Efeitos da placa e aconselhamento sobre a dor, aspectos psicossociais e relacionados ao sono em pacientes com disfun??o temporomandibular: ensaio cl?nico randomizado

Autor: Bispo, Andressa de Sousa Leite
Jazyk: portugalština
Rok vydání: 2017
Předmět:
Zdroj: Repositório Institucional da UFRNUniversidade Federal do Rio Grande do NorteUFRN.
Druh dokumentu: masterThesis
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Introdu??o: A disfun??o temporomandibulares (DTM) tem etiologia multifatorial e abrangem problemas musculares e articulares do sistema estomatogn?tico. A literatura relata que al?m da dor, poss?veis impactos psicossociais podem ser encontrados, dentre eles, a presen?a de dist?rbios do sono, influ?ncia negativa na qualidade de vida, na sa?de geral e bucal. Objetivo: Avaliar os efeitos das terapias com placa oclusal e aconselhamento, isoladas ou em associa??o, sobre a dor, o sono e a qualidade de vida em pacientes diagnosticados com DTM. M?todos: Foi realizado ensaio cl?nico randomizado cego com 55 pacientes, aplicando tr?s terapias: placa oclusal (PO) (n=23); aconselhamento (AC) (n=13); placa oclusal associada ao aconselhamento (PAC) (n=19)\. Foi realizado controle no baseline, com um m?s e tr?s meses ap?s os tratamentos para avaliar por meio de question?rios a dor com a Escala Visual Anal?gica de Dor (EVA), a qualidade do sono atrav?s do ?ndice de Qualidade do Sono de Pittsburgh (PSQI), a qualidade de vida na sa?de geral com o World Health Organization Quality Of Life-Brief Version (WHOQOL-BREF) e o impacto da sa?de bucal na qualidade de vida com o Oral Health Organization 14 (OHIP-14). O diagn?stico de DTM foi realizado por meio do Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Foi utilizado o teste Split Plot ANOVA para observar a diferen?a entre os grupos ao longo do tempo e dentro do pr?prio grupo, com n?vel de confian?a de 95%. Resultados: Observou-se que as tr?s terapias aplicadas, no per?odo de um m?s e tr?s meses apresentaram melhora significativa na dor (p0,05) para todas os ?ndices avaliados. Conclus?o: Dentro das limita??es do estudo, pode-se concluir que os tratamentos de placa oclusal e aconselhamento, individualmente ou em associa??o, foram efetivos na redu??o da dor, na melhoria do sono e no impacto da sa?de bucal na qualidade de vida, contudo, n?o demonstrou signific?ncia na melhora da qualidade de vida geral. Como tamb?m, nenhum grupo terap?utico foi superior ao outro na redu??o dos par?metros observados.
Introduction: As temporomandibular disfunction (TMD) have a multifactorial etiology and encompass muscular and articular problems of the stomatognathic system. The literature reports that in addition to pain, possible psychosocial impacts can be found, among them, the presence of sleep disturbances, negative influence on quality of life, and still in general and oral health. Objective: To evaluate the effects of occlusal plaque therapy and counseling, alone or in combination, on pain, sleep and quality of life in patients diagnosed with TMD. Methods: A randomized blinded clinical trial with 55 patients was performed, applying three therapies: occlusal plaque (n=23); counseling (n=13); occlusal plaque associated with counseling (n=19). Checks was perfomed in baseline, one month and three months after the treatments to assess the pain with the Visual Analogue Pain Scale (VAS), sleep quality through the Pittsburgh Sleep Quality Index (PSQI), the life quality by World Health Organization Quality of Life-Brief Version (WHOQOL-BREF), and the impact of oral health in life quality throught the Oral Health Organization 14 (OHIP-14). The diagnosis of TMD was performed through the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The Split Plot ANOVA test was used to observe the difference between the groups over time and within the group, with a confidence level of 95%. Results: It was observed that the three applied therapies showed significant improvement in one month and three months in pain (p < 0.001), sleep quality (p = 0.008) and the impact of oral health on quality of life ( p < 0.001) and did not show a significant difference in the general quality of life (p=0.118), however, the levels found did not show differences among different therapies (p>0.05) for all indices evaluated. Conclusion: Within the limitations of the study, it can be concluded that treatments wiith occlusal plaque and counseling, individually or in combination, are effective in reducing pain, improving sleep and the impact of oral health on quality of life, however, it did not demonstrate significant improvement in general quality of life. As well, no therapeutic group was superior to the other in reducing the observed parameters.
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