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Nickel JC, Gonzalez YM, Gallo LM, Iwasaki LR. The challenge of ecological validity in temporomandibular disorders research. J Oral Rehabil 2024. [PMID: 38661423 DOI: 10.1111/joor.13707] [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: 01/03/2024] [Revised: 03/29/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE To review the ecological validity of outcomes from current research involving temporomandibular disorders (TMDs), with an emphasis on chronic myofascial pain and the precocious development of degenerative disease of the temporomandibular joint (TMJ). MATERIALS AND METHODS Current approaches used to study TMDs in terms of neuromechanics, masticatory muscle behaviours, and the dynamics of the autonomic nervous system (ANS) were assessed for ecological validity in this review. In particular, the available literature was scrutinized regarding the effects of sampling, environmental and psychophysiological constraints and averaging data across biological rhythms. RESULTS Validated computer-assisted numerical modelling of the neuromechanics used biological objective functions to accurately predict muscle activation patterns for jaw-loading tasks that were individual-specific. With respect to masticatory muscle behaviour, current findings refute the premise that sustained bruxing and clenching at high jaw-loading magnitudes were associated with painful TMDs such as myofascial pain. Concerning the role of the ANS in TMDs, there remains the need for personalized assessments based on biorhythms, and where the detection of dysregulated physiologic oscillators may inform interventions to relieve pain and restore normal function. CONCLUSIONS Future human research which focuses on TMD myofascial pain or the precocious development and progression of TMJ degenerative joint disease requires experimental designs with ecological validity that capture objectively measured data which meaningfully reflect circadian and ultradian states.
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Affiliation(s)
- Jeffrey C Nickel
- Department of Oral and Craniofacial Sciences, Oregon Health & Science University School of Dentistry, Portland, Oregon, USA
| | - Yoly M Gonzalez
- Department of Oral Diagnostic Sciences, University at Buffalo School of Dental Medicine, Buffalo, New York, USA
| | | | - Laura R Iwasaki
- Department of Oral and Craniofacial Sciences, Oregon Health & Science University School of Dentistry, Portland, Oregon, USA
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Hovhannisyan AH, Lindquist KA, Belugin S, Mecklenburg J, Ibrahim T, Tram M, Corey TM, Salmon AB, Perez D, Ruparel S, Akopian AN. Sensory innervation of masseter, temporal and lateral pterygoid muscles in common marmosets. Sci Rep 2023; 13:23062. [PMID: 38155190 PMCID: PMC10754842 DOI: 10.1038/s41598-023-49882-9] [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: 04/26/2023] [Accepted: 12/13/2023] [Indexed: 12/30/2023] Open
Abstract
Myogenous temporomandibular disorders is associated with an increased responsiveness of nerves innervating the masseter (MM), temporal (TM), and lateral pterygoid muscles (LPM). This study aimed to examine sensory nerve types innervating MM, TM and LPM of adult non-human primate-common marmosets. Sensory nerves were localized in specific regions of these muscles. Pgp9.5, marker for all nerves, and NFH, a marker for A-fibers, showed that masticatory muscles were primarily innervated with A-fibers. The proportion of C- to A-fibers was highest in LPM, and lowest in MM. All C-fibers (pgp9.5+/NFH-) observed in masticatory muscles were peptidergic (CGRP+) and lacked mrgprD and CHRNA3, a silent nociceptive marker. TrpV1 was register in 17% of LPM nerves. All fibers in masticatory muscles were labeled with GFAP+, a myelin sheath marker. There were substantially more peptidergic A-fibers (CGRP+/NFH+) in TM and LPM compared to MM. MM, TM and LPM NFH+ fibers contained different percentages of trkC+ and parvalbumin+, but not trkB+ fibers. Tyrosine hydroxylase antibodies, which did not label TG, highlighted sympathetic fibers around blood vessels of the masticatory muscles. Overall, masticatory muscle types of marmosets have similarities and differences in innervation patterns.
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Affiliation(s)
- Anahit H Hovhannisyan
- Departments of Endodontics, The School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
| | - Karen A Lindquist
- Integrated Biomedical Sciences (IBMS) Program, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Sergei Belugin
- Departments of Endodontics, The School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
| | - Jennifer Mecklenburg
- Departments of Endodontics, The School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
| | - Tarek Ibrahim
- Departments of Endodontics, The School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
| | - Meilinn Tram
- Departments of Endodontics, The School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
- Integrated Biomedical Sciences (IBMS) Program, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Tatiana M Corey
- Departments of Laboratory Animal Resources, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Adam B Salmon
- Departments of Molecular Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
- Sam and Ann Barshop Institute for Longevity and Aging Studies, The University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
- South Texas Veterans Health Care System, Geriatric Research Education and Clinical Center San Antonio, San Antonio, TX, 78229, USA
| | - Daniel Perez
- Oral and Maxillofacial Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Shivani Ruparel
- Departments of Endodontics, The School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
- Integrated Biomedical Sciences (IBMS) Program, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
- Departments of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Armen N Akopian
- Departments of Endodontics, The School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA.
- Integrated Biomedical Sciences (IBMS) Program, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA.
- Departments of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA.
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Hovhannisyan AH, Lindquist K, Belugin S, Mecklenburg J, Ibrahim T, Tram M, Corey T, Salmon A, Ruparel S, Ruparel S, Akopian A. Sensory innervation of masseter, temporal and lateral pterygoid muscles in common marmosets. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.10.528062. [PMID: 36798270 PMCID: PMC9934658 DOI: 10.1101/2023.02.10.528062] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Myogenous temporomandibular disorders (TMDM) is associated with an increased responsiveness of nerves innervating the masseter (MM), temporal (TM), medial pterygoid (MPM) and lateral pterygoid muscles (LPM). This study aimed to examine sensory nerve types innervating MM, TM and LPM of adult non-human primate - common marmosets. Sensory nerves are localized in specific regions of these muscles. Pgp9.5, marker for all nerves, and NFH, a marker for A-fibers, showed that masticatory muscles were predominantly innervated with A-fibers. The proportion of C- to A-fibers was highest in LPM, and minimal (6-8%) in MM. All C-fibers (pgp9.5+/NFH-) observed in masticatory muscles were peptidergic (CGRP+) and lacked mrgprD, trpV1 and CHRNA3, a silent nociceptive marker. All fibers in masticatory muscles were labeled with GFAP+, a myelin sheath marker. There were substantially more peptidergic A-fibers (CGRP+/NFH+) in TM and LPM compared to MM. Almost all A-fibers in MM expressed trkC, with some of them having trkB and parvalbumin. In contrast, a lesser number of TM and LPM nerves expressed trkC, and lacked trkB. Tyrosine hydroxylase antibodies, which did not label TG, highlighted sympathetic fibers around blood vessels of the masticatory muscles. Overall, masticatory muscle types of marmosets have distinct and different innervation patterns.
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Almășan O, Hedeșiu M, Băciuț M, Buduru S, Dinu C. Physiotherapy and occlusal splint treatment in myalgia, cervi-cogenic headache, and arthralgia: a case report. BALNEO AND PRM RESEARCH JOURNAL 2022. [DOI: 10.12680/balneo.2022.518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract: The purpose of this study was to describe a rare case of myalgia, cervicogenic headache, and arthralgia in which interaction of physiotherapy, relaxation techniques, cognitive and behavioral counseling, psychosocial support, and occlusal splint treatment resulted in a positive outcome. A 27-year-old woman presented to our clinic with myalgia of the right side of the face, right temporomandibular joint arthralgia, right and left temple pain, jaw elevator muscle pain, and head and neck muscle soreness. The right and left joints' magnetic resonance imaging revealed anterior disc displacement without reduction. The treatment strategy aimed for a non-invasive treatment approach to relieve pain and restore functions. An occlusal appliance with an anterior bite plane was selected, along with counseling, psychosocial support, physiotherapy, posture self-control, massage of the head and neck muscles, mouth opening exercises, and self-massage. A temporomandibular specialist oversaw the splint treatment's progress, a maxillofacial surgeon managed the clinical signs and symptoms of the muscles and joints, and a physiotherapist provided the physiotherapy. Muscle stability in the head and neck has been related to temporomandibular disorders and may have repercussions on craniofacial structure and function.
Keywords: physiotherapy; massage; relaxation techniques; oral splint; temporomandibular dis-order
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Affiliation(s)
- Oana Almășan
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hațieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Mihaela Hedeșiu
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Mihaela Băciuț
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
| | - Smaranda Buduru
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hațieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Cristian Dinu
- Department of Maxillofacial Surgery and Implantology, Iuliu Hațieganu University of Medicine and Pharmacy, 37 Iuliu Hossu Street, 400029 Cluj-Napoca, Romania
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