ABSTRACT
This study compared the effects of LED therapy associated with occlusal splint (OS) on the signs and symptoms of temporomandibular disorder (TMD). In this randomized, double-blind clinical trial, 70 TMD patients were randomly divided into six groups. The volunteers received the following treatments: Group 1 (G1) was the control and received only conventional therapy with OS; Group 2 (G2) was the placebo and received treatment with OS and therapy with LED (device turned off); Group 3 (G3) LED therapy (infrared,) once a week; Group 4 (G4) LED therapy (infrared) twice a week; Group 5 (G5) OS associated with LED (infrared) therapy (once a week); Group 6 (G6) received OS therapy plus infrared LED (two sessions per week). The patients were evaluated before, after, and 30 days after treatment. The pain intensity in masticatory system was recorded at each interval. The evaluation of the electromyographic signals (EMG) of the muscles (masseter and temporal) and blood lactate was performed before and after treatment. The associated groups presented better clinical results in relation to the control. The associated groups showed significant differences (p < 0.05) from control in the analysis of pain intensity and in decrease of the RMS value (EMG analysis). In the intragroup analysis, the volunteers in G6 exhibited a significant reduction (p < 0.05) in blood lactate. In conclusion, the association of LED therapy and OS presented superior results in relation to the isolated therapies, especially the protocol with two weekly sessions.
Subject(s)
Occlusal Splints , Temporomandibular Joint Disorders , Double-Blind Method , Humans , Pain Measurement , Temporomandibular Joint Disorders/therapy , Treatment OutcomeABSTRACT
This case report aims to evaluate the treatment of Temporomandibular Disorder (TMD) of muscular origin by associating facial massage (FM), dry needling (DN), and low-level laser therapy (LLLT). The pre- and post-treatment evaluations consisted of clinical examinations based on the Research Diagnostic Criteria (RDC) for TMD, pain intensity quantification by means of the Visual Analog Scale (VAS), mandibular movement measurement, and electromyographic (EMG) analysis of the masseter and temporal muscles. Post-therapy assessment indicated a decrease in pain sites of 58%, in pain intensity mean (1.3), and an increase in the maximum aperture of 10 mm, in addition to normalization of EMG signals. We conclude that, after application of the treatment protocol, there was a decrease in painful sites, gain in amplitude of mandibular movements, and normalization of EMG activity.
Subject(s)
Complementary Therapies/methods , Low-Level Light Therapy/methods , Massage/methods , Needles , Temporomandibular Joint Disorders/therapy , Adult , Combined Modality Therapy , Electromyography , Facial Muscles/physiopathology , Facial Pain/therapy , Female , Humans , Pain Measurement , Reproducibility of Results , Temporomandibular Joint Disorders/physiopathology , Treatment OutcomeABSTRACT
OBJETIVOS: Apresentar a transformada wavelet como uma ferramenta alternativa para o processamento dos sinais oriundos da eletromiografia quando utilizada na avaliação da atividade elétrica do músculo masseter de mulheres com disfunção temporomandibular. MÉTODOS: Cinco voluntárias com disfunção temporomandibular passaram por quatro sessões de terapia com diodo emissor de luz (LED, light emitting diode). A eletromiografia do músculo masseter foi realizada bilateralmente antes e após o tratamento, empregando um eletromiógrafo de dois canais. Na análise dos sinais eletromiográficos foi empregada a transformada wavelet na função Morlet. RESULTADOS: Nos escalogramas, observou-se a diminuição da ativação das fibras de alta frequência no protocolo de repouso e seu aumento no protocolo de movimento isométrico. Na análise baseada no sistema de cores RGB, foi possível observar que no protocolo de repouso do músculo masseter direito houve redução dos momentos de máxima intensidades de energia em 82% para frequências de 256-512Hz e em 42% para frequências acima de 512Hz. No músculo masseter esquerdo a redução foi de 42% na banda de frequências de 256-512Hz. CONCLUSÕES: A análise pela transformada wavelet permitiu identificar fatores fisiológicos relacionados não somente à ativação do músculo masseter, mas também à intensidade e à relação tempo/frequência, assim como os principais tipos de fibras ativadas durante os protocolos antes e após a terapia LED em pacientes com disfunção temporomandibular
AIMS: To present the wavelet transform as an alternative tool in the evaluation of the masseter muscle electrical activity in women with temporomandibular disorder after therapy with Light Emitting Diode (LED). METHODS: Five volunteers with temporomandibular disorder underwent four sessions of LED therapy. Electromyography of the masseter muscle was performed bilaterally before and after treatment. For analysing the electromyographic signals, the wavelet transform was applied in the Morlet function. RESULTS: In the scalogram, a decrease in the activation of the high-frequency fibers in the rest protocol and its increase in the isometric movement protocol were observed. In the analysis based on the RGB color system, we observed that in the right masseter muscle resting protocol, the moments of maximum energy intensities were reduced by 82% for frequencies of 256-512Hz and by 42% for frequencies above 512Hz. In the left masseter muscle the reduction was 42% in the frequency band of 256-512Hz. CONCLUSIONS: Analysis by the wavelet transform allowed identification of physiological factors related not only to the activation of the masseter muscle, but also to the intensity and time / frequency relationship, as well as the main types of fibers activated during the protocols before and after LED therapy in patients with dysfunction temporomandibular.
Subject(s)
Electromyography , Low-Level Light Therapy , Temporomandibular Joint Dysfunction Syndrome/therapyABSTRACT
ABSTRACT This case report aims to evaluate the treatment of Temporomandibular Disorder (TMD) of muscular origin by associating facial massage (FM), dry needling (DN), and low-level laser therapy (LLLT). The pre- and post-treatment evaluations consisted of clinical examinations based on the Research Diagnostic Criteria (RDC) for TMD, pain intensity quantification by means of the Visual Analog Scale (VAS), mandibular movement measurement, and electromyographic (EMG) analysis of the masseter and temporal muscles. Post-therapy assessment indicated a decrease in pain sites of 58%, in pain intensity mean (1.3), and an increase in the maximum aperture of 10 mm, in addition to normalization of EMG signals. We conclude that, after application of the treatment protocol, there was a decrease in painful sites, gain in amplitude of mandibular movements, and normalization of EMG activity.
RESUMO O objetivo do presente relato de caso é avaliar a associação entre a Massagem Facial (MF), Agulhamento a Seco (AS) e Terapia a Laser de Baixa Intensidade (TLBI) no tratamento da Disfunção Temporomandibular (DTM) de origem muscular. Paciente com DTM crônica foi submetida a 4 sessões de associação entre a MF, AS e TLBI. A avaliação inicial e final foi composta por exame clínico baseado nos Critérios diagnósticos de pesquisa para DTM (RDC - Research Diagnostic Criteria), quantificação da intensidade da dor por meio da Escala visual analógica de dor, mensuração dos movimentos mandibulares e análise eletromiográfica (EMG) dos músculos masseter e temporal. Na pós-terapia, foi observada a redução de 58% dos sítios dolorosos, da média (1,3) da intensidade de dor e aumento de 10 mm na abertura máxima, além da normalização dos sinais EMG. Conclui-se que, após a aplicação de protocolo de tratamento, houve a redução dos sítios dolorosos, ganho de amplitude dos movimentos mandibulares e normalização da atividade EMG.
Subject(s)
Humans , Female , Adult , Complementary Therapies/methods , Temporomandibular Joint Disorders/therapy , Low-Level Light Therapy/methods , Massage/methods , Needles , Pain Measurement , Facial Pain/therapy , Temporomandibular Joint Disorders/physiopathology , Reproducibility of Results , Treatment Outcome , Combined Modality Therapy , Electromyography , Facial Muscles/physiopathologyABSTRACT
OBJETIVOS: Avaliar o efeito da terapia light emitting diode (LED) na disfunção temporomandibular. DESCRIÇÃO DO CASO: Uma paciente diagnosticada com disfunção temporomandibular foi submetida a quatros sessões de terapia LED com intervalo de sete dias entre as irradiações. No exame inicial da articulação temporomandibular a paciente apresentava abertura de boca sem dor de 23 mm, abertura máxima de 25 mm e abertura máxima com auxílio de 27 mm. Após o tratamento houve aumento de 7 mm na abertura sem dor entre a primeira e a última avaliação enquanto que a abertura máxima de boca e a abertura máxima com auxílio aumentaram 6 mm entre a primeira e a última avaliação. Após 21 dias de tratamento detectou-se redução de 50% dos sítios dolorosos ao exame de palpação. Após o final do tratamento, a escala visual analógica de dor detectou diminuição da intensidade de dor em ambos os lados, e houve diminuição da média total da intensidade de dor. Pela análise das respostas ao questionário Medical Outcomes Study 36- item Short Form Health Survey (SF-36), dos oito domínios de qualidade de vida avaliados, quatro apresentaram melhora. CONCLUSÕES: No protocolo empregado neste caso, após a terapia LED houve redução da intensidade da dor e aumento da amplitude de movimentos mandibulares. A remissão dos sinais e sintomas da disfunção temporomandibular resultou em melhora na qualidade de vida da paciente.
AIMS: To evaluate the effect of light emitting diode (LED) therapy on temporomandibular disorder. CASE DESCRIPTION: A woman diagnosed with temporomandibular disorder was subjected to four LED therapy sessions at a seven-day interval. In the initial examination of the temporomandibular joint the patient presented a mouth opening without pain of 23 mm, a maximum opening of 25 mm and a maximum opening with the aid of 27 mm. After the treatment, there was an increase of 7 mm in the opening without pain between the first and last evaluation, while the maximum opening of the mouth and the maximum opening with aid increased 6 mm between the first and last evaluation. After 21 days of treatment, a 50% reduction in painful sites was detected on the palpation examination. After the end of the treatment, the visual analog pain scale detected a decrease in pain intensity on both sides, and there was a decrease in the total mean pain intensity. By analyzing the responses to the Medical Outcomes Study 36-item Short Form Health Survey (SF-36), of the eight quality of life domains evaluated, four showed improvement. CONCLUSIONS: In this case study, after LED therapy there was reduction in pain intensity and increase of the mandibular range of motion. The resolution of the signs and symptoms of temporomandibular disorder resulted in patient's better quality of life.
Subject(s)
Humans , Temporomandibular Joint Dysfunction Syndrome , Low-Level Light Therapy , PhototherapyABSTRACT
Gingival recession is defined by the displacement of the gingival margin in the apical direction, which overcomes the cementum enamel junction. The etiology of gingival retraction is related to tissue inflammation caused by the accumulation of biofilm, by trauma from brushing action. Aesthetic periodontal surgery aims to return the root coverage to aesthetic harmony, and reduce the risk of periodontal disease and caries. To assist in the root coverage process, the porcine collagen matrix (PCM) has been widely studied. The objectives of this study are to identify the types of collagen that make up the PCM and analyze their morphology. For this, five PCM fragments, 2 mm (thickness) × 2.6 mm (width), were analyzed with the aid of scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR). The analysis by SEM showed that the PCM consists of two layers; the surface layer is compact, low porosity, and smooth surface, and a foamed underlying layer has high porosity. Through FTIR we identified that the surface and underlying layers are composed of collagen types I and III, respectively. This biomaterial is conducive to root coverage; it allows adsorption and cell proliferation following the matrix resorption and periodontal tissue neoformation. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1326-1329, 2017.