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94

CARTA AO EDITOR

Sociedade Brasileira para o Estudo da Dor c

Rev Dor. São Paulo, 2012 jan-mar;12(1):94

Sr. Editor,

Reconhecemos o trabalho publicado: “Diretrizes para avaliação somatossensorial em pacientes portadores de

dis-função temporomandibular e dor orofacial”1 devido à sua importância porque os testes quantitativos sensitivos (QST)

são úteis para a avaliação do paciente, no entanto é importante considerá-los como dados adicionais ao exame clínico e à anamnese. Existem vários artigos sobre essa metodologia na literatura e QST são usados principalmente em pesquisa, e existem protocolos sistematizados para a região orofacial2-5.

A importância da dor neuropática nessa área do corpo é crucial. Além das informações desse trabalho, existem outros tipos de QST no mercado, como equipamentos da Somedic, e a literatura atual sobre avaliação orofacial indicam que não apenas os aspectos somatossensitivos, mas também as funções gustativas e olfativas podem ser afetadas pela dor crônica6-13.

Também é uma ferramenta importante para acompanhar o progresso da perda sensitiva após cirurgias orais, inclusive com-plicações de implantes dentários14,15.

Portanto, protocolos e diretrizes padronizadas para QST na região orofacial podem ser usados em associação com os exa-mes de pacientes com dor orofacial.

Atenciosamente, Silvia Regina Dowgan Tesseroli de Siqueira José Tadeu Tesseroli de Siqueira

REFERÊNCIAS

1. Sydney PBH, Conti PCR. Diretrizes para avalia-ção somatossensorial em pacientes portadores de dis-função temporomandibular e dor orofacial. Rev Dor 2011;12(4):349-53.

2. Matos R, Wang K, Jensen JD, et al. Quantitative sen-sory testing in the trigeminal region: site and gender di-fferences. J Orofac Pain 2011;25(2):161-9.

3. Pigg M, Baad-Hansen L, Svensson P, et al. Reliabili-ty of intraoral quantitative sensory testing (QST). Pain 2010;148(2):220-6.

4. List T, Leijon G, Svensson P. Somatosensory abnor-malities in atypical odontalgia: A case-control study. Pain 2008;15;139(2):333-41.

5. Siqueira SR, Okada M, Lino AM, et al. Proposal for a standardized protocol for the systematic orofacial exa-mination of patients with Hereditary Sensory Radicular Neuropathy. Int Endod J 2006;39(11):905-15.

6. Ayesh EE, Jensen TS, Svensson P. Effects of intra--articular ketamine on pain and somatosensory function in temporomandibular joint arthralgia patients. Pain. 2008;137(2):286-94.

7. Baad-Hansen L, Arima T, Arendt-Nielsen L, et al. Quantitative sensory tests before and 1(1/2) years af-ter orthognathic surgery: a cross-sectional study. J Oral Rehabil 2010;37(5):313-21.

8. Siviero M, Teixeira MJ, Siqueira JT, et al. Central

me-chanisms in burning mouth syndrome involving the olfac-tory nerve: a preliminary study. Clinics 2011;66(3):509-12. 9. Siviero M, Alvarez FK, Okada M, et al. Facial sensi-bility of patients with trigeminal neuralgias. Clin Neurol Neurosurg 2011;113(4):268-71.

10. Arap A, Siqueira SR, Silva CB, et al. Trigeminal pain and quantitative sensory testing in painful peripheral diabetic neuropathy. Arch Oral Biol 2010;55(7):486-93. 11. Siviero M, Teixeira MJ, de Siqueira JT, et al.

Somes-thetic, gustatory, olfactory function and salivary low

in patients with neuropathic trigeminal pain. Oral Dis 2010;16(5):482-7.

12. Alvarez FK, de Siqueira SR, Okada M, et al. Evalua-tion of the sensaEvalua-tion in patients with trigeminal post-her-petic neuralgia. J Oral Pathol Med 2007;36(6):347-50. 13. Siqueira SR, Nóbrega JC, Teixeira MJ, et al. Olfactory threshold increase in trigeminal neuralgia after balloon compression. Clin Neurol Neurosurg 2006;108(8):721-5. 14. Siqueira JTT, Siqueira SRDT. Persistent pain, sen-sory abnormalities, nervous injury and loss of implant after dental implant surgery: clinical approach. Rev Dor 2011;12(2):172-81.

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