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Prevalência de sintomas autorreportados de disfunção temporomandibular em cantores: estudo observacional transversal
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| Projeto de pós-graduação_39658 | 1.01 MB | Adobe PDF |
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Abstract(s)
O termo disfunções temporomandibulares (DTM) refere-se a um grupo de patologias músculo-esqueléticas que, a nível mundial, apresentam uma prevalência que varia de 31% nos adultos a 11% nos adolescentes, afetando mais frequentemente as mulheres (15-26%) do que os homens (8-15%), e manifestando-se com maior incidência entre os 20 e os 50 anos, alcançando um pico por volta dos 40 anos. Estes distúrbios afetam os músculos do sistema estomatognático, a articulação temporomandibular (ATM) e as estruturas associadas. A prática de canto é considerada um fator que pode contribuir para o desenvolvimento de DTM. O objetivo deste trabalho foi avaliar a prevalência de sintomas autorrelatados de disfunção temporomandibular, como dor cervical e cefaleia, em cantores (grupo de estudo), comparando-os com um grupo controlo de músicos (violoncelo, percussão e teclas). Um total de 205 participantes (músicos e cantores) provenientes de diferentes contextos musicais (escolas de música, conservatórios, bandas, coros acadêmicos) participou de um questionário online baseado na versão em língua portuguesa e italiana do “Symptom Questionnaire” (SQ) dos Critérios Diagnósticos para Distúrbios Temporomandibulares (DC/TMD), que inclui a Oral Behaviors Checklist, aprovada pelo Consórcio Internacional RDC/TMD. O questionário também continha perguntas sociodemográficas (idade e gênero), informações específicas sobre a atividade musical (instrumento tocado, número médio de horas de estudo por dia nos últimos 30 dias e anos de experiência musical), hábitos de aquecimento, pausas durante o estudo e hábitos de exercício físico. Os resultados mostraram uma prevalência significativamente maior de “dor na mandíbula, na fonte, no ouvido ou à frente do ouvido” autorreferida no grupo dos cantores, em comparação com o grupo controlo (34,2% contra 20,5%, p-value = 0.030). O fator de risco univariado que apresentou uma associação significativa com a “dor na mandíbula, na fonte, no ouvido ou à frente do ouvido” foi a faixa etária, com um OR de 4,278 (IC95%: 1,114-16,424, p-value = 0,034). Em relação aos fatores de risco multivariados associados à “dor na mandíbula, na fonte, no ouvido ou à frente do ouvido”, o estado de depressão constante apresentou um OR de 5,141 (IC95%: 1,393-18,971, p-value = 0,014), enquanto a presença de comportamentos orais apresentou um OR de 1,179 (IC95%: 1,013-1,372, p-value = 0,033). O aumento do número de comportamentos orais revelou-se um fator de risco multivariado significativo para a “dor no pescoço e/ou nos ombros” com um OR de 1,241 (IC95%: 1,069-1,441, p-value = 0,005). O fator de risco univariado que mostrou uma associação significativa com a “cefaleia” foi “ter menos interesse na maioria das coisas”, com um OR de 8,580 (IC95%: 1,773-41,522, p-value = 0,008), e o estado de depressão constante com um OR de 5,141 (IC95%: 1,393-18,971, p-value = 0,014). Conclui-se que os cantores são mais suscetíveis a desenvolver "dor na mandíbula, nas têmporas, no ouvido ou à frente do ouvido" em comparação com o grupo de controle composto por músicos que tocam instrumentos que não sobrecarregam o sistema estomatognático.
The term “temporomandibular disorders” (TMD) refers to a group of musculoskeletal pathologies that, worldwide, have a prevalence ranging from 31% in adults to 11% in adolescents, affecting women (15-26%) more frequently than men (8-15%), and manifesting more commonly between the ages of 20 and 50, reaching a peak around 40 years old. These disorders have an impact in the muscles of the stomatognathic system, the temporomandibular joint (TMJ), and associated structures. Singing is considered a factor that may contribute to the development of TMD. The aim of this study was to assess the prevalence of self-reported symptoms of temporomandibular dysfunction, such as neck pain and headaches, in singers (study group), comparing them with a control group of musicians (cellists, percussionists, and keyboard players). A total of 205 participants (musicians and singers) from various musical backgrounds (music schools, conservatories, bands, and academic choirs) took part in an online questionnaire based on the Portuguese and Italian versions of the “Symptom Questionnaire” (SQ) from the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), which includes the Oral Behaviors Checklist, approved by the International RDC/TMD Consortium. The questionnaire also contained sociodemographic questions (age and gender), specific information about the participants' musical activity (instrument played, average number of study hours per day over the last 30 days, and years of musical experience), warm-up habits, study breaks, and exercise habits. The results showed a significantly higher prevalence of self-reported "pain in the jaw, temples, ear, or in front of the ear" in the singers' group compared to the control group (34.2% vs. 20.5%, p-value = 0.030). The univariate risk factor that showed a significant association with "pain in the jaw, temples, ear, or in front of the ear" was age, with an OR of 4.278 (95% CI: 1.114-16.424, p-value = 0.034). Regarding the multivariate risk factors associated with "pain in the jaw, temples, ear, or in front of the ear," constant depression status presented an OR of 5.141 (95% CI: 1.393-18.971, p-value = 0.014), while the presence of oral behaviors had an OR of 1.179 (95% CI: 1.013-1.372, p-value = 0.033). An increase in the number of oral behaviors proved to be a significant multivariate risk factor for "neck and/or shoulder pain," with an OR of 1.241 (95% CI: 1.069-1.441, p-value = 0.005). The univariate risk factor that showed a significant association with "headache" was "having less interest in most things," with an OR of 8.580 (95% CI: 1.773-41.522, p-value = 0.008), and constant depression status with an OR of 5.141 (95% CI: 1.393-18.971, p-value = 0.014). In conclusion, singers are more susceptible to developing "pain in the jaw, temples, ear, or in front of the ear" compared to the control group of musicians who play instruments that do not overload the stomatognathic system.
The term “temporomandibular disorders” (TMD) refers to a group of musculoskeletal pathologies that, worldwide, have a prevalence ranging from 31% in adults to 11% in adolescents, affecting women (15-26%) more frequently than men (8-15%), and manifesting more commonly between the ages of 20 and 50, reaching a peak around 40 years old. These disorders have an impact in the muscles of the stomatognathic system, the temporomandibular joint (TMJ), and associated structures. Singing is considered a factor that may contribute to the development of TMD. The aim of this study was to assess the prevalence of self-reported symptoms of temporomandibular dysfunction, such as neck pain and headaches, in singers (study group), comparing them with a control group of musicians (cellists, percussionists, and keyboard players). A total of 205 participants (musicians and singers) from various musical backgrounds (music schools, conservatories, bands, and academic choirs) took part in an online questionnaire based on the Portuguese and Italian versions of the “Symptom Questionnaire” (SQ) from the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), which includes the Oral Behaviors Checklist, approved by the International RDC/TMD Consortium. The questionnaire also contained sociodemographic questions (age and gender), specific information about the participants' musical activity (instrument played, average number of study hours per day over the last 30 days, and years of musical experience), warm-up habits, study breaks, and exercise habits. The results showed a significantly higher prevalence of self-reported "pain in the jaw, temples, ear, or in front of the ear" in the singers' group compared to the control group (34.2% vs. 20.5%, p-value = 0.030). The univariate risk factor that showed a significant association with "pain in the jaw, temples, ear, or in front of the ear" was age, with an OR of 4.278 (95% CI: 1.114-16.424, p-value = 0.034). Regarding the multivariate risk factors associated with "pain in the jaw, temples, ear, or in front of the ear," constant depression status presented an OR of 5.141 (95% CI: 1.393-18.971, p-value = 0.014), while the presence of oral behaviors had an OR of 1.179 (95% CI: 1.013-1.372, p-value = 0.033). An increase in the number of oral behaviors proved to be a significant multivariate risk factor for "neck and/or shoulder pain," with an OR of 1.241 (95% CI: 1.069-1.441, p-value = 0.005). The univariate risk factor that showed a significant association with "headache" was "having less interest in most things," with an OR of 8.580 (95% CI: 1.773-41.522, p-value = 0.008), and constant depression status with an OR of 5.141 (95% CI: 1.393-18.971, p-value = 0.014). In conclusion, singers are more susceptible to developing "pain in the jaw, temples, ear, or in front of the ear" compared to the control group of musicians who play instruments that do not overload the stomatognathic system.
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Keywords
Distúrbios da articulação temporomandibular Cantores Músicos Dor orofacial Temporomandibular joint disorders Singers Musicians Orofacial pain