Relation of painful TMD with the speech function: What are the possible characteristics of mandibular movements and the main symptoms reported?
Relação da DTM dolorosa com a função de fala: Quais as possíveis características de movimentos mandibulares e os principais sintomas relatados?
Melissa de Oliveira Melchior; Marcelo Oliveira Mazzetto; Laís Valencise Magri
Abstract
Objective: To analyze the mandibular movements of patients with painful TMD during the speech function in order to understand possible alterations and which subgroups of patients may present them. In addition to identifying which signs and symptoms related to painful TMD are perceived in the performance of this function. Methods: Thirty-two subjects aged between 18-60 years old (35.1 ± 8.9), 23 with TMD (DC/TMD; eight men and 15 women) and nine controls were evaluated regarding: self-perception of TMD signs and symptoms during speech (ProTMDMulti); range of mandibular movements during the reading of a word list (electrognatography, Jaw Motion Analyzes). The percentage of movement usage during the speech performance as a function of maximum individual amplitude was calculated, and groups of patients with painful TMD (TMD-D) and painful/joint (TMD-D/A) were subdivided. Results: The TMD-D/A group presented a higher percentage of use of lateral movement during speech than the other groups. Pain, joint noise, and difficulty in speaking were the most commonly reported signs/symptoms of speech performance. The perception of joint noises and the presence of lateral deviations were significantly higher in the TMD-D/A group (p<0.05). Conclusion: The lateral deviations are the main alteration of the mandibular movement during the speech performance in painful TMD. Such deviations are more expected in joint TMD (disc displacement and degenerative diseases). The perception of pain and joint noise are the main complaints related to the orofacial speech function in individuals with painful TMD.
Keywords
Resumo
Objetivo: Analisar os movimentos mandibulares de pacientes com DTM dolorosa durante a função de fala, a fim de compreender possíveis alterações e quais subgrupos de pacientes podem apresentá-las. Além de identificar quais sinais e sintomas relacionados com a DTM dolorosa são percebidos no desempenho desta função. Método: Trinta e dois sujeitos com idade entre 18 e 60 anos (35,1 ± 8,9), 23 com DTM (DC/TMD; oito homens e 15 mulheres) e nove controles foram avaliados quanto à: autopercepção de sinais e sintomas de DTM durante a fala (ProDTMMulti); amplitude de movimentos mandibulares durante a leitura de lista de palavras (eletrognatografia, Jaw Motion Analyses). Foi calculada a porcentagem de utilização de movimento durante o desempenho da fala em função da amplitude máxima individual, e foram subdivididos grupos de pacientes com DTM dolorosa (DTM-D) e dolorosa/articular (DTM-D/A). Resultados: O grupo DTM-D/A apresentou maior porcentagem de utilização de movimento na lateralidade durante a fala que os demais grupos. A dor, os ruídos articulares e a dificuldade para falar foram os sinais/sintomas mais relatados no desempenho da fala. A percepção de ruídos articulares e a presença de desvios laterais foram significativamente superiores no grupo DTM-D/A (p<0,05). Conclusão: Os desvios laterais são a principal alteração de movimento mandibular durante o desempenho da fala na DTM dolorosa. Tais desvios são mais esperados nos quadros de DTM articular (deslocamentos de disco e doenças degenerativas). A percepção de dor e de ruídos articulares são as principais queixas relacionadas à função orofacial de fala em indivíduos com DTM dolorosa.
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Referências
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Submetido em:
17/07/2018
Aceito em:
08/10/2018
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