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Master's Dissertation
DOI
https://doi.org/10.11606/D.58.2012.tde-07022013-151632
Document
Author
Full name
Carolina Almeida Rodrigues
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2012
Supervisor
Committee
Mazzetto, Marcelo Oliveira (President)
Braga, Neilor Mateus Antunes
Zuim, Paulo Renato Junqueira
Title in Portuguese
Impacto da dor e do ruído articular na qualidade e no custo de vida de indivíduos com disfunção temporomandibular
Keywords in Portuguese
Custo de Vida.
Disfunção Temporomandibular
Dor
Qualidade de Vida
Ruídos Articulares
Abstract in Portuguese
A disfunção temporomandibular (DTM) acomete uma relativa parcela da população e seus sinais e sintomas podem afetar as atividades rotineiras do indivíduo, com o potencial de gerar transtornos tanto aos serviços de saúde devido ao aumento na demanda quanto à economia devido aos dias perdidos de trabalho por incapacidade temporária do trabalhador. O objetivo desse estudo foi avaliar a influência da dor e dos ruídos articulares na qualidade de vida de indivíduos com DTM. Oitenta indivíduos foram triados no Serviço de Oclusão e Disfunção da Articulação Temporomandibular da Faculdade de Odontologia de Ribeirão Preto - Universidade de São Paulo (SODAT/FORP-USP). Os sujeitos incluídos na pesquisa foram submetidos ao exame clínico do eixo I do Research Diagnostic Criteria (RDC/TMD), posteriormente, a severidade da disfunção foi determinada pelo Índice Craniomandibular (ICM) e os sons articulares foram avaliados através da eletrovibratografia (EVG), através do sistema SonoPAK (BioReserch). O impacto na qualidade de vida dos pacientes foi avaliado através do questionário OHIP-14 e o custo financeiro através do questionário específico. Durante o diagnóstico, maior numero de pacientes (43.75%) apresentaram desordens de disco associadas à desordens musculares, e um índice craniomandibular de 0.519 ± 0.175, com 62,5% dos sujeitos classificados em DTM moderada. Os ruídos articulares foram analisados durante a abertura e fechamento mandibular. Durante a abertura mandibular foram observadas diferenças estatísticas entre os lados esquerdo e direito, no total integral dos ruídos (56.78 ± 107.65 e 35.89 ± 82.28 no lado esquerdo e direito, respectivamente e p = 0.012), no pico de amplitude (3.71 ± 7.73 no lado esquerdo e 2.42 ± 5.19 no lado direito, p=0.013) e no pico de frequência (71.31 ± 70.41 no lado esquerdo e 52.09 ± 45.35 no lado direito, p=0.011). O fechamento mandibular apresentou diferenças estatísticas entre o lado esquerdo e direito, no total integral dos ruídos (35.77 ± 66.87 no lado esquerdo e 22.10 ± 50.39 no lado direito, p = 0.004), pico de amplitude (2.71 ± 3.49 e 1.97 ± 2.69, lado esquerdo e direito, respectivamente, e p = 0.017) e pico de frequência (47.99 ± 52.46 e 39.14 ± 38.02 lado esquerdo e direito, respectivamente, e p = 0.024). Quando analisado apenas uma articulação, esquerda ou direita houve diferença apenas no lado esquerdo, com maior pico de frequência durante a abertura mandibular (p = 0.019). Com relação ao impacto gerado na qualidade vida dos sujeitos com DTM, segundo a correlação de Spearman entre o OHIP=14 (10.64 ± 5.63) e o ICM (0.519 ± 0.175) houve significância estatística p = 0.019. Além disso, 64 pacientes se submeteram a algum tipo de atendimento previamente ao inicio da pesquisa, 48 deles perderam acima de 30 minutos por atendimento e 46 sujeitos (57.5%) fizeram uso de algum tipo de medicação para dor, sendo que 20 deles recebiam os medicamentos do Sistema Único de Saúde (SUS). Pode-se concluir que as disfunções temporomandibulares interferem na qualidade e no custo de vida de indivíduos com DTM.
Title in English
Impact of pain and joint sounds in quality and cost of living for individuals with temporomandibular dysfunction.
Keywords in English
Cost of living.
Joint sounds
Pain
Quality of life
Temporomandibular disorders
Abstract in English
The temporomandibular disorder (TMD) affects the relative share of the population and its symptoms can affect daily activities of the individual, with the potential to generate both disorders to health services due to increased demand as the economy due to lost days of work temporary disability of the employee. The aim of this study was to evaluate the influence of pain and joint sounds in quality of life of individuals with TMD. Eighty individuals were selected in Service Occlusion and Temporomandibular Joint Dysfunction, College of Dentistry of Ribeirão Preto - University of São Paulo (SODAT / FORP-USP). The subjects included in the study underwent clinical examination Axis I of the Research Diagnostic Criteria (RDC / TMD), subsequently the severity of dysfunction was determined by Craniomandibular Index (CMI) and the joint sounds were evaluated by electrovibratography through the system SonoPAK (BioReserch). The impact on quality of life was evaluated using the OHIP-14 questionnaire and the financial cost through specific questionnaire. During the diagnosis, the greater number of patients (43.75%) had disc disorders associated with muscular disorders, and a craniomandibular index of 0519 ± 0175, with 62.5% of subjects classified as moderate TMD. The joint noises were analyzed during jaw opening and closing. During the opening mandibular statistical differences were observed between the left and right sides, the total integral noise (107.65 ± 56.78 and 35.89 ± 82.28 in the left and right side, respectively, p = 0.012), peak amplitude (3.71 ± 7.73 on the left and 2.42 ± 5.19 on the right side, p = 0.013) and peak frequency (71.31 ± 70.41 and 52.09 on the left side on the right side ± 45.35, p = 0.011). The closing mandibular showed statistical differences between the left and right, total integral noise (35.77 ± 66.87 to 22.10 ± left side and right side in 50.39, p = 0.004), peak amplitude (2.71 ± 1.97 ± 2.69 and 3:49, left and right side, respectively, p = 0.017) and peak frequency (47.99 ± 52.46 and 39.14 ± 38.02 left and right side, respectively, p = 0.024). When analyzed only one joint, left or right difference on the left side only, with higher peak frequency during the opening symptoms (p = 0.019). With respect to the impact generated on quality of life subjects with TMD, according to the Spearman correlation between the OHIP-14 (10.64 ± 5.63) and ICM (0519 ± 0175) was statistically significant at p = 0.019. In addition, 64 patients underwent some type of care previous to the onset of the study, 48 of them lost over 30 minutes for care and 46 subjects (57.5%) had used some type of pain medication, and 20 of them received the medicines of the Unified Health System. One can conclude that temporomandibular disorders affect quality of life and cost of TMD patients.
 
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Publishing Date
2013-03-27
 
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