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Master's Dissertation
DOI
Document
Author
Full name
Andresa Ferreira Gonçalves
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2019
Supervisor
Committee
Witzel, Andréa Lusvarghi (President)
Júnior, Celso Augusto Lemos
Biazevic, Maria Gabriela Haye
Samuelian, Adrianna Loduca Ribeiro
Title in Portuguese
Avaliação dos benefícios da educação e automanejo no tratamento de pacientes portadores da disfunção temporomandibular
Keywords in Portuguese
Automanejo
Dor
DTM
Qualidade de sono
Qualidade de vida
Abstract in Portuguese
A Disfunção temporomandibular é definida como um conjunto de distúrbios que afetam os músculos mastigatórios, a articulação temporomandibular (ATM) e estruturas associadas. A dor e desconforto nas regiões da ATM e da musculatura mastigatória; são sintomas frequentemente relacionados à DTM. O tratamento das DTMs tem como objetivos, reduzir a dor, diminuir a sobrecarga adversa e restaurar a função. O estudo foi composto por 100 pacientes consecutivos, que procuraram o ambulatório de dor e apresentavam o diagnóstico de DTM de acordo com os critérios de diagnóstico e pesquisa - RDC-TMD. Os Pacientes foram acompanhados por 3 semanas, foram avaliados quanto a intensidade da dor, por meio da escala EVA, abertura máxima passiva e ativa, movimentos excursivos, o impacto do tratamento na qualidade de vida por meio do questionário OHIP-14 e a qualidade de sono desses pacientes durante o tratamento, por meio do PSQI. Os questionários foram aplicados no baseline e no final do tratamento. O tratamento com aconselhamento e automanejo consistiu em, por meio de uma palestra, a elucidação dos pacientes, quanto aos fatores etiológicos da doença e orientação de como diminuir a sobrecarga e hábitos nocivos á ATM, músculos da mastigação e estruturas adjacentes. Os resultados demonstraram que o tratamento promove melhorias na qualidade de sono (p=0.0200), no relato da dor espontânea (p<0.0001), além de colaborar para melhora na amplitude dos movimentos excursivos direito (p=0.0040) e esquerdo (p=0.0002). De acordo com os resultados obtidos neste estudo, concluímos que a educação e automanejo influencia na melhora da dor aferida pela escala EVA, cinemática mandibular, qualidade de vida e na qualidade de sono.
Title in English
Evaluation of the benefits of self-management and education in the treatment of temporomandibular disorders patients
Keywords in English
Quality of life
Quality of sleep
Self-management
Temporomandibular pain
TMJ
Abstract in English
Temporomandibular disorders (TMD) comprehend a range of conditions affecting the masticatory muscles, temporomandibular joint (TMJ) and associated structures. The most common symptoms reported by patients with TMD are the discomfort and pain in the affected area, therefore, the aim of TMD treatment is to reduce the painful symptomatology, decrease adverse overload and restore function. The study was composed by 100 consecutively selected patients, that sought treatment for orofacial pain and presented a TMD diagnosis according to the research and diagnostic criteria for temporomandibular disorders (RDC-TMD). The patients received treatment based in counseling and self-management, in which they received a lecture aiming their comprehension of the disease etiological factors and the orientation of how to reduce the muscular and articular overload and harmful habits to their TMJ and associated structures. Pain intensity was accessed through a visual analogic scale and clinical examination evaluated maximal passive and active mouth opening and excursive movements. The treatment impact in the quality of life and sleep were evaluated with the questionnaires OHIP-14 and PSQI, respectively. The questionnaires were applied at baseline and at the end of treatment, which comprehended into 3 weeks of follow-up. The results showed that the treatment promotes improvements in sleep quality (p = 0.0200), in the report of spontaneous pain (p <0.0001), and also contributed to improve the range of jaw movements to the right (p = 0.0040) and to the left (p = 0.0002). According to the results obtained in this study, we concluded that self-management and education has influence in the improvement of EVA scale, jaw movements, quality of life and sleep quality.
 
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Publishing Date
2019-11-07
 
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