Pathways between temporomandibular disorders, occlusal characteristics, facial pain, and oral health-related quality of life among patients with severe malocclusion

Abstract

The aim of this study was to examine the pathways between temporomandibular disorders (TMDs), occlusal characteristics, facial pain, and oral health-related quality of life in patients with severe malocclusion. The study comprised 94 (34 men and 60 women, mean age 38 years) adult patients who were referred for orthodontic or surgical-orthodontic treatment. All the patients had severe malocclusion. Oral health-related quality of life was measured with the Oral Health Impact Profile-14 scale (OHIP-14), the intensity of facial pain using a Visual Analogue Scale (VAS), TMD with Helkimo's clinical dysfunction index (Di), and occlusal characteristics with the Peer Assessment Rating (PAR). A hypothetical model of the interrelationships between these factors was constructed based on the conceptual model of biological, behavioural, and psychosocial consequences of oral diseases. The associations were studied with path analysis. Women reported poorer oral health-related quality of life, higher pain levels, and had more severe TMD than men, but the gender difference was statistically significant only in pain and TMD. In contrast to the hypothetical model, among women the occlusal characteristics were not directly associated with oral health-related quality of life or facial pain. Among men, the occlusal characteristics were directly associated with oral health-related quality of life. In conclusion, patients with severe malocclusion who also have TMD and facial pain more often have impaired oral health-related quality of life. The associations of the occlusal characteristics with oral health-related quality of life differ between genders. Therefore, these associations should be studied separately among genders.

Calidad de Vida Relacionada con Salud Oral: Impacto de Diversas Situaciones Clínicas Odontológicas y Factores Socio-Demográficos. Revisión de la Literatura

“…Sin embargo, los trastornos de la ATM no alteraron la calidad de vida (Calderon et al), resultado distinto al encontrado en otro estudio donde que vio en mujeres con niveles más elevados de dolor y patología más severa, aunque la oclusión se encontró afectada en los hombres (Rusanen et al, 2012). Sin embargo, en otro estudio encontraron asociación entre la gravedad del trastorno y la calidad de vida (Pereira et al).…”

“…Entre los hombres, las características oclusales fueron directamente relacionados con la calidad de la salud oral (Rusanen et al, 2012). Se evaluó como incide en la calidad de vida oral la presencia de maloclusiones severas y deformidades faciales, antes del tratamiento dental, y la influencia del género en dicha percepción.…”

Oral Health- Related Quality of Life Assessed in Adults: Integrative Review

“…Surge como instrumento único de avaliação em 13 estudos: na Jordânia (Al Habashneh et al, 2012); no Brasil (Pereira et al, 2009); Japão (Inukai et al,2010); na China (Zheng et al, 2011); no Irão (Motallebnejad et al, 2011); Finlândia (Miettinen et al, 2012;Rusanen et al, 2012;Silvola et al, 2012); Espanha (Gil-Montoya et al, 2013;Montero et al, 2009;Perea et al, 2013); Nova Zelândia (Thomson et al, 2006) e com indivíduos croatas e eslovenos (RenerSitar et al, 2008). É utilizado em simultâneo com outro instrumento numestudo desenvolvido noCanadá por Locker e Gibson (2005).…”

“…Destaca-se a utilização da variável referente à presença ou número de dentes naturais presente em 10 estudos (Gil-Montoya et al, 2013;Hsu et al, 2014;Inukai et al, 2010;Locker & Gibson, 2005;Montero et al, 2008;Motallebnejad et al, 2011;Perea et al, 2013;Pistorius et al, 2013;Wright, 2009;Thomson et al, 2006;); a presença de dentes deteriorados (cariados), perdidos ou obturados e doenças periodontais em 4 estudos (Montero et al, 2008;Montero et al, 2009;Motallebnejad et al, 2011;Thomson et al, 2006); a má oclusão avaliada em 4 estudos (Hsu et al, 2014;Rusanen et al, 2012;Sardenberg et al, 2011;Silvola et al,2012); a utilização de próteses dentárias em 3 estudos (Montero et al, 2008;Perea et al, 2013;Pistorius et al, 2013;Wright et al, 2009); a xerostomia em 2 estudos (Perea et al, 2013;Thomson et al, 2006); a dor facial em 2 estudos Zheng et al, 2011); as disfunções temporomandibulares em 3 estudos (Miettinen et al, 2012;Pereira et al, 2009;Rusanen et al, 2012) e a dor de dentes em apenas 1 estudo (Rener-Sitar et al, 2008).…”

Correlação entre sinais e sintomas da Disfunção Temporomandibular (DTM) e severidade da má oclusão

“…Rusanen et al 19 , em estudo realizado com 94 pacientes adultos (34 homens e 60 mulheres, idade média 38 anos), que foram encaminhados para tratamento ortodôntico ou ortocirúrgico, também observaram pontuações do índice PAR estatisticamente mais elevadas em indivíduos com DTM.…”