Dor, controle neuromotor e postura em indivíduos com disfunção temporomandibular com e sem queixas otológicas: um estudo transversal

Abstract

Background: Temporomandibular disorders (TMD) are conditions that affect the temporomandibular joint (TMJ), the masticatory muscles and associated structures. Common signs and symptoms include TMJ and muscle pain, limited mouth opening, joint noises, headaches, earache, and altered jaw movement. In addition, studies suggest direct associations between TMD and alterations of the cervical spine. The coexistence of neck pain and TMD is common and it can be associated with weakness and lack of endurance of the neck muscles. Earache, tinnitus and vertigo are also reported as commom complaints of otological origin in patients with TMD. Objective: The aim of this study was to evaluate pain, neuromotor control and head and neck posture in individuals with TMD with and without otological complaints. Methods: In this cross-sectional study, 57 individuals with TMD diagnosed with RDC/TMD between 18 and 59 years of age and both genders were evaluated. Subjects with TMD were divided into two groups: a group with otological complaints (GCQ; n=31) and a group without otological complaints (GSQ; n=26). Otological complaints considered symptoms of dizziness, vertigo, tinnitus, earache, ear fullness or hearing loss. Self reported pain, masticatory and neck muscles pain threshold, head and neck posture, neck disability and neuromotor control and muscular endurance of deep neck flexors (DNF) were evaluated in both groups. All descriptive and inferential analyzes were performed using the statistical software SPSS 22.0 for Windows. A 95% confidence interval and significant level of p<0.05 was adopted. Results: The TMD group with otological complaints presented less muscle activation scores (GCQ 24 mmHg [24 - 26]; GSQ 26 mmHg [24 - 28]), less endurance (GCQ 44 [28 - 78]; GSQ 105 [46 - 140]) and greater neck disability (GCQ 13.32 ± 6.36 points; GSQ 8.15 ± 5.89 points) (p<0.05) when compared to the group of TMD without otological complaints. There were no significant differences in pressure pain thresholds, self-reported pain and head posture between groups. Conclusion: Individuals with TMD with otologic complaints present diminished neuromotor control of the deep neck flexors, greater neck disability and same pain levels and head and neck posture compared to individuals with TMD without otological complaints.