Comparation of treatments of temporomandibular joint problems

INTERVENTION: ‐24 ‐24 Woman in night use of intra‐oral occlusal splint; it consists in an intra‐oral device made after the upper and lower arch mold of each patient in acrylic resin. patients used it during night sleep for four months and it received adjustments every fifteen days. ‐ 24 Woman use of amitriptyline drug in the dose of 10mg/day, for four months; ‐ 24 Woman in acupuncture group, weekly sessions performed individually to each patient by acupuncturist dentists according to the principles of the traditional chinese medicine. ‐ 24 Woman in control group in which it has been made no intervention D02.455.426.559.847.181.384.100 Device E06.658.578.200 H02.004 CONDITION: C23.888.592.612.330 F00‐F99 Temporomandibular joint disorders; Other depressive episodes; Sleep disorders; Other chronic pain; Facial Pain ; K07.6 ; G47 ; F32.8 ; R52.2 ; C23.888.592.612.330 PRIMARY OUTCOME: After treatments, decrease of pain intensity reported by patients, through Visual Analogic Scale, from 0 to 10 and increase of pain threshold to pressure through digital algometer The results show decrease of pain intensity reported by patients, through Visual Analogic Scale, from 0 to 10 and increase of pain threshold to pressure through digital algometer SECONDARY OUTCOME: Expected improvement of the quality of life by the questioning OHIP‐30, measured before and after 4 months It was expected to improve the quality of sleep by the question of Pittsburgh, measured before and after 4 months There was improvement in the quality of life and depression in the amitriptyline and multimodal groups, when compared to the control group There was improvement in the quality of sleep in the acupuncture group, when compared to the control group Was expected decrease of depression by the questioning back inventory depression, measured before and after 4 months INCLUSION CRITERIA: Female gender; age between 18 and 59 years; diagnosis temporomandibular dysfunction; adequate bilateral occlusal contacts between molars and premolars; history of orofacial pain, at least during the last 6 months; absence of previous treatment for pain; pain intensity equal to or greater than 7 on a visual analogue scale from 0 to 10; good receptivity and understanding of spoken Portuguese; ability to provide free and informed consent; and availability for attendance to evaluation returns