ABSTRACT
A disfunção temporomandibular (DTM) constitui um importante problema de saúde pública, já que é uma das causas mais relatadas de dor orofacial crônica que interfere nas atividades diárias. Aspectos biológicos e comportamentais como depressão e qualidade do sono, podem desempenhar um papel importante na adaptação à dor e recuperação desses pacientes. Objetivo: avaliar a influência das terapias conservadoras, placa, aconselhamento e terapia manual, sobre a intensidade de dor, nível depressão e qualidade do sono em pacientes portadores de DTM. Métodos: 85 pacientes diagnosticados com DTM através do RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders) foram incluídos nesse ensaio clinico randomizado. Aleatoriamente eles foram distribuídos em 4 grupos de tratamento distintos: placa oclusal-PO (n= 24), placa oclusal associada ao aconselhamento-PAC (n=24), terapia manual-TM (n=19) e aconselhamento-AC (n=18). Os pacientes foram avaliados quanto a intensidade de dor por meio da Escala Visual Analógica (EVA), nível de depressão pelo Inventário de Depressão de Beck (BDI) e pela Escala Hospitalar de Ansiedade e Depressão (HADSd) e qualidade do sono através do Índice de Qualidade de Sono de Pittsburgh (PSQI) no baseline e também nos períodos de um e três meses após realização do tratamento. Os dados foram analisados utilizando o teste Split Plot ANOVA, com o intuito de observar a diferença ao longo do tempo e entre grupos, com nível de confiança de 95%. Resultados: Ao analisar as variáveis ao longo do tempo todas as terapias se mostraram positivas, com redução da intensidade de dor (p=0,000), diminuição dos escores do nível de depressão avaliado pelo BDI (p=0,001) e também de qualidade do sono avaliada pelo PSQI (p=0,005). Exceto nos níveis de depressão avaliado pela HADSd não foi encontrada diferença significativa ao longo do tempo (p=0,106) e entre grupos (p=0,890). Diferença significativa também não foi evidenciada entre os grupos de tratamento, em nenhuma variável durante o período da pesquisa. Conclusão: As terapias PO, PAC, AC e TM possuem resultados positivos, quanto a intensidade de dor, níveis de depressão e qualidade do sono em pacientes portadores de DTM a curto prazo (1 e 3 meses), sem diferenças entre elas (AU).
Temporomandibular disorders (TMDs) is a major public health problem, as they are the most commonly reported causes of pain that interfere with daily activities. Biological and behavioral aspects such as depression and sleep quality may play an important role in adapting to pain and canceling out patients. Objective: to evaluate the therapy of conservative therapies, occlusal splint, counseling and manual therapy on the intensity of pain, anxiety level and sleep quality in patients with temporomandibular disorders. Methods: 85 patients diagnosed with TMD through RDC / TMD (Diagnostic Criteria for Research in Temporomandibular Disorders) were included in this randomized clinical trial. They were randomly assigned to 4 different treatment groups: oclusal splint (n = 24), occlusal splint associated with counseling (n = 24), manual therapy (n = 19) and counseling (n = 18). The patients were evaluated for pain intensity by means of the Visual Analogue Scale (VAS), pressure level by the Beck Intelligence Inventory (BDI) and the Hospital Anxiety and Depression Scale (HADSd) and the quality of sleep through Pittsburgh Sleep Quality Index (PSQI) there is no baseline and also the last two weeks after the treatment. The data were used in the Split Plot ANOVA test, in order to observe the difference between time and groups, with a confidence level of 95%. Results: When analyzing how variables over time all therapies differ positively, with reduction of pain intensity (p = 0.000), decrease in depression levels by BDI (p = 0.001) and also sleep quality evaluated by PSQI (p = 0.005). Except for confidence levels at the same time that HADSd was not different over time (p = 0.106) and between groups (p = 0.890). Significant difference was not found between treatment groups in any of the variables during the study period. Conclusion: As therapy of occlusal splint, counseling therapy and manual terapy, have positive results regarding pain intensity, depression levels and sleep quality in patients with short-term MS (1 and 3 months) with no differences between them (AU).
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Facial Pain , Temporomandibular Joint Dysfunction Syndrome/prevention & control , Occlusal Splints , Depression , Sleep Quality , Analysis of Variance , Counseling , Musculoskeletal Manipulations/methods , Dental Occlusion , Conservative Treatment/methodsABSTRACT
Purpose: To evaluate the impact of rehabilitation with implant-supported prostheses on the quality of life (QoL) of patients. Methods: The OHIP-14 questionnaire was applied to 114 patients and information regarding gender, age, type of prosthesis and time of use were obtained. To analyze whether there were any statistically significant differences between the mean scores of the seven parameters of the OHIP-14, the Mann-Whitney and Kruskal-Wallis test were used. All data were evaluated using a significance level of 5%. Results: Patients were predominantly female (78.9%) and single crowns users (41.2%). Patients reported a good QoL (3.07). Psychological discomfort and physical pain were the worst dimensions evaluated by the subjects. Results differed significantly (p<0.05) only for functional limitations and psychological discomfort in the different genders. Conclusions: Patients presented a high level of quality of life, regardless of age, duration of use and the type of prosthesis used. However, women presented more psychological distress and functional limitations than men (AU)
