Publication: Aproximación Clínica a la Disfunción de la Articulación Temporomandibular
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2013
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Abstract
Dada la relevancia que está cobrando la disfunción temporomandibular (DTM) en el ámbito del dolor orofacial, el objetivo del presente trabajo es proponer unas bases de tratamiento fisioterápico para el abordaje de esta entidad clínica, que faciliten la funcionalidad articular y contribuyan a una mejora en la calidad de vida del paciente, fundamentadas en la evidencia científica existente al respecto.
La DTM hace referencia a varias alteraciones que afectan a la articulación temporomandibular (ATM), los músculos masticatorios y las estructuras contiguas. El síntoma más común es dolor localizado o referido en la región de cabeza y cuello.
Aunque la DTM es una causa común del dolor craneofacial, es imprescindible para el fisioterapeuta obtener una completa historia, haciendo un examen físico cuidadoso y obteniendo estudios diagnósticos apropiados.
Se encuentran dos tipos frecuentes de DTM que desarrollaremos más ampliamente en este trabajo: el dolor miógeno (dolor de los músculos masticatorios) y el dolor artrógeno (trastornos internos articulares sobre todo en forma de desplazamientos discales).
Después llevaremos a cabo la redacción de ciertos procedimientos que en el ámbito clínico, no exclusivo de la fisioterapia, se pueden llevar a cabo para mejorar y aliviar dichos trastornos, como el tratamiento farmacológico, ortopédico y conductual. Para terminar citaremos lo que se puede realizar en el ámbito fisioterápico para tratar la DTM, distinguiendo terapias físicas (biofeedback, termoterapia, crioterapia, tratamiento con ultrasonidos, iontoforesis, ENET, láser y acupuntura) y técnicas manuales (ejercicios activos, pasivos y asistidos, masaje, estiramiento y reeducación postural).
Due to the relevance that is taking temporomandibular dysfunction (TMD) in the area of orofacial pain, the objective of this work is to propose bases of physiotherapy treatment for this clinical approach, to facilitate joint function and contribute to improved the life´s quality of patients, based on scientific evidence concerning this area. The DTM refers to several disorders affecting the temporomandibular joint (TMJ), masticatory muscles, and contiguous structures. The most common symptom is localized or referred pain in head and neck region. Although the DTM is a common cause of craniofacial pain, is essential for the physiotherapist to obtain a complete history, doing a careful physical examination and obtaining appropriate diagnostic studies. Are two common types of DTM to develop further in this paper: myogenic pain (pain of the masticatory muscles) and artrogenic pain (internal joint disorders especially as disc displacement). Then take out the writing of certain procedures in the clinical setting, nonexclusive physiotherapy can take to improve and alleviate these disorders, such as pharmacologic, orthopedic and behavioral treatments. Finally we will mention what can be done in the field of physiotherapy to treat DTM, distinguishing physical therapies (biofeedback, thermotherapy, cryotherapy, ultrasound treatment, iontophoresis, TENS, laser and acupuncture) and manual techniques (active, passive and assisted exercises, massage, stretching and postural reeducation).
Due to the relevance that is taking temporomandibular dysfunction (TMD) in the area of orofacial pain, the objective of this work is to propose bases of physiotherapy treatment for this clinical approach, to facilitate joint function and contribute to improved the life´s quality of patients, based on scientific evidence concerning this area. The DTM refers to several disorders affecting the temporomandibular joint (TMJ), masticatory muscles, and contiguous structures. The most common symptom is localized or referred pain in head and neck region. Although the DTM is a common cause of craniofacial pain, is essential for the physiotherapist to obtain a complete history, doing a careful physical examination and obtaining appropriate diagnostic studies. Are two common types of DTM to develop further in this paper: myogenic pain (pain of the masticatory muscles) and artrogenic pain (internal joint disorders especially as disc displacement). Then take out the writing of certain procedures in the clinical setting, nonexclusive physiotherapy can take to improve and alleviate these disorders, such as pharmacologic, orthopedic and behavioral treatments. Finally we will mention what can be done in the field of physiotherapy to treat DTM, distinguishing physical therapies (biofeedback, thermotherapy, cryotherapy, ultrasound treatment, iontophoresis, TENS, laser and acupuncture) and manual techniques (active, passive and assisted exercises, massage, stretching and postural reeducation).