Page 11 - SPEMD_61-2

rev port estomatol med dent cir maxilofac . 2020;61(2):45-51 49

10.63 at Fu6m, with statistically significant differences be- ly significant moderate positive correlation between NG and TI
tween Bas and Fu6 and between Tx8 and Fu6m (paired sam- (ρ = 0.582, ρ = 0.614 and ρ = 0.537, respectively). In Group II, a
ples, t -test, p<0.05). No statistically significant differences very weak/weak correlation (ρ = 0.046 and ρ = 0.375, respective-
(p>0.01; Mann -Whitney U test) were found for NG between the ly) was observed at Bas and Fu4, with no statistical significance
two groups in the assessed time points (Table 3). in any of the cases. At two months under the control regime,
TI in Group I was 711.3 ± 661.15 at Bas, 475.1 ± 487.02 at this interaction became strong with statistical significance (ρ =
Fu4, 429.8 ± 501.16 at Fu8, and 445.6 ± 518.84 at Fu6m. When 0.745 and p=0.001). However, at 6 months, it lost statistical sig-
comparing the baseline appointment with the first three con- nificance and became a weak correlation (ρ = 0.221).
trols (Fu4, Fu8, Fu6m), statistically significant differences
(paired t -test samples) were verified, with p=0.004, p=0.001,
and p=0.04, respectively. The mean follow -up was not statisti- Discussion
cally significant.
The TI level of Group II was 448.8 ± 499.71 at Bas, 240.7 ± Following the available literature and scientific evidence, the
311.45 at Fu4, 272.0 ± 284.47 at Fu8, and 247.4 ± 176.84 at Fu6m. treatment protocol was proposed to assess how SB patients
In a comparison (using paired t -test samples) between Bas and experiencing pain would respond to medium - and long -term
the first, second, and third controls (Fu4, Fu8, and Fu6m), sta- treatments with a CES device. The use of CES reduced the pain
tistically significant differences (p<0.001) were observed, with and TI of grinding per night in patients with masticatory myo-
decreasing values for the TI level. When comparing the mean fascial pain with definitive SB. EMG activity on the temporalis
TI between both groups (I and II), no statistically significant muscle had an inconsistent evolution after CES therapy.
differences were found in the different time points. The com- Baseline characteristics of the study population were sim-
parative analysis of the different pair variables in each group ilar between the study groups, except for the TI, and pain relief
was performed using the Spearman’s rho test for the same was observed in both protocols, with no recurrence throughout
time points and the Pearson’s test for Fu8 in Group I regarding the study. However, the minor improvements observed after
the pair Mean Pain -TI. the 4 -week treatment suggest that extended treatment proto-
In Group I, at baseline, the Mean Pain -NG pair showed a cols may offer no further advantages. Thus, a protocol with 1
moderate positive correlation (ρ = 0.415), with statistical sig- month of CES appears to be sufficient. The authors suggest
nificance (p=0.044). In Tx1, Tx2, Tx3, and Tx4, it had a moderate that, in a clinical setting, shorter protocols are more favorable
to very weak correlation (ρ = 0.545, ρ = 0.370, ρ = 0.120 and ρ = and achieve the same results.
0.125), with a non -significant p value at every stage except Tx1 Since the inclusion criteria in this study were not based on
(p=0.006). In Fu4 and Fu8, a moderate Mean Pain -NG correla- gender, but rather on complaints and reasons for consultation,
tion was observed (ρ = 0.428 and ρ = 0.451, respectively), with it was not possible to attribute a real relationship between
statistical significance (p=0.037 and p=0.027, respectively). In prevalence and epidemiology of gender and SB.
Fu6m, this correlation (ρ = 0.366) had no statistical significance A decrease in temporal muscle activity and concomitant
(p=0.108), becoming weaker over the course of the study. In myofascial pain in patients with SB had been previously re-
15
23
Group II, a weak Mean Pain -NG correlation was detected in Bas ported, corroborating our findings. Another study, with a
(ρ = 0.248; p = 0.242). In Tx1, Tx2, Tx3, Tx4, Tx5, Tx6, Tx7, and design comparable to the present one, with 19 individuals
24
Tx8, that correlation was weak/very weak (ρ = 0.048, ρ = 0.060, diagnosed with SB (using the AASM criteria), observed a
ρ = 0.253, ρ = 0.253, ρ = 0.051, ρ = 0.202, ρ = 0.268 and ρ = 0.286, 56.9% pain relief in 58% of the sample – the motivated group,
respectively), although without statistical significance (p>0.05) and a 28.8% pain relief in 42% of the sample – the group con-
at every stage of the active treatment, except Tx1 (p=0.048). In sidered skeptical in the initial analysis. The motivated group
the control period – Fu4, Fu8 and Fu6m, no correlation was values were similar to those found in the present study (pain
detected (ρ = 0.184, ρ = -0.030, and ρ = -0.085, respectively) relief in 69.8% and 64.4% in Groups I and II, respectively). In
between NG and Mean Pain, with no statistical significance in light of the results, the authors hypothesized the importance
all readings. of the parameter “duration of the bruxism event” and its “in-
In Group I, at baseline, a moderate positive correlation (ρ = tensity” in the perpetuation of pain, supporting the hypothe-
0.423; p=0.116) was observed in the Mean Pain -TI pair. In Fu4, sis that long and short events are signaled equally by the CES
there was a strong positive Mean Pain -TI correlation (ρ = 0.781), device, regardless of their intensity. A systematic review pub-
with a p=0.001, showing that those who started to feel less lished in 2014, pointed out that CES had the potential to in-
pain, started to grind less intensely. The same occurred in Fu8 duce long -term changes in behaviors that could include the
25
and Fu6m, where there were strong correlations (ρ = 0.792 and reduction or elimination of patient symptoms. A systemat-
ρ = 0.835, respectively), with p<0.001 in both. In Group II, a very ic review published in 2015 highlighted that it was yet to be
weak Mean Pain -TI correlation (ρ = 0.116, ρ = 0.110, ρ = 0.144, proven that a reduction in muscle activity could help decrease
26
and ρ = 0.142, respectively) was observed in all study weeks the patient’s clinical pain. The present study corroborated
(Bas, Fu4, Fu8, and Fu6m); i.e., both variables decreased these statements, emphasizing the importance of diagnostic
throughout the study, but with no statistical relevance. consultation for the adoption of adequate and effective ther-
In Group I, at baseline, the NG -TI pair showed a strong pos- apeutic strategies.
itive correlation (ρ = 0.705; p=0.003), meaning that those who As a general observation, it is important to note that none
experienced the highest level of grinding did so with the great- of the participants reported complaints concerning sleep
est intensity. In Fu4, Fu8, and Fu6m, there was also a statistical- throughout the study, similar to the results obtained by a pre-