Evaluation of Pressure Pain Threshold (LDP) and masticatory capacity of obese patients referred for bariatric surgery

Author(s)

Francisco Juliherme Pires de Andrade

• Document type: Master's Dissertation
• Press: Bauru.
• Institution: Universidade de São Paulo (USP). Faculdade de Odontologia de Bauru (FOB/SDB)
• Defense date: 2013-04-24

Examining board members

Sílvia Helena de Carvalho Sales Peres; Paulo Cesar Rodrigues Conti; Altair Antoninha Del Bel Cury

• Advisor: Sílvia Helena de Carvalho Sales Peres

Abstract

This cross-sectional study aimed to evaluate the Pain Threshold Pressure (PTP) and masticatory capacity of obese patients referred for bariatric surgery. It was composed of 90 patients, 60 with tooth loss indicating oral rehabilitation (EG-experimental group) and 30 fully dentate (control group-CG. Data collection was conducted in two periods for the experimental group before and after the making of the prosthesis according to his statement. In the control group, the collection was performed in one time. The collection comprised the test pressure pain threshold (PTP), visual analysis scale (VAS) for pain sensation, muscle fatigue test, ability and masticatory efficiency and analysis of quality of life using the Oral Health Impact Profile (OHIP -14). After verified the normality of the variables, the Student\'s t test was used to assess differences between the groups of toothed and toothless and for evaluating the initial to the end of the experimental group. To evaluate the differences between the periods of masticatory fatigue testing was performed ANOVA for repeated measures followed by the Tukey test. The PTP kept up with normal characteristics before and after installation of dental prosthesis, despite the lowering of the threshold for some muscle groups. Comparied to the control group there were no distinctions, except the masseter (p = 0.012). Although there was no complaint of pain VAS scores a statistical reduction (p = 0.000) after installation of the prosthesis for GE, becoming even smaller. The masticatory fatigue test appeared similar between groups, however, the PTP and the VAS during the test indicated changes between times, but aspects of normality were kept. The ability and masticatory efficiency of GE evolved after prosthetic treatment (p = 0.000), although the control group (toothed) remained higher (p = 0.000). The analysis of OHIP, for both groups, showed that oral condition of these patients does not interfere with their quality of life. It was concluded that the analysis of the pressure pain threshold showed that the dental status, presence or absence of teeth, in morbidly obese patients achieved normal levels for asymptomatic patients for orofacial pain. The ability and masticatory efficiency showed a significant improvement after oral rehabilitation, however, did not reach levels similar to the control group. The morbidly obese patients referred for bariatric surgery should undergo dental treatment, especially oral rehabilitation before and after surgery, collaborating with the new systemic condition of the patient. (AU)

• FAPESP's process: 11/04685-2 - Evaluation of muscular function and masticatory capacity of obese patients with indication for bariatric surgery
• Grantee: Francisco Juliherme Pires de Andrade
• Support Opportunities: Scholarships in Brazil - Master