Desordens temporomandibulares em pacientes com deformidades dentofaciais e sua correlacao com biomarcadores e qualidade de vida

Abstract

Compelling data suggest a close relationship between dentofacial deformities (DFD) and temporomandibular disorders (TMD). Regardless of discussions about the positive impacts of orthognathic surgery on TMD, further studies are required to better understand this link, opening new approaches for the comprehensive management of individuals with DFD. This study aimed to evaluate the presence of TMD in patients with DFD, before orthognathic surgery, correlating the findings with salivary biomarkers and with the levels of quality of life (QoL). The present observational clinical study was carried out at the Occlusion, Orthodontics, and Oral Surgery clinics of the School of Health and Life Sciences/PUCRS. The study enrolled 51 patients, divided into three groups: (i) patients undergoing orthodontic treatment; (ii) patients diagnosed with TMD; (iii) patients with DFD undergoing orthodontic treatment before orthognathic surgery. In addition to the general assessment form, the following questionnaires validated in the Brazilian Portuguese language were applied: (i) Diagnostic Criteria for Temporomandibular Disorders (DC/TMD); (ii) Oral Health Impact Questionnaire on Quality of Life (OHIP-14). Salivary levels of interleukin-1β (IL-1β), glutamate, and serotonin were analyzed in samples of stimulated whole saliva. Individuals with DFD had a positive diagnosis for TMD, as indicated by Axis I of the DC/TMD. Patients in this group also showed higher rates of chronic pain, in addition to unfavorable scores concerning the functional and psychological dimensions, according to the questionnaires of Axis II DC/TMD. The application of OHIP-14 showed higher scores for individuals who had DFD, indicating low QoL. Analysis of salivary biomarkers revealed higher levels of IL-1β for patients in the DDF group, while glutamate concentrations showed a positive correlation with several behavioral parameters of Axis II DC/TMD and with the results of OHIP-14. A trend towards a positive correlation between serotonin levels and chronic pain scores was observed. Our data provide new evidence on the presence and influence of TMD in patients with DFD, revealing the impaired quality of life and salivary variations of inflammatory markers and neurotransmitters in these individuals. Based on these results, it is worth proposing a shift in the current paradigms for the management and preparation of patients with DFD, before and after orthognathic surgery.