Dieta livre de glúten reduz sensibilidade dolorosa de mulheres com dor miofascial da musculatura mastigatória

Abstract

Dietary patterns have been identified as exacerbators of chronic painful diseases, among them, Temporomandibular Disorders (TMD). Gluten, a structural protein complex found in wheat, has been associated with a pro-inflammatory activity even in individuals without celiac disease. This study aimed to evaluate the impact of a Gluten-Free Diet (GFD) on pain sensitivity of women with myofascial pain of masticatory muscles. The sample comprised of 39 volunteers, aged from 18 to 55 years, divided into 3 groups: healthy control (n=14); TMD (n=12) and TMD+GFD (n=13), being the first composed by healthy women and the last by women diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The parameters used for evaluation - on baseline and after one month - were: Self-report Pain Intensity (PI), Mechanical Pain Threshold (MPT), Pressure Pain Threshold (PPT) and frequency of somatosensory abnormalities. MPT and PPT were applied bilaterally to masseter muscle and thenar eminence. PPT was also applied to anterior temporalis muscle. After clinical evaluation, a nutritionist prescribed an individualized GFD for group TMD+GFD. Data were submitted to statistical analysis with a 5% significance level (Kolmogorov-Smirnov, Kruskal-Wallis followed by Dunn's test, Wilcoxon test and hypothesis test for proportions Patients treated with DLG had a reduction in PI (T1 = 7.69 ± 1.49, T2 = 4.00 ± 2.61, p = 0.006), increase on PPT of masseter muscle (T1 = 0.57 ± 0.37, T2 = 0.76 ± 0.35, p = 0.033) and reduction in frequency of somatosensory abnormalities (T1 = 47.7%, T2 = 30.8%, p = 0.02). TMD group did not show any improvement. A GFD seems to be a promising approach as adjuvant treatment for myofascial pain of masticatory muscles.