Efficacy of associated therapy in the treatment of temporomandibular disorders

Orofacial pain is manifested in the face or oral cavity area, and includes the disorders of TMJ [1]. Between 5-12% of adult people in the United States [2], 33% of the adult Chinese population in Hong Kong [3], and 33.3% of 2005 individuals in Italy [4], experience pain associated with disorders of the TMJ. The usual symptoms of myogenic temporomandibular disorders (TMDs) are represented by the facial pain, earaches or ringing of the ears, dull, chronic headaches, jaw locking, clicking or popping sounds in the jaw joint, a bite that feels uncomfortable or “off”, neck, shoulder and back pain, and swelling on the side of the face [5-7]. The classical treatment used were injections, physical therapy, splints, anti-inflammatory medications (that could have side effects when used over long periods of time), to which have been added self-management strategies, laser therapies and interventions based on cognitive behavioral approaches [8-10].
At present, a conservative treatment approach prevails over surgery, given it is less aggressive and usually results in satisfactory clinical outcomes in mild-moderate temporomandibular disorder (TMDs).
Nocturnal grinding is a detrimental motor activity, a self-destructive parafunction, characterized by „the consequences of a normal function used in abnormal condition”. Differential diagnosis in nocturnal or day-grinding patients is realized according to the frequency of phenomenon, the destruction degree, the social discomfort and the manifested symptomatology.