Ortodontik Tedavi Görmek İsteyen Bireylerde Kaygı Düzeyleri, Temporomandibular Eklem Disfonksiyonu Skorları ve Ortodontik Maloklüzyon Arasındaki İlişkinin Değerlendirilmesi

Öz

Amaç: Ortodontik tedavi görme isteğiyle başvuran genç yetişkin bireylerde Beck Anksiyete İndeksi (BAI) ile belirlenen kaygı düzeyleri ve Fonseca Anamnestik İndeksi (FAI) ile belirlenen Temporomandibular Eklem Disfonksiyonu (TMD) prevalansı ile Sınıf I, Sınıf II ve Sınıf III ortodontik maloklüzyonlar arasındaki ilişkinin değerlendirilmesidir. Gereç ve Yöntemler: Maloklüzyonlarının düzeltilmesi için ardışık olarak başvuran, 14-24 yaş arası genç yetişkinlerden oluşan 120 katılımcı çalışmamızın gerecini oluşturmuştur. Yapılan klinik muayene sonucunda dental maloklüzyonlarına göre bireyler Angle Sınıf I, II ve III olarak 3 gruba ayrılmıştır. Her grup kendi içinde kadın ve erkek bireyler olarak iki alt gruba ayrılmış ve sonuçta her bir grupta 20 birey olacak şekilde 6 grup oluşturulmuştur. Hastalara rutin ortodontik muayenenin yanı sıra TMD prevalansı ve şiddetini değerlendirmek amacıyla FAI ve kaygı düzeylerini belirlemek amacıyla da Beck Anksiyete BAI uygulanmıştır. Verilerin istatistiksel değerlendirmesi için Fischer’s Exact, Mann-Whitney U ve Kruskal Wallis testleri kullanılmıştır. BAI ve FAI arasındaki ilişkiyi değerlendirmek için Kendall Tau-b korelasyon testi kullanılmıştır. Anlamlılık düzeyi p<0,05 olarak kabul edilmiştir. Bulgular: Çalışmaya katılan bireylerin cinsiyet, sayı ve yaş bakımından benzer dağılım gösterdiği belirlenmiştir. FAI’e göre TMD semptomu bulunan kadın bireylerin erkek bireylerden daha fazla olduğu ve şiddetli TMD semptomu gösteren bireylerin tamamının kadın olduğu görülmüştür. Dental maloklüzyon gruplarına göre FAI-TMD skorlarının dağılımı açısından anlamlı bir fark olmadığı belirlenmiştir (p=0,093). BAI skorlarının kadın bireylerde erkek bireylere göre daha yüksek olduğu ve bu farkın istatistiksel olarak da anlamlı olduğu görülmüştür (p<0,05). Toplam anksiyete skorları açısından Sınıf I, Sınıf II ve Sınıf III grupları arasında istatistiksel olarak anlamlı farklılık bulunmazken, en yüksek ortalama anksiyete skorunun dental Sınıf III maloklüzyonda olduğu tespit edilmiştir. FAI skorları ile BAI skorları arasında her iki cinsiyette de pozitif korelasyon gözlenirken; kadın hastalarda korelasyon değerinin erkek hastalara göre daha yüksek olduğu bulunmuştur (Kadın r=0,537; p<0,01), Erkek r=0,319; p<0,01). FAI skorları ile BAI skorları arasında tüm maloklüzyon grupları için pozitif korelasyon bulunmaktadır. Sonuç: Farklı maloklüzyon tiplerine sahip ortodontik tedavi görmek isteyen bireylerin kişilik ve psikososyal durumlarındaki farklılıkların, farklı maloklüzyon tiplerine ve TMD bulgularına yansıdığı ve bu özelliklerin cinsiyet faktöründen de etkilendiği görülmektedir. Ortodontik tedavi yaklaşımları ve tedavi alternatifleri belirlenirken farklı maloklüzyonlara sahip bireyler psikososyal bir perspektif ile değerlendirilmelidir.

Anahtar Kelimeler

• Malokluzyon
• Kaygı
• Temporomandibular Hastalık
• Beck Anksiyete İndeksi
• Fonseca Anamnestik İndeks.

Evaluation of the Relationship between Anxiety Levels, Temporomandibular Joint Dysfunction Scores and Orthodontic Malocclusion in Individuals who Seeking Orthodontic Treatment

Öz

Aim: To evaluate the relationship between anxiety levels determined by Beck Anxiety Index (BAI) and Temporomandibular Joint Dysfunction (TMD) prevalence determined by Fonseca Anamnestic Index (FAI) and Class I, Class II and Class III orthodontic malocclusions in young adults who apply with the desire to receive orthodontic treatment. Material and Methods: 120 participants, consisting of young adults aged 14-24, who consecutively applied for the correction of malocclusions, constitute the material of our study. As a result of the clinical examination, individuals were divided into 3 groups as Angle Class I, II and III according to their dental malocclusions. Each group is divided into two subgroups as male and female individuals. As a result, 6 groups were formed with 20 individuals in each group. In addition to routine orthodontic examination, FAI was applied to evaluate the prevalence and severity of TMD, and BAI was applied to determine their anxiety levels. Fischer’s Exact test, Mann-Whitney U test and Kruskal Wallis test were used to evaluate the data. Kendall Tau-b correlation test was used to evaluate the relationship between BAI and FAI. Significance level was accepted as p<0.05. Results: It was determined that the individuals participating in the study showed a similar distribution in terms of gender, number and age. According to the FAI, it was observed that female individuals with TMD symptoms were more common than male individuals, and all individuals with severe TMD symptoms were female. It was determined that there was no significant difference in terms of distribution of FAI TMD scores according to dental malocclusion groups (P=0.093). BAI scores were found to be higher in females than in males, and this difference was statistically significant (P<0.05). While there was no statistically significant difference between Class I, Class II and Class III groups in terms of total anxiety scores, it was determined that the highest mean anxiety score was in dental Class III malocclusion. While a positive correlation was observed between FAI scores and BAI scores in both genders, it was found that the correlation value was higher in female patients than in male patients (Female r=0.537, p<0.010; Male r=0.319, p<0.010). There was a positive correlation between FAI scores and BAI scores for all malocclusion groups. Conclusion: It is seen that the differences in personality and psychosocial status of individuals who want to receive orthodontic treatment with different malocclusion types are reflected in different malocclusion types and TMD findings, and these characteristics are also affected by the gender factor. While determining orthodontic treatment approaches and treatment alternatives, individuals with different malocclusions should be evaluated from a biopsychosocial perspective.

Anahtar Kelimeler

• Malocclusion
• Anxiety
• Temporomandibular Disease
• Beck Anxiety Index
• Fonseca Anamnestic Index.

Kaynakça

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