Psychological aspects of temporomandibular disorder patients: evaluations
               after acupuncture treatment

Grillo, Cassia Maria; Canales, Giancarlo de La Torre; Wada, Ronaldo Seichi; Barbosa, Célia Marisa Rizzatti; Berzin, Fausto; Sousa, Maria da Luz Rosário de

doi:10.5935/1806-0013.20150022

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ORIGINAL ARTICLES • Rev. dor 16 (2) • Jan-Mar 2015 • https://doi.org/10.5935/1806-0013.20150022 copy

Psychological aspects of temporomandibular disorder patients: evaluations after acupuncture treatment^* * Received from School of Dentistry of Piracicaba, University of Campinas, Piracicaba, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND AND OBJECTIVES:

Depression and somatization are emotional features present in chronic temporomandibular disorder pain patients. This study aimed at evaluating results after acupuncture on psychological aspects of females with chronic muscle temporomandibular disorder pain.

METHODS:

Sample was made up of 40 females, aged between 18 and 45 years, submitted to two procedures: acupuncture and splint. Patients were evaluated for one month by the Research Diagnostic Criteria for Temporomandibular Disorders questionnaire Axis II before and after treatment. Treatment expectation before treatment was also evaluated by a visual analog scale with verbal anchors: negative expectation and positive expectation.

RESULTS:

There has been chronic pain improvement in 53.3% of acupuncture patients and in 60% of splint patients. For severe depression, 11.1% of acupuncture and 50% of splint patients have improved. Patients with severe somatization had 16.7% improvement with acupuncture and 44.4% with splint. There has been negative correlation (p<0.05) between treatment expectation and somatization (including and excluding pain items) for the acupuncture group.

CONCLUSION:

Both groups have improved some psychological aspects (depression and somatization) after a short period of treatment.

Keywords:
Acupuncture therapy; Chronic pain; Depressive symptoms; Masticatory muscles; Temporomandibular joint

	Confidence Interval (95%)
	Mean	SD	Upper	Lower	Minimum	Maximum
Age (years)
Acupuncture	30.05	(6.59)	33.13	26.97	21.00	45.00
Splint	30.40	(6.83)	33.60	27.20	18.00	45.00
Pain onset (years)
Acupuncture	4.82	(3.79)	6.60	3.05	0.50	16.00
Splint	(4.05	(5.08)	6.43	1.67	0.50	20.00
Worst pain (last 6 months)
Acupuncture	8.20	(1.28)	8.80	7.60	6.00	10.00
Splint	8.10	(1.55)	8.83	7.37	5.00	10.00
Mean pain (last 6 months)
Acupuncture	6.40	(1.96)	7.32	5.48	2.00	9.00
Splint	6.05	(1.82)	6.90	5.20	2.00	10.00
Absence of work (days)
Acupuncture	1.60	(3.99)	3.47	-0.27	0.00	15.00
Splint	2.00	(4.61)	4.16	-0.16	0.00	15.00
Treatment expectation (VAS)
Acupuncture	8.10	(1.48)	8.80	7.41	6.00	10.00
Splint	8,49	(1,56)	9,23	7,74	4,50	10,00

	Groups
	Acupuncture (n=20)		Splint (n=20)
RDC/TMD Axis II	Initial (%)	Final (%)	Initial (%)	Final (%)
Chronic pain scale (GCPS)
0 (no disability)	0	0	0	0
I (low disability and low pain intensity)	10	50	10	60
II (low disability and high pain intensity)	75	35	75	30
III (high disability, moderate limitation)	10	15	15	10
IV (high disability, severe limitation)	5	0	0	0
Depression
Normal	30	45	45	50
Moderate	25	15	25	35
Severe	45	40	30	15
Nonspecific physical symptoms including pain
Normal	30	40	20	50
Moderate	10	10	35	25
Severe	60	50	45	25
Nonspecific physical symptoms excluding pain
Normal	45	55	45	65
Moderate	10	10	20	15
Severe	45	35	35	20

		Stages
Variables	Groups	Initial	Final
Depression	Acupuncture	1.08 (0.74) A,a	0.93 (0.79) A,a
	Splint	0.81 (0.61) A,a	0.60 (0.44) B,a
Nonspecific physical symptoms including pain	Acupuncture	1.10 (0.77) A,a	0.91 (0.75) A,a
	Splint	0.91 (0.54) A,a	0.62 (0.43) B,a
Nonspecific physical symptoms excluding pain	Acupuncture	0.78 (0.68) A,a	0.61 (0.67) A,a
	Splint	0.70 (0.66) A,a	0.41 (0.50) B,a

Variables	Groups	Correlation	p value
Variables	Groups	Coefficient	p value
Depression	Acupuncture	- 0.19	0.4101
	Splint	- 0.03	0.8981
Nonspecific physical symptoms with pain	Acupuncture	- 0.46	0.0388^* * Statistically significant (p<0.05)
	Splint	- 0.23	0.3262
Nonspecific physical symptoms without pain	Acupuncture	- 0.51	0.0198^* * Statistically significant (p<0.05)
	Splint	- 0.34	0.1403

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[1] Correspondence to: Cassia Maria Grillo Av. Limeira, 901, Areão 13414-903 Piracicaba, SP, Brasil. E-mail: gricag@hotmail.com

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Psychological aspects of temporomandibular disorder patients: evaluations after acupuncture treatment* * Received from School of Dentistry of Piracicaba, University of Campinas, Piracicaba, SP, Brazil.

ABSTRACT

BACKGROUND AND OBJECTIVES:

METHODS:

RESULTS:

CONCLUSION:

Psychological aspects of temporomandibular disorder patients: evaluations after acupuncture treatment^* * Received from School of Dentistry of Piracicaba, University of Campinas, Piracicaba, SP, Brazil.