Impact event and orofacial pain amid the COVID-19 pandemic in Brazil: a cross-sectional epidemiological study

Abstract Objectives This study aims to assess the impact of social isolation, due to the Covid-19 pandemic, on mental health, Temporomandibular Disorder (TMD) and orofacial pain in men and women. Methodology Individuals living in Brazil answered an online questionnaire on their sociodemographic and behavioral aspects, emotional scale (DASS-21), Impact of Event Scale, and Pain Screener in Temporomandibular Disorders (TMD-Pain Screener) during June 2020. Descriptive statistical analyses and logistic and linear regressions were applied (5% significance). Results Overall, 2301 individuals were included, 89.1% practiced social isolation, 72.6% were employed/studying, at least 15% presented severe or extremely severe levels of emotional distress and presence of powerful (34.1%) and severe impact event (15%). During the outbreak, 53.2% perceived feeling worse and 31.8% reported that orofacial pain started or worsened after the pandemic outbreak. Gender was associated with "social class" (P=0.036), "pain/stiffness in the jaw on awakening" (P=0.037), "change of pain during jaw habits" (P=0.034) and "perception of change in the situations mentioned in the TMD-Pain Screener" (P=0.020), "depression" (P=0.012), "anxiety" (P=0.006) and "impact of the event" (P=8.3E-11). Social isolation had a lesser chance to change the routine, to be practiced by the unemployed/not studying, and to be practiced by men (all with P<0.001). Associations were found between social class and all subscales of the DASS-21 and IES, all with P<0.001. Conclusions The practice of social isolation has social determinants. High levels of psychological and event impacts were detected. The presence of orofacial pain seemed to increase during the health crisis, and there were gender differences in the response to the COVID-19 pandemic.

Efeitos da reabilitação oral com novas próteses totais convencionais sobre a força de mordida e a amplitude eletromiográfica dos músculos supra-hióideos e esternocleidomastóideos e suas correlações com a dimensão vertical de oclusão / Effects of oral rehabilitation with new conventional complete dentures on bite force and electromyographic amplitude of suprahyoid and sternocleidomastoid muscles and their correlation with vertical occlusal dimension

Objetivos: Analisar os efeitos da reabilitação oral com próteses totais sobre o força máxima de mordida e eletromiografia dos músculos supra-hióideos e esternocleidomastóideo e suas correlações com a DVO. Métodos: Pacientes usuários de próteses totais insatisfatórias participaram em três sessões (T0, T1 e T2). No T0, enquanto os pacientes ainda usavam suas próteses velhas, eles foram submetidos a exames de força de mordida e eletromiografia dos músculos supra-hióideos e esternocleidomastóideos. Novamente, esses exames foram repetidos e a DVO foi medida enquanto os pacientes usavam as suas próteses novas e as velhas, 30 dias após a instalação das novas próteses (T1). Cem dias após a instalação das novas próteses (T2) os exames foram repetidos. Os dados foram submetidos aos testes de normalidade de ShapiroWilk, análise de variância (ANOVA), correlação de Pearson e regressão linear, todos com 5% de significância. Resultados: Quinze pacientes participaram do estudo. Nenhuma diferença estatisticamente significante foi observada para força de mordida e eletromiografia. Porém, os testes de correlação e regressão demonstraram importantes interações entre DVO e força de mordida, e DVO e eletromiografia durante a deglutição para os músculos supra-hióideos. Conclusão: A reabilitação não impactou a força de mordida nem as atividades dos músculos estudados (eletromiografia). Por outro lado, a DVO demonstrou ser um fator importante para força de mordida e deglutição de água após a reabilitação(AU)

Objectives: The purpose of this study was to assess the effects of oral rehabilitation with complete dentures on bite force and electromyography of the suprahyoid and sternocleidomastoid muscles, and their correlation with OVD. Materials and Methods: Patients wearers of unsatisfactory removable complete dentures were attended in three sessions (T0, T1 and T2). At T0, while the patients still wore the old dentures, they were submitted to bite force and surface electromyographic exams of the suprahyoid and sternocleidomastoid muscles. These exams were repeated and the OVD was measured while the patients wore their old and new prostheses, 30 days after insertion of the new prosthesis (T1). The exams were repeated 100 days after the insertion of the new prosthesis (T2). The data were submitted to the ShapiroWilk normality test, analysis of variance (ANOVA), and Pearson correlation and linear regression, all with 5% significance. Results: Fifteen patients participated in the study. No statistically significant difference was observed for bite force or electromyography in T0, T1, or T2. However, the correlation and regression tests showed important interactions between the OVD and bite force, as well as the OVD and electromyography during deglutition for the suprahyoid muscles. Conclusion: Rehabilitation did not impact bite force nor the activity of the assessed muscles (electromyography). On the other hand, OVD was shown to be an important factor for bite force, and deglutition of water after rehabilitation(AU)

Diagnóstico diferencial de limitação de abertura bucal / Differential diagnosis of limited mouth opening

O objetivo do presente estudo é apresentar uma revisão de literatura exemplificando alguns dos possíveis fatores etiológicos de limitação de abertura bucal e ilustrar o caso de um paciente diagnosticado com hiperplasia do processo coronoide. Foi realizada uma busca nas bases de dados PUBMED/MEDLINE, Scielo, Bireme e Google Acadêmico utilizando-se inicialmente o termo "limited mouth opening" e "limitação de abertura bucal" no mês de novembro de 2016. Além disso, foi realizada busca manual em periódicos e nas bases de dados com novas palavras-chave como disfunção temporomandibular, tétano, traumas, doenças genéticas e imitação de abertura bucal e hiperplasia do processo coronóide. Foram incluídos estudos clínicos, revisões de literatura, revisões sistemáticas e relatos de caso publicados em idioma inglês ou português. Foram descritos os aspectos relevantes sobre desordens na articulação temporomandibular, tétano, traumas e fraturas, lesões orais, neoplasias e efeito colateral de radio e quimioterapia, desordens genéticas, hiperplasia do processo coronóide. O diagnóstico da limitação de abertura bucal é complexo devido ao grande número de fatores que podem provocar o problema. Diante disso, é de suma importância que seja realizada correta anamnese e investigação minuciosa do histórico do paciente, além da realização de exames complementares, permitindo assim, que a causa do problema seja detectada e que o tratamento correto seja aplicado, por meio de abordagem multidisciplinar, melhorando a qualidade de vida e devolvendo saúde ao paciente(AU)

The objective of this study is to present a review of literature exemplifying some of the possible etiological factors of oral opening limitation and to illustrate the case of a patient diagnosed with coronoid hyperplasia. A searched was made on PUBMED / MEDLINE, Scielo, Bireme and Google Scholar databases initially using the term "limited mouth opening" and "limitação de abertura bucal" in the month of November 2016. In addition, a manual search was carried out in journals and with new keywords like temporomanbidular disorders, tetanus, traumas, genetic disorders and limited open mouth and coronoid process hiperplasia. Clinical studies, literature reviews, systematic reviews and case reports published in English or Portuguese were included in the review. Relevant aspects of temporomandibular joint disorders, tetanus, trauma and fractures, oral lesions, neoplasys and side effects of radiotherapy and chemotherapy, genetic disorders, and coronoid process hyperplasia were described. The diagnosis of oral opening limitation is complex because of the many causes of the problem. Therefore, it is very important that a correct anamnesis and detailed investigation of the patient's history be performed, in addition to performing complementary tests, thus allowing the cause of the problem to be detected and treated correctly, through a multidisciplinary approach, improving the quality of life and healing the patient(AU)

Aleitamento materno como fator de proteção contra a instalação de hábitos bucais deletérios / Breast feeding as a protection factor to avoid non-nutritive sucking habits

Objetivo: avaliar a possível associação entre as variáveis sociodemográficas, desmame precoce e o desenvolvimento e manutenção dos hábitos bucais deletérios em crianças de três a cinco anos de idade das creches públicas de Vitória/ES.Método: trata-se de um estudo longitudinal, retrospectivo, com uma amostra final de 903 escolares, aleatorizada e representativa das 9.829 crianças matriculadas. Para a comparação entre as variáveis predictoras e hábitos foi utilizado o teste exato de Fisher e a força da associação medida pelo Odds Ratio.Resultados: 12,4% das crianças apresentaram hábito de sucção digital e 37,7%, o de chupeta. Não foi verificada associação estatisticamente significante do hábito de sucção digital com desmame precoce. As crianças do sexo feminino (p=0,045) demonstraram 20% mais chance de adquirir e permanecer com o hábito de chupeta, e as que tiveram o desmame precoce apresentaram aproximadamente quatro vezes mais a chance de desenvolver o hábito de chupetas (p= 0.000).Conclusão: associação entre hábito de chupeta e desmame precoce foi verificada. O desmame precoce pode ser considerado fator de risco para a permanência do hábito de chupeta.

Purpose: evaluate association between social and demographic variables, breastfeeding interruption and deleterious oral habits and the prevalence of non-nutritive sucking habits in 03 to 05 years old school children in Vitória, Espírito Santo.Method: this is a retrospective longitudinal study with a final random sample of 903 children from a universe of 9.829 students. The comparison between predictive variables and non-nutritive sucking habits used Fisher Exact test and strength of association verified by Odds Ratio.Results: 12,4% of the children present or had presented finger sucking habit and 37,7% of sucking pacifier. There was no statistically significant association between finger sucking with weaning. Female children had 20% more chance to have habit of sucking pacifier (p=0,000). Children that had early breast feeding interruption presented approximately 4 times more chance of developing the habit of sucking pacifiers (p= 0.000).Conclusions: the association of pacifier sucking habit and weaning was verified. Early weaning can be considered a risk factor for maintenance of pacifiers sucking habit.