title: [Relationship between the severity of temporomandibular disorder and voice].
abstract: BACKGROUND
  Temporomandibular dysfunction is one of the most complex disorders of the body, capable of unchaining alterations in the mandibular movements which in turn can cause damage not only to speech articulation but also to the quality of voice. In the literature, the relationship between the symptomatology severity levels of this dysfunction and their influence on vocal production has been scarcely studied.
  
  
  OBJECTIVE
  To verify the relationship between the symptomatology severity levels of temporomandibular dysfunction and vocal production.
  
  
  METHODS
  Participants of this study were 24 females, with ages between 16 and 56 years, who were submitted to an anamnesis index questionnaire (Fonseca et al., 1994), to odontological and otolaryngological examinations and to a hearing evaluation. Later, the participants were submitted to a voice recording, using a digital recorder, for a perceptive-auditive analysis of voice parameters such as: vocal type, resonance, quality of emission, pitch and loudness and for the analysis of the acoustic parameters of the wide and narrow band spectrography and of the Multi Dimensional Voice Program (MDVP) -- Key Elementrics Real Time software.
  
  
  RESULTS
  Considering the parameters of the perceptive-auditive evaluation, it was observed that only individuals with severe symptomatology presented a statistically significant decrease in loudness (p = 0.013). The hoarse vocal quality was the most frequent type among the participants, with severities classified as mild and severe, followed by the breathy type. In the wide band spectrography, there was a statistically significant difference for the anti-resonance increase (p = 0.013) in individuals with severe temporomandibular dysfunction.
  
  
  CONCLUSIONS
  It was verified that the severity level causes a decrease in loudness, an increase of noise and alterations in voice resonance, interfering in the vocal quality of these individuals.
authors.affiliation: Universidade Federal de São Paulo, Brazil. adsl1122@san.psi.br
authors.forename: Ana Maria Toniolo da
authors.initials: AM
authors.lastname: Silva
authors.forename: Marcela Forgiarini
authors.initials: MF
authors.lastname: Morisso
authors.forename: Carla Aparecida
authors.initials: CA
authors.lastname: Cielo
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008875:Middle Aged; D012720:Severity of Illness Index; D013018:Sound Spectrography; D013061:Speech Acoustics; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis / Q000503:physiopathology*; D014831:Voice / Q000502:physiology*; D014832:Voice Disorders / Q000175:diagnosis / Q000503:physiopathology; D014833:Voice Quality / Q000502:physiology