Eficacia de la terapia y/o los ejercicios terapéuticos en pacientes con trastorno temporomandibular. Alteración cóndilo-discal posterior.

Pregunta: ¿Qué tipo de terapia manual y/o ejercicios terapéuticos son más eficaces en pacientes con trastorno temporomandibular? Objetivo: Evaluar y comparar la eficacia de la terapia manual y/o los ejercicios terapéuticos en pacientes con trastorno temporomandibular. Metodología: la presente revisión bibliográfica se centra en bases de datos Medline, Scopus, PEDro y Google Scholar. Los artículos obtenidos fueron publicados entre los años 2004 y 2014. Se incluyen un total de 12 ensayos clínicos aleatorios. La literatura consta de pacientes con trastorno temporomandibular que hayan sido intervenidos con técnicas de terapia manual y/o ejercicios terapéuticos aplicados por un fisioterapeuta. Resultados: fueron seleccionados 10 estudios de alta evidencia científica para demostrar que la terapia manual combinada con ejercicio terapéutico disminuye el dolor, aumenta la abertura de la boca y corrige la anteversión de la cabeza. Conclusiones: la terapia manual combinada con ejercicios terapéuticos es efectiva para disminuir los síntomas en pacientes con trastornos temporomandibulares.

Scientific evidence on the usefulness of intraarticular hyaluronic acid injection in the management of temporomandibular dysfunction

Hyaluronic acid (HA) is found in high concentrations in cartilage and synovial fluid, and is an important component of the extracellular matrixes- exerting joint lubrication and buffering actions thanks to its viscoelastic properties. The present study examines the scientific evidence found in the current literature on the usefulness of the intraarticular injection of HA in patients with temporomandibular dysfunction. A literature search was made up until May 2008 in the following databases: PubMed / MEDLINE. Of the articles found in the literature, the present review included 18 relevant studies on the application of HA in the temporomandibular joint (TMJ). The quality, level of evidence and strength of recommendation of the articles was evaluated based on the"Strength of Recommendation Taxonomy" criteria. It is concluded that type A level of recommendation exists in favor of the intraarticular injection of HA in dysfunction of the TMJ. However, further studies are needed to establish the true therapeutic effects and to identify the best dosing regimen.

The use of tricyclic antidepressants in the treatment of temporomandibular joint disorders: systematic review of the literature of the last 20 years

Many therapies have been proposed for the management of temporomandibular disorders, including the use of different drugs. However, lack of knowledge about the mechanisms behind the pain associated with this pathology, and the fact that the studies carried out so far use highly disparate patient selection criteria, mean that results on the effectiveness of the different medications are inconclusive. This study makes a systematic review of the literature published on the use of tricyclic antidepressants for the treatment of temporomandibular disorders, using the SORT criteria (Strength of recommendation taxonomy) to consider the level of scientific evidence of the different studies. Following analysis of the articles, and in function of their scientific quality, a type B recommendation is given in favor of the use of tricyclic antidepressants for the treatment of temporomandibular disorders.