Frequência de desordens temporomandibulares em escolares adolescentes e associação com a qualidade do sono

Abstract

The TMD are defined as a group of painful and / or dysfunctional conditions involving the muscles of clashing and / or the temporomandibular joints (TMJ). Its prevalence is high, ranging between 21,3% and 88% depending on the population studied. This study determined the frequency of TMD and investigated its possible relationship to sleep quality in 18 and 19-year-old adolescents students. This is a cross sectional observational study conducted on 200 adolescents students enrolled in high school. The diagnosis of temporomandibular disorders was obtained by means of Research Diagnostic Criteria (RDC/TMD Axis I). The intra examiner agreement presented a Kappa coefficient of 0.867. The sleep was assessed by means of the Brazilian version of Pittsburgh Sleep Quality Index - PSQI. Data analysis was performed using the SPSS program for Windows 18.0 and included the frequency distribution and association tests. For the multivariate analysis, the Chi-Square test and the Student`s t-test were used. It was observed that TMD occurred in 71 adolescents studied (35.5%), in which case the muscular diagnoses occurred in 9.5% and articular disc displacement, with and without reduction, occurred in 8.5% and 11,5%, respectively. No adolescent presented disc displacement without reduction with mouth opening limitation. Arthralgia occurred in 7.5% of the students assessed, TMJ osteoarthritis in 0.5% and TMJ osteoartthrosis in 1.5%. An statistically significant association with the female gender was found (p-value<0.001, OR=2.73 with CI 95% 1.5 - 4.98). Poor sleep quality was detected in 41% of adolescents. The mean PSQI total score of the participants diagnosed with TMD, was 7.34, and, in the case of the participants who were not diagnosed with TMD, it was 4.76. This difference is statistically significant (p-value<0.001). It was also observed that there is an association between male gender and good sleep quality (p-value<0.001, OR= 3.62 with IC 95% 2,0 6,56). The mean PSQI total score was 6.5 for girls and 4.9 for the boys and the difference between these values was also significant ( = 5%). It was concluded that the frequency of TMD is high among adolescents assessed, and diagnoses of articular disc displacement were more frequent. Furthermore, the presence of TMD pain in the adolescents should be considered an important clinical problem. The occurrence of poor sleep quality was high in the population studied. The results show an important association among female gender, sleep problems and the occurrence of the temporomandibular disorders, but it is suggested that the results be used to identify a trend to be confirmed in future studies.