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A influência da dieta na manifestação e gravidade dos sintomas de disfunção temporomandibular (DTM)
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Abstract(s)
Objetivos. A nutrição e a dieta emergiram como fatores potencialmente modificáveis na gestão da dor crônica; no entanto, ainda há evidências limitadas sobre a relação direta entre dieta, nutrição e disfunção temporomandibular (DTM). O objetivo deste estudo transversal foi explorar a relação entre padrões dietéticos e DTM dolorosas, com um foco particular no potencial inflamatório da dieta, adesão à dieta mediterrânea e preditores psicossociais.
Materiais e Métodos. Noventa e dois participantes (45 pacientes com DTM e 47 controles) com idades entre 20 e 50 anos foram recrutados em Portugal e Espanha. O diagnóstico de DTM foi baseado nos Critérios Diagnósticos para DTM (DC/TMD). O estado psicossocial foi avaliado utilizando o PHQ-9 (depressão), PHQ-15 (sintomas somáticos) e a Lista de Verificação de Comportamentos Orais (OBC). Os dados dietéticos foram coletados através de um recordatório de 24 horas e avaliados utilizando o Índice de Alimentação Saudável (HEI), o Índice Inflamatório Dietético (DII) e o Questionário de Adesão à Dieta Mediterrânea (MEDAS). Os limiares de dor à pressão (PPT) foram avaliados na ATM e nos músculos mastigatórios. Os dados foram analisados utilizando testes t independentes, Mann-Whitney U e modelagem multivariada OPLS-DA. Resultados. Pacientes com DTM apresentaram escores significativamente mais altos para sintomas somáticos, sintomas depressivos e comportamentos orais inadequados (p=0.001). Embora nenhuma diferença significativa tenha sido encontrada para os escores do DII ou do MEDAS entre os grupos, os pacientes com DTM tiveram escores do HEI (p=0.001) e valores de PPT significativamente mais baixos nas regiões do masséter (p=0.04), temporal (p=0.03) e ATM (p=0.01). A OPLS-DA identificou comportamentos orais, sintomas somáticos e menor HEI como os preditores mais fortes que distinguem os pacientes com DTM dos controles. Conclusões. A DTM dolorosa está associada a maior comprometimento psicossocial e menor qualidade dietética.
Objectives. Nutrition and diet have emerged as modifiable factors in the management of chronic pain, however, there is still limited evidence regarding the direct relationship between diet, nutrition, and temporomandibular disorders (TMD). The aim of this cross-sectional study was to explore the relationship between dietary patterns and painful TMD, with a particular focus on dietary inflammatory potential, adherence to the Mediterranean diet, and psychosocial predictors. Materials and Methods. This study was approved by three ethics committees. Ninety-two participants (45 TMD patients and 47 controls) aged 20350 were recruited in Portugal and Spain. TMD diagnosis was based on the Diagnostic Criteria for TMD (DC/TMD). Psychosocial status was assessed using PHQ-9 (depression), PHQ-15 (somatic symptoms), and the Oral Behavior Checklist (OBC). Dietary data were collected through a 24-hour recall and assessed using the Healthy Eating Index (HEI), Dietary Inflammatory Index (DII), and Mediterranean Diet Adherence Screener (MEDAS). Pressure pain thresholds (PPT) were recorded at the TMJ and masticatory muscles. Data was analyzed using independent t-tests, Mann-Whitney U, and OPLS-DA multivariate modeling. Results. TMD patients showed significantly higher scores for somatic symptoms, depressive symptoms, and maladaptive oral behaviors (p=0.001). While no significant differences were found for DII or MEDAS scores between groups, TMD patients had significantly lower HEI (p=0.001) scores and PPTs values in the masseter (p=0.04), temporalis (p=0.03), and TMJ (p=0.01) regions. OPLS-DA identified oral behaviors, somatic symptoms, and lower HEI as the strongest predictors distinguishing TMD patients from controls. Conclusions. Painful TMD is associated with higher psychosocial distress and poorer dietary quality.
Objectives. Nutrition and diet have emerged as modifiable factors in the management of chronic pain, however, there is still limited evidence regarding the direct relationship between diet, nutrition, and temporomandibular disorders (TMD). The aim of this cross-sectional study was to explore the relationship between dietary patterns and painful TMD, with a particular focus on dietary inflammatory potential, adherence to the Mediterranean diet, and psychosocial predictors. Materials and Methods. This study was approved by three ethics committees. Ninety-two participants (45 TMD patients and 47 controls) aged 20350 were recruited in Portugal and Spain. TMD diagnosis was based on the Diagnostic Criteria for TMD (DC/TMD). Psychosocial status was assessed using PHQ-9 (depression), PHQ-15 (somatic symptoms), and the Oral Behavior Checklist (OBC). Dietary data were collected through a 24-hour recall and assessed using the Healthy Eating Index (HEI), Dietary Inflammatory Index (DII), and Mediterranean Diet Adherence Screener (MEDAS). Pressure pain thresholds (PPT) were recorded at the TMJ and masticatory muscles. Data was analyzed using independent t-tests, Mann-Whitney U, and OPLS-DA multivariate modeling. Results. TMD patients showed significantly higher scores for somatic symptoms, depressive symptoms, and maladaptive oral behaviors (p=0.001). While no significant differences were found for DII or MEDAS scores between groups, TMD patients had significantly lower HEI (p=0.001) scores and PPTs values in the masseter (p=0.04), temporalis (p=0.03), and TMJ (p=0.01) regions. OPLS-DA identified oral behaviors, somatic symptoms, and lower HEI as the strongest predictors distinguishing TMD patients from controls. Conclusions. Painful TMD is associated with higher psychosocial distress and poorer dietary quality.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Dor crónica Disfunção temporomandibular Dieta Inflamação