Auriculoterapia no manejo de sintomas associados às disfunções temporomandibulares: uma revisão sistemática e metanálise de ensaios clínicos randomizados (ECR)

Abstract

Objective: To evaluate the effectiveness of auriculotherapy in symptoms associated with temporomandibular disorder (TMD). Methodology: A systematic review with meta-analysis of randomized clinical trials was carried out based on the Cochrane collaboration guidelines, PRISMA guidelines and registration in PROSPERO, between May 2022 and February 2024, in the databases MEDLINE, Embase, LILACS, Cochrane Central, PEDro and VIP Chinese database and gray literature through Clinical Trials and Google Scholar. The search strategy was developed based on the selection of controlled vocabularies and Boolean operators. The elements of the acronym, PICO, established were population (Patients with TMD), intervention (Auriculotherapy), comparator (Conservative therapies for TMD), outcome (Pain intensity, mouth opening, disability process and emotional symptoms), the meta-analysis was based in the random effect model, in the calculation of the difference in standardized means and heterogeneity quantified by the I² test. Results: Six studies were selected within the eligibility criteria, three studies with low risk of bias according to RoB 2.0, two studies with some concerns and one with high risk. 195 individuals participated, with 52.31% (n=102) of these undergoing auriculotherapy, using photobiomodulation in 50% (n=3) of the studies, needles in 33.33% (n=2) and mustard seeds in 16 .67% (n=1). The qualitative analysis showed the joint use of auriculotherapy and occlusal splint with better analgesic capacity in the interval of four and eight weeks, with an effectiveness of 35.29% in the fourth week and 72.73% in the eighth, with a number of orofacial structures with reduced pain intensity from three to eight. In the process of disability, auriculotherapy techniques, regardless of the association with the plaque, were unable to show any effect. The meta-analysis for the anxiety level outcome did not show superiority of the intervention compared to placebo (p=0.21), as well as in limiting mouth opening compared to the occlusal splint (p= 0.15) and placebo (p= 0.35). Evidence through GRADE for the level of anxiety was very low and for limitation of mouth opening, low. Conclusion: The findings did not prove to be sufficient to support auriculotherapy as an integrative resource for the management of physical symptoms resulting from TMD and emotional symptoms associated with the dysfunction.