Quality of life and general health in patients with temporomandibular disorders

The aim of this study was to associate minor psychiatric disorders (general health) and quality of life with temporomandibular disorders (TMD) in patients diagnosed with different TMD classifications and subclassifications with varying levels of severity. Among 150 patients reporting TMD symptoms, 43 were included in the present study. Fonseca's anamnestic index was used for initial screening while axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD) was used for TMD diagnosis (muscle-related, joint-related or muscle and joint-related). Minor psychiatric disorders were evaluated through the General Health Questionnaire (GHQ) and quality of life was assessed using the World Health Organization Quality Of Life-Brief Version (WHOQOL-BREF). An association was found between minor psychiatric disorders and TMD severity, except for stress. A stronger association was found with mild TMD. Considering TMD classifications and severity together, only the item "death wish" from the GHQ was related to severe muscle-related TMD (p = 0.049). For quality of life, an association was found between disc displacement with reduction and social domain (p = 0.01). Physical domains were associated with TMD classifications and severity and the association was stronger for muscle and joint-related TMD (p = 0.37) and mild TMD (p = 0.042). It was concluded that patients with TMD require multiple focuses of attention since psychological indicators of general health and quality of life are likely associated with dysfunction.

Cárie oclusal sem cavitação: divergências na decisão terapêutica / Oclusal decay without cavitation: divergency on the terapeutic decision

A grande susceptibilidade à cárie dentária e as dificuldades de diagnóstico nas superfícies oclusais suscitam a necessidade de novo estudos relacionados ao tratamento das mesmas. Este estudo objetivou identificar a conduta terapêutica adotada, nos casos de cárie oclusal sem cavitação clínica, por professores e concluintes do curso de Odontologia da UFRN, com vistas a se obter um perfil das possíveis diferenças de conduta entre eles. A amostra foi constituída por 30 examinadores (20 concluintes e 10 professores) que receberam fotografias de 18 casos clínicos e suas radiografias correspondentes para registrarem o tratamento que dariam a cada caso. A concordância entre os examinadores foi analisada através do coeficiente Kappa e a associação entre o tipo de tratamento adotado e o fato deserem professores ou alunos foi verificada através do teste exato de Fisher para um a=0,05. No que se ao tratamento adotado, a conduta invasiva foi predominante, em ambos os grupos. No entanto, observou-se uma concordância baixa entre aluos e professores e entre os dois grupos. Nenhuma associação significativa (p-0,687) entre o fato de o examinador ser professor ou aluno na conduta terapêutica adotada foi observada. As divergências de opiniões dentro do próprio grupo de professores, repercutem diretamente na opinião dos alunos. O predomínio da conduta invasiva reflete a presença da filofia restauradora.