To evaluate the association between temporomandibular disorder (TMD) and anxiety, quality of sleep, and quality of life in nursing professionals at theHospital de Clínicas de Uberlândiaof theUniversidade Federal de Uberlândia – HCU-UFU (Medical University Hospital of the Federal University of Uberlândia), four questionnaires were given to nursing professionals. The questionnaires were completed by 160 of these professionals. The Fonseca’s questionnaire was used to evaluate the presence and severity of TMD, the IDATE was used to evaluate anxiety, the SAQ was used to evaluate quality of sleep, and the SF-36 was used to evaluate quality of life. Forty-one nurses (25.6%) reported having no TMD (Fonseca’s questionnaire score ≤ 15), 66 (41.3%) had mild TMD (Fonseca’s questionnaire score 20–40), 39 (24.4%) had moderate TMD (Fonseca’s questionnaire score 45–65), and 14 (8.8%) had severe TMD (Fonseca’s questionnaire score ≥ 70). According to Fonseca’s questionnaire, the presence of TMD was associated with trait anxiety, but the TMD severity was associated with state anxiety classification (mild, moderate, severe). The SAQ score differed significantly from Fonseca classification. The Fonseca’s questionnaire score correlated negatively with the score of each dimension of the SF-36 (r = –0.419 to –0.183). We conclude that TMD is common among nursing professionals; its presence was associated with trait anxiety, and its severity was associated with state anxiety. Hence, the presence of TMD may reduce quality of sleep and quality of life.

O objetivo deste estudo foi avaliar a capacidade de identificação de prematuridades oclusais por meio de imagens obtidas de cortes paraxiais de tomografias computadorizadas de feixe cônico. Para este fim, realizou-se um estudo piloto em que 16 pacientes jovens assintomáticos foram submetidos ao exame clínico, incluindo análise oclusal criteriosa, e em seguida foram confeccionados dispositivos desprogramadores individuais (“JIG de Lucia”). Mediante manipulação mandibular e marcação interoclusal com papel carbono (Accufilm) identificou-se clinicamente o contato prematuro em relação cêntrica (RC) de cada paciente. Posteriormente estes dispositivos foram ajustados na posição de contato cêntrico e utilizados durante os exames tomográficos para que se pudessem obter imagens tomográficas na posição de relação cêntrica. Após o processamento das imagens, estas foram analisadas com o intuito de identificar prematuridades oclusais nas imagens visualizadas por 30 profissionais divididos de acordo com as áreas de atuação (Oclusão, Clínica Geral e Radiologia, n=10 para cada área) e tempo de exercício profissional (<5; entre 5 e 10; e >10 anos). Mediante comparação entre os contatos prematuros identificados na análise clínica oclusal e as imagens tomográficas apontadas pelos profissionais como áreas de contatos prematuros, foram calculados os índices de concordância entre essas duas variáveis. Os dados obtidos foram analisados estatisticamente pela Análise de Variância ANOVA e teste de Scott-Knott (α=0,05). Os resultados deste estudo demonstraram que a identificação de prematuridades oclusais por meio de cortes paraxiais de tomografias computadorizadas de feixe cônico mostrou-se como um método de confiabilidade média.

The aim of this study was to evaluate the ability to identify occlusal prematurity by images from paraxial slices of cone-beam computed tomography (CBCT). For such purpose, a pilot study was performed in which 16 asymptomatic young patients were subjected to a clinical examination, including a careful occlusal analysis and then individual deprogrammer devices (“Lucia's JIG”) were fabricated. Premature contacts were clinically identified in centric relation (CR) for each patient by jaw manipulation and interocclusal marking with articulating paper (Accufilm). Subsequently, these devices were adjusted in CR and used during the tomographic exams in such a way that CBCT in CR could be obtained. After routine processing, the images were analyzed in order to identify occlusal prematurity on the displayed images by 30 professionals divided according to areas of activity (occlusion specialist, general practitioner and radiologist; n=10 per area) and time of professional experience (less than 5, between 5 and 10, and over 10 years). By comparing the premature contacts identified in the clinical analysis and CBCT images, an agreement index between these two variables was calculated. Data were analyzed statistically by ANOVA and Scott-Knott test (α=0.05). The results showed that the identification of occlusal prematurity by paraxial CBCT slices was proven to be a method of average reliability.

The magnitude of occasional discrepancies between the centric relation and maximal intercuspation positions remains a controversial subject. This study quantitatively evaluated the possible discrepancies in the condyle/mandibular fossa relationship between these positions using cone-beam computed tomography. Twenty young and asymptomatic volunteers were distributed equally into normal occlusion and Angle Class I, II and III malocclusion groups. They were submitted to one tomographic scan in maximal intercuspation and one in centric relation. Measurements were performed on lateral and frontal cuts of the patients' temporomandibular joints, and the data collected were compared using Student's t test at a significance level of 5%. The results showed that there were no statistically significant differences between the centric relation and maximal intercuspation positions in young and asymptomatic patients with practically intact dentitions using cone-beam computed tomography.