Sinais e sintomas de disfunção temporomandibular em pacientes tratados ortopedicamente com avanço mandibular

Abstract

This study had as its aim evaluate the incidence of signs and symptoms of temporomandibular disorders (TMD) in children and adolescents during the growth, with Angle Class II division 1 malocclusion. The sample comprised 56 subjects (males and females), randomly divided into treated group (28 patients) and control group (28 patients), being the first one submitted to an orthopedic treatment for mandibular advancement (for 18 months) with the Fränkel functional regulator 2 (RF-2). The patients from both groups answered to an anamnestic questionnaire and were examined to detect TMD signs, according to discipline of Occlusion(UMESP). Both procedures were done at the beginning of the research and at the end of the 18 months. The data were analyzed by he chi-square proportion test, and the results showed that, in the treated group, there was an increase of the proportions finded at the beginning to headaches, temporomandibular joint tenderness, joint sounds and dental pressing, pointing higher frequency of patients with answers no to TMD signs in final evaluation. In the control group, there was a higher proportion of individuals without headaches by the end of the afternoon, TMJ tenderness and clicks from TMJ (in 2 situations).In treated group there was not increase of the initial proportions any sign or symptom evaluated; however, in control group there was worst of the initial situation to 3 of the symptoms evaluated. The most frequent signs/symptoms of TMD were headaches, headaches by the end of the afternoon, joint sounds and limitation of jaw opening. There was no statistical difference between genders (p> 0,05), when the 19 variables (signs/symptoms) were analyzed. This investigation has shown that signs and symptoms of TMD can occur in children and adolescents, and Fränkel therapy, at the same time, corrected the occlusal Classe II relationship in the treated patients and promoted an improvement in signs/symptoms of TMD, although there were no significant differences.