Full text
| |
| Author(s): |
Kelly Machado de Andrade
Total Authors: 1
|
| Document type: | Doctoral Thesis |
| Press: | Campinas, SP. |
| Institution: | Universidade Estadual de Campinas (UNICAMP). Faculdade de Odontologia de Piracicaba |
| Defense date: | 2016-01-19 |
| Examining board members: |
Renata Cunha Matheus Rodrigues Garcia;
Maria da Gloria Chiarello de Mattos;
Daniela Aparecida de Godoi Gonçalves;
Juliana Trindade Clemente Napimoga;
Valentim Adelino Ricardo Barão
|
| Advisor: | Renata Cunha Matheus Rodrigues Garcia |
| Abstract | |
Rheumatoid arthritis (RA) is a prevalent disease, which may cause severe damage to the temporomandibular joint (TMJ) and possibly to the stomatognathic system functions. The aim of this study was to compare the masticatory function of elderly individuals with and without TMJ commitment due to RA. For this, 30 volunteers aged over 60 years, partially or totally edentulous, were assigned to two groups: (1) with RA and TMJ impaired, (2) without RA or TMD (control). The TMJ was evaluated by the RDC/TMD. Subjects were rehabilitated through new removable prostheses, and the elderly were evaluated before and after prosthesis installation for the following variables: maximum bite force (MBF), masticatory performance (MP), jaw chewing movements, range of mandibular movements and oral health-related quality of life (OHRQoL). The MBF was determined via pressure sensors placed bilaterally in the molar region. The MP was evaluated by sieving method using test material, considering the median particle size (X50) and distribution of particles along the sieve (b). An electromagnetic jaw tracking method was used to evaluate jaw chewing movements (time, angle and velocity) during mastication of the test material, and the range of mandibular movements (sagittal and vertical opening, right and left laterality, mandibular lateral deviation and protrusion). The OHRQoL was assessed by OHIP-14 and their physical, psychological and social domains. The data obtained were analyzed using ANOVA followed by Tukey-Kramer test. All tests were performed at a significance level of ? = 0.05. It was observed that elderly individuals with RA and TMJ impairment showed a significant reduction in the MBF (P <0.0001), the opening angle of the jaw chewing movements and the range of mandibular movements of the sagittal and vertical opening, and right and left laterality, as well as a significant increase in X50 and b values, indicating low MP (P <0.05). It also found greater negative OHRQoL in general aspects and domains (D1, D2, D3, D4, D5 and D7), in the RA+TMD group when compared to the control. After prosthesis installation, there was a significant increase in both groups (P <0.05) in MBF, distribution of the particles (lower b values), the opening and closing angles of the jaw chewing movements and the range of mandibular movements, except for lateral deviation (P = 0.3769) and right laterality (P = 0.0735). Although the RA+TMD group maintained the lowest values, the new prosthesis had a greater positive effect on the masticatory function in this group, reflected in significant reduction in X50 during the MP, in the OHRQoL, and all domains (P <0.05). In the control group, there was a reduction in the negative OHRQoL in general and domains D1 and D2. Therefore, it was concluded that the commitment in TMJ due to AR impairs masticatory function among the elderly, causing a negative OHRQoL. Further, well-planned prostheses shown to be crucial in the dental treatment of elderly with the disease helping to minimize the deleterious effects of RA in masticatory function, in addition to improving the masticatory function of the elderly, decreasing the OHRQoL (AU) | |
| FAPESP's process: | 12/08374-4 - Evaluation of maximum bite force, masticatory capacity and standard of mandibular movement during mastication of elderly with rheumatoid arthritis |
| Grantee: | Kelly Machado de Andrade |
| Support Opportunities: | Scholarships in Brazil - Doctorate |