Associação entre disfunção temporomandibular dolorosa, comorbidades e doenças sistêmicas em adolescentes
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Data
2017-07-07
Autores
Braido, Guilherme Vinícius do Vale [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: A disfunção temporomandibular (DTM) dolorosa em crianças e adolescentes pode causar um impacto negativo na vida desses indivíduos. A presença de comorbidades associadas à DTM tende a tornar a dor persistente e favorecer sua cronificação. Objetivo: Investigar a presença de doenças sistêmicas e dor no corpo regional e espalhada e sua relação com a DTM dolorosa. Material e Método: O presente estudo é de modelo observacional, do tipo transversal. A amostra foi composta por 412 adolescentes, com 12-14 anos de idade, regularmente matriculados em escolas da cidade de Araraquara–SP. A amostra foi caracterizada de acordo com os critérios do Instituto Brasileiro de Geografia e Estatística (IBGE). A DTM foi classificada de acordo com os Critérios de Diagnóstico para Pesquisa das Disfunções Temporomandibulares (RDC/TMD). A presença de dor nas costas e outras regiões foi avaliada de acordo com o Questionário Nórdico Padronizado, e o Questionário de Condição Médica do Adolescente foi utilizado para verificar a presença de doenças sistêmicas. A maturação sexual foi avaliada por meio da Escala de Estágios Pubertais. Exame intraoral foi realizado para avaliação da saúde bucal e identificação de possíveis fatores de exclusão. Para testar as associações de interesse foram utilizados o teste de Mann Witney para variáveis quantitativas, e o teste do qui-quadrado e o exato de Fisher para as variáveis qualitativas. Foi considerado o nível de significância de 5%. Resultados: A amostra final foi composta por 396 adolescentes, com idade média de 12,7 (±0,74) (58,6% meninas), sendo que 15,7% apresentaram DTM dolorosa. Dentre as doenças sistêmicas, a asma (p=0,003) e a bronquite (p=0,003) se mostraram associadas com a DTM dolorosa. Dentre as dores no corpo, apenas a dor no pescoço esteve significativamente associada com a DTM dolorosa (p=0,006), entretanto pode-se observar que os adolescentes com DTM dolorosa apresentaram maior número de áreas de dor no corpo quando comparados com aqueles sem DTM dolorosa (4,26 versus 3,11; p<0,001). Adolescentes que apresentaram DTM dolorosa tiveram uma redução significativa na qualidade de vida quando comparadados aos adolescentes sem DTM dolorosa (p<0,001). Conclusão: Adolescentes apresentam uma prevalência significativa de DTM doloroa. Assim como em adultos, em adolescentes a DTM dolorosa pode estar associada com doenças sistêmicas e dor no corpo, apontando para um maior risco de cronificação da dor. Além disso, a presença da DTM afeta negativamente a qualidade de vida dos indivíduos. Nossos resultados enfatizam a importância do diagnóstico e tratamento destas condições tanto para o controle da dor, como para reduzir o risco de cronificação em adolescentes.
Introduction: Painful temporomandibular disorders (TMD) in children and adolescents can negatively impact on the individual´s life. The presence of comorbidities associated with TMD can make the pain persistent and facilitate its chronification. Objective: To investigate the presence of systemic diseases and other painful conditions and its possible relationship with painful TMD. Methods: This was an observational study, with a cross-sectional design. The sample was characterized according to the criteria of the Brazilian Institute of Geography and Statistics (IBGE). We classified the TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The presence of body pain was assessed according to the Standardized Nordic Questionnaire, and the Adolescent Medical Condition Questionnaire was used to verify the presence of systemic diseases. Sexual maturation was assessed using the Pubertal Stages scale. We conducted an intraoral clinical examination to evaluate the oral health conditions and to identify possible exclusion factors. To test the associations of interest we used the Mann-Witney test for quantitative variables, and the chisquare test and the Fisher's exact test for the qualitative variables. The level of significance was 5%. Results: The final sample consisted of 396 adolescents, with a mean age of 12.7 (± 0.74) (58.6% girls), and 15.7% presented painful TMD. Among systemic diseases, asthma (p=0.003) and bronchitis (p=0.003) were associated with painful TMD. Among the different areas of body pain, only neck pain was significantly associated with painful TMD (p=0.006); however, we found that adolescents with painful TMD presented greater number of areas of body pain when compared to those without TMD Painful (4.26 versus 3.11, p<0.001). Adolescents presenting painful TMD had a significant reduction in the quality of life when compared to adolescents without painful TMD (p<0.001). Conclusion: Adolescents can present a significant prevalence of painful TMD. As previously seen in adults, this condition can be associated with systemic diseases and body pain, pointing to a higher risk of chronification of pain. In addition, the presence of TMD negatively affects the quality of life of these individuals. These results emphasize the importance of diagnostic and treatment of TMD in adolescentes for both the control of pain and to prevent the development of chronic pain.
Introduction: Painful temporomandibular disorders (TMD) in children and adolescents can negatively impact on the individual´s life. The presence of comorbidities associated with TMD can make the pain persistent and facilitate its chronification. Objective: To investigate the presence of systemic diseases and other painful conditions and its possible relationship with painful TMD. Methods: This was an observational study, with a cross-sectional design. The sample was characterized according to the criteria of the Brazilian Institute of Geography and Statistics (IBGE). We classified the TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The presence of body pain was assessed according to the Standardized Nordic Questionnaire, and the Adolescent Medical Condition Questionnaire was used to verify the presence of systemic diseases. Sexual maturation was assessed using the Pubertal Stages scale. We conducted an intraoral clinical examination to evaluate the oral health conditions and to identify possible exclusion factors. To test the associations of interest we used the Mann-Witney test for quantitative variables, and the chisquare test and the Fisher's exact test for the qualitative variables. The level of significance was 5%. Results: The final sample consisted of 396 adolescents, with a mean age of 12.7 (± 0.74) (58.6% girls), and 15.7% presented painful TMD. Among systemic diseases, asthma (p=0.003) and bronchitis (p=0.003) were associated with painful TMD. Among the different areas of body pain, only neck pain was significantly associated with painful TMD (p=0.006); however, we found that adolescents with painful TMD presented greater number of areas of body pain when compared to those without TMD Painful (4.26 versus 3.11, p<0.001). Adolescents presenting painful TMD had a significant reduction in the quality of life when compared to adolescents without painful TMD (p<0.001). Conclusion: Adolescents can present a significant prevalence of painful TMD. As previously seen in adults, this condition can be associated with systemic diseases and body pain, pointing to a higher risk of chronification of pain. In addition, the presence of TMD negatively affects the quality of life of these individuals. These results emphasize the importance of diagnostic and treatment of TMD in adolescentes for both the control of pain and to prevent the development of chronic pain.
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Palavras-chave
Dor, Síndrome da disfunção da articulação temporomandibular, Comorbidade, Dor facial, Dor nas costas, Adolescente, Temporomandibular joint dysfunction syndrome, Comorbidities, Orofacial pain, Back pain, Adolescent