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Master's Dissertation
DOI
https://doi.org/10.11606/D.25.2022.tde-18072022-104010
Document
Author
Full name
Paulo Roberto Jara de Souza
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2022
Supervisor
Committee
Bonjardim, Leonardo Rigoldi (President)
Alcalde, Murilo Priori
Duarte, Marco Antonio Hungaro
Silva, Guilherme Ferreira da
Title in Portuguese
Avaliação clínica, sensorial e psicológica em pacientes com pulpite irreversível e dor referida
Keywords in Portuguese
Diagnóstico
Dor referida
Pulpite
Abstract in Portuguese
O objetivo deste estudo foi comparar pacientes com pulpite irreversível sintomática com e sem dor referida, considerando aspectos (1) clínicos relacionados à dor, (2) somatossensoriais e (3) pscicológicos que podem contribuir para o diagnóstico precoce e posterior tratamento endodôntico. Pacientes com pulpite irreversível sintomática foram divididos em dois grupos de acordo com a presença de dor referida (com e sem, n = 23 e 12, respectivamente). As características clínicas da dor foram avaliadas para o dente com diagnóstico de pulpite irreversível. Aspectos psicossociais e descritores de dor foram avaliados por meio de questionários. A intensidade e a duração da dor após os testes de sensibilidade pulpar foram mensuradas nos dentes com pulpite e contralateral, bem como uma avaliação qualitativa somatossensorial foi realizada nas regiões intra e extra-orais, no início e após a anestesia. Também foram registradas informações sobre a localização da dor, presença de dor referida, uso de medicamentos para alívio da dor e necessidade de anestesia complementar. Os testes T, Qui-quadrado e McNemar foram aplicados aos dados. Os pacientes com dor referida apresentaram pior condição clínica, ou seja, maior intensidade da dor dentária (teste T, t = 4,39, df = 33, p <0,05). Além disso, esses pacientes também apresentaram resultados piores para os descritores de dor, ou seja, índice de classificação de dor mais alto (teste T, t = 2,18, df = 14,07, p <0,05) e maior número de descritores de dor (teste T, t = 2,93, df = 33, P <0,05). Além disso, a intensidade da dor (teste T, t = 2,89, df = 32,31, p <0,05) e tempo de dor após o teste de sensibilidade pulpar no dente contralateral foram maiores para os pacientes com dor referida (teste T, t = 2,30, df = 32,93, P <0,05). Conclui-se que pacientes com dor referida apresentam alterações relevantes principalmente relacionadas à dor clínica e provocada. A presença de dor referida pode contribuir para uma melhor caracterização e avaliação clínica dos pacientes com pulpite irreversível sintomática com possíveis implicações no tratamento destes pacientes.
Title in English
Clinical, sensory and psychological evaluation in patients with irreversible pulpitis and referred pain
Keywords in English
Diagnosis
Pulpitis
Referred pain
Abstract in English
The aim of this study was to compare patients with symptomatic irreversible pulpitis with and without referred pain, considering (1) general clinical aspects related to pain, (2) somatosensory and (3) psychological aspects that may contribute to early diagnosis and subsequent endodontic treatment. Patients with symptomatic irreversible pulpitis were divided into two groups according to the presence of referred pain (with and without, n = 23 and 12, respectively). Clinical features of pain were evaluated for the tooth diagnosed with irreversible pulpitis. Psychosocial aspects and pain descriptors were assessed using questionnaires. The intensity and duration of pain after pulp sensitivity tests were measured in the teeth with pulpitis and contralateral, as well as a qualitative somatosensory assessment was performed in the intra- and extra-oral regions, at baseline and after anesthesia. Information on pain location, presence of referred pain, use of pain relief medications and need for additional anesthesia were also recorded. T, Chi-square and McNemar tests were applied to the data. Patients with referred pain had a worse clinical condition, that is, greater intensity of dental pain (T test, t = 4.39, df = 33, p <0.05). In addition, these patients also presented worse results for pain descriptors, that is, higher pain classification index (T test, t = 2.18, df = 14.07, p < 0.05) and greater number of pain descriptors (T test, t = 2.93, df = 33, P < 0.05). In addition, pain intensity (T test, t = 2.89, df = 32.31, p < 0.05) and pain time after pulp sensitivity test on the contralateral tooth were higher for patients with referred pain. (T test, t=2.30, df=32.93, P<0.05). Patients with referred pain present relevant changes mainly related to clinical and evoked pain. The presence of referred pain may contribute to a better characterization and clinical evaluation of patients with symptomatic irreversible pulpitis with possible implications for the treatment of these patients.
 
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Release Date
2024-04-14
Publishing Date
2022-07-20
 
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