Effectiveness of the Biopsychosocial Model Versus the Measurable Neurophysiological Model in Patients With Temporomandibular Joint Arthropathies

Abstract

Abstract OBJECTIVE To evaluate the efficacy patients treated based on the biopsychosocial model, with a Michigan-type myorelaxant/stabilization splint combined with alternative therapies, and Neurophysiological model with intermediate Occlusal Devices in patients with temporomandibular joint (TMJ) arthropathies based on two different treatment philosophies. PATIENTS AND METHODS: This was an interventional and longitudinal study of the randomized clinical trial with blinding. The survey was approved by the CEP under: CAAE 66446216.6.0000.5207. Statistical analyzes were performed based on the selection of 43 patients with diagnosis of temporomandibular arthropathies after examination of the Diagnostic Criteria for Temporomandibular Dysfunction (DC / TMD) and assistance with images such as CT scans and magnetic resonance imaging. The patients were divided into two groups: G1-Biopsychosocial group and G2-Neurophysiological group. The variables studied were pain, mandibular function, need for alternative therapies and physiological parameters of muscle recruitment and masticatory cycle, measured by electromyography and kinesiography, respectively. All patients were followed for a minimum period of 06 to 09 months. RESULTS The results were favorable to both treatment groups in relation to the decrease in pain symptomatology, but were more consistent and remained smaller at the end of the evaluation in the neurophysiological group. Also significant was the difference in muscle recruitment during treatment with the G2 and less use of alternative therapies for pain control compared to the Biopsychosocial group. CONCLUSIONS Even in the case of a preliminary and unpublished study, this research provides strong indications of the benefit of the treatment with the Neurophysiological model in patients with TMJ arthritis, as well as the improvement of the symptomatic aspects, there was a clear improvement in muscle recruitment patterns, masticatory cycle, bone marrow regeneration and joint disc recapture. Further research with anti-etiologic treatment model should be performed to confirm these results. CLINICAL RELEVANCE: This innovative research highlights a new model for diagnosing and treating TMJ pathologies beyond traditional palliative treatment measures, enabling a more assertive anti-etiological treatment.