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Antonopoulos SR, Garten DA, Durham PL. Dietary supplementation with grape seed extract from Vitus vinifera prevents suppression of GABAergic protein expression in female Sprague Dawley trigeminal ganglion in a model of chronic temporomandibular joint disorder. Arch Oral Biol 2024; 165:106014. [PMID: 38833771 DOI: 10.1016/j.archoralbio.2024.106014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 05/18/2024] [Accepted: 05/25/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVE To investigate cellular changes in protein expression in the trigeminal ganglion in an established preclinical chronic model of temporomandibular joint disorder (TMD) in response to grape seed extract (GSE) supplementation based on its beneficial use in preclinical chronic orofacial pain models. DESIGN Three experimental conditions included female Sprague-Dawley rats as naïve controls, and animals subjected to neck muscle inflammation and prolonged jaw opening with and without daily supplementation of GSE in the drinking water prior to inflammation. Changes were evaluated in mechanical sensitivity to von Frey filaments and protein expression in the trigeminal ganglion of animals 14 days post jaw opening. RESULTS Calcitonin-gene related peptide and protein kinase A, proteins positively associated with peripheral sensitization and enhanced nociception, did not show elevated expression at day 14 in the model compared to naïve or GSE supplemented animals. However, neuronal levels of glutamate decarboxylase (GAD) 65/67, which are enzymes responsible for the synthesis of the inhibitory neurotransmitter GABA that functions to suppress neuronal excitability, were significantly decreased on day 14 post jaw opening. Similarly, a significant decrease in neuronal expression of the GABA receptor subunits GABAB1 and GABAB2, but not GABAA, was observed in the TMD model. Importantly, GSE prevented suppression of GAD 65/67 and GABAB subunits, maintaining levels similar to naïve animals. CONCLUSION Results from our study provide evidence of the downregulation of inhibitory GABAergic proteins in trigeminal ganglion neurons in a preclinical chronic TMD model and the benefits of GSE supplementation in preventing their suppression and maintaining normal levels.
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Affiliation(s)
- Sophia R Antonopoulos
- Missouri State University, Jordan Valley Innovation Center, Department of Biology, Springfield, MO 65806, USA
| | - Daniel A Garten
- Missouri State University, Jordan Valley Innovation Center, Department of Biology, Springfield, MO 65806, USA
| | - Paul L Durham
- Missouri State University, Jordan Valley Innovation Center, Department of Biology, Springfield, MO 65806, USA.
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Cairns BE, He N. β 2-adrenergic receptor activation decreases the mechanical sensitivity of rat masticatory muscle afferent fibres. J Oral Rehabil 2024. [PMID: 38894554 DOI: 10.1111/joor.13787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/29/2024] [Accepted: 06/10/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Activation of β2 adrenergic receptors reduces cutaneous mechanical pain thresholds in rats. While β2 adrenergic receptor activation may contribute to mechanisms that underlie temporomandibular joint pain, its effect on masticatory muscle pain sensitivity is uncertain. OBJECTIVES The current study sought to determine the extent to which β adrenergic receptors are expressed by masticatory muscle afferent fibres, and to assess the effect of local activation of these receptors on the mechanical sensitivity of masticatory muscle afferent fibres in rats. METHODS Trigeminal ganglion neurons that innervate the rat (n = 12) masseter muscle and lower lip were identified by tissue injection of fluorescent dyes and were then stained with antibodies against β1 or β2 adrenergic receptors. Extracellular recordings from 60 trigeminal ganglion neurons that innervate the masticatory muscle were undertaken in a second group of anaesthetised rats of both sexes (n = 37) to assess afferent mechanical activation thresholds. Thresholds were assessed before and after injection of the β adrenergic receptor agonists into masticatory muscle. RESULTS β1 and β2 adrenergic receptor expression was greater in labial skin than in masticatory muscle ganglion neurons (p < .05, one-way ANOVA, Holm-Sidak test). There was a higher expression of β2 adrenergic receptors in masticatory muscle ganglion neurons in males than in females. The mixed β agonist isoproterenol increased afferent mechanical activation threshold in male but not female rats (p < .05, Mann-Whitney test). In male rats, salbutamol, a β2 selective agonist, also increased afferent mechanical activation threshold but hydralazine, a vasodilator, did not (p < .05, Mann-Whitney test). CONCLUSION Activation of β2 adrenergic receptors decreases the mechanical sensitivity of masticatory muscle afferent fibres in a sex-related manner.
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Affiliation(s)
- Brian E Cairns
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Nathan He
- Department of Anesthesia, Pharmacology and Therapeutics, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
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Chen L, Zhang S, Tan Y, Zheng Y, Fang S, Yi Y, Xiong X. Anxiety mediates association between sex and jaw function limitation in temporomandibular disorder patients from China. Front Neurol 2024; 15:1398788. [PMID: 38803643 PMCID: PMC11128587 DOI: 10.3389/fneur.2024.1398788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 04/24/2024] [Indexed: 05/29/2024] Open
Abstract
Aim The objective of this study is to explore the relationship between sex and jaw function and to test whether anxiety mediates the causal relationship between sex and jaw function in temporomandibular disorders (TMDs) patients. Methods A total of 488 participants with TMD were included in the analysis. Demographic data were collected. Generalized anxiety symptoms and anxiety severity were initially assessed using the GAD-7 questionnaire. And jaw function limitation was measured using the JFLS-8 scale. A directed acyclic graph (DAG) was used in this study to evaluate the hypotheses. Mediation analysis was conducted to explore causality and to calculate the total effect, natural direct effect (NDE) and natural indirect effect (NIE). Results In TMD patients, there was a significant association between female and jaw function (r = 0.17, p < 0.001), female and anxiety (r = 0.15, p = 0.002), anxiety and jaw function (r = 0.35, p < 0.001). In addition, sex can directly lead to differences in impaired jaw function (NDE: 3.719, 95% CI: 1.619-5.828, p < 0.001), and can also be causally related to jaw function through anxiety (NIE: 1.146, 95% CI: 0.267-2.024, p = 0.011). And the total effect was 4.865 (95% CI, 2.709-7.029, p < 0.001). Conclusion A causal mechanism was found that anxiety acts as a mediator of sex effects on jaw function. Therefore, psychological factors need to be taken into account in the treatment of female TMD patients. Further clinical trials are needed to explore whether psychotherapy is more beneficial to improve jaw function in female TMD patients.
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Affiliation(s)
- Li Chen
- State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shuyuan Zhang
- West China Hospital of Sichuan University, Chengdu, China
| | - Yanyue Tan
- State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Nursing, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yunhao Zheng
- West China Hospital of Sichuan University, Chengdu, China
| | - Shanbao Fang
- Department of Orthodontics, College and Hospital of Stomatology, Guangxi Medical University, Nanning, China
| | - Yating Yi
- State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Xiong
- State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Ehrmann E, Bernabeu M, Tillier Y, Camia J, Ecalle C, Savoldelli C, Charavet C. Impact of Orthodontic-Surgical Treatments on the Signs and Symptoms of Temporomandibular Disorders: A Systematic Review. Dent J (Basel) 2024; 12:132. [PMID: 38786530 PMCID: PMC11120548 DOI: 10.3390/dj12050132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/26/2024] [Accepted: 05/01/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION Some patients exhibit temporomandibular joint or muscular disorders of the masticatory system before, during, or after orthognathic surgery (OS). These are collectively referred to as temporomandibular disorders (TMDs). This systematic literature review aimed to determine the relationship between orthodontic-surgical treatment and TMDs. METHODS An electronic search of the PubMed database, supplemented by a manual search, was performed; the search included any studies published between 2021 (date of the last search in a systematic review of the literature on the subject) and June 2023 that evaluate the prevalence of TMDs during orthodontic-surgical treatment. The diagnosis of TMDs had to be established using the diagnostic algorithm "diagnostic criteria for temporomandibular disorders (DC/TMDs)", and the diagnosis of disc displacement had to be confirmed using magnetic resonance imaging (MRI). The data were extracted and statistically analyzed. RESULTS Of the 100 results, seven eligible articles were included, representing a total of 529 cases undergoing orthodontic-surgical treatment. A reduction in joint noises (64.8%), arthralgia (57 to 77%), and myalgia (73 to 100%) was found after orthodontic-surgical treatment despite the fact that a minority of patients exhibited these signs and symptoms even though they were asymptomatic before treatment. The effects of OS on disc position were objectively unpredictable. After surgery, the presence of headaches decreased without significance and the risk of their occurrence was very low (1%). The studies converged toward a reduction in the amplitudes of mouth opening and lateral/protrusion movements. Finally, after the treatment, mandibular function was improved. CONCLUSION Under the conditions of this study, OS seems to have a positive impact on the signs and symptoms of TMDs; however, it is not possible to predict the consequential effects on the position of the TMJ disc, whether it is initially in a normal position or displaced.
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Affiliation(s)
- Elodie Ehrmann
- Université Côte d’Azur, Faculté de Chirurgie Dentaire, Département de Réhabilitation Orale, 06300 Nice, France; (E.E.); (M.B.)
- Centre Hospitalier Universitaire de Nice, Institut de Médecine Bucco-Dentaire, Unité Douleur et Dysfonction Orofaciales, 06300 Nice, France
- Biomechanics/Department of Computational Mechanics & Physics, Mines Paris, PSL University, Centre for Material Forming (CEMEF), UMR7635 CNRS, 06904 Sophia Antipolis, France; (Y.T.); (C.S.)
| | - Marie Bernabeu
- Université Côte d’Azur, Faculté de Chirurgie Dentaire, Département de Réhabilitation Orale, 06300 Nice, France; (E.E.); (M.B.)
- Centre Hospitalier Universitaire de Nice, Institut de Médecine Bucco-Dentaire, Unité Douleur et Dysfonction Orofaciales, 06300 Nice, France
| | - Yannick Tillier
- Biomechanics/Department of Computational Mechanics & Physics, Mines Paris, PSL University, Centre for Material Forming (CEMEF), UMR7635 CNRS, 06904 Sophia Antipolis, France; (Y.T.); (C.S.)
| | - Julien Camia
- Université Côte d’Azur, Faculté de Chirurgie Dentaire, Département d’Orthodontie, 06300 Nice, France; (J.C.)
- Centre Hospitalier Universitaire de Nice, Institut de Médecine Bucco-Dentaire, Unité d’Orthodontie, 06300 Nice, France
| | - Corentin Ecalle
- Université Côte d’Azur, Faculté de Chirurgie Dentaire, Département d’Orthodontie, 06300 Nice, France; (J.C.)
- Centre Hospitalier Universitaire de Nice, Institut de Médecine Bucco-Dentaire, Unité d’Orthodontie, 06300 Nice, France
| | - Charles Savoldelli
- Biomechanics/Department of Computational Mechanics & Physics, Mines Paris, PSL University, Centre for Material Forming (CEMEF), UMR7635 CNRS, 06904 Sophia Antipolis, France; (Y.T.); (C.S.)
- Centre Hospitalier Universitaire de Nice, Institut Universitaire de la Face et du Cou, 06300 Nice, France
- Université Côte d’Azur, Faculté de Médecine, 06800 Nice, France
| | - Carole Charavet
- Université Côte d’Azur, Faculté de Chirurgie Dentaire, Département d’Orthodontie, 06300 Nice, France; (J.C.)
- Centre Hospitalier Universitaire de Nice, Institut de Médecine Bucco-Dentaire, Unité d’Orthodontie, 06300 Nice, France
- Université Côte d’Azur, Laboratoire MICORALIS, UPR 7554, 06800 Nice, France
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Santiago V, Janal MN, Cook DB, Raphael KG. Examination of Conditioned Pain Modulation in Myofascial TMD With Consideration of Temporal Summation. THE JOURNAL OF PAIN 2024; 25:104430. [PMID: 37993032 PMCID: PMC11058037 DOI: 10.1016/j.jpain.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/03/2023] [Accepted: 11/10/2023] [Indexed: 11/24/2023]
Abstract
Research on myofascial temporomandibular disorder (mTMD) has often focused on potential dysfunction in endogenous pain modulation. However, studies on the specific inhibitory and facilitatory components of endogenous pain modulation using conditioned pain modulation (CPM) and temporal summation of second pain (TSSP) have shown mixed results. This study aimed to 1) examine whether women with mTMD demonstrated efficient CPM compared to controls; 2) explore the association between independent measures of CPM and TSSP in women with mTMD relative to controls; and 3) determine whether resulting modulatory profiles differentially predicted pain intensity among cases. All participants were recruited from dental clinics. Cases were women who met the research diagnostic criteria for mTMD. Controls did not have facial pain on exam and were selected to be sociodemographically similar to cases. CPM and TSSP were assessed via independent psychophysical protocols. CPM was examined in linear mixed models predicting pain thresholds adjusted for age and stratified by TSSP. Mean CPM was estimated at a 2.2 (SD = 2.8) degree increase in pain thresholds (P ≤ .001), similar in cases and controls (P = .67). CPM was less efficient in cases with enhanced TSSP (P = .031), but not in controls. Although the double-pronociceptive profile of both low CPM and high TSSP trended higher among cases than controls, it did not predict higher levels of pain intensity among cases. This study does not support deficient inhibitory endogenous pain modulation in mTMD, but results suggest that inhibitory and facilitatory pain modulation should be examined concomitantly in the study of endogenous pain modulation. PERSPECTIVE: This manuscript presents a novel examination of inhibitory modulation by the level of facilitatory modulation in mTMD. The findings and approach may prove useful for mechanistic researchers studying endogenous pain modulation and clinical researchers seeking to jointly examine conditioned pain modulation and temporal summation in future research on chronic pain.
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Affiliation(s)
- Vivian Santiago
- Department of Oral & Maxillofacial Pathology, Radiology & Medicine, New York University College of Dentistry, New York, NY, USA
| | - Malvin N Janal
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY, USA
| | - Dane B Cook
- Research Service, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Department of Kinesiology, University of Wisconsin-Madison School of Education, Madison, WI, USA
| | - Karen G Raphael
- Department of Oral & Maxillofacial Pathology, Radiology & Medicine, New York University College of Dentistry, New York, NY, USA
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Alajbeg IZ, Vrbanovic E, Alajbeg I, Orabovic I, Naka K, Mrla A, Boucher Y. Time-course of pain and salivary opiorphin release in response to oral capsaicin differ in burning mouth syndrome patients, temporomandibular disorders patients and control subjects. Clin Oral Investig 2024; 28:246. [PMID: 38589630 DOI: 10.1007/s00784-024-05653-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 04/03/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVES Opiorphin is an analgesic peptide released by salivary glands and capsaicin an agonist of TRPV1 receptors eliciting burning sensations. The primary objective of this study was to assess opiorphin release after stimulation of the tongue by capsaicin (STC). The secondary objectives were to compare opiorphin release after STC in 3 groups of subjects [healthy (CTRL), Burning Mouth Syndrome (BMS), painful Temporomandibular disorders (TMDp)] and pain evoked by STC in these 3 groups. MATERIALS AND METHODS Salivary opiorphin was assessed with high-performance liquid chromatography at 3 different time points (baseline, after 5 min and 20 min of STC). Pain was self-reported on a (0-10) numeric rating scale. RESULTS Three groups (N = 16) of adults were recruited at the Clinical Hospital Centre and School of Dental Medicine in Zagreb. Opiorphin levels were higher (1) in TMDp compared to CTRL in 1st (2.23 ± 1.72 pg/ul vs. 0.67 ± 0.44 pg/ul, p = 0.002) and 3rd sampling (2.44 ± 2.01 pg/ul vs. 0.74 ± 0.52 pg/ul, p = 0.020) and (2) within BMS group at 3rd sampling vs. baseline (p < 0.025). Pain scores were higher in BMS compared to TMDp (p < 0.025) and CTRL (p < 0.025). CONCLUSION This study evidenced (1) a differential basal amount of opiorphin in two pain conditions and control subjects (2) a differential kinetic of release of opiorphin after STC in CTRL, BMS and TMDp (3) a differential pain perception after STC in BMS and TMDp vs. CTRL, which can provide a readout for animal models. CLINICAL RELEVANCE The specific regulation of opiorphin release in patients with orofacial painful conditions provides valuable insights for clinicians and researchers in physiology and pathology and encourages further research in this area. TRIAL REGISTRATION ClinicalTrials.gov NCT04694274. Registered on 01/05/2021.
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Affiliation(s)
- Iva Z Alajbeg
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, University of Zagreb, Zagreb, 10000, Croatia.
- Department of Dental Medicine, Clinical Hospital Centre Zagreb, Zagreb, 10000, Croatia.
| | - Ema Vrbanovic
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, University of Zagreb, Zagreb, 10000, Croatia
| | - Ivan Alajbeg
- Department of Oral Medicine, University of Zagreb School of Dental Medicine, University of Zagreb, Zagreb, 10000, Croatia
- Department of Dental Medicine, Clinical Hospital Centre Zagreb, Zagreb, 10000, Croatia
| | - Ivan Orabovic
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, University of Zagreb, Zagreb, 10000, Croatia
| | - Klara Naka
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, University of Zagreb, Zagreb, 10000, Croatia
| | - Antonija Mrla
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, University of Zagreb, Zagreb, 10000, Croatia
| | - Yves Boucher
- Laboratoire de Neurobiologie Orofaciale, UFR Odontologie, Université Paris Cité, Paris, 75006, France
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Uzunçıbuk H, Marrapodi MM, Meto A, Ronsivalle V, Cicciù M, Minervini G. Prevalence of temporomandibular disorders in clear aligner patients using orthodontic intermaxillary elastics assessed with diagnostic criteria for temporomandibular disorders (DC/TMD) axis II evaluation: A cross-sectional study. J Oral Rehabil 2024; 51:500-509. [PMID: 38041596 DOI: 10.1111/joor.13614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND The objective of this investigation is to assess the relationship between the utilisation of orthodontic intermaxillary elastics and temporomandibular disorder (TMD) symptoms in clear aligner patients and to examine the correlation between the elastic usage time with the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)-Axis II Evaluation Forms. METHODS This study was carried out on a total of 40 clear aligner patients using intermaxillary elastics in the experimental group and 30 clear aligner patients who did not use any intermaxillary elastics in the control group. The data were evaluated using the Mann-Whitney U, chi-square, Fisher's exact chi-square, and Fisher Freeman Halton exact chi-square tests. RESULTS The characteristic pain intensity, mastication, mobility, communication, global and PHQ-9 scores of the experimental group were significantly higher than those of the control group (p < .05). The characteristic pain intensity score, interference score and chronic pain grade score of patients using Class III elastics were statistically significantly higher than those of patients using Class II elastics (p < .05). Patients who used elastics for less than 6 months had statistically significantly higher PHQ-9 scores than those who used elastics for more than 6 months (p < .05). CONCLUSIONS Orthodontic treatment may affect occlusion, bite force and jaw movement, which may cause or worsen TMD symptoms, and the DC/TMD questionnaires can determine if orthodontic patients acquire TMD by assessing their psychosocial state and pain-related problems.
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Affiliation(s)
- Hande Uzunçıbuk
- Department of Orthodontics, Dentistry Faculty, Trakya University, Edirne, Turkey
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Aida Meto
- Department of Dentistry, Faculty of Dental Sciences, University of Aldent, Tirana, Albania
| | - Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Giuseppe Minervini
- Saveetha Dental College & Hospitals, Saveetha Institute of Medical & Technical Sciences, Saveetha University, Chennai, India
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
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Zanelatto FB, Vieira WF, Nishijima CM, Zanotto TM, Magalhães SFD, Sartori CR, Parada CA, Tambeli CH. Effect of propranolol on temporomandibular joint pain in repeatedly stressed rats. Eur J Oral Sci 2024; 132:e12957. [PMID: 37908149 DOI: 10.1111/eos.12957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/02/2023] [Indexed: 11/02/2023]
Abstract
Stress substantially increases the risk of developing painful temporomandibular disorders (TMDs) by influencing the release of endogenous catecholamines. Propranolol, an antagonist of β-adrenergic receptors, has shown potential in alleviating TMD-associated pain, particularly when the level of catecholamines is elevated. The aim of this study was to explore whether intra-articular propranolol administration is effective in diminishing temporomandibular joint (TMJ) pain during repeated stress situations. Additionally, we investigated the effect of repeated stress on the expression of genes encoding β-adrenoceptors in the trigeminal ganglion. In the present study, rats were exposed to a stress protocol induced by sound, then to the administration of formalin in the TMJ (to elicit a nociceptive response), followed immediately afterward by different doses of propranolol, after which the analgesic response to propranolol was evaluated. We also assessed the levels of beta-1 and beta-2 adrenergic receptor mRNAs (Adrb1 and Adrb2, respectively) using reverse transcription-quantitative PCR (RT-qPCR). Our findings revealed that propranolol administration reduces formalin-induced TMJ nociception more effectively in stressed rats than in non-stressed rats. Furthermore, repeated stress decreases the expression of the Adrb2 gene within the trigeminal ganglion. The findings of this study are noteworthy as they suggest that individuals with a chronic stress history might find potential benefits from β-blockers in TMD treatment.
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Affiliation(s)
- Fernanda Barchesi Zanelatto
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | | | - Catarine Massucato Nishijima
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Tamires Marques Zanotto
- Department of Internal Medicine, School of Medical Science, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Silviane Fernandes de Magalhães
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - César Renato Sartori
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Carlos Amilcar Parada
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Claudia Herrera Tambeli
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
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Son H, Shannonhouse J, Zhang Y, Gomez R, Chung MK, Kim YS. Elucidation of neuronal activity in mouse models of TMJ injury by in vivo GCaMP Ca 2+ imaging of intact trigeminal ganglion neurons. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.16.575919. [PMID: 38293055 PMCID: PMC10827170 DOI: 10.1101/2024.01.16.575919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Patients with temporomandibular disorders (TMD) typically experience facial pain and discomfort or tenderness in the temporomandibular joint (TMJ), causing disability in daily life. Unfortunately, existing treatments for TMD are not always effective, creating a need for more advanced, mechanism-based therapies. In this study, we used in vivo GCaMP3 Ca 2+ imaging of intact trigeminal ganglia (TG) to characterize functional activity of the TG neurons in vivo , specifically in TMJ animal models. This system allows us to observe neuronal activity in intact anatomical, physiological, and clinical conditions and to assess neuronal function and response to various stimuli. We observed a significant increase in spontaneously and transiently activated neurons responding to mechanical, thermal, and chemical stimuli in the TG of forced mouth open (FMO) mice. An inhibitor of the CGRP receptor significantly attenuated FMO-induced facial hypersensitivity. In addition, we confirmed the attenuating effect of CGRP antagonist on FMO-induced sensitization by in vivo GCaMP3 Ca 2+ imaging of intact TG. Our results contribute to unraveling the role and activity of TG neurons in the TMJ pain animal models of TMD, bringing us closer understanding the pathophysiological processes underlying TMD. Our study also illustrates the utility of in vivo GCaMP3 Ca 2+ imaging of intact TG for studies aimed at developing more targeted and effective treatments for TMD.
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Zhao J, Xia S, Yue S, Luo Y, Shen P, Yang C. Factors Influencing Mandibular Deviation: A Retrospective Clinical Study. J Craniofac Surg 2024; 35:e28-e31. [PMID: 38294302 DOI: 10.1097/scs.0000000000009710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/28/2023] [Indexed: 02/01/2024] Open
Abstract
This study aimed to investigate the correlation between mandibular deviation (MD) and possible clinical factors in patients with anterior disc displacement (ADD). This retrospective clinical study enrolled 296 patients with ADD, diagnosed using magnetic resonance imaging, from 2015 to 2018. The clinical symptoms and medical histories of these patients were carefully examined and recorded. Mandibular deviation was the primary outcome variable confirmed by a combination of clinical examination and facial photographs or posteroanterior cephalograms. The primary predictor variable was ADD staging. Secondary predictor variables included condylar height and distance of disc displacement. Other predictor variables were age, sex, disease course, oral parafunctions, depression, and bone mineral density. We used logistic regression to examine the correlation between the MD and all predictor variables. The χ2 test and analysis of variance were used to exclude the correlation between the predictor variables. In this study, the prevalence of MD was 77% among 278 patients with ADD. Bilateral ADD staging significantly contributed to MD on both sides. The odds ratio increased with the deterioration of disc displacement. The present study demonstrated that the ADD staging influences the condylar height and MD, and that articular disk position should be considered while treating MD.
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Affiliation(s)
- Jiong Zhao
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine
| | - Simo Xia
- Transform Studio for Endodontium Stem Cell, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine
| | - Shijing Yue
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine
| | - Yi Luo
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shangai, China
| | - Pei Shen
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shangai, China
| | - Chi Yang
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shangai, China
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11
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Ali HA, Hadi HA. Can the Autogenous Nanofat Injection Improve the Symptoms of Patients With Temporomandibular Joint Internal Derangement? A Prospective Observational Clinical Study. J Craniofac Surg 2023:00001665-990000000-01190. [PMID: 37955518 DOI: 10.1097/scs.0000000000009820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/29/2023] [Indexed: 11/14/2023] Open
Abstract
Since nanofat is considered one of the richest sources of adipose-derived stem cells with an increased need for new biological approaches for managing temporomandibular joint internal derangement (TMJ-ID) symptoms that impair a patient's lifestyle, this study evaluated the effectiveness of autogenous nanofat intra-articular injection in managing ID symptoms regarding pain, mouth opening, and joint sound. Furthermore, to assess the consequences and complications of this procedure, 20 patients with 38 TMJs with varying stages of Wilkes classification were included in the study. All involved patients were previously diagnosed with ID depending on a clinical and radiographical basis and had no previous response to conservative management for at least 4 to 6 months. Evaluation of the ID in the preoperative phase, as well as 2 weeks, 1 month, 3 months, and 6 months postoperatively. An evaluation was done depending on pain assessment using a visual analog scale (VAS), measuring maximum mouth opening (MMO) and joint noise if it was present or absent preoperatively and postoperatively. The results show improvement in the symptoms in all follow-up appointments since the VAS of pain decreased significantly with increased MMO and the absence of clicking in most cases during follow-up appointments. We conclude from this study that nanofat intra-articular injection was influential in managing ID symptoms and was safe without significant side effects.
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Affiliation(s)
- Huda Akram Ali
- Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Baghdad, Baghdad, Iraq
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12
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Almpani K, Tran H, Ferri A, Hung M. Assessment of condylar anatomy and degenerative changes in temporomandibular joint disorders - A scoping review. J Oral Biol Craniofac Res 2023; 13:764-780. [PMID: 38028230 PMCID: PMC10665941 DOI: 10.1016/j.jobcr.2023.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 09/05/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Temporomandibular disorders (TMDs) are a group of conditions that cause pain and dysfunction in the temporomandibular joint (TMJ) and muscles that control mandibular movement. In most cases, the etiology is unclear and is considered multifactorial. Recent research suggests that some forms of TMD could be associated with specific TMJ morphological characteristics. This study aims to provide a review of the reported anatomical and degenerative morphological condylar characteristics of subjects with a clinical diagnosis of TMD as described with the use of CBCT imaging, as well as the detection of potential predisposing anatomical factors. This review was developed and reported in accordance with the PRISMA-ScR Checklist. A comprehensive search was performed in five databases. Reports were screened by two independent reviewers based on preselected inclusion and exclusion criteria. 45 studies were included in this review. The most frequently reported degenerative changes associated with TMD were condylar surface erosion, flattening, osteophytes, and sclerosis. Anatomical characteristics included a small condylar size and a posterior position of the condylar head in the TMJ. The anterosuperior area of the condylar head appears to be the most frequently affected. More studies are required to determine potential specific predisposing anatomical characteristics.
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Affiliation(s)
- Konstantinia Almpani
- Roseman University of Health Sciences College of Dental Medicine, 10894 S River Front Pkwy, South Jordan, UT, 84095, USA
| | - Huy Tran
- Roseman University of Health Sciences Advanced Education in Orthodontics and Dentofacial Orthopedics, 4 Sunset Way Bldg B, Henderson, NV, 89014, USA
| | - Anna Ferri
- Roseman University of Health Sciences Library, 11 Sunset Way, Henderson, NV, 89014, USA
| | - Man Hung
- Roseman University of Health Sciences College of Dental Medicine, 10894 S River Front Pkwy, South Jordan, UT, 84095, USA
- Roseman University of Health Sciences Advanced Education in Orthodontics and Dentofacial Orthopedics, 4 Sunset Way Bldg B, Henderson, NV, 89014, USA
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Sangalli L, Eli B, Mehrotra S, Sabagh S, Fricton J. Calcitonin Gene-Related Peptide-Mediated Trigeminal Ganglionitis: The Biomolecular Link between Temporomandibular Disorders and Chronic Headaches. Int J Mol Sci 2023; 24:12200. [PMID: 37569575 PMCID: PMC10418780 DOI: 10.3390/ijms241512200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/22/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
A bidirectional causal relationship has been established between temporomandibular disorders (TMDs) and chronic headaches. Recent advances in the neurobiology of chronic pain offer a framework for understanding the comorbidity between these two conditions that might reside in the shared biomolecular mechanisms of peripheral and central sensitization. The initiation of these processes is inflammatory in nature and is most likely mediated by key molecules, including calcitonin gene-related peptide (CGRP). This scoping review proposes that CGRP-mediated neuroinflammation in the trigeminal ganglion may partly explain the biomolecular bidirectional link between TMDs and chronic headaches. Finally, clinical implications of this neuropathologic process are briefly discussed.
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Affiliation(s)
- Linda Sangalli
- College of Dental Medicine—Illinois, Midwestern University, Downers Grove, IL 60515, USA
| | - Bradley Eli
- Facial Pain Specialists, San Diego, CA 92121,USA; (B.E.); (S.M.); (S.S.)
| | - Sachi Mehrotra
- Facial Pain Specialists, San Diego, CA 92121,USA; (B.E.); (S.M.); (S.S.)
| | - Suzan Sabagh
- Facial Pain Specialists, San Diego, CA 92121,USA; (B.E.); (S.M.); (S.S.)
| | - James Fricton
- Division of TMD and Orofacial Pain, University of Minnesota Schoof of Dentistry, Minneapolis, MN 55455, USA
- Minnesota Head and Neck Pain Clinic, Plymouth, MN 55447, USA
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14
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Crescente BB, Bisatto NV, Rübensam G, Fritscher GG, Campos MM. Assessment of temporomandibular disorders and their relationship with life quality and salivary biomarkers in patients with dentofacial deformities: A clinical observational study. PLoS One 2023; 18:e0288914. [PMID: 37471347 PMCID: PMC10358945 DOI: 10.1371/journal.pone.0288914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023] Open
Abstract
A close relationship between dentofacial deformities (DFD) and temporomandibular disorders (TMD) has been suggested, which might impact the quality of life (QoL) and psychological aspects. We evaluated the presence of TMD in DFD patients, correlating these findings with QoL and salivary levels of biochemical markers of pain and psychological disorders. The study enrolled 51 patients, which were distributed into three groups: (i) orthodontic, (ii) TMD, and (iii) DFD. TMD diagnosis was conducted according to Axis I and II of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). QoL was evaluated by the Oral Health Impact Profile (OHIP-14). The salivary levels of interleukin-1β (IL-1β) were determined by ELISA, while glutamate and serotonin amounts were evaluated by mass spectroscopy. DFD individuals had a positive diagnosis for TMD, as indicated by the Axis I (DC/TMD). They exhibited poorer outcomes regarding pain, functional, and psychological dimensions, according to the Axis II DC-TMD. The QoL evaluation demonstrated poorer outcomes for DFD individuals, accompanied by greater IL-1β salivary contents. Notably, glutamate levels had a positive correlation with behavioral parameters in Axis II DC-TMD, with a mild relevance for serotonin. DFD patients display chronic myofascial pain featuring TMD, with altered psychological symptoms and poor QoL, encompassing changes in pain mediators. Data bring new evidence about the relevance of TMD in DFD patients, which likely impacts the QoL and the salivary levels of biochemical markers of functional, painful, and psychological disorders.
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Affiliation(s)
- Betina B Crescente
- Programa de Pós-graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Natalia V Bisatto
- Programa de Pós-graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Gabriel Rübensam
- Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Guilherme G Fritscher
- Ambulatório de Cirurgia Oral, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Maria M Campos
- Programa de Pós-graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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15
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Jha AK, Gupta S, Sinha A, Tanna M, Priya L, Singh S, Gore NR. Efficacy of Two Types of Noninvasive Nerve Stimulation in the Management of Myofascial Pain Caused by Temporomandibular Joint (TMJ) Disorders. Cureus 2023; 15:e42584. [PMID: 37637545 PMCID: PMC10460256 DOI: 10.7759/cureus.42584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/27/2023] [Indexed: 08/29/2023] Open
Abstract
Background A range of diseases affecting the jaw muscles and/or temporomandibular joint are referred to as temporomandibular disorders (TMDs). Nearly 80% of the general population is affected by TMDs, and 48% of those people have trouble opening their mouths and have painful muscles. Aim To compare the effectiveness of transcutaneous electrical nerve stimulation (TENS) and microcurrent nerve stimulation (MENS) for the relief of masticatory muscle discomfort. Methods Groups I and II were further separated into two groups of 30 persons each (A and B), as well as subgroups C and D. Subjects in Group I received TENS treatment for 20 minutes at frequencies of 0-5 and 5-5 for subgroups A and B, and with visual analog scale (VAS) scores of 1-5 and 6-10 for subgroups C and D, respectively. Subjects in Group II received MENS for 20 minutes, with subgroups C and D receiving the same frequency and VAS score as subgroups A and B, respectively. All individuals underwent treatment with a comparable frequency and length of time every day for five days. Results For subgroup D treated with MENS, there was a considerable reduction in pain; however, for subgroups A and C, there was a comparable reduction in the VAS score for both groups treated with MENS and TENS therapy. Conclusion Compared to TENS, MENS provides quicker and more effective pain relief. Paresthesia and tingling are two adverse effects of TENS that are not present with MENS. However, MENS and TENS are equally helpful at treating masticatory muscle discomfort that is both acute and chronic, as well as improving mouth opening.
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Affiliation(s)
- Awanindra K Jha
- Department of Orthodontics and Dentofacial Orthopaedics, Rajendra Institute of Medical Sciences (RIMS), Ranchi, IND
| | - Sweta Gupta
- Departmental of Orthodontics and Dentofacial Orthopedics, Patna Dental College and Hospital, Patna, IND
| | - Abhishek Sinha
- Department of Dentistry, Patna Medical College, Patna, IND
| | - Medha Tanna
- Departmental of Orthodontics and Dentofacial Orthopedics, Government Dental College and Hospital, Mumbai, IND
| | - Leena Priya
- Department of Oral Medicine and Radiology, Patna Medical College and Hospital, Patna, IND
| | - Shailee Singh
- Department of Oral and Maxillofacial Surgery, Pacific Dental College and Research Center, Udaipur, IND
| | - Navmi R Gore
- Department of Dentistry, Dr. Vasantrao Pawar Medical College and Research Centre, Nashik, IND
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16
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Zanelatto FB, Vieira WF, Nishijima CM, Sartori CR, Parada CA, Tambeli CH. Effect of sound-induced repeated stress on the development of pain and inflammation in the temporomandibular joint of female and male rats. Eur J Oral Sci 2023:e12936. [PMID: 37243959 DOI: 10.1111/eos.12936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 05/03/2023] [Indexed: 05/29/2023]
Abstract
Temporomandibular disorder (TMD) is a common painful condition of the temporomandibular joint (TMJ) and associated structures. Stress is a significant risk factor for developing this painful condition that predominantly affects women. This study aimed to test the hypothesis that stress increases the risk of developing TMJ pain by facilitating inflammatory mechanisms in female and male rats. To test this hypothesis, we evaluated TMJ carrageenan-induced expression of pro-inflammatory cytokines and migration of inflammatory cells and TMJ formalin-induced nociception in female and male rats submitted to a repeated stress protocol induced by sound. We found that sound-induced repeated stress facilitates TMJ inflammation and contributes to TMJ nociception development equally in females and males. We conclude that stress is a risk factor for developing painful TMJ conditions in males and females, at least in part, by favoring the inflammatory process similarly in both sexes.
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Affiliation(s)
- Fernanda Barchesi Zanelatto
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Campinas, São Paulo, Brazil
| | - Willians Fernando Vieira
- Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Catarine Massucato Nishijima
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Campinas, São Paulo, Brazil
| | - César Renato Sartori
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Campinas, São Paulo, Brazil
| | - Carlos Amilcar Parada
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Campinas, São Paulo, Brazil
| | - Claudia Herrera Tambeli
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Campinas, São Paulo, Brazil
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17
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Suttle A, Wang P, Dias FC, Zhang Q, Luo Y, Simmons L, Bortsov A, Tchivileva IE, Nackley AG, Chen Y. Sensory Neuron-TRPV4 Modulates Temporomandibular Disorder Pain Via CGRP in Mice. THE JOURNAL OF PAIN 2023; 24:782-795. [PMID: 36509176 PMCID: PMC10164682 DOI: 10.1016/j.jpain.2022.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 11/25/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022]
Abstract
Temporomandibular disorder (TMD) pain that involves inflammation and injury in the temporomandibular joint (TMJ) and/or masticatory muscle is the most common form of orofacial pain. We recently found that transient receptor potential vanilloid-4 (TRPV4) in trigeminal ganglion (TG) neurons is upregulated after TMJ inflammation, and TRPV4 coexpresses with calcitonin gene-related peptide (CGRP) in TMJ-innervating TG neurons. Here, we extended these findings to determine the specific contribution of TRPV4 in TG neurons to TMD pain, and examine whether sensory neuron-TRPV4 modulates TMD pain via CGRP. In mouse models of TMJ inflammation or masseter muscle injury, sensory neuron-Trpv4 conditional knockout (cKO) mice displayed reduced pain. Coexpression of TRPV4 and CGRP in TMJ- or masseter muscle-innervating TG neurons was increased after TMJ inflammation and masseter muscle injury, respectively. Activation of TRPV4-expressing TG neurons triggered secretion of CGRP, which was associated with increased levels of CGRP in peri-TMJ tissues, masseter muscle, spinal trigeminal nucleus, and plasma in both models. Local injection of CGRP into the TMJ or masseter muscle evoked acute pain in naïve mice, while blockade of CGRP receptor attenuated pain in mouse models of TMD. These results suggest that TRPV4 in TG neurons contributes to TMD pain by potentiating CGRP secretion. PERSPECTIVE: This study demonstrates that activation of TRPV4 in TG sensory neurons drives pain by potentiating the release of pain mediator CGRP in mouse models of TMJ inflammation and masseter muscle injury. Targeting TRPV4 and CGRP may be of clinical potential in alleviating TMD pain.
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Affiliation(s)
- Abbie Suttle
- Department of Neurology, Duke University, Durham, North Carolina
| | - Peng Wang
- Department of Neurology, Duke University, Durham, North Carolina
| | - Fabiana C Dias
- Department of Neurology, Duke University, Durham, North Carolina
| | - Qiaojuan Zhang
- Department of Neurology, Duke University, Durham, North Carolina
| | - Yuhui Luo
- Department of Neurology, Duke University, Durham, North Carolina
| | - Lauren Simmons
- Department of Neurology, Duke University, Durham, North Carolina
| | - Andrey Bortsov
- Department of Endodontics, Center for Translational Pain Medicine, Department of Anesthesiology, Duke University, Durham, North Carolina
| | - Inna E Tchivileva
- Center for Pain Research and Innovation, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Andrea G Nackley
- Department of Endodontics, Center for Translational Pain Medicine, Department of Anesthesiology, Duke University, Durham, North Carolina; Department of Pharmacology and Cancer Biology, Duke University, Durham, North Carolina
| | - Yong Chen
- Department of Neurology, Duke University, Durham, North Carolina; Department of Endodontics, Center for Translational Pain Medicine, Department of Anesthesiology, Duke University, Durham, North Carolina; Department of Pathology, Duke University, Durham, North Carolina.
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18
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Ananias FEF, Santos VABD, Groppo FC, Henriques GEP, Toledo JR, da Silva Pais R, Figueroba SR. Inflammatory and degenerative effects of induced osteoarthritis/rheumatoid arthritis models on temporomandibular joint of rats. Arch Oral Biol 2023; 150:105693. [PMID: 37030192 DOI: 10.1016/j.archoralbio.2023.105693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/08/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVE The present study compared three models of induction of osteoarthritis (OA) and rheumatoid arthritis (RA) in the temporomandibular joint (TMJ) of rats. DESIGN The induction method was by injection of complete Freund's adjuvant (CFA) + type II bovine collagen (CII). Twenty-four adult male rats were divided into four groups (n = 6): G1: Sham, 50 μL of 0.9% sodium chloride at the base of the tail and in each TMJ; G2: OA, 50 μL CFA+CII in each TMJ; G3: RA+OA, 100 μL of CFA+CII at the base of the tail and 50 μL CFA+CII in each TMJ; G4: RA, 100 μL of CFA+CII at the base of the tail. All injections were repeated 5 days later. Twenty-three days after the first injection, the animals were sacrificed and the TMJs were submitted to histomorphometric analysis and measurement of cytokines. The Kruskal-Wallis and Dunn tests were used (alpha=0.05). RESULTS The total thickness of the condylar cartilage increased in G2 in relation to the other groups, G3 and G4 reduced in relation to G1; and G2 and G4 reduced in relation to G2 and G3. The levels of IL-1β, IL-6 and TNF-α increased in the three induction models compared to G1. The level of IL-10 increased in G2 compared to the other groups and reduced in G3 and G4 compared to G1. CONCLUSION CFA+CII induced inflammation and degeneration compatible with RA (advanced chronic stage) when injected in the tail, and compatible with OA (acute stage or early disease) when injected only in the TMJ.
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İnal Ö. Investigation of the predictors of temporomandibular disorders in engineers across different variables: sociodemographic characteristics, neck pain and neck awareness. Somatosens Mot Res 2023:1-7. [PMID: 36939816 DOI: 10.1080/08990220.2023.2188931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
PURPOSE/AIM This study aimed to investigate the predictors of temporomandibular disorders (TMD) in desk-bound engineers. MATERIALS AND METHODS The Fonseca Anamnestic Index (FAI), The Visual Analogue Scale (VAS), The Neck Pain and Disability Scale (NPDS), Neck Bournemouth Questionnaire (NBQ) and The Fremantle Neck Awareness Questionnaire-Turkish (FreNAQ-T) were used for TMD severity, pain, disability, neck awareness. RESULTS The study was conducted with 208 desk-bound engineers. Mild-to-severe TMD was detected in 78.9% of the subjects. Intensity of pain at rest and during activity was higher in female engineers compared to male engineers (p = 0.002 and <0.01, respectively) and mean FAI, NBQ, NPDS and FreNAQ-T scores were also higher than that of male engineers (p = 0.005, 0.005, 0.006 and 0.016, respectively). FAI, VAS, NPDS, NBQ and FreNAQ-T were found to be correlated with each other (p < 0.05). A statistically significant contribution to the regression model was observed for the variables gender, daily duration of computer use, neck pain at rest, and NBQ (p = 0.043, p = 0.043, p = 0.031 and p = 0.003, respectively). NBQ was identified as the most influential variable in this model, followed by neck pain at rest. CONCLUSIONS Temporomandibular disorders are common among desk-bound engineers and are associated with neck pain, disability, and neck awareness. For this reason, it is important to take preventive and protective ergonomic approaches at the personal and institutional levels in desk-bound engineers.
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Affiliation(s)
- Özgü İnal
- University of Health Sciences Turkey, Faculty of Gülhane Physiotherapy and Rehabilitation, Department of Neurological Physiotherapy-Rehabilitation, Ankara, Turkey
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20
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Chung MK, Wang S, Alshanqiti I, Hu J, Ro JY. The degeneration-pain relationship in the temporomandibular joint: Current understandings and rodent models. FRONTIERS IN PAIN RESEARCH 2023; 4:1038808. [PMID: 36846071 PMCID: PMC9947567 DOI: 10.3389/fpain.2023.1038808] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023] Open
Abstract
Temporomandibular disorders (TMD) represent a group of musculoskeletal conditions involving the temporomandibular joints (TMJ), the masticatory muscles and associated structures. Painful TMD are highly prevalent and conditions afflict 4% of US adults annually. TMD include heterogenous musculoskeletal pain conditions, such as myalgia, arthralgia, and myofascial pain. A subpopulations of TMD patients show structural changes in TMJ, including disc displacement or degenerative joint diseases (DJD). DJD is a slowly progressing, degenerative disease of the TMJ characterized by cartilage degradation and subchondral bone remodeling. Patients with DJD often develop pain (TMJ osteoarthritis; TMJ OA), but do not always have pain (TMJ osteoarthrosis). Therefore, pain symptoms are not always associated with altered TMJ structures, which suggests that a causal relationship between TMJ degeneration and pain is unclear. Multiple animal models have been developed for determining altered joint structure and pain phenotypes in response to various TMJ injuries. Rodent models of TMJOA and pain include injections to induce inflammation or cartilage destruction, sustained opening of the oral cavity, surgical resection of the articular disc, transgenic approaches to knockout or overexpress key genes, and an integrative approach with superimposed emotional stress or comorbidities. In rodents, TMJ pain and degeneration occur during partially overlapping time periods in these models, which suggests that common biological factors may mediate TMJ pain and degeneration over different time courses. While substances such as intra-articular pro-inflammatory cytokines commonly cause pain and joint degeneration, it remains unclear whether pain or nociceptive activities are causally associated with structural degeneration of TMJ and whether structural degeneration of TMJ is necessary for producing persistent pain. A thorough understanding of the determining factors of pain-structure relationships of TMJ during the onset, progression, and chronification by adopting novel approaches and models should improve the ability to simultaneously treat TMJ pain and TMJ degeneration.
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Affiliation(s)
- Man-Kyo Chung
- Department of Neural and Pain Sciences, School of Dentistry, Program in Neuroscience, Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, United States
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21
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Martins IS, Radaic P, Marchi L, Barreto G, Pastore GP. Assessment of postoperative pain in patients undergoing temporomandibular joint arthroscopy with infiltration of dexamethasone disodium phosphate in different concentrations. A randomized controlled trial. J Craniomaxillofac Surg 2023; 51:89-97. [PMID: 36774309 DOI: 10.1016/j.jcms.2023.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 01/23/2023] [Accepted: 02/03/2023] [Indexed: 02/05/2023] Open
Abstract
The main aim of this work was to evaluate the effect of intra-articular, sub-synovial steroid injections (IASSSI) with different doses during temporomandibular joint (TMJ) arthroscopy. Using a single-blind, randomized clinical trial, the investigators enrolled a sample of subjects who underwent TMJ arthroscopy with vs. without IASSSI for treating TMJ disorder (TMD). The predictor variable was the treatment group classified as no treatment (A - without IASSSI) or active treatments (IASSSI (B) with 2 mg or (C) 4-mg dexamethasone). Study medications were randomly assigned. Only subjects were blinded to treatment assignment. The main outcome variables included the following: 1) pain assessed up to postoperative day 30 with the McGill Pain Questionnaire and visual analog scale (VAS); 2) maximum mouth opening (MMO); and 3) analgesic and anti-inflammatory drug consumption. Other variables were demographic (age, sex) or pathologic (disease manifestations and classifications). Descriptive and bivariate statistics were computed. Statistical significance was set at p ≤ 0.5, one-tailed test of hypothesis. The sample comprised 36 patients (n = 12 per study group). In the active group with 4 mg corticosteroids, pain reduction measured by VAS (odds ratio [OR] = 0.18; p = 0.013) and McGill scale scores (OR = 0.15; p = 0.048) was significantly higher than in the control group. The McGill scale scores significantly decreased in both IASSSI groups, compared to the control group, at the final follow-up (all p < 0.012), and IASSSI was significantly associated with reduced analgesic consumption at postoperative days 7 and 14 (p = 0.003). However, there was no significant difference regarding MMO among the three groups. Within the limitations of the study, it seems that intra-articular, sub-synovial steroid injections (IASSSI) with 4 mg dexamethasone should be preferred whenever appropriate when pain relief is the priority of the procedure. Brazilian Registry of Clinical Trials (ReBec)- 28yb2g.
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Affiliation(s)
- Ivan Solani Martins
- Hospital Sírio Libanês, São Paulo, Brazil; Instituto Vita, São Paulo, Brazil.
| | - Patricia Radaic
- Hospital Sírio Libanês, São Paulo, Brazil; Instituto Vita, São Paulo, Brazil
| | | | - Gustavo Barreto
- Hospital Sírio Libanês, São Paulo, Brazil; Instituto Vita, São Paulo, Brazil
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Al-Moraissi EA, Christidis N, Ho YS. Publication performance and trends in temporomandibular disorders research: A bibliometric analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101273. [PMID: 36057419 DOI: 10.1016/j.jormas.2022.08.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/25/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Temporomandibular disorders (TMD) are common, can be both painful and non-painful, and encompass various conditions affecting the temporomandibular joint, the masticatory muscles or both TMD. Therefore, the purpose of this bibliometric analysis was to synthetically analyze citation performance in TMD, to address a more innovative method including details of article title, author keyword, KeyWords Plus, and abstracts. MATERIAL AND METHODS Data used in this study were retrieved from the Clarivate Analytics Web of Science Core Collection, the online version of the Science Citation Index Expanded (SCI-EXPANDED) between 1992 and 2021. The distribution of key words in the article title and author‑selected keywords were used to evaluate research trends. RESULTS Of the 7,228 documents in SCI-EXPANDED, 6,138 documents met all inclusion criteria and were included in the final analysis, of which 4,945 were articles. The present bibliometric analysis of the articles published in the research filed of TMD revealed that orofacial pain, bruxism, chronic pain, and myofascial pain are the most commonly used keywords by the authors. Further, over the last 30 years 4,945 articles are published in the field of TMD, and the far most frequently cited study was published 8 years ago and handles the diagnostic criteria of TMD. The USA and Brazil were top two ranking productive countries of publication on TMD. The most productive journal was Journal of Oral Rehabilitation, followed by Cranio-The Journal of Craniomandibular & Sleep Practice and Journal of Oral & Facial Pain and Headache. The most productive authors were P. Svensson, R. Ohrbach, and F. Lobbezooas. The most productive institutes were Sao Paulo University (Brazil), Malmo University (Sweden), and Washington university (USA) CONCLUSION: Based on the outcome of this bibliometric study, the authors hope that both clinicians and researchers will have information to shape their future research focus, finding prominent institutions in their nearby area, or even to be stimulated to initiate new international or even multinational collaborations.
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Affiliation(s)
- Essam Ahmed Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar, Yemen
| | - Nikolaos Christidis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge SE-141 04, Sweden
| | - Yuh-Shan Ho
- Trend Research Centre, Asia University, No. 500 Lioufeng Road, Wufeng, Taichung 41354, Taiwan.
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23
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Jasim H. Topical review - salivary biomarkers in chronic muscle pain. Scand J Pain 2023; 23:3-13. [PMID: 36228098 DOI: 10.1515/sjpain-2022-0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/23/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND AIMS Muscle related temporomandibular disorders (myogenous TMD), one of the most common orofacial pain conditions, is characterized by facial pain and often accompanied by jaw movement limitations. Although the underlying biological mechanisms are still unclear, a cluster of proteins and peptides is assumed to be involved in the pathophysiology. These proteins and peptides may be measured in a simple non-invasive saliva sample. This work investigated whether saliva can be used to sample algogenic substances that can serve as molecular biomarkers for TMD myalgia. METHODS Saliva and blood samples were collected from healthy individuals (n=69) and patients diagnosed with TMD myalgia (n=39) according to the Diagnostic Criteria for TMD. Unstimulated and stimulated whole, parotid, and sublingual saliva were analysed. The protein profiles were investigated using two-dimensional gel electrophoresis followed by identification with liquid chromatography tandem mass spectrometry. Levels of nerve growth factor (NGF), calcitonin gene-related peptide (CGRP), and brain derived neuro-tropic factor (BDNF) were determined using western blotting based technology and multiplex electro-chemiluminescence assay panel. Glutamate, serotonin, and substance p (SP) were determined using commercially available methods. RESULTS Different saliva collection approaches resulted in significant differences in the protein profile as well as in the expression of NGF, BDNF, CGRP, SP, and glutamate. Stimulated whole saliva showed least variability in protein concentration (35%) and was correlated to plasma levels of glutamate. Unlike SP and glutamate, NGF and BDNF expressed a rhythmic variation in salivary expression with higher levels in the morning (p<0.05). Patients with a diagnosis of TMD myalgia had significantly higher levels of salivary glutamate but lower salivary NGF and BDNF compared to controls; in addition, the lower NGF and BDNF levels correlated to psychological dysfunction. The quantitative proteomics data revealed 20 proteins that were significantly altered in patients compared to controls. The identified proteins are involved in metabolic processes, immune response, and stress response. Dissimilarities in protein profile and clinical variables were observed between TMD myalgia and myofascial pain. CONCLUSIONS The work highlights the importance of consistency in saliva collection approaches, including the timing of the collection. It displayed significant changes in pain specific mediators and protein profile in TMD myalgia and furthermore dissimilarities between subclasses indicating different pathophysiology. After extensive validation, potential salivary biomarkers can be combined with clinical features to better understand and diagnose TMD myalgia.
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Affiliation(s)
- Hajer Jasim
- Eastman Institutet, Folktandvården Stockholms Län AB, Stockholm, Sweden
- Division of Oral Diagnostics & Rehabilitation, Department of Dental Medicine, Karolinska Institutet and Scandinavian Center for Orofacial Neuroscience (SCON), Huddinge, Sweden
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24
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Wang P, Zhang Q, Dias FC, Suttle A, Dong X, Chen Y. TMEM100, a regulator of TRPV1-TRPA1 interaction, contributes to temporomandibular disorder pain. Front Mol Neurosci 2023; 16:1160206. [PMID: 37033371 PMCID: PMC10077888 DOI: 10.3389/fnmol.2023.1160206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 02/27/2023] [Indexed: 04/11/2023] Open
Abstract
There is an unmet need to identify new therapeutic targets for temporomandibular disorder (TMD) pain because current treatments are limited and unsatisfactory. TMEM100, a two-transmembrane protein, was recently identified as a regulator to weaken the TRPA1-TRPV1 physical association, resulting in disinhibition of TRPA1 activity in sensory neurons. Recent studies have also shown that Tmem100, Trpa1, and Trpv1 mRNAs were upregulated in trigeminal ganglion (TG) after inflammation of the temporomandibular joint (TMJ) associated tissues. These findings raise a critical question regarding whether TMEM100 in TG neurons is involved in TMD pain via regulating the TRPA1-TRPV1 functional interaction. Here, using two mouse models of TMD pain induced by TMJ inflammation or masseter muscle injury, we found that global knockout or systemic inhibition of TRPA1 and TRPV1 attenuated pain. In line with their increased genes, mice exhibited significant upregulation of TMEM100, TRPA1, and TRPV1 at the protein levels in TG neurons after TMD pain. Importantly, TMEM100 co-expressed with TRPA1 and TRPV1 in TG neurons-innervating the TMJ and masseter muscle and their co-expression was increased after TMD pain. Moreover, the enhanced activity of TRPA1 in TG neurons evoked by TMJ inflammation or masseter muscle injury was suppressed by inhibition of TMEM100. Selective deletion of Tmem100 in TG neurons or local administration of TMEM100 inhibitor into the TMJ or masseter muscle attenuated TMD pain. Together, these results suggest that TMEM100 in TG neurons contributes to TMD pain by regulating TRPA1 activity within the TRPA1-TRPV1 complex. TMEM100 therefore represents a potential novel target-of-interest for TMD pain.
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Affiliation(s)
- Peng Wang
- Department of Neurology, Duke University, Durham, NC, United States
| | - Qiaojuan Zhang
- Department of Neurology, Duke University, Durham, NC, United States
| | - Fabiana C. Dias
- Department of Neurology, Duke University, Durham, NC, United States
| | - Abbie Suttle
- Department of Neurology, Duke University, Durham, NC, United States
| | - Xinzhong Dong
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Yong Chen
- Department of Neurology, Duke University, Durham, NC, United States
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University, Durham, NC, United States
- Department of Pathology, Duke University, Durham, NC, United States
- *Correspondence: Yong Chen,
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25
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Evaluation of the lateral pterygoid muscle area, attachment type, signal intensity and presence of arthrosis, effusion in the TMJ according to the position of the articular disc. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e973-e980. [PMID: 35472484 DOI: 10.1016/j.jormas.2022.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/05/2022] [Accepted: 04/21/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE The aim of this study was to evaluate the lateral pterygoid muscle (LPM) area, attachment type, signal intensity and presence of arthrosis, effusion in the temporomandibular joint (TMJ) by magnetic resonance imaging (MRI) according to the position of the articular disc. METHODS The study included a total of 126 TMJs belonging to 69 patients over the age of 18 years who had MRI due to TMJ complaints. The position of the articular disc, the area, attachment type, and signal intensity of the LPM, the presence of arthrosis on the condyle surface, and the presence of effusion in the joint space were evaluated. RESULTS The attachment type of the LPM did not show a statistically significant difference according to the position of the articular disc. The groups were not statistically different in terms of LPM intensity. Although the distribution of the LPM area was found to be low in the anterior disc displacement with reduction (R+DD) group and high in the anterior disc displacement without reduction (R-DD) group. It was determined that the rate of arthrosis at the condyle head was significantly higher in the R-DD group compared to the normal disc position group. The incidence of effusion was found significantly higher in the R-DD and R+DD groups than joints with normal disc position. CONCLUSIONS Pathological changes in LPM and TMJ can be detected by MRI. In the group with R-DD, the rate of arthrosis at the condyle head, effusion, LPM area, and intensity of the Sup. LPM were higher.
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Santiago V, Janal MN, Cook DB, Raphael KG. Temporal Summation and Aftersensations of Second Pain in Women with Myofascial Temporomandibular Disorder Differ by Presence of Temporomandibular Joint Pain. J Pain Res 2022; 15:3275-3286. [PMID: 36284523 PMCID: PMC9588293 DOI: 10.2147/jpr.s381640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/08/2022] [Indexed: 11/08/2022] Open
Abstract
Purpose Mechanisms underlying myofascial temporomandibular disorder (mTMD) are poorly understood. One theory is dysfunction in the central mediation of pain, specifically in enhanced facilitatory pain modulation. Because mechanisms leading to central sensitization may differ for joint and muscle pain, this study of mTMD addressed phenotypic heterogeneity by temporomandibular (TM) joint pain in the examination of quantitative sensory testing (QST). Patients and Methods The stimulus dependent increase in second pain (temporal summation (TS)) and associated aftersensations (AS) were examined across groups of women with mTMD with TM joint pain and without, and a demographically matched control group. Results TS was slightly more evident in mTMD without joint pain vs with (p = 0.035), but AS were most robustly persistent in the group with joint pain vs without (p < 0.002). Conclusion While both subgroups demonstrated evidence of central sensitization relative to controls on one of two measures, differences in QST results, if replicated, may point to possible differences in the mechanisms that yield central sensitization. Alternatively, it may represent methodological artifacts that need to be addressed. Therefore, greater consideration should be given to symptom-based phenotypes in studies examining TS and AS.
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Affiliation(s)
- Vivian Santiago
- Department of Oral & Maxillofacial Pathology, Radiology & Medicine, New York University College of Dentistry, New York, NY, USA,Correspondence: Vivian Santiago, Department of Oral & Maxillofacial Pathology, Radiology & Medicine, New York University College of Dentistry, 137th East 25th Street, Rm 731, New York, NY, 10010, USA, Tel +1 212 998-9419, Email
| | - Malvin N Janal
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY, USA
| | - Dane B Cook
- Research Service, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA,Department of Kinesiology, University of Wisconsin-Madison School of Education, Madison, WI, USA
| | - Karen G Raphael
- Department of Oral & Maxillofacial Pathology, Radiology & Medicine, New York University College of Dentistry, New York, NY, USA
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27
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Wadhokar OC, Patil DS. Current Trends in the Management of Temporomandibular Joint Dysfunction: A Review. Cureus 2022; 14:e29314. [PMID: 36277551 PMCID: PMC9579904 DOI: 10.7759/cureus.29314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 09/15/2022] [Indexed: 11/09/2022] Open
Abstract
The temporomandibular joint (TMJ) is a synovial bi-condylar joint with 3 degrees of freedom. One-third of the adult population reportedly suffers from temporomandibular joint dysfunction (TMD). Females are more commonly affected than males. Almost 50% of TMD patients do not require any intervention, and the symptoms are self-limiting within one year after the onset; however, 75-80% of adults suffering from TMD require medical intervention and it takes up to three years for the complete remission of the symptoms. The clinical features of TMD are clenching, clicking, and locking of the jaw, and occlusion due to faulty posture. Based on the diagnostic criteria for temporomandibular disorder (DC/TMD) criteria proposed in the year 2014, the classification of TMD is done based on axis I and axis II diagnoses. This review aims to provide an overview of TMD and examine available treatment strategies for TMD. Various conservative treatment methods have been proven to be effective, including self-care strategies, dental treatment strategies, pharmacological treatment, physical therapy modalities, manual mobilization, electrotherapy and dry needling, relaxation techniques, intra-articular injections, cognitive behavioral therapy, and surgical corrections.
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28
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Feng Y, Lu JJ, Ouyang ZY, Xue LX, Li T, Chen Y, Gao ZR, Zhang SH, Zhao J, Zhao YQ, Ye Q, Hu J, Feng YZ, Guo Y. The Chinese version of the Oral Health Impact Profile-14 (OHIP-14) questionnaire among college students: factor structure and measurement invariance across genders. BMC Oral Health 2022; 22:405. [PMID: 36115994 PMCID: PMC9482739 DOI: 10.1186/s12903-022-02441-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/07/2022] [Indexed: 11/28/2022] Open
Abstract
Background The Oral Health-related Quality of Life (OHRQoL) is a multi-dimensional concept commonly used to examine the impact of health status on quality of life, and the Oral Health Impact Profile-14 (OHIP-14) questionnaire is a good self-assessment tool. This study was designed to investigate the factor structure of the OHIP-14 scale Chinese version, measurement invariance and latent mean differences across genders among college students. Methods The online survey was completed by 919 college students. This study used confirmatory factor analysis (CFA) to check the structural models of the OHIP-14 scale, The correlation of each item with the scale total score could test homogeneity, and Cronbach’s alpha (Cronbach’s α) could evaluate internal consistency. Multi-group CFA was used to explore whether the Chinese version of the OHIP-14 scale was used in male and female populations for measurement consistency. T-test compared scores between men and women. Regression analyses were used to evaluate the relationship between age, gender, education, subject, and the score on the OHIP-14 scale. Results We found that the 7-factor structure had the best fit index in the sample. According to Cronbach’s α, the overall score of OHIP was 0.958, and Cronbach’s α for 7 factors was: functional limitation was 0.800, physical pain was 0.854, psychological discomfort was 0.902, physical disability was 0.850, psychological disability was 0.768, social disability was 0.862, social handicap was 0.819 and the test–retest reliability interval was 0.723. Multi-group confirmatory factor analysis supported residual measurement invariance across gender. T-test for scores showed that females scored higher significantly than men as did the overall score, in terms of physical pain (p<0.001), physical disability (p<0.001), and psychological disability (p<0.001). Conclusions This study found the OHIP-14 Chinese version to be a good tool for assessing the college students' OHRQoL in China, allowing people to conduct self-assessments. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02441-6.
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29
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Cairns BE. The contribution of autonomic mechanisms to pain in temporomandibular disorders: A narrative review. J Oral Rehabil 2022; 49:1115-1126. [PMID: 36098708 DOI: 10.1111/joor.13370] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/22/2022] [Accepted: 09/06/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Temporomandibular disorders (TMD) are diagnosed based on symptom presentation and, like other functional pain disorders, often lack definitive pathology. There is a strong association between elevated stress levels and the severity of TMD-related pain, which suggests that alterations in autonomic tone may contribute to this pain condition. OBJECTIVES This narrative review examines the association between altered autonomic function and pain in TMD. METHODS Relevant articles were identified by searching PubMed and through the reference list of those studies. RESULTS TMD sufferers report an increased incidence of orthostatic hypotension. As in other chronic musculoskeletal pain conditions, TMD is associated with increased sympathetic tone, diminished baroreceptor reflex sensitivity and decreased parasympathetic tone. It remains to be determined whether ongoing pain drives these autonomic changes and/or is exacerbated by them. To examine whether increased sympathetic tone contributes to TMD-related pain through β2 adrenergic receptor activation, clinical trials with the beta blocker propranolol have been undertaken. Although evidence from small studies suggested propranolol reduced TMD-related pain, a larger clinical trial did not find a significant effect of propranolol treatment. This is consistent with human experimental pain studies that were unable to demonstrate an effect of β2 adrenergic receptor activation or inhibition on masticatory muscle pain. In preclinical models of temporomandibular joint arthritis, β2 adrenergic receptor activation appears to contribute to inflammation and nociception, whereas in masticatory muscle, α1 adrenergic receptor activation has been found to induce mechanical sensitization. Some agents used to treat TMD, such as botulinum neurotoxin A, antidepressants and α2 adrenergic receptor agonists, may interact with the autonomic nervous system as part of their analgesic mechanism. CONCLUSION Even if dysautonomia turns out to be a consequence rather than a causative factor of painful TMD, the study of its role has opened up a greater understanding of the pathogenesis of this condition.
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Affiliation(s)
- Brian E Cairns
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
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30
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Lee YH, Auh QS. Clinical factors affecting depression in patients with painful temporomandibular disorders during the COVID-19 pandemic. Sci Rep 2022; 12:14667. [PMID: 36038574 PMCID: PMC9421627 DOI: 10.1038/s41598-022-18745-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 08/18/2022] [Indexed: 01/16/2023] Open
Abstract
Temporomandibular disorders (TMD) are a multifactorial condition associated with both physical and psychological factors. Stress has been known to trigger or worsens TMD. We aimed to investigate whether the novel coronavirus disease-2019 (COVID-19) pandemic aggravates depression in patients with painful TMD, and the factors that affect their level of depression. We included 112 patients with painful TMD (74 females, 38 males; mean age: 35.90 ± 17.60 years; myalgia [n = 38], arthralgia [n = 43], mixed joint-muscle TMD pain [n = 31]). TMD was diagnosed based on the Diagnostic Criteria for TMD Axis I. Physical pain intensity was recorded using the visual analog scale (VAS); psycho-emotional status (depression: Beck Depression Inventory [BDI], anxiety: Beck Anxiety Inventory [BAI], and generalized stress related to COVID19: Global Assessment of Recent Stress [GARS]) was investigated twice (before [BC] and after COVID-19 [AC]). Additionally, factors affecting BDI-AC were investigated. BDI (p < 0.001), BAI (p < 0.001), GARS (p < 0.001), and VAS (p < 0.01) scores were significantly increased at AC than BC. The depression, anxiety, and stress levels were significantly positively correlated, and the AC and BC values of each factor showed a high correlation. In the mixed TMD group, BDI-AC was positively correlated with VAS-AC (p < 0.001). In the multiple regression analysis, clenching habit was the strongest predictor of an increase in the BDI scores from moderate to severe, followed by psychological distress, muscle stiffness, female sex, BAI-AC, and TMJ sounds. COVID-19 has negatively affected the psycho-emotional state of patients with painful TMD, and several clinical factors, including female sex and clenching habits, have influenced depression.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine Kyung Hee University Dental Hospital, Kyung Hee University, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, South Korea.
| | - Q-Schick Auh
- Department of Orofacial Pain and Oral Medicine Kyung Hee University Dental Hospital, Kyung Hee University, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, South Korea
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31
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Huang Z, Aarab G, Chattrattrai T, Su N, Volgenant CMC, Hilgevoord AAJ, de Vries N, Lobbezoo F. Associated factors of primary snoring and obstructive sleep apnea in patients with sleep bruxism: a questionnaire study. J Oral Rehabil 2022; 49:970-979. [PMID: 35789500 PMCID: PMC9543241 DOI: 10.1111/joor.13354] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/16/2022] [Accepted: 06/20/2022] [Indexed: 11/28/2022]
Abstract
Background By being aware of the associated factors of primary snoring (PS) and obstructive sleep apnoea (OSA) in sleep bruxism (SB) patients, dentists may contribute to the screening and early recognition of SB patients with PS or OSA. Objective To identify the associated factors of PS and OSA from questionnaire‐based data in SB patients. Methods A total of 968 self‐reported SB patients (31.6% men; median age 44.5 years) were retrospectively enrolled. Self‐reported sleep‐related breathing status (viz., no sleep‐related breathing condition, PS and OSA) was the dependent variable. Independent variables were questionnaire‐based data on demographics, lifestyle, psychological status, pain and sleep. Results For PS, no statistically significant associated factor was identified in analyses. For OSA, increased age (OR = 1.04 [1.03–1.06]), male gender (OR = 3.33 [2.17–5.00]), daily alcohol consumption (OR = 1.96 [1.18–3.33]), depression (OR = 1.10 [1.06–1.14]), daytime sleepiness (OR = 2.94 [1.85–4.76]) and high risk of gastroesophageal reflux disease (GERD; OR = 2.63 [1.52–4.76]) were found to be significant risk factors, while high risk of temporomandibular disorder (TMD) pain (OR = 0.51 [0.30–0.86]) and chronic pain (OR = 0.73 [0.59–0.90]) were significant protective factors. These results were confirmed in the subsequent network analysis. Conclusion Within the limitations of this study, no associated factor is identified for PS. For OSA, dentists should keep in mind that increased age, male gender, daily alcohol consumption, depression, daytime sleepiness and high GERD risk are associated with increased OSA risk in SB patients, while high TMD‐pain risk and chronic pain are associated with decreased OSA risk in this population.
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Affiliation(s)
- Zhengfei Huang
- Department of Orofacial Pain and Dysfunction Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam the Netherlands
- Department of Clinical Neurophysiology OLVG Amsterdam the Netherlands
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam the Netherlands
| | - Thiprawee Chattrattrai
- Department of Orofacial Pain and Dysfunction Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam the Netherlands
| | - Naichuan Su
- Department of Oral Public Health Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam the Netherlands
| | - Catherine M. C. Volgenant
- Department of Preventive Dentistry Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam the Netherlands
| | | | - Nico de Vries
- Department of Orofacial Pain and Dysfunction Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam the Netherlands
- Department of Otorhinolaryngology ‐ Head and Neck Surgery OLVG Amsterdam the Netherlands
- Department of Otorhinolaryngology ‐ Head and Neck Surgery Antwerp University Hospital (UZA) Antwerp Belgium
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam the Netherlands
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Alrashdan MS, Al-Omiri MK. Psychosocial profiles and their correlation with physical diagnosis in temporomandibular disorders, a preliminary report. Cranio 2022:1-9. [PMID: 35695735 DOI: 10.1080/08869634.2022.2084224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To assess representative psychosocial features in a group of temporomandibular disorder (TMD) patients from Jordan using Axis II of the Diagnostic Criteria for TMD (DC/TMD) protocol. METHODS Ninety-eight TMD patients were examined according to Axis I DC/TMD protocol in addition to assessment of their pain-related disability, psychological distress, and stress reactivity. RESULTS Just under half of the patients (49%) had high intensity of characteristic pain (self-reported TMJ-related pain) and one-third (32%) had high levels of pain-related disability. Furthermore, significant proportions of patients expressed moderate-severe degrees of distress and stress reactivity (41% and 39%, respectively). Significant correlations were identified between the Graded Chronic Pain Scale (GCPS) and each of the pain-related TMD subgroups. CONCLUSION TMD patients are susceptible to high levels of pain-related psychosocial impairment, and clinicians should be aware of the possible correlations between the physical TMD diagnosis and specific psychosocial features during treatment planning.
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Affiliation(s)
- Mohammad S Alrashdan
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan (On Leave)
| | - Mahmoud Khaled Al-Omiri
- Department of Prosthodontics, School of Dentistry, University of Jordan, Amman, Jordan
- Department of Prosthodontics, The City of London School of Dentistry, (BPP) University, London, UK
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33
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Silveira FD, Gomes FIF, do Val DR, Freitas HC, de Assis EL, de Almeida DKC, Braz HLB, Barbosa FG, Mafezoli J, da Silva MR, Jorge RJB, Clemente-Napimoga JT, Costa DVDS, Brito GADC, Pinto VDPT, Cristino-Filho G, Bezerra MM, Chaves HV. Biological and Molecular Docking Evaluation of a Benzylisothiocyanate Semisynthetic Derivative From Moringa oleifera in a Pre-clinical Study of Temporomandibular Joint Pain. Front Neurosci 2022; 16:742239. [PMID: 35546897 PMCID: PMC9083263 DOI: 10.3389/fnins.2022.742239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 03/14/2022] [Indexed: 11/18/2022] Open
Abstract
Objective Moringa oleifera possesses multiple biological effects and the 4-[(4′-O-acetyl-α-L- rhamnosyloxy) benzyl] isothiocyanate accounts for them. Based on the original isothiocyanate molecule we obtained a semisynthetic derivative, named 4-[(2′,3′,4′-O-triacetyl-α-L-rhamnosyloxy) N-benzyl] hydrazine carbothioamide (MC-H) which was safe and effective in a temporomandibular joint (TMJ) inflammatory hypernociception in rats. Therefore, considering that there is still a gap in the knowledge concerning the mechanisms of action through which the MC-H effects are mediated, this study aimed to investigate the involvement of the adhesion molecules (ICAM-1, CD55), the pathways heme oxygenase-1 (HO-1) and NO/cGMP/PKG/K+ATP, and the central opioid receptors in the efficacy of the MC-H in a pre-clinical study of TMJ pain. Methods Molecular docking studies were performed to test the binding performance of MC-H against the ten targets of interest (ICAM-1, CD55, HO-1, iNOS, soluble cGMP, cGMP-dependent protein kinase (PKG), K+ATP channel, mu (μ), kappa (κ), and delta (δ) opioid receptors). In in vivo studies, male Wistar rats were treated with MC-H 1 μg/kg before TMJ formalin injection and nociception was evaluated. Periarticular tissues were removed to assess ICAM-1 and CD55 protein levels by Western blotting. To investigate the role of HO-1 and NO/cGMP/PKG/K+ATP pathways, the inhibitors ZnPP-IX, aminoguanidine, ODQ, KT5823, or glibenclamide were used. To study the involvement of opioid receptors, rats were pre-treated (15 min) with an intrathecal injection of non-selective inhibitor naloxone or with CTOP, naltrindole, or norbinaltorphimine. Results All interactions presented acceptable binding energy values (below −6.0 kcal/mol) which suggest MC-H might strongly bind to its molecular targets. MC-H reduced the protein levels of ICAM-1 and CD55 in periarticular tissues. ZnPP-IX, naloxone, CTOP, and naltrindole reversed the antinociceptive effect of MC-H. Conclusion MC-H demonstrated antinociceptive and anti-inflammatory effects peripherally by the activation of the HO-1 pathway, as well as through inhibition of the protein levels of adhesion molecules, and centrally by μ and δ opioid receptors.
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Affiliation(s)
| | | | - Danielle Rocha do Val
- Graduate Programme in Biotechnology, North-Eastern Biotechnology Network, Federal University of Pernambuco, Recife, Brazil
| | | | | | | | - Helyson Lucas Bezerra Braz
- Graduate Program in Morphofunctional Sciences, Department of Morphology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | | | - Jair Mafezoli
- Graduate Programme in Chemistry, Science Center, Federal University of Ceará, Fortaleza, Brazil
| | | | - Roberta Jeane Bezerra Jorge
- Graduate Program in Morphofunctional Sciences, Department of Morphology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil.,Drug Research and Development Center (NPDM), Federal University of Ceará, Fortaleza, Brazil
| | | | - Deiziane Viana da Silva Costa
- Graduate Program in Morphofunctional Sciences, Department of Morphology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Gerly Anne de Castro Brito
- Graduate Program in Morphofunctional Sciences, Department of Morphology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Vicente de Paulo Teixeira Pinto
- Graduate Programme in Health Sciences, Federal University of Ceará, Sobral, Brazil.,Faculty of Medicine, Federal University of Ceará, Sobral, Brazil
| | - Gerardo Cristino-Filho
- Graduate Programme in Health Sciences, Federal University of Ceará, Sobral, Brazil.,Faculty of Medicine, Federal University of Ceará, Sobral, Brazil
| | - Mirna Marques Bezerra
- Graduate Programme in Health Sciences, Federal University of Ceará, Sobral, Brazil.,Faculty of Medicine, Federal University of Ceará, Sobral, Brazil
| | - Hellíada Vasconcelos Chaves
- Graduate Programme in Health Sciences, Federal University of Ceará, Sobral, Brazil.,Faculty of Dentistry, Federal University of Ceará, Sobral, Brazil.,Graduate Program in Dentistry, Federal University of Ceará, Fortaleza, Brazil
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Botros J, Gornitsky M, Samim F, der Khatchadourian Z, Velly AM. Back and neck pain: A comparison between acute and chronic pain-related Temporomandibular Disorders. Can J Pain 2022; 6:112-120. [PMID: 35799959 PMCID: PMC9255212 DOI: 10.1080/24740527.2022.2067032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Temporomandibular disorders (TMDs) are common and cause persistent pain. Comorbidities are associated with TMDs and can affect the effectiveness of their treatments. The literature is lacking enough evidence on the difference between acute and chronic pain, particularly in TMDs. Investigating this difference could highlight potential risk factors for the transition from acute to chronic pain–related TMDs. Aim To compare the likelihood of back and neck pain (BP, NP) between acute and chronic pain–related TMDs (AP-TMD, CP-TMD) as defined by pain duration and pain-related disability. Methods Participants with AP-TMDs (≤3 months) and CP-TMDs (>3 months) were recruited according to the diagnostic criteria and research diagnostic criteria of TMD. BP and NP were assessed using a self-reported checklist. CP-TMDs defined by disability (chronic disability) and depression and anxiety symptoms were assessed using validated instruments. Logistic regression analyses were employed. Results This study enrolled 487 adults with AP-TMD (n = 118) and CP-TMD (n = 369). Relative to AP-TMD, participants with CP-TMD had twice the odds of reporting NP (odds ratio [OR] = 2.17, 95% CI 1.27–3.71) but not BP (OR = 0.96, 95% CI 0.57–1.64). Participants with chronic disability were twice as likely to report NP (OR = 1.95, 95% CI 1.20–3.17) but not BP (OR = 1.13, 95% CI 0.69–1.82) compared to those without. All analyses were adjusted for age, sex, and anxiety and depression symptoms. Conclusions Within the limitations of this study, results suggest that central dysregulation or trigeminocervical convergence mechanisms are implicated in the process of pain-related TMD chronification and highlight the relevance of considering disability when defining CP-TMDs.
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Affiliation(s)
- Jack Botros
- Department of Dentistry, Jewish General Hospital, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Montreal, QC, Canada
| | - Mervyn Gornitsky
- Department of Dentistry, Jewish General Hospital, Montreal, QC, Canada
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Montreal, QC, Canada
| | - Firoozeh Samim
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
- Department of Dentistry, Montreal General Hospital, Montreal, QC, Canada
| | - Zovinar der Khatchadourian
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
- Alan Edwards Pain Management Unit, Montreal General Hospital, Montreal Quebec
| | - Ana Miriam Velly
- Department of Dentistry, Jewish General Hospital, Montreal, QC, Canada
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Montreal, QC, Canada
- Alan Edwards Pain Management Unit, Montreal General Hospital, Montreal Quebec
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Veríssimo CP, Acosta Filha LG, Moreira da Silva FJ, Westgarth H, Coelho Aguiar JDM, Pontes B, Moura-Neto V, Gazerani P, DosSantos MF. Short-Term Functional and Morphological Changes in the Primary Cultures of Trigeminal Ganglion Cells. Curr Issues Mol Biol 2022; 44:1257-1272. [PMID: 35723307 PMCID: PMC8946888 DOI: 10.3390/cimb44030084] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 12/30/2022] Open
Abstract
Several studies have proved that glial cells, as well as neurons, play a role in pain pathophysiology. Most of these studies have focused on the contribution of central glial cells (e.g., microglia and astrocytes) to neuropathic pain. Likewise, some works have suggested that peripheral glial cells, particularly satellite glial cells (SGCs), and the crosstalk between these cells and the sensory neurons located in the peripheral ganglia, play a role in the phenomenon that leads to pain. Nonetheless, the study of SGCs may be challenging, as the validity of studying those cells in vitro is still controversial. In this study, a research protocol was developed to examine the potential use of primary mixed neuronal–glia cell cultures obtained from the trigeminal ganglion cells (TGCs) of neonate mice (P10–P12). Primary cultures were established and analyzed at 4 h, 24 h, and 48 h. To this purpose, phase contrast microscopy, immunocytochemistry with antibodies against anti-βIII-tubulin and Sk3, scanning electron microscopy, and time-lapse photography were used. The results indicated the presence of morphological changes in the cultured SGCs obtained from the TGCs. The SGCs exhibited a close relationship with neurons. They presented a round shape in the first 4 h, and a more fusiform shape at 24 h and 48 h of culture. On the other hand, neurons changed from a round shape to a more ramified shape from 4 h to 48 h. Intriguingly, the expression of SK3, a marker of the SGCs, was high in all samples at 4 h, with some cells double-staining for SK3 and βIII-tubulin. The expression of SK3 decreased at 24 h and increased again at 48 h in vitro. These results confirm the high plasticity that the SGCs may acquire in vitro. In this scenario, the authors hypothesize that, at 4 h, a group of the analyzed cells remained undifferentiated and, therefore, were double-stained for SK3 and βIII-tubulin. After 24 h, these cells started to differentiate into SCGs, which was clearer at 48 h in the culture. Mixed neuronal–glial TGC cultures might be implemented as a platform to study the plasticity and crosstalk between primary sensory neurons and SGCs, as well as its implications in the development of chronic orofacial pain.
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Affiliation(s)
- Carla Pires Veríssimo
- Laboratório de Morfogênese Celular (LMC), Instituto de Ciências Biomédicas (ICB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil; (C.P.V.); (L.G.A.F.); (F.J.M.d.S.); (J.D.M.C.A.); (B.P.); (V.M.-N.)
- Laboratório de Biologia Tumoral (LBT), Instituto de Ciências Biomédicas (ICB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil
| | - Lionete Gall Acosta Filha
- Laboratório de Morfogênese Celular (LMC), Instituto de Ciências Biomédicas (ICB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil; (C.P.V.); (L.G.A.F.); (F.J.M.d.S.); (J.D.M.C.A.); (B.P.); (V.M.-N.)
- Programa de Pós-Graduação em Neurociência Translacional, Instituto Nacional de Neurociência Translacional (INNT-UFRJ), Rio de Janeiro 20231-092, Brazil
| | - Fábio Jorge Moreira da Silva
- Laboratório de Morfogênese Celular (LMC), Instituto de Ciências Biomédicas (ICB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil; (C.P.V.); (L.G.A.F.); (F.J.M.d.S.); (J.D.M.C.A.); (B.P.); (V.M.-N.)
| | - Harrison Westgarth
- Laboratório de Virologia Molecular, Departamento de Genética, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil;
| | - Juliana De Mattos Coelho Aguiar
- Laboratório de Morfogênese Celular (LMC), Instituto de Ciências Biomédicas (ICB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil; (C.P.V.); (L.G.A.F.); (F.J.M.d.S.); (J.D.M.C.A.); (B.P.); (V.M.-N.)
- Programa de Pós-Graduação em Anatomia Patológica, Hospital Universitário Clementino Fraga Filho (HUCFF), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
- Laboratório de Biomedicina do Cérebro, Instituto Estadual do Cérebro Paulo Niemeyer (IECPN), Secretaria de Estado de Saúde, Rio de Janeiro 20231-092, Brazil
| | - Bruno Pontes
- Laboratório de Morfogênese Celular (LMC), Instituto de Ciências Biomédicas (ICB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil; (C.P.V.); (L.G.A.F.); (F.J.M.d.S.); (J.D.M.C.A.); (B.P.); (V.M.-N.)
- Centro Nacional de Biologia Estrutural e Bioimagem (CENABIO), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil
| | - Vivaldo Moura-Neto
- Laboratório de Morfogênese Celular (LMC), Instituto de Ciências Biomédicas (ICB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil; (C.P.V.); (L.G.A.F.); (F.J.M.d.S.); (J.D.M.C.A.); (B.P.); (V.M.-N.)
- Programa de Pós-Graduação em Neurociência Translacional, Instituto Nacional de Neurociência Translacional (INNT-UFRJ), Rio de Janeiro 20231-092, Brazil
- Programa de Pós-Graduação em Anatomia Patológica, Hospital Universitário Clementino Fraga Filho (HUCFF), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
- Laboratório de Biomedicina do Cérebro, Instituto Estadual do Cérebro Paulo Niemeyer (IECPN), Secretaria de Estado de Saúde, Rio de Janeiro 20231-092, Brazil
| | - Parisa Gazerani
- Department of Life Sciences & Health, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway;
- Department of Health Science & Technology, Faculty of Medicine, Aalborg University, 9220 Aalborg, Denmark
| | - Marcos F. DosSantos
- Laboratório de Morfogênese Celular (LMC), Instituto de Ciências Biomédicas (ICB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-902, Brazil; (C.P.V.); (L.G.A.F.); (F.J.M.d.S.); (J.D.M.C.A.); (B.P.); (V.M.-N.)
- Programa de Pós-Graduação em Neurociência Translacional, Instituto Nacional de Neurociência Translacional (INNT-UFRJ), Rio de Janeiro 20231-092, Brazil
- Departamento de Prótese e Materiais Dentários, Faculdade de Odontologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
- Programa de Pós-Graduação em Odontologia (PPGO), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
- Faculdade de Odontologia, Universidade Federal do Rio de Janeiro (UFRJ), Cidade Universitária, Ilha do Fundão, Rio de Janeiro 21941-617, Brazil
- Correspondence: ; Tel.: +55-(21)-3938-6465
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Montinaro F, Nucci L, d'Apuzzo F, Perillo L, Chiarenza MC, Grassia V. Oral nonsteroidal anti-inflammatory drugs as treatment of joint and muscle pain in temporomandibular disorders: A systematic review. Cranio 2022:1-10. [PMID: 35129419 DOI: 10.1080/08869634.2022.2031688] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate pain control in patients with joint and muscle pain in temporomandibular disorder (TMD) diagnosis treated with oral non-steroidal anti-inflammatory drugs (NSAIDs). METHODS The systematic research was conducted via Pubmed, Scopus, Web of Science, Google Scholar, and Cochrane databases. RESULTS Four full-text randomized-controlled trials (RCTs) were considered eligible. This systematic review included 164 patients whose VAS scores were assessed before and after therapy. In the selected studies, a strong heterogeneity in the diagnosis and in the use of different types and prescriptions of NSAIDs was highlighted. These limitations had to be considered to understand whether a clinical recommendation could be made. Eventually, all patients treated with NSAIDs showed an improvement in pain. CONCLUSION The use of oral NSAIDs as the first approach to control joint and muscle pain is sustained by the current scientific literature, but further investigations on this topic are still needed.
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Affiliation(s)
- Federica Montinaro
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Fabrizia d'Apuzzo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Letizia Perillo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Maria Chiara Chiarenza
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Vincenzo Grassia
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
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Temporomandibular disorders cases with high-impact pain are more likely to experience short-term pain fluctuations. Sci Rep 2022; 12:1657. [PMID: 35102207 PMCID: PMC8803984 DOI: 10.1038/s41598-022-05598-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/11/2022] [Indexed: 11/08/2022] Open
Abstract
AbstractTemporomandibular disorders (TMD) patients can present clinically significant jaw pain fluctuations which can be debilitating and lead to poor global health. The Graded Chronic Pain Scale evaluates pain-related disability and its dichotomous grading (high/low impact pain) can determine patient care pathways and in general high-impact pain patients have worse treatment outcomes. Individuals with low-impact TMD pain are thought to have better psychosocial functioning, more favorable disease course, and better ability to control pain, while individuals with high-impact pain can present with higher levels of physical and psychological symptoms. Thereby, there is reason to believe that individuals with low- and high-impact TMD pain could experience different pain trajectories over time. Our primary objective was to determine if short-term jaw pain fluctuations serve as a clinical marker for the impact status of TMD pain. To this end, we estimated the association between high/low impact pain status and jaw pain fluctuations over three visits (≤ 21-day-period) in 30 TMD cases. Secondarily, we measured the association between jaw pain intensity and pressure pain thresholds (PPT) over the face and hand, the latter measurements compared to matched pain-free controls (n = 17). Jaw pain fluctuations were more frequent among high-impact pain cases (n = 15) than low-impact pain cases (n = 15) (OR 5.5; 95% CI 1.2, 26.4; p value = 0.033). Jaw pain ratings were not associated with PPT ratings (p value > 0.220), suggesting different mechanisms for clinical versus experimental pain. Results from this proof-of-concept study suggest that targeted treatments to reduce short-term pain fluctuations in high-impact TMD pain is a potential strategy to achieve improved patient perception of clinical pain management outcomes.
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Liu JQ, Wan YD, Xie T, Miao T, Wang J, Xiong X. Associations among Orthodontic History, Psychological Status, and Temporomandibular-Related Quality of Life: A Cross-Sectional Study. Int J Clin Pract 2022; 2022:3840882. [PMID: 35685561 PMCID: PMC9167145 DOI: 10.1155/2022/3840882] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/08/2022] [Accepted: 05/19/2022] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES This cross-sectional study aimed to evaluate the associations among orthodontic history, psychological status, and temporomandibular-related quality of life. METHODS A questionnaire was developed and distributed to students in a local college, containing questions about demographic information, the Patient Health Questionnaire-4 (PHQ-4), the Fonseca anamnestic index, and the Oral Health Impact Profile for Temporomandibular Disorders (OHIP-TMD). The respondents were divided into with orthodontic history (OS) group and without OS group. Binary logistic regression and multiple linear regression were performed for statistical analysis. RESULTS A total of 531 valid questionnaires were collected, covering 161 participants with OS and 370 participants without OS. No statistically significant differences were observed in the scores of PHQ-4 between the two groups. There was statistical difference in the prevalence of TMD (with OS group, 54.66%; without OS group, 40.81%) and the mean value ( ± standard deviations) of the scores of OHIP-TMD (with OS group, 9.64 ± 12.36; without OS group, 6.64 ± 10.79) (p < 0.05). After adjusting confounding factors, participants with OS have worse temporomandibular-related quality of life and a higher risk of having TMD than the participants without OS. CONCLUSIONS Orthodontic history was related with the higher prevalence of TMD and worse temporomandibular-related quality of life, but not related with psychological distress, and the cause-and-effect relationship needs further exploration.
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Affiliation(s)
- Jia-Qi Liu
- National Clinical Research Center for Oral Diseases, State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yi-Dan Wan
- National Clinical Research Center for Oral Diseases, State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Department of Nursing, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Tian Xie
- Department of Stomatology, The Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Tao Miao
- National Clinical Research Center for Oral Diseases, State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jun Wang
- National Clinical Research Center for Oral Diseases, State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xin Xiong
- National Clinical Research Center for Oral Diseases, State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Ma J, Wang J, Huang D, Wang Z, Hu M, Liu H, Jiang H. A comparative study of condyle position in temporomandibular disorders patients with chewing side preference using cone-beam computed tomography. J Oral Rehabil 2021; 49:265-271. [PMID: 34902183 DOI: 10.1111/joor.13293] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 11/25/2021] [Accepted: 12/08/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Chewing side preference (CSP) could cause structural and morphological changes of temporomandibular joint (TMJ) and has been suggested as one etiology of temporomandibular disorders (TMDs), but the condylar position in TMD patients with CSP is unknown. OBJECTIVE To compare the condylar position in the TMD patients with and without CSP. METHODS Ninety TMD patients with unilateral symptom (69 with CSP and 21 without CSP) and 20 asymptomatic participants received cone-beam computed tomography. The condylar position was determined based on the measurements of sagittal joint spaces. Intergroup and intragroup comparisons of the condylar position were performed. RESULTS The condyles in asymptomatic participants located nearly randomly in anterior, centric, and posterior positions. Patients without CSP had significantly more posterior condyles than asymptomatic participants (57.1% vs 30.0%, P<0.05). In patients with CSP, 50.7% of the condyles on the preferred chewing side and 42.0% on the unpreferred side located posteriorly, reaching no significant level compared with the asymptomatic participants and patients without CSP (P>0.05). The symptomatic joints and asymptomatic joints in patients with CSP and without CSP showed no significant differences in condylar position. While patients without CSP had significantly more posterior condyles in symptomatic joints than asymptomatic participants (P<0.05), patients with CSP showed a trend towards more posterior condyles in symptomatic joints compared with the asymptomatic participants (53.6% vs 30.0%, P=0.054). CONCLUSION Condylar position is not a strong indicator to differentiate CSP-related TMDs from none-CSP-related TMDs. Posterior condyle could not be viewed as one indicator of TMD.
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Affiliation(s)
- Junli Ma
- Department of Stomatology, General Hospital of Southern Theater of PLA, Guangzhou, China
| | - Jiazhu Wang
- Department of Stomatology, Chinese PLA General Hospital, Beijing, China
| | - Dongzong Huang
- Department of Stomatology, Chinese PLA General Hospital, Beijing, China
| | - Zhaowu Wang
- Department of Stomatology, Chinese PLA General Hospital, Beijing, China
| | - Min Hu
- Department of Stomatology, Chinese PLA General Hospital, Beijing, China
| | - Hongchen Liu
- Department of Stomatology, Chinese PLA General Hospital, Beijing, China
| | - Hua Jiang
- Department of Stomatology, Chinese PLA General Hospital, Beijing, China
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Sabsoob O, Elsaraj SM, Gornitsky M, Laszlo E, Fricton JR, Schiffman EL, Velly AM. Acute and Chronic Temporomandibular Disorder Pain: A critical review of differentiating factors and predictors of acute to chronic pain transition. J Oral Rehabil 2021; 49:362-372. [PMID: 34800343 DOI: 10.1111/joor.13283] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 11/01/2021] [Accepted: 11/06/2021] [Indexed: 11/28/2022]
Abstract
AIMS The aims of this critical review were to: (i) assess the factors that differentiate acute from chronic temporomandibular disorders (TMD) pain; (ii) assess the risk factors associated with the transition from acute to chronic TMD pain; and (iii) summarize and appraise the studies. METHOD The databases used were MEDLINE, Embase, and Cochrane Database of Systematic Reviews. Eligible studies included articles comparing acute to chronic TMD pain, and cohort studies assessing the risk factors implicated in the transition from acute to chronic TMD pain. RESULTS Seven articles were selected: one case-control study, three cross-sectional studies, and three cohort studies. These studies found that psychological factors were more common in chronic than acute TMD pain patients; however, these factors did not increase the transition risk in the multivariable model. Myofascial and baseline pain intensity were associated with the transition from acute to chronic TMD pain at a 6-month follow-up. Due to methodological weaknesses in the available literature, more research is required to establish the risk factors implicated in the transition from acute to chronic TMD pain. CONCLUSION This review found some evidence that myofascial pain is associated with the transition risk from acute to chronic TMD pain at a 6-month follow-up and that pain intensity at baseline is associated with more intense TMD pain 6 months later. There is insufficient evidence to draw conclusions about the role of demographics and psychological disorders as independent risk factors.
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Affiliation(s)
- Omar Sabsoob
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,Department of Dentistry, Jewish General Hospital, Montreal, Quebec, Canada
| | - Sherif M Elsaraj
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,Department of Dentistry, Jewish General Hospital, Montreal, Quebec, Canada
| | - Mervyn Gornitsky
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,Department of Dentistry, Jewish General Hospital, Montreal, Quebec, Canada
| | - Elise Laszlo
- Department of Dentistry, Jewish General Hospital, Montreal, Quebec, Canada
| | - James R Fricton
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA.,Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Eric L Schiffman
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ana M Velly
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,Department of Dentistry, Jewish General Hospital, Montreal, Quebec, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
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41
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Quinelato V, Bonato LL, Vieira AR, Granjeiro JM, Menezes K, Borojevic R, Casado PL, Calasans-Maia JA, Tesch R. PAX7 gene polymorphism in muscular temporomandibular disorders as potentially related to muscle stem cells. BMC Musculoskelet Disord 2021; 22:959. [PMID: 34789211 PMCID: PMC8600756 DOI: 10.1186/s12891-021-04846-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 10/07/2021] [Indexed: 11/10/2022] Open
Abstract
Background Temporomandibular disorders (TMD) are a group of painful and debilitating disorders, involving the masticatory muscles and/or the temporomandibular joint (TMJ). Chronic TMD pain can be associated with genetic changes in the key muscle development genes. Objective To evaluate the association between polymorphisms in the PAX7 (paired box 7) gene and masticatory myalgia in patients with temporomandibular disorders (TMD). Materials and methods This is a case-control study. Patients with TMD were divided into two groups: (a) presence of muscular TMD (n = 122) and (b) absence of muscular TMD (n = 49). Genomic DNA was obtained from saliva samples from all participants to allow for genotyping single nucleotide polymorphisms in PAX7 (rs766325 and rs6659735). Over-representation of alleles was tested using chi-square or Fisher’s exact tests. Values of p < 0.05 were considered to be statistically significant. Results Individuals without muscular TMD were less likely to have the PAX7 rs6659735 GG genotype (p = 0.03). No associations were found for PAX7 rs766325. Conclusions Alterations in PAX7 may influence muscular pathophysiology and individuals with TMD and the rs6659735 homozygous genotype (GG) are seemingly associated with muscular involvement of the disorder. No associations were found in the region rs766325.
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Affiliation(s)
- Valquiria Quinelato
- School of Dentistry, Universidade Federal Fluminense, Mario Santos Braga St, 28 - Center, Niterói, RJ, 24020-140, Brazil.
| | - Letícia Ladeira Bonato
- School of Dentistry, Universidade Federal Fluminense, Mario Santos Braga St, 28 - Center, Niterói, RJ, 24020-140, Brazil
| | | | | | - Karla Menezes
- School of Medicine of Petropolis, Petropolis, Brazil
| | | | - Priscila Ladeira Casado
- School of Dentistry, Universidade Federal Fluminense, Mario Santos Braga St, 28 - Center, Niterói, RJ, 24020-140, Brazil
| | - Jose Albuquerque Calasans-Maia
- School of Dentistry, Universidade Federal Fluminense, Mario Santos Braga St, 28 - Center, Niterói, RJ, 24020-140, Brazil
| | - Ricardo Tesch
- School of Medicine of Petropolis, Petropolis, Brazil
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Evidence That a TRPA1-Mediated Murine Model of Temporomandibular Joint Pain Involves NLRP3 Inflammasome Activation. Pharmaceuticals (Basel) 2021; 14:ph14111073. [PMID: 34832855 PMCID: PMC8622821 DOI: 10.3390/ph14111073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/14/2021] [Accepted: 10/14/2021] [Indexed: 11/17/2022] Open
Abstract
This study investigates the role of transient receptor potential ankyrin 1 (TRPA1) in murine temporomandibular joint (TMJ) inflammatory hyperalgesia and the influence of the NLR family pyrin domain-containing 3 (NLRP3) inflammasome. Two distinct murine models of TMJ pain and inflammation (zymosan and CFA) were established. Spontaneous pain-like behaviours were observed as unilateral front paw cheek wipes. Ipsilateral cheek blood flow was used as a measure of ongoing inflammation, which, to our knowledge, is a novel approach to assessing real-time inflammation in the TMJ. Joint tissue and trigeminal ganglia were collected for ex vivo investigation. Both zymosan and CFA induced a time-dependent increase in hyperalgesia and inflammation biomarkers. Zymosan induced a significant effect after 4 h, correlating with a significantly increased IL-1β protein expression. CFA (50 µg) induced a more sustained response. The TRPA1 receptor antagonist A967079 significantly inhibited hyper-nociception. The NLRP3 inhibitor MCC950 similarly inhibited hyper-nociception, also attenuating inflammatory markers. In the trigeminal ganglia, CFA-induced CGRP expression showed trends of inhibition by A967079, whilst lba1 immunofluorescence was significantly inhibited by A967079 and MCC950, where the effect of TRPA1 inhibition lasted up to 14 days. Our results show that stimulation of TRPA1 is key to the TMJ pain. However, the inflammasome inhibitor exhibited similar properties in attenuating these pain-like behaviours, in addition to some inflammatory markers. This indicates that in addition to the therapeutic targeting of TRPA1, NLRP3 inhibition may provide a novel therapeutic strategy for TMJ inflammation and pain.
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Relationship between Clinical Symptoms and Magnetic Resonance Imaging in Temporomandibular Disorder (TMD) Patients Utilizing the Piper MRI Diagnostic System. J Clin Med 2021; 10:jcm10204698. [PMID: 34682820 PMCID: PMC8539230 DOI: 10.3390/jcm10204698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 02/02/2023] Open
Abstract
Clinical problems of the temporomandibular joint (TMJ) and the masticatory musculature are both included in the term temporomandibular disorder (TMD). The purpose of the present study was to examine the pathology of the joints of patients diagnosed with TMD utilizing the dedicated Piper MRI-based classification, and to link these pathologies with various symptoms while considering their severity. In total, 64 patients with clinical TMD were examined. Symptoms were recorded using a questionnaire. The clinical examination included diagnosing the occlusion in centric relation, which was followed by a standardized MRI. It was confirmed that, although they occurred in a high percentage in all classes, muscle pain and occlusal interference are not indicators of TMJ damage. The results indicate that the progressive degradation of the TMJ, represented by qualification to the higher Piper classes, is associated with an increase in TMJ pain only up to a certain stage. For the highest Piper classes, the joint pain occurs in a smaller percentage of patients, but sounds are more frequent.
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COL5A1 RS12722 Is Associated with Temporomandibular Joint Anterior Disc Displacement without Reduction in Polish Caucasians. Cells 2021; 10:cells10092423. [PMID: 34572072 PMCID: PMC8470511 DOI: 10.3390/cells10092423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/11/2021] [Indexed: 11/26/2022] Open
Abstract
Numerous reports describe the association between the single-nucleotide polymorphism (SNP) rs12722 and rs13946 in the COL5A1 gene and injuries, such as Achilles tendon pathology, anterior cruciate ligament (ACL) injuries, and tennis elbow. Hence, there were no studies investigating COL5A1 and temporomandibular joint (TMJ) pathology. The aim of this study is to evaluate the relationship between COL5A1 rs12722 and rs13946 SNPs and TMJ articular disc displacement without reduction (ADDwoR). In this case-control study, the study group consisted of 124 Caucasian patients of both sexes. Each patient had a history of ADDwoR no more than 3 months prior. The control group comprised 126 patients with no signs of TMD according to DC/TMD. Genotyping of the selected SNPs was performed by real-time PCR using TaqMan probes. The significance of the differences in the distribution of genotypes was analyzed using Pearson’s chi-square test. Logistic regression modeling was performed to analyze the influence of the 164 investigated SNPs on ADDwoR. The COL5A1 marker rs12722 turned out to be statistically significant (p-value = 0.0119), implying that there is a difference in the frequencies of TMJ ADDwoR. The distribution of rs12722 SNPs in the study group TT(66), CC(27), CT(31) vs. control group TT(45), CC(26), CT(51) indicates that patients with CT had an almost 2.4 times higher likelihood of ADDwoR (OR = 2.41) than those with reference TT (OR = 1), while rs13946 genotypes were shown to be insignificant, with a p-value of 0.1713. The COL5A1 rs12722 polymorphism is a risk factor for ADDwoR in the Polish Caucasian population.
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Kandagal Veerabhadrappa S, Anbananthan TD, Ying CX, Ramamurthy PH, Yadav S, Bin Zamzuri AT. Effectiveness of TENS and home exercises as an adjunct to drug therapy in the management of myogenous masticatory pain: a comparative study. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2021. [DOI: 10.1051/mbcb/2021019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Pain relief is the primary goal of treatment in patients with myogenous temporomandibular disorder. This study evaluated the effectiveness of TENS and Home exercises as an adjunct to drugs in relieving myogenous masticatory pain. Materials and methods: This prospective clinical study was conducted on 60 patients with myogenous masticatory pain. Patients were randomly allocated into three groups of 20 patients each. Patients in Group A received TENS and drugs, while patients in Group B received home exercises and drugs and Group C received drugs only. The drugs prescribed were Diclofenac 50 mg and Orphenadrine 100 mg, to be taken twice daily for 5 days. All patients were followed up for three weeks. The severity of pain was recorded using the Visual Analog Scale. Inter and intragroup differences in the pain scores were analyzed using one-way ANOVA along with post hoc Tukey's test, and Paired t-test, respectively. p < 0.05 was considered as statistically significant. Results: There was a significant reduction in the mean pain scores in all the three groups at 1st, 2nd, and 3rd post-treatment weeks as compared to the baseline scores with p < 0.001. However, when the pain scores were compared across groups, maximum pain reduction was observed in group A (0.2 ± 0.04), followed by group B (0.5 ± 0.06), and the least reduction was noticed in group C (2.1 ± 0.8). This result was significant with p < 0.001. Conclusion: Both TENS and Home exercises program were effective as adjuncts to drugs, in controlling myogenous masticatory pain, as compared to drugs alone.
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Zieliński G, Ginszt M, Zawadka M, Rutkowska K, Podstawka Z, Szkutnik J, Majcher P, Gawda P. The Relationship between Stress and Masticatory Muscle Activity in Female Students. J Clin Med 2021; 10:3459. [PMID: 34441752 PMCID: PMC8397028 DOI: 10.3390/jcm10163459] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 02/06/2023] Open
Abstract
The aim of the study was to analyze the relationship between stress measured by the perceived stress scale (PSS-10) questionnaire and masticatory muscle activity. Experimental design assumed the study of healthy young women without temporomandibular disorders, dividing them into three groups depending on the result of the stress level and then comparing these groups in terms of bioelectrical activity of the masticatory muscles. After the exclusion criteria were applied, 63 female students (mean age: 22.3 ± 2.4 years) from Medical University of Lublin were included in the study. The subjects were then divided into 3 groups: with low (n = 18), medium (n = 18) and high stress level (n = 27), according to PSS-10 results. Resting and functional activity of temporalis anterior (TA) and masseter (MM) muscles were measured by electromyograph BioEMG III. There were statistically significant effects of group on the absolute value of asymmetry index (AsI) of TA and MM during maximum voluntary clenching on dental cotton rollers (both p = 0.02). Post hoc analysis shows that there were statistically significant differences between medium and high stress groups in AsI TA (p = 0.01) and between low and high stress groups in AsI MM (p = 0.02). Perceived stress measured by PSS-10 questionnaire seems to be associated with changes in muscular asymmetry in functional clenching activity.
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Affiliation(s)
- Grzegorz Zieliński
- Department of Sports Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (M.Z.); (P.G.)
| | - Michał Ginszt
- Department of Rehabilitation and Physiotherapy, Medical University of Lublin, 20-093 Lublin, Poland; (M.G.); (P.M.)
| | - Magdalena Zawadka
- Department of Sports Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (M.Z.); (P.G.)
| | - Katarzyna Rutkowska
- Faculty of Pedagogy and Psychology, Maria Curie-Sklodowska University in Lublin, 20-612 Lublin, Poland;
| | - Zuzanna Podstawka
- Interdisciplinary Scientific Group of Sports Medicine, Department of Sports Medicine, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Jacek Szkutnik
- Department of Functional Masticatory Disorders, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Piotr Majcher
- Department of Rehabilitation and Physiotherapy, Medical University of Lublin, 20-093 Lublin, Poland; (M.G.); (P.M.)
| | - Piotr Gawda
- Department of Sports Medicine, Medical University of Lublin, 20-093 Lublin, Poland; (M.Z.); (P.G.)
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Alhilou AM, Shimada A, Svensson CI, Svensson P, Ernberg M, Cairns BE, Christidis N. Nerve growth factor and glutamate increase the density and expression of substance P-containing nerve fibers in healthy human masseter muscles. Sci Rep 2021; 11:15673. [PMID: 34341446 PMCID: PMC8328992 DOI: 10.1038/s41598-021-95229-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/16/2021] [Indexed: 11/21/2022] Open
Abstract
Nocifensive behavior induced by injection of glutamate or nerve growth factor (NGF) into rats masseter muscle is mediated, in part, through the activation of peripheral NMDA receptors. However, information is lacking about the mechanism that contributes to pain and sensitization induced by these substances in humans. Immunohistochemical analysis of microbiopsies obtained from human masseter muscle was used to investigate if injection of glutamate into the NGF-sensitized masseter muscle alters the density or expression of the NMDA receptor subtype 2B (NR2B) or NGF by putative sensory afferent (that express SP) fibers. The relationship between expression and pain characteristics was also examined. NGF and glutamate administration increased the density and expression of NR2B and NGF by muscle putative sensory afferent fibers (P < 0.050). This increase in expression was greater in women than in men (P < 0.050). Expression of NR2B receptors by putative sensory afferent fibers was positively correlated with pain characteristics. Results suggest that increased expression of peripheral NMDA receptors partly contributes to the increased pain and sensitivity induced by intramuscular injection of NGF and glutamate in healthy humans; a model of myofascial temporomandibular disorder (TMD) pain. Whether a similar increase in peripheral NMDA expression occurs in patients with painful TMDs warrants further investigation.
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Affiliation(s)
- Abdelrahman M Alhilou
- Department of Restorative Dentistry, College of Dentistry, Umm Al-Qura University, Makkah al Mukarramah, Saudi Arabia.
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, and Scandinavian Center for Orofacial Neurosciences (SCON), Box 4064, 141 04, Huddinge, Sweden.
| | - Akiko Shimada
- Department of Geriatric Dentistry, Osaka Dental University, Osaka, Japan
| | - Camilla I Svensson
- Department of Physiology and Pharmacology, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Peter Svensson
- Department of Dentistry and Oral Health, Aarhus University, and Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
| | - Malin Ernberg
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, and Scandinavian Center for Orofacial Neurosciences (SCON), Box 4064, 141 04, Huddinge, Sweden
| | - Brian E Cairns
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
| | - Nikolaos Christidis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, and Scandinavian Center for Orofacial Neurosciences (SCON), Box 4064, 141 04, Huddinge, Sweden
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Yi Y, Zhou X, Xiong X, Wang J. Neuroimmune interactions in painful TMD: Mechanisms and treatment implications. J Leukoc Biol 2021; 110:553-563. [PMID: 34322892 DOI: 10.1002/jlb.3mr0621-731rr] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 06/28/2021] [Accepted: 07/08/2021] [Indexed: 02/05/2023] Open
Abstract
The underlying mechanisms and treatment of painful temporomandibular disorders (TMDs) are important but understudied topics in craniofacial research. As a group of musculoskeletal diseases, the onset of painful TMD is proved to be a result of disturbance of multiple systems. Recently, emerging evidence has revealed the involvement of neuroimmune interactions in painful TMD. Inflammatory factors play an important role in peripheral sensitization of temporomandibular joint (TMJ), and neurogenic inflammation in turn enhances TMJs dysfunction in TMD. Furthermore, centralized neuroimmune communications contribute to neuron excitability amplification, leading to pain sensitization, and is also responsible for chronic TMD pain and other CNS symptoms. Therapeutics targeting neuroimmune interactions may shed light on new approaches for treating TMD. In this review, we will discuss the role of neuroimmune interactions in the onset of painful TMD from the peripheral and centralized perspectives, and how understanding this mechanism could provide new treatment options. Insights into the neuroimmune interactions within TMJs and painful TMD would broaden the knowledge of mechanisms and treatments of this multifactorial disease.
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Affiliation(s)
- Yating Yi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, 610041, China
| | - Xueman Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, 610041, China
| | - Xin Xiong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, 610041, China
| | - Jun Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, 610041, China
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Ashraf J, Närhi M, Suominen AL, Saxlin T. Association of temporomandibular disorder-related pain with severe headaches-a Bayesian view. Clin Oral Investig 2021; 26:729-738. [PMID: 34224000 PMCID: PMC8791898 DOI: 10.1007/s00784-021-04051-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/22/2021] [Indexed: 12/04/2022]
Abstract
Objectives Association of temporomandibular disorders (TMD)-related pain with severe headaches (migraine and tension-type headaches [TTH]) was studied over a follow-up period of 11 years. Materials and methods The data used was from two nationally representative health surveys in Finland—the Health 2000 Survey (baseline) and the Health 2011 Survey (follow-up) (Bioresource Research Impact Factor [BRIF] 8901)—conducted by the Finnish Institute for Health and Welfare (THL). The primary dataset of the current study included a subset of the population undergoing a clinical oral examination, including TMD examination, at baseline, and answering the questions related to severe headaches, both at baseline and at follow-up (n = 530). From the primary dataset, two datasets were created to study the onset of migraine (dataset 1) and TTH (dataset 2) separately. Dataset 1 included participants healthy of migraine, but not other headaches, at baseline (n = 345), and dataset 2 participants healthy of TTH and other headaches, except migraine, at baseline (n = 464). Bayesian logistic regression models with weakly informative priors were utilized to assess the association of muscle-related TMD pain (mTMD) at baseline and temporomandibular joint-related TMD pain (jTMD) at baseline with the presence of migraine and TTH at follow-up. Results Neither of the baseline TMD-related pain variables were associated with the presence of migraine at follow-up (posterior effect estimates-0.12, 95% credible interval [CI] -0.49–0.24, and 0.11, 95% CI -0.38–0.59, for mTMD and jTMD, respectively), whereas mTMD at baseline (posterior effect estimate 0.36, 95% CI 0.02–0.69), but not jTMD at baseline (posterior effect estimate -0.32, 95% CI -0.94–0.25), was associated with the presence of TTH at follow-up. Bayesian sensitivity analyses revealed that the estimates of the regression models were stable, demonstrating sufficient validity and consistency of the estimates. Conclusion These results indicate that diverse mechanisms may exist behind the associations of TMD-related painful conditions with different types of severe headaches. Clinical relevance TMD-related pain is a frequent comorbidity of severe primary headaches. Therapy of severe primary headaches may thus benefit significantly with the incorporation of a multi-disciplinary clinical team.
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Affiliation(s)
- Javed Ashraf
- Institute of Dentistry, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.
| | - Matti Närhi
- Institute of Dentistry, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.,Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland.,Department of Public Health and Welfare, the Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tuomas Saxlin
- Institute of Dentistry, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
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Association between Temporomandibular Joint Disorder and Parkinson's Disease. Brain Sci 2021; 11:brainsci11060747. [PMID: 34200085 PMCID: PMC8229075 DOI: 10.3390/brainsci11060747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 05/31/2021] [Accepted: 06/03/2021] [Indexed: 01/07/2023] Open
Abstract
This study performed two different analyses using a large set of population data from the Korean National Health Insurance Service Health Screening Cohort to evaluate the interactional association between temporomandibular disorder (TMD) and Parkinson’s disease (PD). Two nested case–control population-based studies were conducted on 514,866 participants. In Study I, 4455 participants with TMD were matched with 17,820 control participants, with a ratio of 1:4. In Study II, 6076 participants with PD were matched with 24,304 control participants, with a ratio of 1:4. Obesity, smoking, alcohol consumption, systolic, diastolic blood pressure, fasting blood glucose level, and total cholesterol were adjusted. The adjusted odds ratio (OR) for TMD was 1.43 (95% confidence interval (CI) = 1.02–2.00) in PD patients compared to non-PD patients in Study I (p < 0.001). The adjusted OR for PD was 1.56 (95% CI = 1.13–2.15) in TMD patients compared to non-TMD patients in Study II (p = 0.007). This study demonstrated that patients with TMD have a significantly higher risk of developing PD and, conversely, those with PD have a significantly higher risk of developing TMD.
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