Vignolo Valeria, Vedolin Gabriela Modesti, de Araujo Carlos Dos Reis Pereira, Rodrigues Conti Paulo César
Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo Bauru, São Paulo, Brazil.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Mar;105(3):308-15. doi: 10.1016/j.tripleo.2007.08.044.
The aim of this study was to investigate the influence of the menstrual cycle and oral contraceptive (OC) intake on the pressure pain threshold (PPT) of masticatory muscles in patients with masticatory myofascial pain (MFP).
The sample was composed of 36 women, divided into 4 groups, according to the presence of MFP and the intake of OC (15 patients had MFP [7 taking OC] and 21 were pain-free controls [8 taking OC]). The algometer-based PPT of masseter and temporalis, and the record of subjective pain by visual analog scale (VAS) were determined during 2 consecutives menstrual cycles at 4 phases (menstrual, follicular, periovulatory, and luteal). A 3-way ANOVA for repeated measurements, Kruskal-Wallis, Friedman, and Dunn tests, with a 5% significant level analyzed the data.
PPT was significantly lower in MFP patients when compared with controls throughout the experiment (P < .001). The menstrual phases did not influence PPT (P > .05), while the intake of OC seems to raise PPT levels for the left temporalis (P = .01) and right masseter (P = .04). VAS was, in general, higher at the menstrual phase
Different phases of the menstrual cycle have no influence on PPT values, regardless of the presence of a previous condition, as masticatory myofascial pain, while the intake of OC is associated with decreased levels of reported pain.
本研究旨在调查月经周期和口服避孕药（OC）摄入对咀嚼肌筋膜疼痛（MFP）患者咀嚼肌压力疼痛阈值（PPT）的影响。
样本由36名女性组成，根据是否存在MFP和OC摄入情况分为4组（15例患有MFP [7例服用OC]，21例为无痛对照组 [8例服用OC]）。在两个连续的月经周期中的4个阶段（月经期、卵泡期、排卵期和黄体期），使用压力痛觉计测定咬肌和颞肌的PPT，并通过视觉模拟量表（VAS）记录主观疼痛。采用重复测量的三因素方差分析、Kruskal-Wallis检验、Friedman检验和Dunn检验，显著性水平设定为5%来分析数据。
在整个实验过程中，MFP患者的PPT显著低于对照组（P < .001）。月经周期各阶段对PPT无影响（P > .05），而服用OC似乎会提高左侧颞肌（P = .01）和右侧咬肌（P = .04）的PPT水平。一般来说，VAS在月经期较高。
无论之前是否存在如咀嚼肌筋膜疼痛等情况，月经周期的不同阶段对PPT值均无影响，而服用OC与报告的疼痛水平降低有关。
