O impacto da disfunção temporomandibular na qualidade de vida relacionada à saude bucal.

Abstract

This study had two objectives. The main objective was to evaluate the association of the impact of temporomandibular disorders (TMD) on oral health related quality of life to the psychosocial and psychological factors. The specific objective was to validate the Portuguese version of Axis II questionnaire to Research Diagnostic Criteria for TMD (RDC/TMD) as preconized by Dworkin and LeResche at 1992. The sample was compounded by 156 patients, with TMD, who attempted at Orofacial Pain Control Center School of Dentistry of Pernambuco University, from July 2003 to February 2004. Data collection was done by the author using the following instruments: Simplified Anamnesis Index DMF for screening patients with TMD; RDC/TMD Axis I to evaluated clinically and to classify TMD and Axis II to evaluate psychosocial and psychological factors; the specific questionnaires to evaluated oral health related to quality of life, OIDP and OHIP-14. Two different types of studies were conducted: validation study and cross sectional study. The validation study consisted on the evaluation of internal consistence by alpha Crombach reliability test; reliability and reproducibility estimated by Kappa statistics and by Spearman correlation and also concurrent validity (Spearman). For the transversal study, one has used Kruskall Wallis to test OIDP and ANOVA to test OHIP-14. The Portuguese version for Axis II of RDC/TMD was considered consistent (Crombach a=0,72), reliable (Kappa 0,73-0,91; p<0,01) and valid (p<0,01). According to transversal study, among the variables for sample characterization, the impact on oral health related qualify of life was statistical associated to sex and scholarship, this factor exclusively for OHIP-14. On Axis I, using OIDP, the impact was associated to groups I and II, muscle and joint disorders, respectively. While for OHIP-14, only for group I (muscle disorders) the association was detected. On Axis II, psychological factors, as depression and somatization (inespecific organic symptoms with or without pain) and psychosocial factor of disability and pain were statically associated to the impact of oral health related quality of life, according to evaluation with OIDP and OHIP-14. The validity of Axis II of RDC/TMD followed the methodology proposed at the literature and showed reproducbility and validity for brazilian population. Temporomandibular disorders and psychosocial and psychological factors produced an important impact on oral health related quality of life, associated to psychosocial and psychological factors associated and proportional to their intensity.