Associação entre indicação de adenotonsilectomia e o provável bruxismo do sono e em vigília em crianças
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2019-02-26
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Universidade Federal de Goiás
Resumo
Bruxism is the involuntary activity of the masticatory system produced by contractions of the
jaw-muscle, characterised by the parafunctional activities of clenching and/or grinding of the
teeth. This condition may during wakefulness, indicated as awake bruxism (AB), or during
sleep, indicated as sleep bruxism (SB). Recent studies have investigated the relationship
between bruxism and chronotype (individual circadian preference). It is hypothesized that
bruxism can be triggered by the high demand for school tasks or activities performed at times incompatible with the child's chronotype. The hypertrophy of amygdalas and/or adenoid has been associated with bruxism in children and, consequently, the surgical removal, called adenotonsillectomy (AT), improve the signs and symptoms of bruxism. The objective of this study was to evaluate the association between the indication of adenotonsillectomy and the probable AB and SB in children from 4 to 9 years of age; evaluate the factors associated with the probable AB and SB; evaluate the association between probable AB and SB with the chronotype. This is a nested cross-sectional study within a randomized clinical trial, in partnership with the Faculty of Dentistry and Clinical Hospital (Federal University of Goiás). The sample consisted of 54 children divided into two groups: with AT indication and without AT indication (control group). The investigation of probable bruxism was through a questionnaire and clinical examination, and the definition of chronotype by the application of the Circadian Energy Scale (CIRENS) scale. Statistical analysis was performed using the Chi-square test (X2), Fisher's Exact test and Mann-Whitney U, after, the effect size was calculated. The data were analyzed by the SPSS program considering the level of 5% of significance. In the total sample (n=54) only the headache factor showed a significant association with both types of bruxism (p<0.05). The group with AT indication was composed of 34 children and the group with no AT indication for 20 children. The probable SB was found in 35.2% in the group with AT indication and 25% in the control group (p=0.432), and probably AB, in 34.3% in the group with AT indication and absent in the control group (p=0.004), a significant association. In the group with AT indication, a significant difference was founded with the probable SB and the variables (p<0.05): sleeping in the same room/next to the parents, headache, and nail
biting. In addition, a significant difference was founded with the probable AB and the variables (p<0.05): absence of educational behavior problems and choking/difficulty breathing while sleeping. Considering the total sample other variables showed association with the probable AB (p<0.05): teeth pain/sensitivity, snore loudly, nocturnal enuresis, and tooth wear. There was no association between bruxism and chronotype. As conclusions, the probable AB was associated with the AT indication; the majority of children with probable SB are indicated for AT surgery; the headache factor showed association with both types of bruxism; the probable AB and SB were not associated with the chronotype, suggesting no circadian preference, and thus, the child's adaptation to morningness and eveningness activities.
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OLIVEIRA, C. F. P. Associação entre indicação de adenotonsilectomia e o provável bruxismo do sono e em vigília em crianças. 2019. 74 f. Dissertação (Mestrado em Odontologia) - Universidade Federal de Goiás, Goiânia, 2019.