Evaluation of conservative treatments for pain, anxiety, depression and quality of life in patients with temporomandibular disorders: randomized clinical trial
Temporomandibular Joint Disorders.Pain.Anxiety.Depression.Quality of Life.
Introduction: temporomandibular disorder (TMD) is understood as a set of clinical problems involving the masticatory muscles, the temporomandibular joint (TMJ) and associated structures, with several forms of conservative treatments. Objective: to evaluate the influence of conservative craniopuncture treatments, acupuncture laser therapy, occlusal plaque and counseling on painful symptoms, anxiety, depression and quality of life in patients with TMD. Material and methods: diagnosed using the TMD Diagnostic Criteria (RDC/TMD), sixty-five (65) patients with TMD were divided into four treatment groups: laser therapy acupuncture (LA) (n=15), craniopuncture (CR) (n=15), occlusal plaque (PO) (n=19) and counseling (AC) (n=16). Thus, they were evaluated before starting therapy, after one month and three months of treatment using the RDC/TMD and regarding anxiety, depression, quality of life and pain, using the Hospital Anxiety and Depression (HADS) questionnaires, Inventory Beck's Anxiety (BAI), Beck's Depression Inventory (BDI), World Health Organization Quality of Life Questionnaire (WHOQOL), Impact of Oral Health on Quality of Life (OHIP) and Visual Analogue Scale (VAS). The data obtained were analyzed by SPSS (Statistical Package for the Social Science) 22.0 with the Friedman test between times and Wilcoxon post-test, as well as the Kruskal Wallis test between groups with Mann Whitney post-test. Results: It was observed that after one month of therapy there was no significant difference between the groups regarding anxiety due to HADS (p = 0.524), regarding depression by BDI (p = 0.204) and by HADS (p = 0.713) and regarding the quality of via WHOQOL-general (p = 0.699) and its dimensions and by OHIP (p = 0.745). It was also noticed that there was no significant difference between the groups treated with three months of therapy by both BAI (p = 0.325) and HADS (p = 0.642) with regard to anxiety, as well as by BDI (p = 0.273) and by HADS (p = 0.316) for depressive aspects and WHOQOL-general (p = 0.396) and its dimensions with regard to quality of life. However, after three months of treatment, the group treated with PO showed better parameters in quality of life by OHIP (p=0.023), as well as a lower rate of pain by VAS (p=0.014) compared to the other groups. Conclusion: although in some cases the PO showed better results compared to the other groups, in general it was observed that no treatment group stood out in relation to the others regarding the parameters analyzed after three months of treatment.