Alterações clínicas e psicossociais nos indivíduos em preparo para cirurgia ortognática e suas associações com polimorfismos em diferentes genes

• Autor(a) principal: Sebastiani, Aline
• Data de Publicação: 2019
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório do Centro Universitário Braz Cubas
• Texto Completo: https://repositorio.cruzeirodosul.edu.br/handle/123456789/2175
• topic: Odontologia; Polimorfismo (Genética); Qualidade de vida; CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA

The aim of this study was to evaluate the prevalence of depression and chronic pain in patients with dentofacial deformities (DFD) in prepare for orthognathic surgery and verify if temporomandibular disorders and genetic polymorphisms in Dopamine Receptor D2 (DRD2) and Ankyrin Repeat and Kinase Domain Containing 1 (ANKK1) genes are associated with depression and chronic pain. Also, evaluate these patients about the impact in oral health- related to quality of life (OHRQoL) and verify the influence of depression, temporomandibular disorders (TMD) and genetic polymorphisms in Interleukin 6 gene (IL6) in OHRQoL. The sample of the study was composed by 145 patients with DFD, with Class II and III malocclusion requiring orthognathic surgery, and by 50 patients without DFD. In preoperative appointments, patients were diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and also were accessed about the self-rated OHRQoL, through the simplify version of Oral Health Impact Profile (OHIP-14) questionnaire. The DNA was obtained from buccal cells. Genetic polymorphisms in DRD2 (rs6275 and rs6276), ANKK1 (rs1800497) and in IL6 (rs1800795 and rs1800796) were genotyped using real-time PCR. Data were statistically analyzed with a significance level of 0.05. The DFD group presented more severe depression (p = 0.023), chronic pain (p = 0.021), Nonspecific Physical Symptoms Including Pain (NPSIP), Nonspecific Physical Symptoms Excluding Pain (NPESP), and myofascial pain (p = 0.002). People with depression tend to suffer from chronic pain, NPSIP and NPSEP (p = <0.001), myofascial pain (p = 0.004), and arthralgia (right side: p = 0.016 and left side: p = 0.054). Chronic pain was also associated with NPSIP (p < 0.001), NPSEP (p = 0.002), myofascial pain (p < 0.001), arthralgia (right side p = 0.001 and left side p < 0.001), and with polymorphism rs6275 in DRD2. Individuals with homozygous A and heterozygous AG had more chances to suffer from chronic pain when compared with those with homozygous G (p = 0.037 and p = 0.043; respectively). Concerning OHRQoL, patients with DFD had approximately 4 times more chances to have higher scores of OHIP-14 when compared to Class I (p < 0.001, for both). Females showed higher values of OHIP-14 compared with males (p = 0,002). And the OHIP-14 was also increased in patients with depression, myofascial pain, inflammatory joint diagnoses(p < 0.001). Individuals homozygous C in rs1800795 had increased values in domains 6 and 7 of OHIP-14 when compared to individuals homozygous G (p = 0.038 and p = 0.021; respectively). Individuals heterozygous CG in the marker rs1800796, had increased values in domain 3 compared to individuals homozygous C (p = 0.038). The results of this study suggest that depression and chronic pain are more common in individuals with DFD requiring orthognathic surgery. NPSIP, NPSEP, myofascial pain, and arthralgia are associate with depression and chronic pain. Chronic pain is also associate with DRD2 polymorphism. Concerning OHRQoL, individuals with DFD requiring orthognathic surgery have worse OHRQoL. Female sex, depression, TMD and polymorphisms in IL6 gene contributes to worsen the OHRQoL perception.