Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20220068-en
Brazilian Journal of Pain
Review Article

The knowledge of prescription and the pharmacological role in temporomandibular disorders for dental surgeons: literature review

O conhecimento da prescrição e o papel farmacológico em disfunção temporomandibular para os cirurgiões-dentistas: revisão de literatura

Bárbara Lídia da Silva Pereira; Bruno Pereira Alves; Fernanda Paiva Fiedler

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Abstract

BACKGROUND AND OBJECTIVES: The temporomandibular disorder (TMD) is an anatomical-functional disorder that affects the muscles of chewing, the temporomandibular joint (TMJ) or both structures. It is one of the most common orofacial pain of non-dental origin with a prevalence of 5% to 7% of the population, being considered a public’s health problem. The main symptom of TMD is pain and, when chronic, it affects the quality of life. The drug classes that are commonly used in this condition are antidepressants, anticonvulsants and muscle relaxants that modulate symptomatology in these subjects. The aim of this study was to review the literature about main drugs used to control TMD, its mechanisms of action and effectiveness as well as the possible causes of TMD. 
CONTENTS: Literature was searched in the following databases: Pubmed, Scielo and Lilacs with a time sample from 2010 to 2021. As inclusion parameter, were selected literature’s review and systematic articles, randomized clinical cases, placebo-controlled and double-blind studies with the TMD theme, considering pharmacological treatment’s aspects. As exclusion parameter, articles in which the outcome was not the TMD, congress abstracts and personal opinions were rejected. After the articles’ selection, title’s readings and abstracts, 09 articles were selected consisting of reviews and clinical studies relevant to the subject. 
CONCLUSION: The pharmacological approach has demonstrated its positive effects in the management of TMD-related chronic pain, with more effective results when associated with other therapies, due to its multifactorial characteristic.

Keywords

Orofacial pain, Pharmacological treatment, Temporomandibular joint disorders

Resumo

JUSTIFICATIVA E OBJETIVOS: A disfunção temporomandibular (DTM) é uma desordem anátomo-funcional que afeta os músculos da mastigação, da articulação temporomandibular (ATM) ou ambas as estruturas. É uma das dores orofaciais mais comuns de origem não dentária, com prevalência de 5% a 7% da população, sendo considerada um problema de saúde pública. O principal sintoma da DTM é a dor que, quando crônica, afeta a qualidade de vida. As classes de fármacos mais comumente empregadas nessa condição são os antidepressivos, anticonvulsivantes e relaxantes musculares, que modulam os sintomas nesses pacientes. O objetivo deste estudo foi revisar a literatura acerca dos principais fármacos utilizados no controle da DTM, seus mecanismos de ação e eficácia, bem como as suas possíveis causas. 
CONTEÚDO: Buscou-se na literatura artigos científicos nas bases de dados: Pubmed, Scielo e Lilacs, com a amostra temporal de 2010 a 2021. Como parâmetro de inclusão, foram selecionados artigos de revisão de literatura e sistemática, casos clínicos randomizados, estudos placebo-controlados e estudos duplo-cegos com a temática DTM, considerando aspectos do tratamento farmacológico. Como parâmetro de exclusão, artigos em que o desfecho não era a DTM, resumos em congressos e opiniões pessoais foram rejeitados. Após a seleção dos artigos, leitura de títulos e resumos, 9 artigos foram selecionados, consistindo em revisões e estudos clínicos pertinentes ao assunto. 
CONCLUSÃO: A abordagem farmacológica demonstrou efeitos positivos no manejo da dor crônica em DTM, tendo resultados mais eficazes quando associada a outras terapias, em virtude de sua característica multifatorial.

Palavras-chave

Dor facial, Transtornos da articulação temporomandibular, Tratamento farmacológico. 

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Submitted date:
08/08/2022

Accepted date:
01/19/2023

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