Prevalência da disfunção temporomandibular em pacientes com Síndrome de Down.
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Data
2020-11-13
Autores
Tavoni, Tamires Alessandra Moreira [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: A Desordem temporomandibular (DTM) possui característica multifatorial, comumente envolvendo mais de um fator etiológico. Portadores da síndrome de Down (SD) apresentam alta prevalência de fatores como a má oclusão, hábitos parafuncionais, distúrbios de crescimento ósseo, hipotonia muscular e instabilidade postural, que estão dentro do rol de fatores predisponentes e facilitadores da DTM. Objetivo: Avaliar a prevalência de DTM em portadores da SD e correlacionar com fatores predisponentes e expressão da dor. Metodologia: Dos 187 pacientes portadores da SD, 79 foram selecionados para participar do estudo, de ambos os sexos, na faixa de 13-54 anos. Auxiliados por seus cuidadores, responderam ao Índice Anamnético de Fonseca com 53 questões para avaliação da oclusão dentária e DTMs, além do exame clínico geral para avaliar as condições bucais. Os dados foram submetidos ao teste Qui-quadrado com post hoc de Bonferroni modificado para comparação entre os grupos e os testes de correlação de Pearson para a associação entre DTM, sexo, dor orofacial e ansiedade. Resultados: 24.1% dos pacientes apresentam dor crônica, incluindo na cabeça (15%), ATM (10%) e face (6%). 51.8% dos pacientes apresentam DTM, sendo 43% leve, 6.3% moderada e 2.5% severa. Dos pacientes com dor crônica, 84.2% apresentaram DTM, sendo 21.1% DTM moderada e 10.5% DTM severa (p= 0.0001); com uma correlação positiva com presença de dor crônica na face (Pearson Correlation= 0.460, p≤0.0001), nas articulações temporomandibulares (ATM) (Pearson Correlation= 0.597, p≤0.0001) e na cabeça (Pearson Correlation= 0.496, p≤0.0001). Houve correlação positiva de vários hábitos parafuncionais como bruxismo (Pearson Correlation= 0.387, p=0.0001) e apertamento (Pearson Correlation= 0.310; p=0.005) com a presença e intensidade da DTM. Fatores estressantes (Pearson Correlation= 0.372; p=0.001) e hábitos diários (Pearson Correlation= 0.262; p=0.019) estão correlacionados com a presença de DTM moderada e severa. Conclusão: A prevalência de disfunção temporomandibular é alta em indivíduos portadores da Síndrome de Down e possui correlação com os fatores predisponentes, assim como a expressão da dor está associada às alterações emocionais.
Introduction: Temporomandibular disorder (TMD) has a multifactorial characteristic, commonly involving more than one etiological factor. Patients with Down syndrome (DS) have a high prevalence of factors such as malocclusion, parafunctional habits, bone growth disorders, muscle hypotonia, and postural instability, which are among the list of predisposing and facilitating factors for TMD. Objective: To evaluate the prevalence of TMD in patients with DS and to correlate with predisposing factors and pain expression. Methodology: Of the 187 patients with DS, 79 were selected to participate in the study, of both sexes, aged 13-54 years. Assisted by their caregivers, they answered the Fonseca Anamnetic Index with 53 questions to assess dental occlusion and TMDs, in addition to the general clinical examination to assess oral conditions. The data were submitted to the Chi-square test with modified Bonferroni post hoc for comparison between groups and Pearson's correlation tests for the association between TMD, sex, orofacial pain and anxiety. Results: 24.1% of patients have chronic pain, including head (15%), TMJ (10%) and face (6%). 51.8% of patients have TMD, 43% mild, 6.3% moderate and 2.5% severe. Of the patients with chronic pain, 84.2% had TMD, 21.1% moderate TMD and 10.5% severe TMD (p = 0.0001); with a positive correlation with the presence of chronic pain in the face (Pearson Correlation = 0.460, p≤0.0001), in the temporomandibular joints (TMJ) (Pearson Correlation = 0.597, p≤0.0001) and in the head (Pearson Correlation = 0.496, p≤0.0001 ). There was a positive correlation between various parafunctional habits such as bruxism (Pearson Correlation = 0.387, p = 0.0001) and tightness (Pearson Correlation = 0.310; p = 0.005) with the presence and intensity of TMD. Stress factors (Pearson Correlation = 0.372; p = 0.001) and daily habits (Pearson Correlation = 0.262; p = 0.019) are correlated with the presence of moderate and severe TMD. Conclusion: The prevalence of temporomandibular disorders is high in individuals with Down syndrome and has a correlation with predisposing factors, as well as the expression of pain is associated with emotional changes.
Introduction: Temporomandibular disorder (TMD) has a multifactorial characteristic, commonly involving more than one etiological factor. Patients with Down syndrome (DS) have a high prevalence of factors such as malocclusion, parafunctional habits, bone growth disorders, muscle hypotonia, and postural instability, which are among the list of predisposing and facilitating factors for TMD. Objective: To evaluate the prevalence of TMD in patients with DS and to correlate with predisposing factors and pain expression. Methodology: Of the 187 patients with DS, 79 were selected to participate in the study, of both sexes, aged 13-54 years. Assisted by their caregivers, they answered the Fonseca Anamnetic Index with 53 questions to assess dental occlusion and TMDs, in addition to the general clinical examination to assess oral conditions. The data were submitted to the Chi-square test with modified Bonferroni post hoc for comparison between groups and Pearson's correlation tests for the association between TMD, sex, orofacial pain and anxiety. Results: 24.1% of patients have chronic pain, including head (15%), TMJ (10%) and face (6%). 51.8% of patients have TMD, 43% mild, 6.3% moderate and 2.5% severe. Of the patients with chronic pain, 84.2% had TMD, 21.1% moderate TMD and 10.5% severe TMD (p = 0.0001); with a positive correlation with the presence of chronic pain in the face (Pearson Correlation = 0.460, p≤0.0001), in the temporomandibular joints (TMJ) (Pearson Correlation = 0.597, p≤0.0001) and in the head (Pearson Correlation = 0.496, p≤0.0001 ). There was a positive correlation between various parafunctional habits such as bruxism (Pearson Correlation = 0.387, p = 0.0001) and tightness (Pearson Correlation = 0.310; p = 0.005) with the presence and intensity of TMD. Stress factors (Pearson Correlation = 0.372; p = 0.001) and daily habits (Pearson Correlation = 0.262; p = 0.019) are correlated with the presence of moderate and severe TMD. Conclusion: The prevalence of temporomandibular disorders is high in individuals with Down syndrome and has a correlation with predisposing factors, as well as the expression of pain is associated with emotional changes.
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Palavras-chave
Articulação temporomandibular, Síndrome da disfunção da articulação temporomandibular, Síndrome de Down, Dor facial, Down Syndrome