Avaliação termográfica da região temporomandibular e a sua correlação com a hipervigilãncia da dor e a qualidade do sono

Abstract

Objective: Verify whether Hypervigilance to Pain (HP) and Sleep Quality (SQ) are confounding variables in the infrared thermography (IT) examination of the temporomandibular joint (TMJ) and temporal and masseter muscles. Methodology: A cross-sectional and analytical study was conducted, with a sample of 80 participants without Temporomandibular Disorders (TMD) and 40 participants with TMD. H P and SQ data were collected from participants without TMD and IT was performed on the temporomandibular joint and masseter and temporal muscles of participants with and without TMDs. For the screening and selection of participants who did not show TMD, the TMD Pain Screener questionnaire was applied, with the application of the Diagnostic Criteria for Temporomandibular Disorders in those with the referred dysfunction. The SQ was verified using the Pittsburgh Sleep Quality Index (PSQI). And the HP assessment was done through the Pain Vigilance and Awareness Questionnaire (PVAQ). Infrared thermography was performed in an appropriate laboratory using a portable FLIR infrared sensor camera, model T650 Infrared, and the FLIR ResearchIR Max software for their analysis. The statistical analysis was performed by means of correlations between the temperatures of the areas of interest and the results of the PVAQ and PSQI and by comparing the temperatures of the areas of interest between the participants with and without TMD, where the group without TMD was subdivided, both according to the sleep quality and the level of hypervigilance to pain. The confidence interval for all tests was 95%, using a significance level set at 5%. Results: Among the evaluated participants, no significant correlations were found between SQ and the temperatures of the areas of interest (p>0.05). Regarding HP, a weak but statistically significant positive correlation was found with the asymmetries of temporal muscle temperatures, both regarding the dimensionless (ρ=0.289) and non-dimensionless (ρ=0.223) values. In the comparisons of the temperatures of the participants without TMD controlled by HP and SQ with the participants with TMD, the mean of the absolute bilateral values showed differences in the areas of the temporal and masseter muscles, regardless of the degree of HP and SQ degree of the participants without TMD (p<0.05), with a higher temperature value for patients with TMD. In the mean of the absolute bilateral TMJ values, in the dimensionless values of the bilateral values means in the upper and lower thirds of the masseter, and in the means of the dimensionless asymmetry values of the temporal muscle, the differences between participants with and without TMD were distinguished according to the HP of the participants without TMD (p<0.05). The absolute bilateral values of TMJ and the dimensionless mean bilateral values of the masseter also showed differences according to the SQ of the participants without TMD (p<0.05). Participants with TMD showed higher temperature values than participants without TMD in all comparisons with statistically significant differences. Conclusion: HP and SQ can be considered confounding variables in infrared thermography examination for TMJ and temporal and masseter muscles.