Adição da eletroacupuntura ao protocolo de fisioterapia para recuperação da sensibilidade tátil e função mastigatória em pacientes pós-cirurgia ortognática e mentoplastia: ensaio clínico randomizado

Abstract

Orthognathic surgery is a procedure aimed at correcting dentofacial deformities, which can compromise masticatory function, facial aesthetics, and patients' quality of life. However, the postoperative period can be challenging, with changes in tactile sensitivity and masticatory muscle function. Physiotherapy has been used in the postoperative care of these patients, even without an established protocol. Electroacupuncture has been used as a complementary therapy for various conditions, but its effects on post-orthognathic surgery recovery remain underexplored. Thus, the objective of this study was to investigate the effect of adding electroacupuncture to a physiotherapy protocol on the recovery of tactile sensitivity and masticatory function in patients undergoing orthognathic surgery and mentoplasty. A single-blind, randomized controlled clinical trial was conducted between March 2020 and January 2022. The sample consisted of 118 patients who underwent bimaxillary orthognathic surgery combined with mentoplasty. Participants were randomized into two groups: the Physiotherapy Group (PG), which received a conventional physiotherapy protocol lasting 50 minutes, and the Physiotherapy + Electroacupuncture Group (P+EAG), which received the same physiotherapy protocol supplemented with electroacupuncture sessions lasting 30 minutes, using disposable needles. The electrical current was applied with the following parameters: repetition time of 1 second; (F1 = 10 Hz, F2 = 45 Hz; T = 220 ms). Interventions were performed once a week for six weeks, with weekly assessments and reevaluations at 3 and 6 months. The evaluated outcomes included tactile sensitivity, facial edema, mandibular range of motion, and masticatory quality. The results showed no significant differences between the groups regarding the recovery of tactile sensitivity. However, the P+EAG group showed a significant improvement in masticatory quality after 6 months of follow-up (P = 0.007; ES = 0.58). Regarding mandibular range of motion, the PG showed significant improvement in right and left laterality compared to the P+EAG (p < 0.001). There was no significant interaction between the groups regarding facial edema. In conclusion, the addition of electroacupuncture to the physiotherapy protocol did not accelerate the recovery of tactile sensitivity but improved masticatory quality after 6 months. The results suggest that electroacupuncture may be a useful tool for improving masticatory function in patients undergoing orthognathic surgery and mentoplasty, although it did not demonstrate additional benefits in the recovery of tactile sensitivity, edema, or mandibular range of motion.