ABSTRACT
ABSTRACTBACKGROUND AND OBJECTIVES:This was a randomized clinical trial to compare the analgesic effect of acupuncture and percutaneous electric nerve stimulation for chronic masseter muscle masticatory myalgia.METHODS:Participated in the study 23 patients with unilateral or bilateral masticatory myalgia, who were selected according to Research Diagnostic Criteria for Temporomandibular Disorders and were distributed in two groups. Acupuncture and percutaneous electric nerve stimulation groups were made up of 12 and 11 patients, respectively. In each group, patients were submitted to two weekly treatment sessions lasting 20 minutes, in a total of 9 sessions. Selected points for the acupuncture group were IG4, E36, F3, ShemMen (bilateral auricular), VG20 and Yintang. Needles were inserted and stimulated until “De Qi” was obtained, then remaining without stimulation until procedure completion. In the electric stimulation group, symptomatic points were identified by manual palpation and electric stimulation was applied. Both groups have described pain intensity by means of the visual analog scale, before the first, fifth and ninth sessions. Results were evaluated with Student t and F (ANOVA) tests.RESULTS:There has been mean visual analog scale scores decrease in both groups at each measurement, being that in the last measurement the acupuncture group had statistically lower mean as compared to the percutaneous electric nerve stimulation group.CONCLUSION:Acupuncture and percutaneous electric nerve stimulation are effective methods to improve masseter muscle masticatory myalgia in the short term.
RESUMOJUSTIFICATIVA E OBJETIVOS:Foi conduzido um ensaio clínico randomizado, com o objetivo de comparar o efeito analgésico da acupuntura com a estimulação elétrica percutânea na mialgia mastigatória crônica no músculo masseter.MÉTODOS:Vinte e três pacientes com mialgia mastigatória uni ou bilateral foram selecionados, segundo os Critérios de Diagnóstico em Pesquisa para Desordens Temporomandibulares, e distribuídos em 2 grupos. Os grupos acupuntura e estimulação elétrica percutânea foram constituídos de 12 e 11 pacientes, respectivamente. Em cada grupo, os pacientes foram submetidos a duas sessões semanais de tratamento com duração de 20min, totalizando 9 sessões. No grupo acupuntura, os pontos selecionados foram IG4, E36, F3, ShemMen (auricular bilateral), VG20 e Yintang. As agulhas foram inseridas e estimuladas até a obtenção do “De Qi”, permanecendo sem estimulação adicional até o final do procedimento. No grupo estimulação elétrica percutânea, os pontos sintomáticos foram identificados à palpação manual e o estímulo elétrico foi aplicado. Ambos os grupos descreveram a intensidade da dor por meio da escala analógica visual, antes da primeira, quinta e nona sessões. Os resultados foram avaliados por meio dos testes t de Student e F (ANOVA).RESULTADOS:Houve redução da média dos valores da escala analógica visual em ambos os grupos a cada aferição, sendo que na última o grupo acupuntura apresentou média estatisticamente inferior ao grupo estimulação elétrica percutânea.CONCLUSÃO:A acupuntura e a estimulação elétrica percutânea são métodos eficazes na redução da mialgia mastigatória do músculo masseter no curto prazo.
ABSTRACT
The aim of the present study was to assess the clinical and radiographic repercussions of surgically assisted maxillary expansion on the septum, nasal cavity and nasal conchae. The sample was made up of 15 patients with skeletal maturity (9 females and 6 males between 16 and 45 years of age) and maxillary transverse deficiency. Assessments were performed through anterior rhinoscopy and frontal cephalometric radiographs on three occasions: (T0) preoperative period, (T1) locking of the expander and (T2) six months following the locking procedure. An increase was observed in the basal portion of the pyriform aperture and distances between the lateral wall of the basal portion of the pyriform aperture and the septum. The radiographic exam revealed that the nasal septum did not undergo any statistically significant change in its position. Moreover, no significant changes in the position of the nasal septum or nasal conchae were detected throughout the three evaluation times. The results suggest that surgically assisted maxillary expansion is capable of widening the basal portion of the pyriform aperture, with little repercussion on the anterior position of the nasal septum and inferior nasal conchae.
