SPIELBERGER STATE-TRAIT ANXIETY INVENTORY FOR PATIENTS WITH EXCESSIVE TOOTH ABRASION AND TEMPOROMANDIBULAR DISORDERS

Abstract

Hypertonia and parafunction of masticatory muscles (bruxism), which cause prolonged non-functional sliding movements of the mandible against the maxilla with teeth closed, contribute to the development of functional overload. Increased activity of masticatory muscles may occur due to the agitation of the central nervous system. On the periphery, its action manifests itself in the form of dysfunctions and bruxism, which leads to fatigue in the masticatory muscles, their spasm and the development of symptoms of the pain dysfunction syndrome. There is also an inverse relationship between local disturbances of occlusion and the development of stress. This case occurs, because in stress situations the adaptive capacity for local disturbances of the motor part of the masticatory system, including the disturbances of occlusion, is reduced. This causes a motor reaction in the form of dysfunctions of closing masticatory apparatus, which, in long-term stressful situations, can turn into well-established habits. This explains the appearance of pain symptoms of dysfunction in stressful situations. Consequently, there is convincing evidence that psychological and psychosocial factors play an important role in understanding the TMDs, but there is no conclusive evidence that these factors are etiologic ones.
 The purpose of the study is to determine personal and situational anxiety in patients with excessive tooth abrasion alone and those with both excessive tooth abrasion and temporomandibular disorders, comparing them with each other.
 Materials and Methods. 68 patients were included in the study, 31 (45.6%) included male and 37 (54.4%) contained female patients aged 21 to 70. Studied patients were divided into two groups: the control group and the study group. The control group included 31 patients diagnosed only with excessive tooth abrasion in combination with possible other occlusal disorders. The study group included 37 patients with excessive tooth abrasion, possibly with other occlusal disorders and various forms of temporomandibular disorders: muscle, articular, and combined. The study was conducted individually using the Spielberger State-Trait Anxiety Inventory (STAI), which included instructions and 40 questions, 20 of which were designed to assess the level of situational anxiety (SA) and 20 – to assess the level of personal anxiety (PA). Online questionnaire at: http://psytests.org/psystate/spielberger-run.html was used for automatic data processing of Spielberger psychological evaluation of patients.
 Results. A high level of personal anxiety was observed in patients of the study group with both excessive tooth abrasion and TMDs, in comparison with patients in the control group (48.6% of patients in the study group vs. 0% in the control group), p<0.001.
 Furthermore, a significant prevalence of patients with a high level of situational anxiety was determined among the patients in the study group with excessive tooth abrasion and TMDs, in comparison with patients in the control group with excessive tooth abrasion alone (64.0% in the study group vs. 3.2% in the control group, p<0.001). Thus, statistically significant signs of a high level of personal and situational anxiety were found among patients with excessive tooth abrasion and present temporomandibular disorders in comparison with patients who have only excessive tooth abrasion.