Fisioterapia nas disfunções temporomandibulares associadas ao zumbido: uma revisão sistemática

Abstract

Temporomandibular disorder (TMD) is a broad term that involves different clinical conditions that may affect the temporomandibular joint (TMJ), masticatory muscles and adjacent structures. TMDs main symptom is local or diffuse orofacial pain, however, otological symptoms may also be present. Among otological symptoms, the most commonly associated with TMD is tinnitus. Objective: To determine the effects of physical therapy modalities in individuals with TMD associated with tinnitus. Methods: This is a systematic review that follows the recommendations of the Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and is registered in the International Prospective Registry of Systematic Reviews (PROSPERO). The electronic search was performed in the following databases: MEDLINE, EMBASE, CINAHL, PEDro and CENTRAL. Two independent reviewers selected the studies, extracted data and evaluated risk of bias. Results: 138 studies were retrieved, in which, four met the inclusion criteria. Regarding physical therapy modalities all studies showed a reduction in tinnitus assessment measurements and only two trials showed a decrease in the intensity of pain, increase in the pressure pain thresholds (PPT) and an improvement of disability. Two studies presented low risk of bias, however, due to the heterogeneity of the interventions a meta-analysis was not possible. Conclusion: The present review showed that physical therapy reduces the intensity or severity of tinnitus associated with TMD, however with low certainty of the evidence. The investigation of other commonly impaired clinical parameters in these patients, such as orofacial and neck pain, disability and quality of life, also require further research.