Effect of a physical therapy protocol on the health related quality of life of patients with temporomandibular disorder [I] Efeitos da fi sioterapia na qualidade de vida de pacientes com disfunção temporomandibular [A] Maíra de Oliveira Viana [a,b] Abstract Introduction: Temporomandibular disorders (TMD) comprise a group of diseases that affect not only the temporomandibular joint, but also different areas extrinsic to the joints. Quality of life has been the subject of numerous studies in the Health area, especially aimed at people with chronic diseases, such as TMD. Objective: To evaluate effects of a physical therapy protocol on the quality of life of patients with temporomandibular disorder. Methods: Blinded, prospective, clinical trial, with 60 patients of both genders, aged between 18 and 70 years with TMD diagnosis attended in the clinic of Ribeirão Preto School of Dentistry. The patients were

<p class="western" lang="pt-BR" align="justify"><span style="font-family: Arial, serif;"><span lang="en-US"><strong>Objective: </strong></span></span><span style="font-family: Arial, serif;"><span lang="en-US">T</span></span><span style="font-family: Arial, serif;"><span lang="en-US">o evaluate the effectiveness</span></span><span style="font-family: Arial, serif;"><span lang="en-US">of different methods of</span></span><span style="font-family: Arial, serif;"><span lang="en-US">composite resin</span></span><span style="font-family: Arial, serif;"><span lang="en-US"> pol</span></span><span style="font-family: Arial, serif;"><span lang="en-US">ishing</span></span><span style="font-family: Arial, serif;"><span lang="en-US">after the removal</span></span><span style="font-family: Arial, serif;"><span lang="en-US">of</span></span><span style="font-family: Arial, serif;"><span lang="en-US">orthodontic brackets</span></span><span style="font-family: Arial, serif;"><span lang="en-US">. </span></span><span style="font-family: Arial, serif;"><span lang="en-US"><strong>Material and Methods:</strong></span></span><span style="font-family: Arial, serif;"><span lang="en-US"> 160</span></span><span style="font-family: Arial, serif;"><span lang="en-US">resin</span></span><span style="font-family: Arial, serif;"><span lang="en-US">discs</span></span><span style="font-family: Arial, serif;"><span lang="en-US">made from</span></span><span style="font-family: Arial, serif;"><span lang="en-US">a matrix of</span></span><span style="font-family: Arial, serif;"><span lang="en-US">acrylic resin</span></span><span style="font-family: Arial, serif;"><span lang="en-US">were divided into</span></span><span style="font-family: Arial, serif;"><span lang="en-US">4 groups,</span></span><span style="font-family: Arial, serif;"><span lang="en-US">according to the</span></span><span style="font-family: Arial, serif;"><span lang="en-US">type of composite resin</span></span><span style="font-family: Arial, serif;"><span lang="en-US">used</span></span><span style="font-family: Arial, serif;"><span lang="en-US">: G1 - </span></span><span style="font-family: Arial, serif;"><span lang="en-US">microfilled</span></span><span style="font-family: Arial, serif;"><span lang="en-US">(n = 40)</span></span><span style="font-family: Arial, serif;"><span lang="en-US">, G2 </span></span><span style="font-family: Arial, serif;"><span lang="en-US">-</span></span><span style="font-family: Arial, serif;"><span lang="en-US">microhybrid</span></span><span style="font-family: Arial, serif;"><span lang="en-US">(n = 40)</span></span><span style="font-family: Arial, serif;"><span lang="en-US">, G3 </span></span><span style="font-family: Arial, serif;"><span lang="en-US">-</span></span><span style="font-family: Arial, serif;"><span lang="en-US">nanohybrid</span></span><span style="font-family: Arial, serif;"><span lang="en-US">(n = 40)</span></span><span style="font-family: Arial, serif;"><span lang="en-US">and G4</span></span><span style="font-family: Arial, serif;"><span lang="en-US">-</span></span><span style="font-family: Arial, serif;"><span lang="en-US">nanofilled</span></span><span style="font-family: Arial, serif;"><span lang="en-US">(n = 40).</span></span><span style="font-family: Arial, serif;"><span lang="en-US"> One </span></span><span style="font-family: Arial, serif;"><span lang="en-US">half of the samples was</span></span><span style="font-family: Arial, serif;"><span lang="en-US">subjected</span></span><span style="font-family: Arial, serif;"><span lang="en-US">to thermocycling, at 2000 cycles from </span></span><span style="font-family: Arial, serif;"><span lang="en-US">5 </span></span><span style="font-family: Symbol, serif;"><span lang="en-US"> </span></span><span style="font-family: Arial, serif;"><span lang="en-US">2 ºC to 55 </span></span><span style="font-family: Symbol, serif;"><span lang="en-US"> </span></span><span style="font-family: Arial, serif;"><span lang="en-US">2 ºC, for 1 min each</span></span><span style="font-family: Arial, serif;"><span lang="en-US">. </span></span><span style="font-family: Arial, serif;"><span lang="en-US">Half</span></span><span style="font-family: Arial, serif;"><span lang="en-US">of each group of resins was bonded with Gemini™</span></span><span style="font-family: Arial, serif;"><span lang="en-US"> metallic brackets </span></span><span style="font-family: Arial, serif;"><span lang="en-US">(3M</span></span><span style="font-family: Arial, serif;"><span lang="en-US">Unitek</span></span><span style="font-family: Arial, serif;"><span lang="en-US">) </span></span><span style="font-family: Arial, serif;"><span lang="en-US">and</span></span><span style="font-family: Arial, serif;"><span lang="en-US">the other</span></span><span style="font-family: Arial, serif;"><span lang="en-US">half</span></span><span style="font-family: Arial, serif;"><span lang="en-US"> with </span></span><span style="font-family: Arial, serif;"><span lang="en-US">Transcend™</span></span><span style="font-family: Arial, serif;"><span lang="en-US"> ceramic brackets </span></span><span style="font-family: Arial, serif;"><span lang="en-US">(3M</span></span><span style="font-family: Arial, serif;"><span lang="en-US">Unitek</span></span><span style="font-family: Arial, serif;"><span lang="en-US">). </span></span><span style="font-family: Arial, serif;"><span lang="en-US">The</span></span><span style="font-family: Arial, serif;"><span lang="en-US">brackets were</span></span><span style="font-family: Arial, serif;"><span lang="en-US"> transferred</span></span><span style="font-family: Arial, serif;"><span lang="en-US"> to a</span></span><span style="font-family: Arial, serif;"><span lang="en-US">universal testing</span></span><span style="font-family: Arial, serif;"><span lang="en-US"> machine </span></span><span style="font-family: Arial, serif;"><span lang="en-US">(</span></span><span style="font-family: Arial, serif;"><span lang="en-US">EMIC </span></span><span style="font-family: Arial, serif;"><span lang="en-US">DL</span></span><span style="font-family: Arial, serif;"><span lang="en-US">model</span></span><span style="font-family: Arial, serif;"><span lang="en-US">2000).</span></span><span style="font-family: Arial, serif;"><span lang="en-US">Half</span></span><span style="font-family: Arial, serif;"><span lang="en-US"> of </span></span><span style="font-family: Arial, serif;"><span lang="en-US">the specimens</span></span><span style="font-family: Arial, serif;"><span lang="en-US">from each</span></span><span style="font-family: Arial, serif;"><span lang="en-US">subgroup</span></span><span style="font-family: Arial, serif;"><span lang="en-US">were</span></span><span style="font-family: Arial, serif;"><span lang="en-US"> pol</span></span><span style="font-family: Arial, serif;"><span lang="en-US">ished</span></span><span style="font-family: Arial, serif;"><span lang="en-US">with diamond</span></span><span style="font-family: Arial, serif;"><span lang="en-US"> bur</span></span><span style="font-family: Arial, serif;"><span lang="en-US">s and</span></span><span style="font-family: Arial, serif;"><span lang="en-US">the other half</span></span><span style="font-family: Arial, serif;"><span lang="en-US">with</span></span><span style="font-family: Arial, serif;"><span lang="en-US">Sof</span></span><span style="font-family: Arial, serif;"><span lang="en-US">-</span></span><span style="font-family: Arial, serif;"><span lang="en-US">Lex </span></span><span style="font-family: Arial, serif;"><span lang="en-US">discs</span></span><span style="font-family: Arial, serif;"><span lang="en-US">. </span></span><span style="font-family: Arial, serif;"><span lang="en-US">The average</span></span><span style="font-family: Arial, serif;"><span lang="en-US">surface roughness</span></span><span style="font-family: Arial, serif;"><span lang="en-US"> of composite resin </span></span><span style="font-family: Arial, serif;"><span lang="en-US">discs</span></span><span style="font-family: Arial, serif;"><span lang="en-US">was measured,</span></span><span style="font-family: Arial, serif;"><span lang="en-US">using a</span></span><span style="font-family: Arial, serif;"><span lang="en-US">profilometer,</span></span><span style="font-family: Arial, serif;"><span lang="en-US">before the bonding</span></span><span style="font-family: Arial, serif;"><span lang="en-US">of brackets</span></span><span style="font-family: Arial, serif;"><span lang="en-US">, </span></span><span style="font-family: Arial, serif;"><span lang="en-US">after the removal of brackets</span></span><span style="font-family: Arial, serif;"><span lang="en-US">, </span></span><span style="font-family: Arial, serif;"><span lang="en-US">after removing the</span></span><span style="font-family: Arial, serif;"><span lang="en-US">excess resin</span></span><span style="font-family: Arial, serif;"><span lang="en-US">and</span></span><span style="font-family: Arial, serif;"><span lang="en-US">after polishing</span></span><span style="font-family: Arial, serif;"><span lang="en-US">. <strong>Results: </strong></span></span><span style="font-family: Arial, serif;"><span lang="en-US">After removal of brackets</span></span><span style="font-family: Arial, serif;"><span lang="en-US">and</span></span><span style="font-family: Arial, serif;"><span lang="en-US">after polishing</span></span><span style="font-family: Arial, serif;"><span lang="en-US">, </span></span><span style="font-family: Arial, serif;"><span lang="en-US">the surface roughness</span></span><span style="font-family: Arial, serif;"><span lang="en-US">was greater in</span></span><span style="font-family: Arial, serif;"><span lang="en-US"> the </span></span><span style="font-family: Arial, serif;"><span lang="en-US">microhybrid</span></span><span style="font-family: Arial, serif;"><span lang="en-US">group</span></span><span style="font-family: Arial, serif;"><span lang="en-US">(</span></span><span style="font-family: Arial, serif;"><span lang="en-US">ANOVA, p </span></span><span style="font-family: Arial, serif;"><span lang="en-US">&lt; 0.05).</span></span><span style="font-family: Arial, serif;"><span lang="en-US">After removal</span></span><span style="font-family: Arial, serif;"><span lang="en-US">of ceramic</span></span><span style="font-family: Arial, serif;"><span lang="en-US">brackets,</span></span><span style="font-family: Arial, serif;"><span lang="en-US"> the </span></span><span style="font-family: Arial, serif;"><span lang="en-US">groups showed</span></span><span style="font-family: Arial, serif;"><span lang="en-US">higher surface</span></span><span style="font-family: Arial, serif;"><span lang="en-US">roughness (</span></span><span style="font-family: Arial, serif;"><span lang="en-US">ANOVA, </span></span><span style="font-family: Arial, serif;"><span lang="en-US">p &lt; </span></span><span style="font-family: Arial, serif;"><span lang="en-US">0.05). </span></span><span style="font-family: Arial, serif;"><span lang="en-US">There was no significant</span></span><span style="font-family: Arial, serif;"><span lang="en-US">difference in</span></span><span style="font-family: Arial, serif;"><span lang="en-US">roughness</span></span><span style="font-family: Arial, serif;"><span lang="en-US">related to</span></span><span style="font-family: Arial, serif;"><span lang="en-US">thermocycling</span></span><span style="font-family: Arial, serif;"><span lang="en-US">and the type of</span></span><span style="font-family: Arial, serif;"><span lang="en-US">polishing</span></span><span style="font-family: Arial, serif;"><span lang="en-US">.</span></span><span style="font-family: Arial, serif;"><span lang="en-US"><strong>Conclusion:</strong></span></span><span style="font-family: Arial, serif;"><span lang="en-US">The quality</span></span><span style="font-family: Arial, serif;"><span lang="en-US">of the</span></span><span style="font-family: Arial, serif;"><span lang="en-US">polish</span></span><span style="font-family: Arial, serif;"><span lang="en-US">is subjected</span></span><span style="font-family: Arial, serif;"><span lang="en-US">to the type of</span></span><span style="font-family: Arial, serif;"><span lang="en-US">resin</span></span><span style="font-family: Arial, serif;"><span lang="en-US">used</span></span><span style="font-family: Arial, serif;"><span lang="en-US">. </span></span><span style="font-family: Arial, serif;"><span lang="en-US">Ceramic</span></span><span style="font-family: Arial, serif;"><span lang="en-US">brackets</span></span><span style="font-family: Arial, serif;"><span lang="en-US"> provided </span></span><span style="font-family: Arial, serif;"><span lang="en-US">rougher surfaces</span></span><span style="font-family: Arial, serif;"><span lang="en-US">after removal</span></span><span style="font-family: Arial, serif;"><span lang="en-US">. Both </span></span><span style="font-family: Arial, serif;"><span lang="en-US">types of</span></span><span style="font-family: Arial, serif;"><span lang="en-US">polishing</span></span><span style="font-family: Arial, serif;"><span lang="en-US">used</span></span><span style="font-family: Arial, serif;"><span lang="en-US">are effective</span></span><span style="font-family: Arial, serif;"><span lang="en-US">.</span></span></p>