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Eficácia da ultrassonografia terapêutica associada à terapia miofuncional orofacial na disfunção temporomandibular

2025-08-08T00:00:00Z

Título: Eficácia da ultrassonografia terapêutica associada à terapia miofuncional orofacial na disfunção temporomandibular Autor(es): Balbino, Taliane Rocha Orientador: Benevides, Silvia Damasceno Abstract: Introduction: Temporomandibular dysfunction (TMD) encompasses a set of disorders affecting the temporomandibular joint, masticatory muscles, and adjacent structures, resulting in orofacial pain, joint noises, mandibular deviations, limited mouth opening, headaches, and functional impairment in mastication and speech. The etiology of TMD is multifactorial, involving neuromuscular factors, parafunctional habits, trauma, degenerative processes, and psychosocial aspects such as stress, anxiety, and depression, which can trigger or exacerbate symptoms. Treatment generally prioritizes non-invasive approaches, including pharmacotherapy, occlusal splints, physiotherapy, speech therapy, and psychotherapy, often combined with adjuvant modalities such as low-level laser therapy, electrostimulation, biofeedback, functional taping, and therapeutic ultrasound (TUS). TUS uses high-frequency sound waves to promote analgesia, reduce inflammation, and improve blood circulation. Surgical intervention is reserved for severe or refractory cases.Objective: This study aimed to evaluate the efficacy of therapeutic ultrasound associated with orofacial myofunctional therapy (OMT) in patients with chronic muscular TMD. Methods: A randomized clinical trial was conducted involving 26 women with chronic muscular TMD, aged 18 to 55 years. Participants were randomly assigned to two groups: G1 (OMT + TUS) and G2 (OMT), undergoing four weekly sessions. Data collection included four stages: screening according to the American Academy of Orofacial Pain (AAOP), application of the DC/TMD protocol, myofunctional evaluation using AMIOFE, and therapeutic intervention. OMT included thermotherapy, stretching, muscle relaxation, mandibular mobility exercises, and functional mastication training. TUS was applied to the masseter and anterior temporal muscles. Both groups received guidance on parafunctional habits and home exercises. Outcome measures included pain intensity, pressure pain threshold (PPT), mandibular range of motion, masticatory function, depressive symptoms, anxiety levels, frequency of parafunctional oral behaviors, and interference of pain in daily activities. Results: The OMT + TUS group showed significant improvement in maximal mouth opening (MMO) and mandibular protrusion, with a large effect size, and trends toward significance in right lateral movement and assisted maximal mouth opening. Both groups experienced significant pain reduction, slightly greater in the combined group. Mandibular functional limitation decreased only in the OMT group, while masticatory function improved in specific tasks only in the OMT + TUS group. Although changes in masticatory patterns were not statistically significant, the combined group demonstrated favorable clinical reorganization, showing a transition toward more functional bilateral patterns. The association between depression and parafunctional oral behavior was significant in the OMT group before intervention and disappeared afterward; in the OMT + TUS group, it became significant after intervention, with moderate depression and anxiety associated with high-level parafunctional behavior. No significant association was observed between pain intensity and other psychosocial variables. Conclusion: Although statistically significant efficacy of the OMT + TUS combination was not observed, the clinical effects suggest promising therapeutic potential, particularly regarding pain, mandibular mobility, and masticatory function. Findings in the combined group indicate that pain improvement may mask residual psychological symptoms, emphasizing the importance of integrated approaches addressing both physical and emotional aspects of TMD. Future studies with longer intervention periods are recommended to more comprehensively evaluate the effects of this therapeutic combination. Editor: Universidade Federal da Paraíba Tipo: Dissertação

Índices acústicos multiparamétricos na avaliação de indivíduos disfônicos e não disfônicos

2023-09-28T00:00:00Z

Título: Índices acústicos multiparamétricos na avaliação de indivíduos disfônicos e não disfônicos Autor(es): Melo, Matheus Leão de Orientador: Lopes, Leonardo Wanderley Abstract: Introduction: Currently there is a gradual growth of interest in acoustic analysis with multiparametric approaches. This analysis demonstrates a strong relationship with the auditory-perceptual assessment and great reliability in the detection of dysphonia. However, the multiparametric acoustic indexes (MAI) follow different forms of proposition and validation. Thus, it becomes necessary to understand the different steps taken to validate the MAI, and based on this, propose a manual for the construction and validation of the MAI. Objectives: Map, describe and analyze the phases and steps taken during the construction and validation of MAI; to present a manual of recommendations for the creation and validation of multiparametric acoustic indices used in vocal acoustic evaluation. Methodology: This dissertation was divided into two studies. 1) The first is a scope review whose PCC was P - individuals with and without vocal problems C - construction and validation of MAI and C - voice area. An electronic search was carried out in Pubmed/Medline, LILACS/BVS, Scopus, Web of Science, EMBASE and Cochrane Library, ClinicalTrials, ASHA Wire, Brazilian Digital Library of Theses and Dissertations and ProQuest. Data on the phases and stages of AMI validation were extracted. The analysis was carried out descriptively. 2) Data about the first steps and phases that must be carried out during the construction and validation phase of the MAI were analyzed after reviewing the scope and crossed with methodologies described by associations and researchers in the field of test validation. Results: 1) Studies on the construction and validation of MAI were published between 2000 and 2022, mostly studying the AVQI and the DSI. 98 studies were classified in the scale evaluation phase and 86 in the validity tests phase, with accuracy tests, ROC curve and likelihood ratio calculation being widely used. 2) The recommendations for creating and validating IAMs were compiled in a manual. Conclusion: The processes for constructing and validating AMIs are diverse and there is no consensus among authors regarding which of these phases are essential. The creation of a guideline with step-by-step instructions on how to create and validate an MAI will facilitate the reproducibility of future studies in the area. Editor: Universidade Federal da Paraíba Tipo: Dissertação

A correlação entre cervicalgia, disfunção temporomandibular e ansiedade em acadêmicos de medicina

2023-03-29T00:00:00Z

Título: A correlação entre cervicalgia, disfunção temporomandibular e ansiedade em acadêmicos de medicina Autor(es): Mélo, Sandra Fernandes Pereira de Orientador: Alves, Giorvan Ânderson dos Santos Abstract: Abstract: Temporomandibular disorders (TMD) and cervical spine dysfunction encompass clinical problems of the musculoskeletal structures of the masticatory system and cervical spine. Clinical manifestations such as pain, joint noises and irregular or deviated mandibular function are frequent. The association between signs and symptoms of the muscles of the stomatognathic system and the cervical system or other areas is also common. The literature describes psycho-emotional factors, including anxiety, as causing or aggravating temporomandibular disorders, sometimes requiring treatment of these factors prior to joint treatment. The main objective of the research was to verify the correlation between neck pain, anxiety, and symptoms of temporomandibular dysfunction in medical students. The present research is characterized as a field study, with a descriptive character, where it will present a quantitative approach with the purpose of verifying the relationships between neck pain, anxiety, and symptoms of temporomandibular disorder in medical students. The sample consists of 119 students, who were selected through randomization, with an average of 15 students from the first to the eighth period of the undergraduate course. Three instruments were used for the research, the Neck Bournemouth Questionnaire (NBQ-Brazil), an instrument that has already been translated into Portuguese and validated, which aims at the presence of neck pain, the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), to identify signs and symptoms of temporomandibular disorders, in its summarized version. And the instrument in Portuguese of the State-Trait Anxiety Inventory (STAI). The mean age found was 24.55 years, with 58% of participants being female. The research pointed out that 37% of the participants have neck pain and 80.7% have symptoms related to TMD. Through the application of IDATE, it was observed that all students had some degree of anxiety, with the average degree having the highest incidence, with 59.6%. Despite the literature found massively correlating the three conditions, when an in-depth study was carried out through inferential statistics, using Pearson's Qi-square tests and the Spearman Test, the correlation between temporomandibular dysfunction, neck pain and anxiety was not presented, in the studied population. Editor: Universidade Federal da Paraíba Tipo: Dissertação

Do rastreamento ao diagnóstico da perda auditiva em crianças: uma revisão de escopo e a análise da idade de detecção em Alagoas

2025-09-30T00:00:00Z

Título: Do rastreamento ao diagnóstico da perda auditiva em crianças: uma revisão de escopo e a análise da idade de detecção em Alagoas Autor(es): Lopes, Allan Dayner Silva Orientador: Cavalcanti, Hannalice Gottschalck Abstract: Childhood hearing loss represents a significant public health challenge due to its direct impacts on language, communication, and social inclusion, making it essential to understand both the epidemiological profile of this population and the most effective diagnostic strategies. This dissertation, composed of two complementary studies, sought to broaden the understanding of childhood hearing loss in Brazil while mapping international evidence on early diagnosis. The first study was an observational, crosssectional, and quantitative investigation analyzing 3,495 clinical records of children aged 0 to 12 years, treated between 2012 and 2024 at Specialized Rehabilitation Centers in Maceió, a regional reference for hearing diagnosis and rehabilitation. Results showed a predominance of males (55.5%) and a high prevalence of bilateral sensorineural hearing loss (82%). The main risk indicators were neonatal intensive care unit stay longer than five days, use of ototoxic drugs, and low birth weight (<1500 g), identified in 42% of the children. Although neonatal hearing screening was recorded in 80.9% of cases, only 12.4% were performed within the recommended 30-day timeframe. The mean age at diagnosis was 2.1 years and at intervention onset 2.4 years, with only 28.1% receiving intervention by six months of age, as recommended by the 1-3-6 benchmark. The second study, a scoping review, mapped 10,713 records from major international databases and gray literature, of which 53 met eligibility criteria and described strategies for early diagnosis of hearing loss in infants up to two years old. The evidence highlighted universal neonatal hearing screening as the most recurrent and effective approach, particularly two-stage protocols combining otoacoustic emissions and automated auditory brainstem response. Additional strategies included targeted approaches for at-risk populations, parental awareness initiatives, combined use of electrophysiological and behavioral assessments, and complementary etiological testing. The methodological heterogeneity across studies underscores the urgent need for international standardization and stronger integration among healthcare services to ensure timely diagnosis. Together, the two investigative approaches presented in this dissertation provide a comprehensive overview: despite the broad implementation of neonatal hearing screening, significant gaps remain in timely diagnosis and intervention, alongside inequities in service coverage and quality. The findings emphasize the importance of strengthening maternal and child healthcare networks, enhancing the effectiveness of universal neonatal hearing screening, and adopting standardized and accessible diagnostic protocols. Such measures are essential to promote early detection and hearing rehabilitation, thereby minimizing the communicative, educational, and social impacts of hearing loss and supporting policymakers and professionals in developing inclusive, evidence-based public health strategies. Editor: Universidade Federal da Paraíba Tipo: Dissertação