Association of sleep quality and psychological aspects with reports of bruxism and TMD in Brazilian dentists during the COVID-19 pandemic.

BACKGROUND: Dentists are exposed to contamination by SARS-CoV-2 due to dental interventions, leading to a state of alert and potential risk of negative impact in mental health and sleep quality, associated with Temporomandibular Disorder (TMD) and bruxism. OBJECTIVE: to evaluate the psychosocial status, sleep quality, symptoms of TMD, and bruxism in Brazilian dentists (DSs) during the COVID-19 pandemic. METHODOLOGY: The sample (n=641 DSs) was divided into three groups (quarantined DSs; DSs in outpatient care; and frontline professionals), which answered an electronic form containing the TMD Pain Screening Questionnaire (Diagnostic Criteria for Temporomandibular Disorders - DC/TMD), the Pittsburgh Sleep Quality Index (PSQI), the Depression, Anxiety and Stress Scale (DASS-21), and the sleep and awake bruxism questionnaire. ANOVA test and Mann Whitney post-test were used, with Bonferroni adjustment (p<0.016) and a 95% confidence level. RESULTS: Probable TMD was found in 24.3% (n=156) of the participants, while possible sleep and awake bruxism were diagnosed in 58% (n=372) and 53.8% (n=345) of them, respectively. Among all variables evaluated, only symptoms of depression were significantly greater in the quarantined DSs group when compared to those who were working at the clinical care (p=0.002). Working DSs were significantly less likely (OR=0.630, p=0.001) to have depressive symptoms. Those who were not worried or less worried about the pandemic were less likely to experience stress (OR=0.360), anxiety (OR=0.255), and poor sleep quality (OR=0.256). Sleep had a strong positive and moderate correlation with psychological factors on frontline workers and DSs in outpatient care, respectively. CONCLUSION: The results suggest confinement may have a more negative impact on the life of DSs than the act of being actively working. The concern about Covid-19 and poor sleep quality was significantly prevalent and may negatively affect the quality of life of DSs. Thus, further research on the topic is needed.

Short-Term Effect of Scalp Acupuncture on Pain, Sleep Disorders, and Quality of Life in Patients with Temporomandibular Disorders: A A Randomized Clinical Trial.

OBJETIVE: To evaluate the effects of Chinese scalp acupuncture in patients diagnosed with temporomandibular disorders (TMD) on pain, sleep, and quality of life (QOL), and compare these results with the results from traditional therapies. METHODS: Sixty patients diagnosed with TMD using the research diagnostic criteria for temporomandibular disorders (RDC/TMD) were allocated into four treatment groups: counseling (C = 15), occlusal splint (OS = 15), scalp acupuncture (SA = 15), and manual therapy (MT = 15). Participants were re-evaluated within 1 month. Three questionnaires were used to access sleep disorders, QOL, and pain: The Pittsburgh Sleep Quality Index (PSQI), World Health Organization Quality of Life (WHOQOL-bref), and the Visual Analogue Scale (VAS), respectively. The data obtained were analyzed using the Statistical Package for the Social Science program (SPSS 22.0). RESULTS: The SA group significantly improved pain (P = .015), as well as the OS (P = .01) and MT groups (P = .014). Only the OS (P = .002) and MT (P = .029) groups improved sleep. MT group significantly improved QOL in terms of the physical domain of the WHOQOL-bref (P = .011) and the OS group in the psychological domain (P = .012). CONCLUSIONS: The scalp acupuncture proved to be another alternative for pain relief in patients with TMD, demonstrating positive results in the short term. However, it was not as effective in improving quality of life and sleep.

Short-term effectiveness of conservative therapies in pain, quality of life, and sleep in patients with temporomandibular disorders: A randomized clinical trial.

Objective: To evaluate, in the short term, the effectiveness of conservative therapies in pain, quality of life, and sleep in TMD patients.Methods: Eighty-nine TMD patients diagnosed by RDC-TMD were distributed in occlusal splints (OS; n= 24), manual therapy (MT; n= 21), counseling (C; n= 19), and OS associated with C (OSC; n= 25) therapy groups. Data collection was performed at baseline and within one month by VAS (pain), PSQI (sleep quality -SQ), WHOQOL-BREF (Quality of life - QL) and OHIP-14 (quality of life related to oral health -QLOH). The Split Plot ANOVA test was used to observe the difference between groups and over time.Results: All therapies were effective over time, improving pain (p< .001), SQ (p=.001), QLOH (p< .001), and QL (p= .006), but not between them.Discussion: The therapies were effective in improving pain, SQ, and quality of life; however, no therapeutic group was superior to the other.

Association of sleep quality and psychological aspects with reports of bruxism and TMD in Brazilian dentists during the COVID-19 pandemic

Abstract Dentists are exposed to contamination by SARS-CoV-2 due to dental interventions, leading to a state of alert and potential risk of negative impact in mental health and sleep quality, associated with Temporomandibular Disorder (TMD) and bruxism. Objective: to evaluate the psychosocial status, sleep quality, symptoms of TMD, and bruxism in Brazilian dentists (DSs) during the COVID-19 pandemic. Methodology: The sample (n=641 DSs) was divided into three groups (quarantined DSs; DSs in outpatient care; and frontline professionals), which answered an electronic form containing the TMD Pain Screening Questionnaire (Diagnostic Criteria for Temporomandibular Disorders - DC/TMD), the Pittsburgh Sleep Quality Index (PSQI), the Depression, Anxiety and Stress Scale (DASS-21), and the sleep and awake bruxism questionnaire. ANOVA test and Mann Whitney post-test were used, with Bonferroni adjustment (p<0.016) and a 95% confidence level. Results: Probable TMD was found in 24.3% (n=156) of the participants, while possible sleep and awake bruxism were diagnosed in 58% (n=372) and 53.8% (n=345) of them, respectively. Among all variables evaluated, only symptoms of depression were significantly greater in the quarantined DSs group when compared to those who were working at the clinical care (p=0.002). Working DSs were significantly less likely (OR=0.630, p=0.001) to have depressive symptoms. Those who were not worried or less worried about the pandemic were less likely to experience stress (OR=0.360), anxiety (OR=0.255), and poor sleep quality (OR=0.256). Sleep had a strong positive and moderate correlation with psychological factors on frontline workers and DSs in outpatient care, respectively. Conclusion: The results suggest confinement may have a more negative impact on the life of DSs than the act of being actively working. The concern about Covid-19 and poor sleep quality was significantly prevalent and may negatively affect the quality of life of DSs. Thus, further research on the topic is needed.

Conservative therapies to treat pain and anxiety associated with temporomandibular disorders: a randomized clinical trial.

INTRODUCTION: Temporomandibular dysfunction (TMD) is a condition that affects the stomatognathic system. OBJECTIVE: To determine the effect of treatment with an occlusal splint (OS), manual therapy (MT), counselling (CS) and the combination of an occlusal splint and counselling (OSCS) on pain and anxiety in patients with TMD. MATERIALS AND METHODS: A randomised clinical trial was conducted with 89 patients diagnosed with TMD through RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders) and divided into four groups of treatment: OSCS (n = 25); OS (n = 24); MT (n = 21); and CS (n = 19). Participants were assessed before and after 1 month of therapy for pain, anxiety and TMD diagnosis. Pain was measured by a visual analogue scale. To assess anxiety, Hospital Anxiety and Depression Scale (HADS), Beck Anxiety Inventory (BAI) and the State-Trait Anxiety Inventory (STAI-S and T) were used. The data were analysed using SPSS (Statistical Package for Social Science) 22.0. RESULTS: The four groups obtained a significant reduction (P < 0.001) in the pain after 1 month of treatment. Treatment in all groups promoted a significant reduction in anxiety symptoms 1 month after completion, HADS (P < 0.001), BAI (P < 0.001), STAI-T (P = 0.006). Thus, no group was superior to the other in reducing the studied variables. CONCLUSION: The therapies used were effective in reducing pain and anxiety in patients diagnosed with TMD. However, no treatment was superior to the other in reducing the studied variables.

Relationship between anxiety, quality of life, and sociodemographic characteristics and temporomandibular disorder.

OBJECTIVES: The aim of this study was to evaluate the relationship between anxiety, quality of life (QL), and sociodemographic aspects and temporomandibular disorders (TMDs) and to assess the predisposition to TMDs in patients with low QL and anxiety. STUDY DESIGN: In total, 120 patients (60 TMD/60 non-TMD) were screened to assess QL (World Health Organization Quality of Life Brief Version [WHOQOL]); anxiety (Beck Anxiety Inventory [BAI]; the State-Trait Anxiety Inventory[STAI-S and -T]; the Hospital Anxiety and Depression Scale [HADS]); and TMD (Research Diagnostic Criteria for Temporomandibular Disorders-RDC/TMD). Pearson's χ2 test, the Student t test, odds ratio (OR) analysis, and nonconditional logistic regression analysis were performed. RESULTS: Among patients with TMD, 60% were women (P = .002), 65.1% were single (P = .009), and 71.4% were employed (P = .008). Most of the anxious individuals had TMD, according to HADS, 75% (P < .001); STAI-S, 55.6% (P = .035); STAI-T, 54.9% (P = .011); and BAI, 63.9% (P = .002). WHOQOL showed higher QL for non-TMD participants (P < .001). Sociodemographic data showed an association with TMD: gender (OR = 3.5), professional status (OR = 3.3), and marital status (OR = 2.8). WHOQOL presented higher association strength (OR = 9.2), followed by HADS (OR = 5.0). CONCLUSIONS: A relationship exists between sociodemographic aspects, anxiety, and QL and TMD. Patients with TMD have higher anxiety levels and lower QL, and this can interfere with treatment, reinforcing the need for therapies that consider the various factors of the disorder.

Efeitos de diferentes terapias conservadoras sobre a dor, aspectos psicossociais, relacionados ao sono e à qualidade de vida em indivíduos com disfunção temporomandibular: ensaio clínico randomizado / Effects of different conservative therapies on pain, psychosocial aspects, sleep-related aspects and quality of life in individuals with temporomandibular disorders: randomized clinical trial

A disfunção temporomandibular (DTM) consiste em um conjunto de condições que envolve as articulações temporomandibulares (ATM), os músculos mastigatórios e estruturas associadas. É bastante prevalente no Brasil e no mundo, tem caráter multifatorial e auto limitante, o que proporcionou o desenvolvimento de uma grande variedade de terapias para manejo dos seus principais sinais e sintomas. Esse ensaio clínico randomizado cego avaliou o efeito de terapias conservadoras sobre sintomas físicos, psicológicos, relacionados ao sono e à qualidade de vida em pacientes diagnosticados com DTM e se alterações psicológicas e do sono interferem no controle da dor desses pacientes após as condutas terapêuticas. A amostra foi constituída por 87 indivíduos diagnosticados com DTM pelo Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD) randomicamente alocados entre os grupos de tratamento: dispositivo oclusal (DO), aconselhamento (AC), fisioterapia (FT) e DO associado ao AC. Os sintomas de ansiedade foram diagnosticados pelo Índice de Ansiedade Traço-Estado (IDATE), Escala Hospitalar de Ansiedade e Depressão (HADS) e Inventário de Ansiedade de Beck (BAI). Os sintomas de depressão foram avaliados através do HADS e Inventário de Depressão de Beck (BDI). A qualidade subjetiva do sono, qualidade de vida geral e relacionada á saúde bucal, função e intensidade de dor foram investigadas através do Índice de Qualidade do Sono de Pittsburgh (PSQI), Questionário de Qualidade de Vida da Organização Mundial de Saúde - abreviado (WHOQOL), Impacto da Saúde Bucal na Qualidade de Vida (OHIP 14) e Escala Analógica Visual (EVA) respectivamente. As coletas foram realizadas no baseline, com 1 mês e 3 meses após a conclusão das terapias por um investigador cego e treinado. Utilizou-se o teste SPANOVA para a análise do efeito das terapias ao longo do tempo e entre os grupos e os testes de Friedman e Mann Whitney para avaliar os níveis de dor intra e intergrupos em todos os tempos com um nível de significância de 5 %. Observou-se que nenhuma terapia apresentou diferença estatisticamente significante em relação a outra e que todas apresentaram efeitos significativos na melhoria dos índices avaliados (sintomas de ansiedade IDATE p=0,002 ­ HADS p<0,001 ­ BAI p<0,001, depressão BDI p=0,001, qualidade subjetiva do sono PSQI p=0,005, qualidade de vida geral WHOQOL p=0,029 e relacionada a saúde bucal OHIP p <0,001 e índice de dor p<0,001) ao longo do tempo, exceto para o HADS depressão p=0,106. Verificou-se que todos os pacientes com sintomas alterados reduziram significativamente seus níveis de dor após as terapias (HADS p<0,001; BAI p<0,001; BDI p<0,001; PSQI p=0,010), mas que os pacientes ansiosos (BAI p=0,021) tiveram uma redução estatisticamente significativa maior (delta=2,84) quando comparados aos indivíduos normais (delta=1,10) e igualmente a qualidade do sono (QS) alterada (p=0,006). Conclui-se que todas as terapias conservadoras geraram resultados positivos em relação a sintomas físicos, psicológicos, relacionados ao sono e à qualidade de vida e que não houve elementos para afirmar que os tratamentos não foram iguais. E ainda que a presença de sintomas de ansiedade e depressão e QS ruim apresentaram maiores níveis de dor no baseline, porém esses fatores não influenciaram negativamente na melhora após as terapias conservadoras com DO, AC, FT, DO+AC para DTM e que ansiedade e sono alterado podem até gerar um efeito maior nesta redução (AU).

Temporomandibular Disorder (TMD) consists of a set of conditions that involve the temporomandibular joints (TMJ), masticatory muscles and associated structures. It is very prevalent in Brazil and worldwide, has a multifactorial and self-limiting character, which has allowed the development of a great variety of therapies to manage its main signs and symptoms. This blinded randomized clinical trial evaluated the physical, functional, psychological, sleep-related and quality of life symptoms in patients diagnosed with TMD after different therapies: occlusal splint (OS), counseling (C), manual therapy (TM) and associated OS to C and if psychological and sleep disturbances interfere in the pain control of these patients after the therapeutic conducts. The sample consisted of 87 individuals diagnosed with TMD by the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD) randomly assigned between the treatment groups. Anxiety symptoms were diagnosed by the Trait-State Anxiety Index (IDATE), Hospital Anxiety and Depression Scale (HADS), and Beck Anxiety Inventory (BAI). Symptoms of depression were assessed using the HADS and Beck Depression Inventory (BDI). The subjective quality of sleep, general quality of life and related to oral health, function and intensity of pain were investigated through the Pittsburgh Sleep Quality Index (PSQI), World Health Organization Quality of Life Questionnaire - bref (WHOQOL ), Oral Health Impact Profile (OHIP 14) and Visual Analogue Scale (VAS), respectively. The assessments were performed at the baseline, 1 month and 3 months after completion of the therapies by a blind and trained investigator. The SPANOVA test was used to analyze the effect of therapies over time and between groups with a confidence level of 95% and Friedman and Mann Whitney tests to assess intra- and intergroup pain levels at all times with a significance level of 5%. It was observed that no therapy had a statistically significant difference in relation to the other, and that all had significant effects on the improvement of the indexes evaluated (anxiety IDATE p=0.002 ­ HADS p<0.001 ­ BAI p<0.001 and depression BDI p=0.001 symptoms, subjective sleep quality PSQI p=0.005, general quality of life WHOQOL p=0.029, oral health related quality of life OHIP p <0.001 and pain intensity p<0.001) over time, except for the HADS depression (p = 0.106). It was found that all patients with altered symptoms significantly reduced their pain levels after the therapies (HADS p <0.001; BAI p <0.001; BDI p <0.001; PSQI p = 0.010), but that anxious patients (BAI p = 0.021) had a statistically significant greater reduction (delta = 2.84) when compared to normal individuals (delta = 1.10) and also the altered QS (p = 0.006). It was concluded that all conservative therapies generated positive outcomes regarding physical, psychological, sleep-related and quality of life symptoms and there were no elements to state that the treatments were not equal. And although anxious, depressed patients with low QS had higher levels of pain in the baseline and these factors did not negatively influence their reduction after DO, AC, FT, DO + AC and TMD therapies, and that anxiety and altered sleep may even have a greater effect on this reduction (AU).

Relationship between anxiety and temporomandibular disorders in dental students.

OBJECTIVE: To evaluate the prevalence of temporomandibular disorder (TMD) in dental students and its correlation with anxiety. METHODS: After probability sampling, 105 students were selected. The diagnosis of TMD was carried out using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) - Axis I; the anxiety level was obtained by the State-Trait Anxiety Inventory (STAI). Data from TMD and anxiety were calculated through frequency and Chi-square test to assess the association between TMD and anxiety, considering a significance level of 5%. RESULTS: TMD was present in 36.2% of the students; disc displacement (42.1%), and arthralgia (42.1%) were the most prevalent subtypes. The majority of students presented both traits (57.1%) and state (65.7%) anxiety in mild levels, followed by moderate levels. No statistical association between TMD and anxiety was found (p > 0.05). CONCLUSION: Joint TMD was the most prevalent subtype of TMD in dental students and was not associated with anxiety levels.

Sensitivity and specificity of different indexes used to diagnose Temporomandibular Disorders / Sensibilidade e especificidade de diferentes índices utilizados para o diagnóstico de disfunções temporomandibulares

Objective: To verify the level of agreement among different indexes used to achieve the prevalence of Temporomandibular Disorders (TMD). Material and Methods: One hundred one dental students were selected by a randomized process. TMD were evaluated by the Fonseca's Anamnestic Index (FAI), Helkimo's Clinical Index (HCI), and the Research Diagnostic Criteria for TMD (RDC/TMD). Data was analyzed using Chi-square and Kappa tests, considering a significance level of 5%. Results: HCI showed the highest prevalence of TMD, and the comparison between RDC/TMD, FAI, and HCI showed low agreement (k=0.17 and k=0.35 respectively). Most individuals presented mild TMD for both FAI and HCI indexes. A moderate correlation for TMD severity was obtained (kw=0.53) between FAI and HCI, and a high sensitivity and low specificity were observed for both diagnosis when compared to RDC/TMD. Conclusion: The prevalence of TMD may vary significantly depending on the index used for its diagnosis, which may lead to a large number of false positives and overtreatments. (AU)

Objetivo: Verificar o nível de concordância entre diferentes índices utilizados para avaliar a prevalência de disfunções temporomandibulares (DTMs). Material e Métodos: Cento e um estudantes de odontologia foram selecionados por um processo randomizado. As DTMs foram avaliadas pelo Índice Anamnéstico de Fonseca (IAF), pelo Índice Clínico de Helkimo (ICH) e pelo Research Diagnostic Criteria for TMD (RDC / TMD). Os dados foram analisados pelos testes Qui-quadrado e Kappa, considerando um nível de significância de 5%. Resultados: A aplicação do ICH levou a uma maior prevalência de DTM, e a comparação entre o RDC/TMD, IAF e ICH mostrou baixa concordância (k = 0,17 e k = 0,35, respectivamente). A maioria dos indivíduos apresentou DTM leve para os índices FAI e ICH. Uma correlação moderada para a gravidade da DTM foi obtida (kw = 0,53) entre FAI e HCI, e uma alta sensibilidade e baixa especificidade foram observadas para ambos os diagnósticos quando comparados com o RDC/TMD. Conclusão: A prevalência de DTM pode variar significativamente, dependendo do índice usado para o seu diagnóstico, o que pode levar a um grande número de falsos positivos e sobretratamentos. (AU)

Psychosocial aspects and temporomandibular disorders in dental students.

OBJECTIVE: Dental students have high levels of anxiety that can affect not only academic performance but also increase the risk for other diseases. It is believed that the increase in the incidence of chronic orofacial pain in temporomandibular disorders (TMDs) may have an impact on the quality of life and general health of subjects. The aim of this study was to evaluate the prevalence of TMD in dental students and its association with general health, quality of life, and anxiety. METHOD AND MATERIALS: Ninety students were evaluated by four questionnaires to determine the prevalence and sever-ity of TMD (Fonseca's questionnaire) and to quantify general health (General Health Questionnaire - GHQ), quality of life (World Health Organization Quality of Life - Brief version - WHOQOL-brief) and anxiety levels (State-Trait Anxiety Index - STAI). RESULTS: Approximately 58.9% of dental students presented TMD. Among the indicators of general health, psychologic stress (P = .010), distrust in their own performance (P = .012), and psychosomatic disorders (P = .020) showed a statistically significant difference with the presence of TMD. The four areas proposed in the questionnaire regarding quality of life, such as physical (P = .016), psychologic (P < .001), social (P = .045), and environmental (P = .017) factors also showed significant differences with the presence of TMD. CONCLUSION: A high prevalence of TMD was observed in dental students. In addition, some psychologic domains are important psychosocial indicators associated with the presence of TMDs.

Signs of Combination Syndrome and removable partial denture wearing / Sinais da Síndrome da Combinação e o uso de prótese parcial removível

Introduction: Combination Syndrome (CS) is a pathological condition observed in maxillary complete denture (CD) and mandibular removable partial denture (RPD) wearers. Purpose: The aim of this study was to observe and measure the prevalence of CS signs in treatment-seeking wearers of maxillary CD associated or not with RPD (mandibular Kennedy Class I). The association between RPD wearing and the number of CS clinical signs was also evaluated. Material and method: The sample included 62 patients seen at the Department of Dentistry, Federal University of Rio Grande do Norte (UFRN). A clinical oral examination was conducted to assess the presence of specific clinical signs of CS as described by Kelly (1972): bone resorption in the maxillary anterior region, tuberosity overgrowth, palatal papillary hyperplasia, extrusion of mandibular anterior teeth and bone resorption in the mandibular posterior region. The chi-square test at the 95% level of significance was used to test the association between dependent and independent variables. Result: Mandibular resorption was the most frequent complication (93.5%). There was a statistically significant difference between RPD wearers and non-wearers with regard to extrusion of mandibular anterior teeth (p = 0.045). Conclusion: Within the limitations of the present study, a high prevalence of CS clinical signs was observed, but no association between RPD wearing and syndrome characteristics was found. .

Introdução: A Síndrome da Combinação (SC) é uma condição patológica associada aos pacientes usuários de prótese total maxilar e prótese parcial removível (PPR) mandibular. Objetivo: Observar e mensurar a prevalência dos sinais da Síndrome da Combinação encontrados em pacientes usuários de prótese total maxilar na presença ou ausência de PPR mandibular (Classe I de Kennedy); e averiguar uma possível associação entre a utilização de PPR e a prevalência dos sinais clínicos da síndrome. Material e método: A amostra foi composta por 62 pacientes atendidos no Departamento de Odontologia da Universidade Federal do Rio Grande do Norte (UFRN). O exame clínico intrabucal foi realizado para a verificação da presença ou ausência dos sinais clínicos específicos da Síndrome da Combinação, descrita por Kelly (1972): reabsorção óssea na região anterior da maxila, aumento das tuberosidades, hiperplasia papilar palatina, extrusão dos dentes naturais inferiores anteriores e reabsorção óssea posterior mandibular (variáveis dependentes). Para determinação da associação entre as variáveis dependentes e independentes (uso de PPR inferior e tempo de edentulismo superior), foi utilizado o teste qui-quadrado com significância de 95%. Resultado: A característica mais frequente foi a presença de reabsorção mandibular (93,5%). Quanto à associação entre o uso de PPR inferior e as características da Síndrome da Combinação, só houve diferença estatisticamente significativa entre portadores e não portadores de PPR com relação à extrusão dos dentes inferiores anteriores (p = 0,045). Conclusão: Dentro ...

Effect of Watsu therapy on psychological aspects and quality of life of patients with temporomandibular disorder: case report / Efeito da terapia Watsu sobre os aspectos psicológicos e a qualidade de vida em pacientes com disfunções temporo-mandibulares: relato de caso

Watsu therapy is a water relaxation intervention technique performed individually in a warm pool with music and peaceful settings involving harmonious rotational movements, stretching, tractions on the joints and pressures at the points of muscle tension. This study evaluated the effect of Watsu therapy on psychological aspects (anxiety and minor psychiatric disorders) and on the quality of life of a patient with temporomandibular disorders. The patient answered three questionnaires: STAI (State-Trait Anxiety Inventory) and GHQ (Goldberg Health Questionnaire) to assess anxiety and psychiatric disorders respectively, and WHOQOL- Brief (World Health Organization Quality of Life) to assess quality of life. Watsu therapy has been used in patients with temporomandibular disorders (TMD) such as myofascial pain diagnosed by RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders). Psychological aspects and quality of life were assessed before and after Watsu therapy. The results after treatment showed relevant and significant improvement on all indices evaluated. Therefore, it was shown that Watsu therapy was effective in reducing anxiety and minor psychiatric disorders, as well as improved quality of life of patients with temporomandibular disorder.

A terapia Watsu é uma técnica de terapia aquática para relaxamento realizada individualmente em piscina aquecida com música em ambiente tranquilo e harmonioso, envolvendo movimentos rotacionais, alongamento, trações nas articulações e pressões em pontos de tensão muscular. Este estudo avaliou o efeito da terapia Watsu nos aspectos psicológicos (ansiedade e distúrbios psiquiátricos menores) e a qualidade de vida de uma paciente com disfunção temporo-mandibular. A paciente respondeu a três questionários: Inventário de Ansiedade - Resumido - Estado e Questionário de Saúde Geral para avaliar ansiedade e distúrbios psiquiátricos menores, respectivamente e; o Questionário de Qualidade de Vida da Organização Mundial de Saúde. A terapia Watsu foi usada em paciente com disfunção temporo-mandibular, como dor miofascial diagnosticada pelos Critérios de diagnóstico em pesquisa para Disfunção Temporo-mandibular. Os aspectos psicológicos e qualidade de vida foram avaliados antes e após a terapia Watsu. Os resultados após o tratamento mostraram melhora relevante e significativa em todos os índices avaliados. Portanto, pode-se concluir que a terapia Watsu foi eficaz na redução de ansiedade e distúrbios psiquiátricos menores, bem como melhora da qualidade de vida em paciente com disfunção temporo-mandibular.

Association between prosthetic factors and temporomandibular disorders in complete denture wearers.

OBJECTIVE: The purpose of this study was to investigate the prevalence of temporomandibular disorders (TMD) in denture wearers and the association between prosthetic factors and this condition. BACKGROUND: There is no consensus about the relationship between prosthetic factors and TMD among denture wearers. MATERIALS AND METHODS: The sample was composed of 92 patients wearing both maxillary and mandibular complete dentures. The Research Diagnostic Criteria for TMD (RDC/TMD) were adopted for patient examination. Objective evaluation of denture quality was determined by analysis of retention and stability of mandibular denture, interocclusal distance, articulation and occlusion. Association between denture quality and TMD diagnosis was analysed using chi-square and Fisher's exact tests. RESULTS: 37.4% of the patients presented TMD. Denture quality was not significantly associated with the presence of TMD: mandibular retention (p = 0.466); mandibular stability (p = 0.466); interocclusal distance (p = 0.328); centric relation (p = 0.175); and balanced occlusion (p = 0.56). CONCLUSION: Within the scope of this case-controlled cross-sectional study, no robust association between prosthetic factors and TMD was found.

Quality of life and general health in patients with temporomandibular disorders

The aim of this study was to associate minor psychiatric disorders (general health) and quality of life with temporomandibular disorders (TMD) in patients diagnosed with different TMD classifications and subclassifications with varying levels of severity. Among 150 patients reporting TMD symptoms, 43 were included in the present study. Fonseca's anamnestic index was used for initial screening while axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD) was used for TMD diagnosis (muscle-related, joint-related or muscle and joint-related). Minor psychiatric disorders were evaluated through the General Health Questionnaire (GHQ) and quality of life was assessed using the World Health Organization Quality Of Life-Brief Version (WHOQOL-BREF). An association was found between minor psychiatric disorders and TMD severity, except for stress. A stronger association was found with mild TMD. Considering TMD classifications and severity together, only the item "death wish" from the GHQ was related to severe muscle-related TMD (p = 0.049). For quality of life, an association was found between disc displacement with reduction and social domain (p = 0.01). Physical domains were associated with TMD classifications and severity and the association was stronger for muscle and joint-related TMD (p = 0.37) and mild TMD (p = 0.042). It was concluded that patients with TMD require multiple focuses of attention since psychological indicators of general health and quality of life are likely associated with dysfunction.

Quality of life and general health in patients with temporomandibular disorders.

The aim of this study was to associate minor psychiatric disorders (general health) and quality of life with temporomandibular disorders (TMD) in patients diagnosed with different TMD classifications and subclassifications with varying levels of severity. Among 150 patients reporting TMD symptoms, 43 were included in the present study. Fonseca's anamnestic index was used for initial screening while axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD) was used for TMD diagnosis (muscle-related, joint-related or muscle and joint-related). Minor psychiatric disorders were evaluated through the General Health Questionnaire (GHQ) and quality of life was assessed using the World Health Organization Quality Of Life-Brief Version (WHOQOL-BREF). An association was found between minor psychiatric disorders and TMD severity, except for stress. A stronger association was found with mild TMD. Considering TMD classifications and severity together, only the item "death wish" from the GHQ was related to severe muscle-related TMD (p = 0.049). For quality of life, an association was found between disc displacement with reduction and social domain (p = 0.01). Physical domains were associated with TMD classifications and severity and the association was stronger for muscle and joint-related TMD (p = 0.37) and mild TMD (p = 0.042). It was concluded that patients with TMD require multiple focuses of attention since psychological indicators of general health and quality of life are likely associated with dysfunction.

Evaluation of complete denture quality and masticatory efficiency in denture wearers.

PURPOSE: This study aimed to investigate (1) the influence of complete denture quality and years of denture use on masticatory efficiency and (2) the relationship between complete denture quality and years of use. MATERIALS AND METHODS: A cross-sectional study was conducted with 93 edentulous patients (mean age: 65.6 years) wearing both mandibular and maxillary dentures. Patients were classified into two categories according to years of denture use: ≤ 2 years and ≥ 5 years. Masticatory efficiency was evaluated via the colorimetric method with beads as the artificial test food. A reproducible method for objective evaluation of the technical quality of complete dentures was employed. The association between denture quality and years of denture use was analyzed using chi-square and Fisher exact tests. The results of masticatory efficiency testing were analyzed using two-way analysis of variance (with the Tukey post hoc test) in terms of years of denture use (≤ 2 years, ≥ 5 years) and denture quality (poor, average, good). RESULTS: A significant relationship was found between denture quality and years of denture use (P < .05). Masticatory efficiency differed significantly (P < .05) between patients with ≤ 2 years of denture use (0.101 ± 0.076 absorbance) and ≥ 5 years of use (0.068 ± 0.076 absorbance). Masticatory efficiency was not influenced by denture quality. CONCLUSIONS: Complete denture quality and masticatory efficiency significantly decreased over time. However, complete denture quality did not influence masticatory efficiency.

Qualidade de vida, eficiência mastigatória e presença de disfunção temporomandibular em usuários ou não de prótese parcial removível com arco dental curto inferior / Quality of life, efficiency and masticatory dysfunction in temporomandibular users or not removable partial denture with shorter lower dental arch

Existe ainda hoje no Brasil um grande número de desdentados e uma precária condição financeira da maior parte da população. Além disso, existe uma meta preconizada pela Organização Mundial de Saúde para saúde bucal, que consiste na manutenção de uma dentição natural, funcional e estética composta de, pelo menos, 20 dentes, sem que haja necessidade de uma intervenção protética ao longo da vida. A partir disso e da escassez de estudos sobre a permanência destes espaços edêntulos na cavidade bucal e ainda, buscando-se evitar sobretratamentos, esta pesquisa foi proposta. Desta forma, objetivou-se avaliar o efeito da variação do encurtamento do arco dental inferior na presença ou ausência de prótese parcial removível (PPR) sobre a função mastigatória, qualidade de vida e presença ou não de disfunção temporomandibular. Com este intuito comparou-se a eficiência mastigatória (teste colori métrico), o conforto oral através do impacto das condições bucais na qualidade de vida (OHIP-14), a presença de disfunção temporomandibular (RDC/TMD) e qualidade de vida geral (WHOQOL) de pacientes com arco dentai curto (ADC) (n=60), ou seja suporte posterior reduzido e ainda a um grupo de indivíduos com arco dental completo (AD Completo) (n = 34). O grupo de pacientes que apresentava ADC foi subdividido entre usuários de PPR (ADC +PPR) (n=I7) e não usuários (n=43). A população foi constituída por pacientes que recebem tratamento nas clínicas do Departamento de Odontologia da UFRN ou que estão em busca do mesmo, a partir de análise de prontuários e triagem prévia.

A amostra foi por conveniência. Para a análise estatística, fez-se um banco de dados no SPSS 17.0, seguida da análise descritiva com frequências, valores absolutos, testes de medidas de tendência central e variabilidade. Os testes estatísticos utilizados foram o qui quadrado e análise de variância seguido do pós teste de Tukey quando aplicável, tudo com nível de confiança de 95%. Com os resultados observou-se que a prevalência de DTM foi de 47,1% entre os pacientes que utilizavam PPR e 69,8% entre os que não utilizavam, mas isto não foi estatisticamente significante. Quanto às médias dos resultados da eficiência mastigatória, WHOQOL e OH1P não houve associação com a presença ou ausência de PPR inferior e nem com o número de unidades oclusais dos pacientes (0, 1,2 ou mais unidades oclusais). A associação só ocorreu entre o grupo AD Completo e os subgrupos de ADC. Levando-se em consideração os resultados pode-se observar que pacientes com suporte posterior bastante reduzido que utilizam PPR inferior não possuem melhor eficiência mastigatória, qualidade de vida geral, nem as condições bucais impactam menos na sua qualidade de vida, nem apresentam menos DTM e nem possuem uma melhor eficiência mastigatória quando comparáveis aos pacientes que não utilizam PPR com as mesmas condições bucais.

Even nowadays there is in Brasil a large number of edentulous and a precarious financial condition of most of the population. ín addition, World Health Organization aims for oral health, which consists on the maintenance of a natural dentition, functional and aesthetic composed of at least 20 teeth, without need of prosthetic intervention throughout life. From this and considering the lack of researches about the permanence of edentulous spaces in the oral cavity, and also avoiding overtreatment, this research has been proposed. Thus, the aim was to evaluate the effect of difTerent lengths of the shortened lower dental arch in the presence or absence of a removable partial denture (RPD) on masticatory function, quality of life and occurrence of temporomandibular dysfunction. To achieve this goal, we compared the masticatory effíciency (colorimetric test), the oral comfort through the analysis of the impact of oral health in quality of life (OFQP-14), the presence of temporomandibular dysfunction (RDC/TMD) and the general quaíity of life (WHOQOL) of patients with shortened dental arches (SDA) (n=60), which is an arch with a reduction of teeth starting posteriorly, and patients with complete dental arch (Complete DA) (n = 34). The group of patients whit SDA was divided among PPR wears (PPD + SDA) (n = 17) and non-wears (n = 43). The population of this study consisted on patients who received or looked for treatment at the clinics of the Department of Dentistry of UFRN, from clinicai analysis and records. The sample was chosen by convenience. For statistical analysis, it was a database in SPSS 17.0, followed by descriptive analysis with frequencies, absolute values, tests of central tendency and variability.

The statistical tests used were chi-squared and analysis of variance as well as Tukey's post test, when applicable, ali with a 95% confídence levei. The results shown a prevalence of TMD of 47,1% among patients using PRP and 69,8% among those who didn't, but this result wasn't statistically significant. The mean of the results of masticatory effíciency, WHOQOL and OHIP didn't show association to the presence or absence of PPR and to the lower number of occlusal units of the patients (0, 1, 2 or more occlusal). The association only occurred among the different groups of SDA and the patients with complete dental arch. Taking into account the results, it could be observed that srudied patients with low posterior support using lower PRP didn't have better masticatory effíciency, general quality of life, íess impacts of their oral conditions in quality of life or not even less temporomandibular dysfunction or better masticatory efficiency when compared to those who didn't use the prosthesis.