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Master's Dissertation
DOI
https://doi.org/10.11606/D.25.2003.tde-05012005-091343
Document
Author
Full name
Leylha Maria Oliveira Nunes
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2003
Supervisor
Committee
Araujo, Carlos dos Reis Pereira de (President)
Alencar Junior, Francisco Guedes Pereira de
Conti, Paulo Cesar Rodrigues
Title in Portuguese
Associação entre bruxismo do sono e disfunção temporomandibular
Keywords in Portuguese
bruxismo
disfunção temporomandibular
reabilitação bucal
Abstract in Portuguese
A fim de ampliar o entendimento sobre a relação estabelecida – entre bruxismo do sono (BS) e Disfunção Temporomandibular (DTM) e de verificar a confiabilidade do diagnóstico clínico de BS, 14 pacientes com DTM e 12 indivíduos sem DTM (correspondentes em sexo e idade) foram avaliados quanto à presença de BS, por meio de diagnóstico clínico (executado por três examinadores) e de avaliação polissonográfica (PSG) de uma noite. Foi realizada avaliação clínica de DTM (anamnese e exame físico, o qual constou de avaliação da dor por EAV, avaliação objetiva de DTM - índice de DTM, palpação articular e dos músculos mastigatórios e cervicais) antes e na manhã seguinte ao exame PSG. O objetivo do estudo foi verificar a presença de associação entre BS e DTM, discutindo alguns aspectos quanto ao estabelecimento de relação de causa-e-efeito, e também a confiabilidade do exame clínico, com relação à PSG. Não foi verificada associação entre BS e DTM, nem entre BS e dor à palpação articular ou muscular e o exame clínico apresentou sensibilidade de 75% e especificidade de 57%. Todos os pacientes, independente da presença de atividade de bruxismo na noite anterior, apresentaram sintomatologia dolorosa na manhã seguinte à PSG. Alguns indivíduos do grupo controle, diagnosticados clinicamente como bruxômanos, apresentaram leve sintomatologia à palpação dos músculos mastigatórios e/ou cervicais, apesar de, na noite do exame PSG não terem apresentado atividade de bruxismo. Concluise que o fato de alguns indivíduos com bruxismo não apresentarem qualquer sintomatologia e o de outros com sintomatologia de DTM, e até piora no quadro clínico, não apresentarem BS reforça a ausência de associação entre essas entidades.
Abstract in English
Fourteen patients with Temporomandibular Disorders (TMD) and 12 non symptomatic control subjects (sex and age matched) were evaluated for the presence of sleep bruxism (SB) by means of clinical diagnosis (performed by three examiners) and polysomnographic (PSG) recording. Clinical evaluation of TMD was carried out by clinical examination, which consisted of pain measurement by visual analog scale (VAS), TMJ and muscle palpation before and in the morning following PSG exam, in order to verify a possible association between SB and signs and symptoms of TMD. The reliability of clinical exam when compared to PSG findings was also performed . No association between SB and TMD, nor between SB and TMD or muscle tenderness to palpation were found. Clinical examination has shown 75% and 57% of specificity. Regardless of bruxism activity’s presence in the previous night, all TMD patients had pain to palpation in the following morning to PSG. Bruxers diagnosed by PSG, and presenting with tenderness to palpation had more activity than those without pain. It can be concluded that the fact of some individuals with SB did not have present any pain nor discomfort and others with signs and symptoms of TMD did not have present SB strengthens the lack of association between two entities. The founds denote that not always a positive association between SB and TMD is present and the existence of two groups of bruxers, with and without pain.
 
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Publishing Date
2005-01-18
 
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