusing because some symptoms are shared with other pathologies. Diagnosis must be made on the basis of symptoms and imaging studies. Treatment can be conservative, acting only on symptoms, or surgical. The aim of this paper is to provide an updated review of the literature on Eagle syndrome and to present three clinical cases with different manifestations (AU)

Integrative approach to the therapeutic use of cannabis for orofacial pain / Abordagem integrativa do uso terapêutico da cannabis nas dores orofaciais

ABSTRACT BACKGROUND AND OBJECTIVES: Faced with the difficulty of treating chronic orofacial pain and seeking an approach that aims at the health and well-being of the patient in a broader way, cannabinoid therapy appears as an adjunct to pharmacological approaches. CONTENTS: Cannabinoid therapy generates analgesia through the activation of the endocannabinoid system, as well as the use of palmitoylethanolamide (PEA), curcumin, grape seed extract, aromatherapy, acupuncture, laser therapy and the practice of physical exercise. In this way, these therapies allow a reduction in the use of analgesic drugs. CONCLUSION: Cannabinoid therapy is part of this integrative approach and the combination of cannabinoids with other forms of activation of the endocannabinoid system contributes to a better therapeutic outcome and a better quality of life for countless patients suffering from chronic orofacial pain.

RESUMO JUSTIFICATIVA E OBJETIVOS: Diante da dificuldade de tratamento das dores orofaciais crônicas e buscando uma abordagem que vise a saúde e o bem-estar do paciente de uma forma mais ampla, surge a terapia canabinoide como coadjuvante nas abordagens farmacológicas. CONTEÚDO: A terapia canabinoide promove analgesia através da ativação do sistema endocanabinoide, assim como o uso da palmitoiletanolamida (PEA), curcumina, extrato de semente de uva, aromaterapia, acupuntura, laserterapia e a prática de exercício físico. Desta forma, essas terapias permitem redução do uso de fármacos analgésicos. CONCLUSÃO: A terapia canabinoide faz parte dessa abordagem integrativa e a combinação dos canabinoides com outras formas de ativação do sistema endocanabinoide contribui para melhores resultados terapêuticos e melhor qualidade de vida para inúmeros pacientes que sofrem de dores orofaciais crônicas.

Can high pain intensity and catastrophizing interfere with the cognitive performance of women with chronic pain related TMD? A cross-sectional study

Abstract Interventions based on pain education and self-management are dependent on factors such as attention, memory, concentration, and executive function. Objective To explore the relationship between cognitive performance and the variables pain intensity, central sensitization, catastrophizing, and hypervigilance in women diagnosed with chronic pain-related TMD. Methodology This is a cross-sectional study. A total of 33 women (mean age: 38±4.6 years; range: 18 to 66 years) with chronic pain-related TMD (myalgia and/or arthralgia) diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Specific questionnaires were used to evaluate cognitive performance, overall pain intensity, central sensitization, hypervigilance, and pain catastrophizing. The data were analyzed using Pearson's correlation coefficient and backward stepwise multiple linear regression (statistical significance at 5% alpha). Results Approximately 53% of the study sample showed decreased cognitive performance. High central sensitization, hypervigilance, and pain catastrophizing were observed. A significant negative correlation was observed between cognitive performance and hypervigilance (p=.003, r=−.49), cognitive performance and catastrophizing (p<.001, r=−.58), and cognitive performance and pain intensity (p<.001, r=−.58). Regarding the partial regression coefficients, only catastrophizing and pain intensity showed statistical significance (t=−2.12, p=.043; t=−2.64, p=.014, respectively), indicating a significant role in explaining cognitive performance at the sample. Conclusion High pain intensity and the presence of catastrophic thoughts regarding pain can predict impaired cognitive performance in women with chronic pain-related TMD. Management strategies addressing psychosocial dimensions such as reducing catastrophizing and ensuring complete understanding of the condition are important.

Sleep disorders are associated with both morning temporal and jaw pain among adults and elderly: a population-based study in Brazil / Distúrbios do sono estão associados à dor temporal matinal e à dor na mandíbula em adultos e idosos: um estudo de base populacional

Objective Purpose: To assess the influence of sleep disorders on temporal and jaw pain in the morning in adults and elderly people. Methods: Population-based study with representative individuals aged 18 years or over. Individuals were selected using a multistage sampling procedure. The outcomes of morning jaw pain and morning temporal pain were assessed. Sleep bruxism, obstructive sleep apnea, and sleep quality were evaluated as exposure variables. Adjusted analysis was conducted using Poisson regression. All analysis was sex stratified. Results: 820 individuals were studied. Female with sleep bruxism were 1.37 times more likely to have morning temporal pain (p=0.041). Male and female with bruxism had a prevalence 160% and 97%, respectively, higher of morning jaw pain (male: p=0.003; female: p<0.001). Women with obstructive sleep apnea were 1.52 times more likely to have morning temporal pain (p=0.023). Men with poor sleep quality had a prevalence 190% higher of morning temporal pain (p=0.005). Conclusion: Morning craniofacial pain is more frequent in individuals with sleep disorders, and there are differences between sexes. Since more than one sleep disorder can be present in the same individual, studies that adjust the analyses for possible confounders are important to avoiding possible overlap between them.

RESUMO Objetivo: Avaliar a influência dos distúrbios do sono nas dores temporais e mandibulares pela manhã em adultos e idosos. Métodos: Estudo de base populacional realizado com uma amostra representativa de indivíduos com 18 anos ou mais. Os participantes foram selecionados por meio de um processo amostral com múltiplos estágios. Os desfechos avaliados foram a dor matinal na mandíbula e a dor temporal matinal. Apneia obstrutiva do sono, bruxismo do sono e qualidade do sono foram as variáveis de exposição avaliadas. Análise ajustada foi realizada através da Regressão de Poisson e todas as análises foram estratificadas por sexo. Resultados: Foram estudados 820 indivíduos. Mulheres com bruxismo do sono tiveram 1,37 vezes mais chance de ter dor temporal matinal (p=0,041). Homens e mulheres com bruxismo tiveram uma prevalência 160% e 97%, respectivamente, maior de dor matinal na mandíbula (homens: p=0,003; mulheres: p<0,001). Mulheres com apneia obstrutiva do sono tiveram 1,52 vezes mais chance de ter dor temporal matinal (p=0,023). Homens com má qualidade do sono tiveram prevalência 190% maior de dor temporal matinal (p=0,005). Conclusão: Dor craniofacial matinal é mais frequente em indivíduos com distúrbios do sono e há diferenças entre os sexos. Uma vez que mais de um distúrbio do sono pode estar presente no mesmo indivíduo, estudos que ajustem as análises para possíveis confundidores são importantes para evitar uma possível sobreposição entre eles.

Burning mouth syndrome is an oral disease connected to emotions

Burning mouth syndrome presents several challenges, which involve the ignorance of the disease and the psychological and economic barriers for the patients who suffer from it. This letter has a reflection on how the syndrome is related to emotions.

Facial pain due to contact between dental implant with the Canalis Sinuosus / Dor facial devido ao contato entre o implante dentário com o Canalis Sinuosus

The Canalis Sinuosus is a structure of the maxilla that allows the passage of the anterosuperior alveolar nerve and has a neurovascular activity. To visualize this structure, Conical Beam Computed Tomography (CBCT) is best recommended. This article aimed to report a case of facial pain after the insertion of a dental implant due to compression of the Canalis Sinuosus. Thus, the implant was removed, followed by the insertion of a bone graft. After that, the facial pain stopped. In conclusion, the identification of anatomical structures in preoperative examinations is essential in surgical dental procedures.

O Canalis Sinuosus é uma estrutura da maxila, que permite a passagem do nervo alveolar anterosuperior e tem uma atividade neurovascular. Para visualizar essa estrutura, a Tomografia Computadorizada de Feixe Cônico (TCFC) é melhor recomendada. Este artigo teve como objetivo relatar um caso de dor facial após a inserção de um implante dentário, devido à compressão do Canalis Sinuosus. Assim, o implante foi removido, seguido pela inserção de um enxerto ósseo. Depois disso, a dor facial foi interrompida. Em conclusão, a identificação de estruturas anatômicas em exames pré-operatórios é essencial em procedimentos odontológicos cirúrgicos.

Phenotypic analysis of discordant monozygotic twins for pain-related temporomandibular joint disorder. Case report / Análise fenotípica de gêmeas monozigóticas discordantes para disfunção temporomandibular dolorosa. Relato de caso

ABSTRACT BACKGROUND AND OBJECTIVES: The design of research with monozygotic twins discordant for the disease has emerged as a powerful tool for the detection of phenotypic risk factors. The aim of this study is to report a clinical case of monozygotic twins discordant for pain-related temporomandibular joint disorder (TMD) from a cognitive-behavioral-emotional phenotypic analysis, from the comparison of clinical variables of pain, history of exposure to painful procedures in early childhood, and coping with pain. CASE REPORT: TMD-Twin presented a diagnosis of painful (myofascial pain with referral) and joint (disk displacement with reduction) TMD according to the criteria of the DC/TMD. Control-Twin did not show TMD, however she presented other chronic pains. TMD-Twin showed reduced pressure pain threshold, hyperalgesia in trigeminal and extra-trigeminal regions compared to the Control-Twin. TMD-Twin was more exposed to painful procedures and emotional events due to congenital heart problems. Both had central sensitization based on the Central Sensitization Inventory, although TMD-Twin had more catastrophic thoughts about pain. TMD-Twin presented an internal locus of control. CONCLUSION: Both monozygotic twins presented a chronic pain phenotype, although they were discordant with the TMD-related pain. The main differences were the lower pressure pain threshold and higher hyperalgesia locally presented by TMD-Twin. The internal locus of control indicates greater pain sensitivity, with better coping of the painful experience for the TMD-Twin. One possible explanation for this clinical condition can be that painful experiences in early childhood have shaped a phenotype of greater sensitivity with better coping and resilience to the painful condition.

RESUMO JUSTIFICATIVA E OBJETIVOS: O desenho da pesquisa com gêmeos monozigóticos discordantes para a doença surgiu como uma ferramenta poderosa para a detecção de fatores de risco fenotípicos. O objetivo deste estudo foi relatar um caso clínico de gêmeas monozigóticas discordantes para disfunção temporomandibular (DTM) dolorosa a partir de análise fenotípica cognitivo-comportamental-emocional entre elas, por meio de comparação de variáveis clínicas de dor, histórico de exposição a procedimentos dolorosos na primeira infância e enfrentamento de dor (autoeficácia e lócus de controle). RELATO DO CASO: A gêmea-DTM apresentou diagnóstico de DTM dolorosa (dor miofascial com referência) e articular (deslocamento do disco com redução) segundo os critérios do Critérios de Diagnóstico para Distúrbios Temporomandibulares. A gêmea--controle não apresentou DTM, contudo apresentou manifestação clínica de outras dores crônicas. A gêmea-DTM apresentou limiar de dor à pressão reduzido, hiperalgesia em regiões trigeminais/extra-trigeminais quando comparados à gêmea-controle, que na primeira infância foi mais exposta a procedimentos dolorosos devido a problemas cardíacos congênitos. Ambas apresentaram sensibilização central de acordo com o Inventário de Sensibilização Central, embora a gêmea-DTM apresentou mais pensamentos catastróficos sobre a dor. A gêmea-DTM apresentou lócus de controle interno. CONCLUSÃO: Ambas as gêmeas apresentaram fenótipo de dor crônica, apesar do fato de serem discordantes para a DTM. Dentre as avaliações, as que mais diferiram entre o par foram o baixo limiar de dor à pressão e hiperalgesia local presentes na gêmea com DTM. O lócus de controle interno associado à maior sensibilidade indicou melhor enfrentamento da experiência dolorosa para a gêmea-DTM. Uma possível explicação para esta manifestação clínica está pautada na hipótese de que experiências dolorosas na primeira infância vivenciadas por ela tenham moldado um fenótipo de maior sensibilidade com melhor enfrentamento e resiliência frente à condição dolorosa.

Electroacupuntura en pacientes con dolor miofacial asociado a disfunción de las articulaciones temporomandibulares / Electroacupuncture in patients with miofacial pain associated with temporomandibular joints dysfunction

Introducción: Los trastornos temporomandibulares constituyen una condición dolorosa que afecta los músculos de la masticación, la articulación temporomandibular, así como varias estructuras anatómicas del sistema estomatognático. Objetivo: Evaluar la efectividad de la electroacupuntura en pacientes con síndrome de dolor miofacial asociado a disfunción de la articulación temporomandibular. Métodos: Se realizó un estudio cuasiexperimental de intervención terapéutica en 80 pacientes asistidos en el Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, desde noviembre del 2018 hasta igual mes de 2021, quienes padecían dolor miofacial por disfunción en las articulaciones temporomandibulares. Estos fueron asignados de forma alterna en dos grupos terapéuticos de 40 integrantes cada uno: el de estudio, al que se le aplicó electroacupuntura, y el de control, el cual recibió medicación farmacológica convencional; luego, se les fue evaluando clínicamente al tercero, quinto, séptimo y décimo días de iniciadas las terapias. Las variables fueron procesadas estadísticamente aplicando el porcentaje como medida de resumen y la prueba de la Χ2 para estimar diferencias en cuanto al tiempo promedio de buena evolución, con un nivel de significación de 0,05. Resultados: Antes de comenzar los tratamientos, el dolor era intenso en la mayoría de los pacientes de ambos grupos; sin embargo, al tercer día de iniciada la intervención terapéutica, la evolución había sido buena en 45,0 % del grupo de estudio y 32,5 % del grupo de control; al quinto día este porcentaje había aumentado a 60,0 en los que recibieron electroacupuntura, pero se mantuvo igual en los que fueron tratados convencionalmente. Al finalizar la intervención se había logrado la recesión o el alivio del dolor miofacial en 97,5 % de los casos y en 90,0 % de los controles. Conclusiones: La electroacupuntura resultó clínicamente más efectiva para paliar el dolor miofacial producido por los trastornos temporomandibulares, con un menor tiempo promedio de buena respuesta terapéutica.

Introduction: The temporomandibular disorders constitute a painful condition that affects the mastication muscles, the temporomandibular joint, as well as several anatomical structures of the stomatognathic system. Objective: To evaluate the effectiveness of electroacupuncture in patients with syndrome of miofacial pain associated with temporomandibular joint dysfunction. Methods: A quasi-experiment study of therapeutic intervention in 80 patients assisted in Dr. Juan Bruno Zayas Alfonso Teaching General Hospital from Santiago de Cuba, was carried out from November, 2018 to the same month in 2021, who suffered from miofacial pain due to dysfunction in the temporomandibular joint. These were assigned in an alternating way in two therapeutic groups of 40 members each one: that of study, to which electroacupuncture was applied, and that of control, which received conventional pharmacological medication; then, they were clinically evaluated at the third, fifth, seventh and tenth days after the therapy. The variables were statistically processed applying the percentage as summary measure and the chi-square test to estimate differences as for the average time of good evolution, with a level of significance of 0.05. Results: Before beginning the therapy, the pain was intense in most of the patients of both groups; however, at the third day of the therapies, the evolution had been good in 45.0 % of the study group and 32.5 % of the control group, and the fifth day this percentage had increased at 60.0 in those that received electroacupuncture, but stayed equally in those that were treated conventionally. When concluding the intervention recession or relief of the miofacial pain in 97.5 % of the cases and in 90.0 % of the controls was achieved. Conclusions: The electroacupuncture was clinically more effective than the conventional medication to palliate the miofacial pain caused by the temporomandibular disorders, with a less average time of good therapeutic response.