TTratamentos das Disfunções Temporomandibulares e seus Efeitos nas Cefaleias
Revisão Sistemática e Metanálise de Ensaios Controlados Randomizados
Palavras-chave:
enxaqueca, dor, articulação temporomandibular, cefaleia do tipo tensional, dor facialResumo
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.
Downloads
Referências
Maixner W, Diatchenko L, Dubner R et al. Orofacial pain prospective evaluation and risk assessment study—the OPPERA study. J Pain 2011;12 T4–11.
Häggman-Henrikson B, Liv P, Ilgunas A, et al. Increasing gender differences in the prevalence and chronification of orofacial pain in the population. Pain 2020. 161 (8): 1768-1775.
Okeson JP, de Leeuw R. Differential diagnosis of temporomandibular disorders and other orofacial pain disorders. Dental clinics of North America 2011. 55(1):105–120.
Peck CC, Goulet JP, Lobbezoo F, et al. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders. J Oral Rehabil 2014.41(1):2-23.
International Classification of Orofacial Pain, 1st edition (ICOP). Cephalalgia 2020. 40(2):129-221.
Yunus, MB. Central sensitivity syndromes: A new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness. Semin Arthritis Rheum 2008. 37:339-352.
Maixner W, Fillingim RB, Williams DA, et al. Overlapping Chronic Pain Conditions: Implications for Diagnosis and Classification. J Pain 2016. 17(9 Suppl):T93-T107.
Nguyen TT, Vanichanon P, Bhalang K, et al. Pain Duration and Intensity Are Related to Coexisting Pain and Comorbidities Present in Temporomandibular Disorder Pain Patients. J Oral Facial Pain Headache 2019. 33(2):205–212.
Ciancaglini R,Radaelli G. The relationship between headache and symptoms of temporomandibular dis- order in the general population. J Dent 2001. 29:93- 98.
Ballegaard V, Thede-Schmidt-Hansen P, Svensson P, et al. Are headache and temporomandibular disorders related? A blinded study. Cephalalgia 2008. 28:832-841.
Gonçalves DA, Bigal ME, Jales LC, et al. Headache and symptoms of temporo- mandibular disorder: An epidemiological study. Headache 2010. 50:231-241.
Kang JK, Ryu JW, Choi JH, et al. Application of ICHD-II criteria for headaches in a TMJ and orofacial pain clinic. Cephalalgia 2010. 30(1): 37–41.
Plesh O, Adams SH, Gansky SA. Self-reported comorbid pains in severe headaches or migraines in a US national sample. Headache 2012. 52(6):946–956.
Tomaz-Morais JF, Lucena LB, Mota IA, et al. Temporomandibular disorder is more prevalent among patients with primary headaches in a tertiary outpatient clinic. Arq Neuropsiquiatr 2015. 73(11):913-7.
Mitrirattanakul S, Merrill RL. Headache impact in patients with orofacial pain. J Am Dent Assoc 2006: 137(9):1267–1274.
Tchivileva IE, Ohrbach R, Fillingim RB, et al. Temporal change in headache and its contribution to the risk of developing first-onset temporomandibular disorder in the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) study. Pain 2017. 158(1):120-129.
Conti PC, Costa YM, Gonçalves DA, et al. Headaches and myofascial temporomandibular disorders: overlapping entities, separate managements? J Oral Rehabil 2016. 43(9):702-15.
Forssell H, Kirveskari P, Kangasniemi P. Changes in headache after treatment of mandibular dysfunction. Cephalalgia 1985. 5(4):229-36.
Ekberg EC, Nilner M. Treatment outcome of short and long-term appliance therapy in patients with TMD of myogenous origin and tension-type headache. J Oral Rehabil 2006. 33(10):713-21.
Doepel M, Nilner M, Ekberg E, et al. Headache: short and long-term effectiveness of a prefabricated appliance compared to a stabilization appliance. Acta Odontol Scand 2011. 69(3):129-36.
Saha FJ, Pulla A, Ostermann T, et al. Effects of occlusal splint therapy in patients with migraine or tension-type headache and comorbid temporomandibular disorder: A randomized controlled trial. Medicine (Baltimore) 2019. 98(33):e16805.
Garrigós-Pedrón M, La Touche R, Navarro-Desentre P, et al. Effects of a Physical Therapy Protocol in Patients with Chronic Migraine and Temporomandibular Disorders: A Randomized, Single-Blinded, Clinical Trial. J Oral Facial Pain Headache 2018. 32(2):137-150.
Costa YM, Porporatti AL, Stuginski-Barbosa J, et al. Headache Attributed to Masticatory Myofascial Pain: Clinical Features and Management Outcomes. J Oral Facial Pain Headache. 2015. 29(4):323-30.
Goncalves DA, Camparis CM, Speciali JG, et al. Treatment of comorbid migraine and temporomandibular disorders: a factorial, double-blind, randomized, placebo-controlled study. J Orofac Pain 2013. 27(4):325-35.
Liljestron MR, Le Bell Y, Anttila P, et al. Headache children with temporomandibular disorders have several types of pain and other symptoms. Cephalal- gia 2005. 25:1054-1060.
Glaros AG, Urban D, Locke J. Headache and temporomandibular disorders: Evidence for diagnostic and behavioural overlap. Cephalalgia 2007. 27:542- 549.
Franco AL, Goncalves DAG, Castanharo SM, et al. Migraine is the most prevalent primary headache in individuals with temporomandibular disorders. J Orofac Pain 2010. 24:287-292.
Gonçalves DA, Camparis CM, Speciali JG, et al. Temporomandibular disorders are differentially associated with headache diagnoses: A controlled study. Clin J Pain 2011. 27:611-615.
Melo CE, Oliveira JL, Jesus AC, et al. Temporomandibular disorders dysfunction in headache patients. Med Oral Patol Oral Cir Bucal 2012. 17:1042-1046.
Gonçalves M, Florencio LL, Chaves T, et al. Do women with migraine have higher prevalence of temporomandibular disorders? Braz J Phys Ther 2013. 17:64-68.
Nilsson IM, List T, Drangsholt M. Headache and comorbid pains associated with TMD pain in adolescents. J Dent Res 2013. 92:802-807.
Franco AL, Fernandes G, Gonçalves DA, et al. Headache associated with temporomandibular dis- orders among young Brazilian adolescents. Clin J Pain 2014. 30:340-345
Emshoff R, Bertram F, Schnabl D, et al. Association Between Chronic Tension-Type Headache Coexistent with Chronic Temporomandibular Disorder Pain and Limitations in Physical and Emotional Functioning: A Case-Control Study. J Oral Facial Pain Headache 2017. 31(1):55-60.
Arbex G, Teixeira VP, Moriyama CM, et al. Temporomandibular disorder and headache in university professors. J Phys Ther Sci 2019. 31(3):217-222.
Fernandes G, Arruda MA, Bigal ME, et al. Painful Temporomandibular Disorder Is Associated With Migraine in Adolescents: A Case-Control Study. J Pain 2019. 20(10):1155-1163.
Speciali JG, Dach F. Temporomandibular dysfunction and headache disorder. Headache 2015. 55 Suppl 1:72-83.
Kang JH. Effects on migraine, neck pain, and head and neck posture, of temporomandibular disorder treatment: Study of a retrospective cohort. Arch Oral Biol 2020. 114:104718.
Schiffman E, Ohrbach R, List T, et al. Diagnostic criteria for headache attributed to temporoman- dibular disorders. Cephalalgia 2012. 32:683-692.
Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018. 38(1):1-211.
Turner DP, Houle TT. Influences on headache trigger beliefs and perceptions. Cephalalgia 2018. 38(9):1545-1553.
Bendtsen L. Central sensitization in tension-type headache–possible pathophysiological mechanisms. Cephalalgia 2000. 20:486–508.
Costa YM, Porporatti AL, Stuginski-Barbosa J, et al. Headache Attributed to Masticatory Myofascial Pain: Clinical Features and Management Outcomes. J Oral Facial Pain Headache 2015. 29(4):323-30.
Hara K, Shinozaki T, Okada-Ogawa A, et al. Headache attributed to temporomandibular disorders and masticatory myofascial pain. J Oral Sci 2016. 58(2):195-204.
Anderson GC, John MT, Ohrbach R, et al. Influence of headache frequency on clinical signs and symptoms of TMD in subjects with temple headache and TMD pain. Pain 2011. 152:765-771.
Slade GD, Greenspan JD, Fillingim RB, et al. Overlap of Five Chronic Pain Conditions: Temporomandibular Disorders, Headache, Back Pain, Irritable Bowel Syndrome, and Fibromyalgia. J Oral Facial Pain Headache 2020. 34:s15-s28.
Cairns BE. Pathophysiology of TMD pain–basic mechanisms and their implications for pharmacotherapy. J Oral Rehabil 2010. 37:391–410.
Ichesco E, Quintero A, Clauw DJ, et al. Altered functional connectivity between the insula and the cingulate cortex in patients with temporomandibular disorder: a pilot study. Headache 2012. 52(3):441-54.
Monaco A, Cattaneo R, Marci MC, Pietropaoli D, Ortu E. Central Sensitization-Based Classification for Temporomandibular Disorders: A Pathogenetic Hypothesis. Pain Res Manag 2017. 2017:5957076.
Charles A. The evolution of a migraine attack - a review of recent evidence. Headache 2013. 53(2):413-9.
Gupta S, McCarson KE, Welch KM, et al. Mechanisms of pain modulation by sex hormones in migraine. Headache 2011. 51(6):905-22.
Shinoda M, Kubo A, Hayashi Y, et al. Peripheral and Central Mechanisms of Persistent Orofacial Pain. Front Neurosci 2019. 13;13:1227.
Nguyen TT, Vanichanon P, Bhalang K, et al. Pain Duration and Intensity Are Related to Coexisting Pain and Comorbidities Present in Temporomandibular Disorder Pain Patients. J Oral Facial Pain Headache 2019. 33(2):205–212.
Slade GD, Ohrbach R, Greenspan JD, et al. Painful Temporomandibular Disorder: Decade of Discovery from OPPERA Studies. J Dent Res 2016. 95(10):1084-92.
Graff-Radford SB, Abbott JJ. Temporomandibular Disorders and Headache. Oral Maxillofac Surg Clin North Am 2016. 28(3):335-49.
Gaynor SM, Bortsov A, Bair E, et al. Phenotypic profile clustering pragmatically identifies diagnostically and mechanistically informative subgroups of chronic pain patients. Pain 2020. Epub ahead of print Nov 30.
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2023 Journal of Health & Biological Sciences
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Os artigos publicados na JHBS são de uso gratuito, destinados a aplicações educacionais e não comerciais.
Este artigo está licenciada sob uma licença Creative Commons - Atribuição-Não Comercial- Sem Derivações 4.0 Internacional
