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Patient experience and satisfaction with different temporomandibular joint treatments
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Introdução: A disfunção da articulação temporomandibular (ATM), dependendo do subtipo, pode ser tratada de forma conservadora, ou através de procedimentos cirúrgicos minimamente invasivos (artroscopia, artrocentese) ou, em alguns casos, cirurgia aberta com ou sem materiais aloplásticos. Atualmente, a literatura apresenta múltiplos estudos com outcomes de diferentes tratamentos, contudo, poucos avaliam o nível de satisfação do doente. Métodos: Este estudo retrospetivo incluiu doentes submetidos a diferentes tipos de tratamentos da ATM (injeções de toxina botulínica, artrocentese, artroscopia, cirurgia aberta sem material aloplástico) entre 2017 e 2021. Todos os doentes foram tratados pelo mesmo médico. Um questionário de satisfação com 11 perguntas foi aplicado via chamada telefónica aos doentes. Resultados: Foram incluídos neste estudo 120 doentes (idade média 41.20 ± 17.78), 109 (90%) mulheres e 11 homens (10%). A satisfação global de todos os doentes, independentemente do tratamento, foi 8.24 ± 2.23 (média ± DP) e 97 doentes (80.8%) voltariam a submeter-se ao mesmo procedimento. A artrocentese e a artroscopia foram os tratamentos que apresentaram maiores níveis de satisfação global (9.09 ± 0.971 e 9.03 ± 1.13, p = 0.021) seguidos da cirurgia aberta (8.38 ± 1.84, p = 0.021). O tratamento com toxina botulínica foi o que apresentou níveis de satisfação mais baixos (7.05 ± 2.90, p = 0.021). Existiram duas correlações estatisticamente significativas: (1) satisfação global e expectativas dos doentes (r = 0.803; p<0.0001); (2) presença de depressão e necessidade de tratamentos adicionais da ATM (r = 0.186; p-value = 0.043). Conclusões: Dentro das suas limitações, o nosso estudo sugere que os quatro tratamentos estudados são bem aceites pelos doentes, associados a altos níveis de satisfação global. As expectativas dos doentes devem ser abordadas ad initium e a presença dum diagnóstico de depressão com disfunção temporomandibular concomitante, deve acautelar o médico e o doente para a necessidade de tratamentos adicionais.
Background: Temporomandibular joint (TMJ) disorders, depending on its subtype, may be treated in a conservative way, or through minimal invasive surgical procedures (arthroscopy, arthrocentesis) or, in some cases, open surgery with or without alloplastic materials. Currently, the available literature presents multiple studies with outcomes of different treatments however, few evaluate the level of patient-reported satisfaction. Methods: This retrospective study included patients submitted to different types of treatments of the TMJ(botulinum toxin injections, arthrocentesis, arthroscopy, and open surgery without alloplastic material) between 2017 and 2021. All patients were treated by the same doctor. A satisfaction questionnaire with 11 questions was applied via phone call to all patients. Results: 120 patients (mean age of 41.20 ± 17.78) were enrolled in this study, being 109 (90%) women and 11 men (10%). The overall satisfaction of all patients, regardless the treatment, was 8.24 ± 2.23 (mean ± SD) and 97 patients (80.8%) would undergo the same procedure again. Arthrocentesis and arthroscopy were the treatments with higher overall satisfaction (9.09 ± 0.971 e 9.03 ± 1.13, p = 0.021) followed by open surgery (8.38 ± 1.84, p = 0.021). Botulinum toxin injections was the treatment with lower levels of satisfaction (7.05 ± 2.90, p = 0.021). There were two statistically significant correlations: (1) overall satisfaction and patient expectations (r = 0.803; p<0.0001***); (2) the presence of depression and the need for further TMJ treatment (r = 0.186; p-value = 0.043*). Conclusions: Within its limitations, our study suggests that all four treatments included are well accepted by the patients, associated with high levels of overall satisfaction. Patient expectations should be addressed ad initium and the presence of a diagnosis of depression with concomitant TMJ disorder must warn the doctor and patient for the need of additional treatment.
Background: Temporomandibular joint (TMJ) disorders, depending on its subtype, may be treated in a conservative way, or through minimal invasive surgical procedures (arthroscopy, arthrocentesis) or, in some cases, open surgery with or without alloplastic materials. Currently, the available literature presents multiple studies with outcomes of different treatments however, few evaluate the level of patient-reported satisfaction. Methods: This retrospective study included patients submitted to different types of treatments of the TMJ(botulinum toxin injections, arthrocentesis, arthroscopy, and open surgery without alloplastic material) between 2017 and 2021. All patients were treated by the same doctor. A satisfaction questionnaire with 11 questions was applied via phone call to all patients. Results: 120 patients (mean age of 41.20 ± 17.78) were enrolled in this study, being 109 (90%) women and 11 men (10%). The overall satisfaction of all patients, regardless the treatment, was 8.24 ± 2.23 (mean ± SD) and 97 patients (80.8%) would undergo the same procedure again. Arthrocentesis and arthroscopy were the treatments with higher overall satisfaction (9.09 ± 0.971 e 9.03 ± 1.13, p = 0.021) followed by open surgery (8.38 ± 1.84, p = 0.021). Botulinum toxin injections was the treatment with lower levels of satisfaction (7.05 ± 2.90, p = 0.021). There were two statistically significant correlations: (1) overall satisfaction and patient expectations (r = 0.803; p<0.0001***); (2) the presence of depression and the need for further TMJ treatment (r = 0.186; p-value = 0.043*). Conclusions: Within its limitations, our study suggests that all four treatments included are well accepted by the patients, associated with high levels of overall satisfaction. Patient expectations should be addressed ad initium and the presence of a diagnosis of depression with concomitant TMJ disorder must warn the doctor and patient for the need of additional treatment.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022
Palavras-chave
Temporomandibular joint Temporomandibular joint surgery Minimally invasive temporomandibular joint treatments Patient satisfaction