Orofacial myofunctional disorder, a possible complicating factor in the management of painful temporomandibular disorder. Case report

BACKGROUND AND OBJECTIVES: The clinical association between painful temporomandibular disorder and orofacial myofunctional disorders is frequent and requires attention. The objective of this study was to describe a clinical case of painful temporomandibular disorder in association with orofacial myofunctional disorders that evidence the importance of dental and speech therapy approaches involving myofunctional orofacial limits, as well as to discuss whether the presence of orofacial myofunctional disorders can be a comorbidity that hinders the temporomandibular disorder management. CASE REPORT: Female patient, 35 years old, complaining of pain in the orofacial region and joint noises during high amplitude mandibular movements for 17 years. She was diagnosed with myofascial pain and arthralgia (RDC/TMD) and orofacial myofunctional disorders (phonoarticulation with deviations and lingual interposition, atypical swallowing, oromandibular incoordination and mandibular hyperexcursion with eminence noise). Complementary tests (electromyography and electrovibratography) were performed in the preand post-treatment moments (1 year after). The treatment consisted of self-management and mindfulness orientations, stabilizing occlusal splint and speech therapy. After the treatment, there was an improvement in pain and mandibular range of motion, with consequent reduction of noise, better electromyographic balance and reduction of orofacial myofunctional disorders scores. CONCLUSION: The case report has suggested that the presence of orofacial myofunctional disorders in association with painful temporomandibular disorder could interfere in the management of pain and the balance of the stomatognathic system because it seems to act as a worsening factor to the temporomandibular Orofacial myofunctional disorder, a possible complicating factor in the management of painful temporomandibular disorder. Case report Distúrbio miofuncional orofacial, um possível fator complicador no manuseio da disfunção temporomandibular dolorosa. Relato de caso Melissa de Oliveira Melchior1, Laís Valencise Magri1, Marcelo Oliveira Mazzetto1 1. Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Odontologia Restauradora, Área de Oclusão, Disfunção Temporomandibular e Dor Orofacial, Ribeirão Preto, SP, Brasil. Apresentado em 25 de outubro de 2017. Aceito para publicação em 29 de janeiro de 2018. Conflito de interesses: não há – Fontes de fomento: não há. Endereço para correspondência: Avenida do Café, s/n, Monte Alegre Faculdade de Odontologia 14040-904 Ribeirão Preto, SP, Brasil. E-mail: laisvmagri@gmail.com © Sociedade Brasileira para o Estudo da Dor disorder signs and symptoms. In this sense, the importance of dental and speech therapy interventions in patients with orofacial myofunctional disorders as possible comorbidity to painful temporomandibular disorder is highlighted.