Avaliação clínica e da qualidade de vida de indivíduos com disfunção temporomandibular / Clinical and quality-of-life assessment among women with temporomandibular disorder

OBJETIVOS: Este estudo teve como objetivo avaliar sintomas de dor, apertamento dos dentes, qualidade do sono e sensibilidade dolorosa nos principais músculos mastigatórios e estabilizadores cervicais e qualidade de vida de mulheres com Disfunção Temporomandibular (DTM). MÉTODOS: Foram avaliadas 45 mulheres, divididas em dois grupos. O grupo I, composto por 27 mulheres (30,1±5,8anos) com diagnóstico de DTM e o grupo II, controle, composto por 18 mulheres saudáveis (23,4±2,3 anos). A intensidade dos sintomas de dor, cefaleia, cervicalgia, de apertamento dos dentes e dificuldade de dormir foram avaliados por escala visual analógica (EVA), o limiar de dor dos músculos masseter, temporal anterior, trapézio superior e esternocleidomastoideo, com dolorímetro e a qualidade de vida, pelo SF-36. Foi realizada análise estatística e o nível de significância foi α=0,05. RESULTADOS: Os resultados mostram que mulheres com DTM têm sintomas mais intensos de cefaleia (p<0,001), cervicalgia (p<0,001), intensidade de apertamento dos dentes (p<0,001) e dificuldade de dormir (p<0,001). Também apresentam limiar de dor mais baixo nos músculos masseter (p<0,001), temporal anterior (p<0,001), trapézio superior (p<0,001), esternocleidomastoideo (p<0,001) e pior qualidade de vida em todos os domínios avaliados (p<0,05), quando comparados com o grupo controle. CONCLUSÕES: Mulheres com DTM têm maior intensidade dos sintomas de dor, apertamento dos dentes, dificuldade de dormir, maior sensibilidade dolorosa em músculos mastigatórios e cervicais e pior qualidade de vida quando comparadas com mulheres sem DTM.

OBJECTIVES: The aim of this study was to evaluate pain symptoms, teeth clenching, quality of sleep, sensitivity to pain in the main masticatory and stabilizer muscles, and quality of life among women with temporomandibular disorder (TMD). METHODS: Forty-five women were evaluated and divided into two groups. Group I included 27 women (mean age 30.1±5.8 years) with a diagnosis of TMD and Group II (control) included 18 healthy women (mean age 23.4±2.3 years). The intensity of pain symptoms (headache, neck pain), teeth clenching and trouble sleeping was evaluated using a visual analog scale (VAS). The pain thresholds of the masseter, anterior temporalis, upper trapezius and sternocleidomastoid muscles were evaluated using a dolorimeter. Quality of life was evaluated using SF-36. Statistical analysis was performed and the significance level was α<0.05. RESULTS: The results showed that the women with TMD presented more intense headache (p<0.001), neck pain (p<0.001), teeth clenching (p<0.001) and trouble sleeping (p<0.001). They also presented lower pain threshold in the masseter (p<0.001), anterior temporalis (p<0.001), upper trapezius (p<0.001) and sternocleidomastoid (p<0.001) muscles and lower quality of life in all evaluated domains (p<0.05) when compared with the control group. CONCLUSIONS:Women with TMD had greater intensity of pain symptoms, teeth clenching, trouble sleeping, sensitivity to pain in the masticatory and neck muscles and lower quality of life, compared with women without TMD.

[Control of the contacts: its interference on the epidemiological status of Hansen's disease]. / Controle dos comunicantes: sua interferéncia na situação epidemiológica da hanseníase.

The control situation of hanseniasis patients' contacts needs a deeper study which would show the reality in the public health centers and their consequence over the whole country. The increasing of the prevalence rate of the disease added to the bad social-economic conditions of the patients and contacts gave us subsidies to important studies to understand the present epidemiological picture. This research had the purpose of diagnosing the control situation of hanseniasis patients' contacts in a public health center which had, at the moment of this research (1983) 160 hanseniasis patients (incidence of 1.2/1000) and 757 contacts registered in a Subprogram of Hansen's Disease Control.

[Disability prevention in Hansen's disease: reality at a health service]. / Prevenção de incapacidades em hanseniase: realidade numa unidade sanitária.

In Hansen's disease, the third part of advanced incidences or non treated cases exhibit some patterns of physical incapacity, besides the prejudice and beliefs generated by deformities-which the patients may present if they do not get a correct treatment. Which basis on this problematical question of the disease a group of professionals composed of medical doctors, nurses, physical therapist, occupational therapist and social worker made a study of the incapacities of the Hansen's disease patients through a detailed physical exam. This study intended to identify sensory and motor injuries of the face, upper and lower limbs. This study also develops a research about the necessity to systematize the assistance given in a public health center.