Banca de DEFESA: CAMILA MARIA BASTOS MACHADO DE RESENDE

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
DISCENTE : CAMILA MARIA BASTOS MACHADO DE RESENDE
DATA : 09/08/2019
HORA: 08:30
LOCAL: Departamento de Odontologia
TÍTULO:

EFFECTS OF DIFFERENT CONSERVATIVE THERAPIES IN TEMPOROMANDIBULAR DYSFUNCTIONS ON PAIN, PSYCHOSOCIAL ASPECTS, RELATED TO SLEEP AND QUALITY OF LIFE: RANDOMIZED CLINICAL TRIAL

PALAVRAS-CHAVES:

Temporomandibular joint disorders; Occlusal splint; Physiotherapy modalities; Counseling; Clinical trial; Anxiety; Depression; Sleep; Quality of life; OHRQoL; Pain

PÁGINAS: 162
GRANDE ÁREA: Ciências da Saúde
ÁREA: Odontologia
RESUMO:

Temporomandibular dysfunction (TMD) consists of a multifactorial pathology, prevalent in Brazil and worldwide. It has a 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), Temporomandibular Index (ITM) 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%. 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 none were superior to other 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 can generate effect.

MEMBROS DA BANCA:
Presidente - 1466265 - GUSTAVO AUGUSTO SEABRA BARBOSA
Interna - 1459400 - ADRIANA DA FONTE PORTO CARREIRO
Interno - 1149540 - ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
Externa à Instituição - KARINA HELGA TURCIO DE CARVALHO - UNESP
Externo à Instituição - ANDRE ULISSES DANTAS BATISTA - UFPB