RESUMO Temporomandibular Disorder According to the Level of Anxiety in AdolescentsABSTRACT -The aim of this study was to determine the prevalence of signs and symptoms of temporomandibular disorder (TMD), according to the level of anxiety in adolescents in the city of São Roque-SP. The Fonseca Index was used to determine the presence and severity of TMD. To assess the level of anxiety the State-Trait Anxiety Inventory it was used. The participants were 3,538 adolescents with ages varying between 10 and 19 years. The results revealed that 73.3% of the adolescents had TMD, and that a "slight" degree of TMD was the most prevalent category. Anxiety was present in 72.7% of the adolescents. The analysis showed the existence of a significant association among female students between the presence of TMD and anxiety. A significant positive correlation was observed between the degree of TMD and the level of anxiety. The results indicate that female adolescents have a higher chance of developing TMD than male adolescents, and that the chance of developing TMD augments with the level of anxiety.

IntroductionEpidemiological data show that the signs and symptoms of temporomandibular disorder (TMD) start becoming apparent from 6 years of age, and during adolescence these signs and symptoms are similar to those of adults. The present study aims to estimate the direct costs for treatment of chronic muscle pain with photobiomodulation therapy, occlusal splint and placebo in patients with TMD; to evaluate the effectiveness of photobiomodulation therapy and occlusal splint for treatment of muscle pain in patients with TMD; to analyse the cost-effectiveness of the two proposed treatments for pain; and to describe and compare the results of the analyses of these treatments.Methods and analysisThis is a prospective trial of clinical and economic analyses that will include 135 patientswith TMD aged between 15 years and 25 years, randomly assigned to a treatment group: G1 (photobiomodulation), G2 (occlusal splint) and G3 (placebo). The analyses will be based on the cost of each treatment during the 12-month period. The outcome of the analysis of effectiveness will be pain, measured periodically by means of clinical examination of Research Diagnostic Criteria for Temporomandibular Disorders. The cost-effectiveness ratio will be calculated using, as end points, pain and the ratio of the differences in costs between the groups studied. The evaluation of the impact of the treatment on quality of life will be determined by applying the adapted EuroQol-5D.Ethics and disseminationThis protocol has been ethically approved by the local medical ethical committee, protocol number 2.014.339. Results will be submitted to international peer-reviewed journals and presented at international conferences.Trial registration numberNCT03096301.