Grau de severidade da disfunção temporomandibular: caracterização de dor craniocervical e fatores socioeconômicos em indivíduos atendidos em serviço de referência

Abstract

Temporomandibular dysfunctions (TMDs) can be considered as a heterogeneous group of conditions that affect the temporomandibular joints (TMJs), muscle groups adjacent to the mandible, as well as other anatomical structures related to the stomatognathic system. TMDs can also be related to other oral manifestations and facial alterations, as well as to various forms of symptomatological manifestations of pain and the self-perception that individuals have about their general and oral health status. Objective: To evaluate the epidemiological profile of patients with temporomandibular disorders treated at a reference institution in the State of Paraíba, characterizing relationships between TMD severity, manifestation, type and location of reported craniocervical painful symptoms, as well as other clinical and socioeconomic aspects associated. Materials and Methods: This was a cross-sectional, observational and analytical study. It was carried out at a Brazilian Higher Education Public Institution, the State University of Paraíba - UEPB Campus I. A total of 358 medical records of patients who sought care for TMD at the Clinics of the Department of Dentistry in the period from 2011 to 2021 were analyzed. It performed with descriptive statistical technique, bivariate analysis using Pearson's chi-square test, Fisher's exact test, and multivariate analysis using Poisson regression. Results: Most individuals studied were female (75.9%), from 30 to 59 years old (48.7%), with 8 years of schooling or less (37.7%). Almost half of the sample reported prodromal migraine symptoms (46.5%) and about a third reported having otological symptoms (33.3%). Poisson regression revealed a significant association between moderate / severe TMD with the age groups of up to 29 years (p = 0.004) and from 30 to 59 years (p = 0.003), with the presence of otological symptoms (p = 0.020) and sleep troubled (p = 0.005). In addition, significant pain (p = 0.016), location in the masseter muscle region (p < 0.001), in the cervical region (p = 0.012), with a feeling of heaviness (p = 0.005) and pulsatile sensation (p = 0.005 ) were related. Conclusion: The manifestation of TMD was greater in individuals mainly in the first half of life and with a significant painful condition installed in the craniocervical region. The findings also reinforce the importance of multidisciplinary work with regard to a more urgent clinical intervention in pain conditions, with emphasis on otorhinolaryngology and physiotherapy, as well as monitoring by sleep doctors in conducting the treatment plan.