Influência da ingestão de nutrientes e sua correlação com a sensibilidade dolorosa em mulheres com disfunção temporomandibular: estudo observacional do tipo caso controle

Abstract

Introduction: Temporomandibular Dysfunction (TMD) is a collective term encompassing clinical problems involving masticatory muscles, the Temporomandibular Joint (TMJ) and associated structures. Pain is one of the most frequently encountered symptoms in individuals with TMD, and represents the main reason why patients seek treatment. In the face of painful experience or functional limitation, TMD patients have changes in their eating pattern, which may be associated with nutritional deficiencies. Objective: to evaluate the food intake of macro and micronutrients in women with TMD and correlate it with painful sensitivity. Methodology: The sample consisted of women aged between 18 and 55 years, literate, recruited from those who sought care at the dental screening service of the Federal University of Ceará, as well as through dissemination through pamphlets, posters and social media. Those who had lost more than five dental elements, poorly adapted prostheses, severe periodontal disease, odontalgia or intra or extra-oral lesions that were capable of compromising masticatory function, other chronic painful disorders, food intolerances and other systemic conditions that were excluded were excluded. generate food restriction, women who abuse legal, illegal drugs and alcohol. For the diagnosis of TMD, the Research Diagnostic Criteria for Temporomandibular Disorders (RDC / TMD) was used in its version translated and validated for the Portuguese language. The participants were selected according to the eligibility criteria and thus, allocated into three groups (control, myofascial pain and arthralgia) according to the RDC / TMD. To evaluate food consumption, filling in a food diary was used for 3 non-consecutive days, and the measurement of macro and micronutrients was performed using nutritional software (Avanutri Online) Pain sensitivity was measured collected through the Threshold of Pressure Pain (LDP) and Numerical Scale (EN) .. Data were subjected to statistical analysis with a 5% significance level (Kruskal-wallis test with Dunn's post-hoc test, T test for independent samples and correlation Spearman's). Results: Ninety women were selected and allocated to the three groups. Regarding age (control 31.40 ± 8.43; myofascial pain 30.35 ± 8.88; arthralgia 31.62 ± 11.50), Body Mass Index (BMI) (control 23.99 ± 3.64; myofascial pain 24.16 ± 3.44; arthralgia 24.34 ± 4.63), educational level and ethnicity, there was no statistically significant difference between the groups evaluated. The myofascial pain group showed reduced protein consumption (16.33 ± 2.54) (p = 0.006) and increased calcium (468.71 ± 206.07) (p = 0.033) compared to the control groups (19.20 ± 5.08; 337.76 ± 188.90) and arthralgia ( 20.96 ± 12.79; 413.71 ± 234.57); and the intake of vitamin B1 (p = 0.04), vitamin B2 (p = 0.007), iron (p = 0.01) and potassium (p = 0.04) correlated with reduced pain sensitivity. In the arthralgia group, the intake of folate (p = 0.03), sodium (p = 0.04) and selenium (p <0.05) correlated with reduced painful sensitivity, while the intake of lipids (p = 0.006) correlated with an greater painful sensitivity. Conclusion: Women with myofascial pain had reduced protein and increased calcium intake compared to healthy women and women with, and the intake of nutrients lipid, calcium, potassium, vitamin B1, iron, folate, sodium and selenium seem to be related to changes in the painful perception of women with TMD, however, further studies focusing on the role of nutrition in the pathophysiology of TMDs are needed.