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Lee YH, Chung JW. Climate temperature and seasonal influences on the prevalence of temporomandibular disorders in South Korea. Sci Rep 2024; 14:10974. [PMID: 38744911 PMCID: PMC11094084 DOI: 10.1038/s41598-024-61829-2] [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: 12/29/2023] [Accepted: 05/10/2024] [Indexed: 05/16/2024] Open
Abstract
This study aimed to explore seasonal variations in temporomandibular disorder (TMD) prevalence in South Korea, utilizing nationwide population-based big data. Data corresponding to the Korean Standard Classification of Diseases code of K07.6, which identifies TMD, were extracted from the Health Insurance Review and Assessment Service online platform for the period from 2010 to 2022. Additionally, we integrated these data with climate temperature records from the Korean Meteorological Administration. We subsequently conducted a statistical analysis of TMD patient data on a monthly and seasonal basis over the past 13 years to assess prevalence. Over the past 13 years, the number of TMD patients in Korea has steadily increased. The prevalence of TMD rose from 0.48% (224,708 out of a total population of 50,515,666) in 2010 to 0.94% (482,241 out of a total population of 51,439,038) in 2022, marking a 1.96-fold increase. Among children under 10 years of age, no significant differences were observed in TMD prevalence between boys and girls. However, a distinct female predominance emerged after the age of 10, with an average female-to-male ratio of 1.51:1. The peak prevalence of TMD occurred in individuals in their 20 s, followed by adolescents in their late 10 s. The majority of TMD patients were concentrated in Seoul and Gyeonggi province, with metropolitan areas accounting for 50% of the total patient count. Seasonally, TMD patient numbers showed no significant increase in winter compared with spring or summer. The temperature difference, defined as the absolute difference between the highest and lowest temperatures for each month, showed a positive correlation with TMD patient counts. A greater temperature difference was associated with higher patient counts. The strongest correlation between temperature differences and TMD patient numbers was observed in winter (r = 0.480, p < 0.01), followed by summer (r = 0.443, p < 0.01), and spring (r = 0.366, p < 0.05). Temperature differences demonstrated a significantly stronger correlation with the increase in the number of TMD patients than absolute climate temperatures. This aspect should be a key consideration when examining seasonal trends in TMD prevalence in South Korea.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, College of Dentistry, Kyung Hee University Dental Hospital, Kyung Hee University, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, South Korea.
| | - Jin-Woo Chung
- Department of Oral Medicine and Oral Diagnosis, Seoul National University School of Dentistry, #101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
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Asadauskas A, Luedi MM, Urman RD, Andereggen L. Modern Approaches to the Treatment of Acute Facial Pain. Curr Pain Headache Rep 2024:10.1007/s11916-024-01260-4. [PMID: 38713367 DOI: 10.1007/s11916-024-01260-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE OF REVIEW Acute facial pain presents a complex challenge in medical practice, requiring a comprehensive and interdisciplinary approach to its management. This narrative review explores the contemporary landscape of treating acute facial pain, delving into pharmacological, non-pharmacological, and advanced interventions. The significance of tailored treatment strategies, rooted in the diverse etiologies of facial pain, such as dental infections, trigeminal neuralgia, temporomandibular joint disorders, sinusitis, or neurological conditions like migraines or cluster headaches, is underscored. We particularly emphasize recent advances in treating trigeminal neuralgia, elucidating current treatment concepts in managing this particular acute facial pain. RECENT FINDINGS Recent research sheds light on various treatment modalities for acute facial pain. Pharmacotherapy ranges from traditional NSAIDs and analgesics to anticonvulsants and antidepressants. Non-pharmacological interventions, including physical therapy and psychological approaches, play pivotal roles. Advanced interventions, such as nerve blocks and surgical procedures, are considered in cases of treatment resistance. Moreover, we explore innovative technologies like neuromodulation techniques and personalized medicine, offering promising avenues for optimizing treatment outcomes in acute facial pain management. Modern management of acute facial pain requires a nuanced and patient-centric approach. Tailoring treatment strategies to the individual's underlying condition is paramount. While pharmacotherapy remains a cornerstone, the integration of non-pharmacological interventions is essential for comprehensive care. Advanced interventions should be reserved for cases where conservative measures prove inadequate. Furthermore, leveraging innovative technologies and personalized medicine holds promise for enhancing treatment efficacy. Ultimately, a holistic approach that considers the diverse needs of patients is crucial for effectively addressing acute facial pain.
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Affiliation(s)
- Auste Asadauskas
- Department of Neurosurgery, Cantonal Hospital of Aarau, Aarau, Switzerland
- Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Markus M Luedi
- Department of Anaesthesiology, Rescue- and Pain Medicine, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Richard D Urman
- Department of Anesthesiology, The Ohio State University, Columbus, OH, 43210, USA
| | - Lukas Andereggen
- Department of Neurosurgery, Cantonal Hospital of Aarau, Aarau, Switzerland.
- Faculty of Medicine, University of Bern, Bern, Switzerland.
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Udhawani NS, Hoover DL. Differential screen and treatment of sternocleidomastoid syndrome versus eagle syndrome: a case report. Physiother Theory Pract 2024; 40:1072-1082. [PMID: 36384424 DOI: 10.1080/09593985.2022.2144560] [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: 03/31/2021] [Revised: 10/28/2022] [Accepted: 10/28/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND/PURPOSE Differential screening is a complex process in chronic pain conditions. There is significant uncertainty that surrounds the pathophysiology of many chronic pain syndromes that may lead to misdiagnosis and treatment failures. Such differential screening is even more challenging where there is regional overlapping from surrounding tissues. This case report chronicles the differential screening and treatment of a patient with sternocleidomastoid syndrome (SCMS) originally diagnosed as Eagle's syndrome (ES). CASE DESCRIPTION A 55-year-old woman, referred to a physical therapist (PT) by an ear, nose and throat (ENT) physician with the diagnosis of ES. The patient complained of yearlong left-sided otalgia, blurred vision, excessive lacrimation, dysphagia, hyperesthesia on the left side of the face, unilateral temporal headaches, and both left mandibular and anterior neck pain. OUTCOMES The PT examination revealed the patient did not exhibit hallmark findings for clinical confirmation of ES and instead demonstrated multiple signs consistent with SCMS. DISCUSSION Manual therapy techniques and therapeutic exercises resolved the patient's year-long chronic symptoms within 6 sessions.
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Affiliation(s)
- Nitin S Udhawani
- Physical Therapy Department, Three Rivers Health Outpatient Physical Therapy, Three Rivers, Michigan, United States
| | - Donald L Hoover
- Doctor of Physical Therapy Department, Western Michigan University, Kalamazoo, Michigan, United States
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Gong Y, Liu Y, Yin D. Effect of the application of digital technology-assisted optimization in the process of adjusting jaw position. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2024; 42:268-276. [PMID: 38597088 PMCID: PMC11034415 DOI: 10.7518/hxkq.2024.2023327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/17/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVES The aim of this study was to demonstrate a novel jaw position adjustment technique derived from digital twins and evaluate the application effect of digital technology-assisted optimization in the process of adjusting jaw position on patients with temporomandibular disorders (TMD). METHODS A total of 74 patients with TMD who attended the Department of Temporomandibular Joint, West China Hospital of Stomatology, Si-chuan University, between June 2022 and May 2023 were selected. The patient's initial computed tomography (CT) and bilateral temporomandibular joint data obtained by magnetic resonance imaging (MRI) were collected. The 148 joints were divided into the normal disc-condyle relationship (N) group, disc displacement with reduction (DDWR) group, and disc displacement without reduction (DDWoR) group. Assisted by digital technology, the patient's CT data were reconstructed, and a personalized reference plane was established to adjust the jaw position. A three-point bite guiding splint was designed by the adjusted occlusal space and then fabricated by 3D printing technology. It was worn by the patients and then reviewed by MRI. Before and after the adjustment of jaw position, the amount and direction of condyle and disc displacement and the angle between condyle and disc were measured as the evaluation indexes of the effect of the adjustment. The correlation with condylar displacement was evaluated. RESULTS In the N group, the disc moved backward and downward along the X and Z axes by (-0.60±0.62) and (0.51±0.71) mm, respectively. In the DDWR group, the disc moved backward and upward along the X and Z axes by (-1.33±1.38) and (-0.09±1.31) mm, respectively. In the DDWoR group, the disc moved forward and downward along the X and Z axes by (0.49±1.76) and (1.35±1.76) mm, respectively. The angle between the condyle and the disc decreased after adjustment of the jaw position in all three groups. All patients showed improvement in symptoms after adjustment. CONCLUSIONS Digital technology-assisted jaw position adjustment can simplify the process, reduce the sensitivity of the technique, and improve patients' disc-condyle structure and symptoms. Therefore, its application in the treatment of patients with TMD is of great clinical significance.
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Affiliation(s)
- Yanji Gong
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yang Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Deqiang Yin
- Dept. of Engineering Mechanics, College of Aerospace Engineering, Chongqing University, Chong-qing 400044, China
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Tao J, Wang X, Xu J. Expression of CGRP in the Trigeminal Ganglion and Its Effect on the Polarization of Macrophages in Rats with Temporomandibular Arthritis. Cell Mol Neurobiol 2024; 44:22. [PMID: 38363424 PMCID: PMC10873438 DOI: 10.1007/s10571-024-01456-7] [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: 10/23/2023] [Accepted: 01/19/2024] [Indexed: 02/17/2024]
Abstract
Calcitonin gene-related peptide (CGRP) is synthesized and secreted by trigeminal ganglion neurons, and is a key neuropeptide involved in pain and immune regulation. This study investigates the expression of CGRP in the trigeminal ganglion (TG) and its regulatory role in the polarization of macrophages in rats with temporomandibular arthritis. A rat model of temporomandibular arthritis was established using CFA. Pain behavior was then observed. Temporomandibular joint (TMJ) and the TG were collected, and immunohistochemistry, immunofluorescence (IF) staining, and RT-qPCR were used to examine the expression of CGRP and macrophage-related factors. To investigate the impact of CGRP on macrophage polarization, both CGRP and its antagonist, CGRP 8-37, were separately administered directly within the TG. Statistical analysis revealed that within 24 h of inducing temporomandibular arthritis using CFA, there was a significant surge in CD86 positive macrophages within the ganglion. These macrophages peaked on the 7th day before beginning their decline. In this context, it's noteworthy that administering CGRP to the trigeminal ganglion can prompt these macrophages to adopt the M2 phenotype. Intriguingly, this study demonstrates that injecting the CGRP receptor antagonist (CGRP 8-37) to the ganglion counteracts this shift towards the M2 phenotype. Supporting these in vivo observations, we found that in vitro, CGRP indeed fosters the M2-type polarization of macrophages. CGRP can facilitate the conversion of macrophages into the M2 phenotype. The phenotypic alterations of macrophages within the TG could be instrumental in initiating and further driving the progression of TMJ disorders.
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Affiliation(s)
- Junli Tao
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Xiaohui Wang
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jie Xu
- College of Stomatology, Chongqing Medical University, Chongqing, China.
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China.
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
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Lisboa MRP, Pereira AF, Alves BWDF, Dias DBS, Alves LCV, da Silva CMP, Lima-Júnior RCP, Gondim DV, Vale ML. Blockage of the fractalkine pathway reduces hyperalgesia and prevents morphological glial alterations-Comparison between inflammatory and neuropathic orofacial pain in male rats. J Neurosci Res 2024; 102:e25269. [PMID: 38284851 DOI: 10.1002/jnr.25269] [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: 04/14/2023] [Revised: 10/09/2023] [Accepted: 10/22/2023] [Indexed: 01/30/2024]
Abstract
This study aimed to evaluate the effects of inhibitors of the fractalkine pathway in hyperalgesia in inflammatory and neuropathic orofacial pain in male rats and the morphological changes in microglia and satellite glial cells (SGCs). Rats were submitted to zymosan-induced arthritis of the temporomandibular joint or infraorbital nerve constriction, and treated intrathecally with a P2 X7 antagonist, a cathepsin S inhibitor or a p-38 mitogen-activated protein kinase (MAPK) inhibitor. Mechanical hyperalgesia was evaluated 4 and 6 h following arthritis induction or 7 and 14 days following nerve ligation. The expression of the receptor CX3 CR1 , phospho-p-38 MAPK, ionized calcium-binding adapter molecule-1 (Iba-1), and glutamine synthetase and the morphological changes in microglia and SGCs were evaluated by confocal microscopy. In both inflammatory and neuropathic models, untreated animals presented a higher expression of CX3 CR1 and developed hyperalgesia and up-regulation of phospho-p-38 MAPK, which was prevented by all drugs (p < .05). The number of microglial processes endpoints and the total branch length were lower in the untreated animals, but the overall immunolabeling of Iba-1 was altered only in neuropathic rats (p < .05). The mean area of SGCs per neuron was significantly altered only in the inflammatory model (p < .05). All morphological alterations were reverted by modulating the fractalkine pathway (p < .05). In conclusion, the blockage of the fractalkine pathway seemed to be a possible therapeutic strategy for inflammatory and neuropathic orofacial pain, reducing mechanical hyperalgesia by impairing the phosphorylation of p-38 MAPK and reverting morphological alterations in microglia and SGCs.
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Affiliation(s)
- Mario Roberto Pontes Lisboa
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
- Graduation in Dentistry, Christus University Center, Fortaleza, Brazil
| | - Anamaria Falcão Pereira
- Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | | | - Diego Bernarde Souza Dias
- Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | | | | | - Roberto César Pereira Lima-Júnior
- Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
- Drug Research and Development Center, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Delane Viana Gondim
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
- Drug Research and Development Center, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Mariana Lima Vale
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
- Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
- Drug Research and Development Center, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
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Krasniqi V, Disha V, Krasniqi S, Qorolli M, Beqaj S. Craniofacial Pain Management in Severe COVID-19 Patients During the Pandemic Peak in Kosovo: A Comprehensive Approach. Cureus 2023; 15:e46111. [PMID: 37900466 PMCID: PMC10612126 DOI: 10.7759/cureus.46111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2023] [Indexed: 10/31/2023] Open
Abstract
Background This cross-sectional study aims to evaluate pain management's success in limiting admissions and assesses remote care's effectiveness for optimal pain relief. By utilizing data from severe COVID-19 inpatients in Prishtina, Kosovo, this study offers insights into the challenges posed by the pandemic and innovative care approaches aimed at improving patient well-being. Methodology This cross-sectional study includes 55 patients with severe COVID-19 after hospital discharge. All study participants completed the questionnaire in the presence of a clinical pharmacologist. The questionnaire of this study consisted of three parts: sociodemographic data (first part), the Intensity and Characteristics of Toothache (IaCofT) and headache (second part), and pharmacological treatment of headache and dental pain (third part). The questionnaire on IaCofT and headache was created with some modifications of the Modified Dental Pain Screening Questionnaire (M-DePaQ). Descriptive statistics were conducted using Prism version 10.0.1 (Windows and Mac). Results According to the study data, 89.1% (n = 49) of the participants experienced pain during hospitalization with COVID-19, while 72.72% (n = 40) of them experienced pain after hospital discharge. Of the participants, 32.7% (n = 18) experienced dental pain, whereas 60% (n = 33) reported having headaches. Regarding the pain scale, more than two-thirds (n = 40, 72.72%) of the participants had moderate to moderately severe pain, and in 70.9% (n = 39) of the cases, the pain occurred episodically. The absolute majority (n = 53, 96.4%) of study participants reported the use of analgesics for pain management. Paracetamol (n = 46, 83.6%) and ibuprofen (n = 14, 25.5%) were the most commonly used analgesics for pain management. Conclusions This study highlighted the prevalence of headache and acute dental pain in these patients. The majority of the study participants were convinced by the healthcare system and were highly dependent on pharmacological treatment for headaches and acute toothache during the COVID-19 peak. The study results showed that the pain was proven to be successfully treated pharmacologically with analgesics such as paracetamol, ibuprofen, and diclofenac. Telemedicine is expected to become an important healthcare practice in the post-COVID-19 era. Therefore, the introduction of this service could be considered.
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Affiliation(s)
- Valon Krasniqi
- Faculty of Medicine, Institute of Pharmacology With Toxicology and Clinical Pharmacology, University of Prishtina "Hasan Prishtina", Prishtina, ALB
| | - Visar Disha
- Faculty of Medicine, Department of Prosthetic, University of Prishtina "Hasan Prishtina", Prishtina, ALB
| | - Shaip Krasniqi
- Faculty of Medicine, Institute of Pharmacology With Toxicology and Clinical Pharmacology, University of Prishtina "Hasan Prishtina", Prishtina, ALB
| | - Merita Qorolli
- Faculty of Medicine, Department of Physiotherapy, University of Prishtina "Hasan Prishtina", Prishtina, ALB
| | - Samire Beqaj
- Faculty of Medicine, Department of Physiotherapy, University of Prishtina "Hasan Prishtina", Prishtina, ALB
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Khawaja SN, Selvi F, Ozdemir M, Talu GK, Bektas Kayhan K. Characterization of head and neck pain symptoms of patients presenting to a tertiary care pain clinic. Cranio 2023; 41:440-445. [PMID: 33345752 DOI: 10.1080/08869634.2020.1863113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To characterize the presentation and symptomatology of individuals presenting with pain in head and neck regions. METHODS A retrospective chart-review was performed on patients with pain in the HFN presenting to a tertiary pain center in Turkey between January 2016 and January 2017. Information regarding the characteristics of pain and medical and treatment history were extracted and reviewed. RESULTS Among 197 subjects, 135 (68.5%) were females. The average duration of pain was 60.13 ± 92.32 months. The pain was continuous in presentation and severe in intensity in 43.1% and 51.8% of the subjects, respectively. The pain was associated with at least one somatosensory symptom in 12.1% of subjects. Common diagnoses were trigeminal neuralgia, persistent idiopathic facial pain, and migraine headaches. CONCLUSION Painful disorders of the HFN are associated with varying and perplexing signs and symptoms. Such patients should undergo a comprehensive clinical assessment with a multidisciplinary team.
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Affiliation(s)
- Shehryar Nasir Khawaja
- Orofacial Pain Medicine, Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan
| | - Firat Selvi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | | | - Gül Köknel Talu
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Kivanc Bektas Kayhan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
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Romero-Reyes M, Arman S, Teruel A, Kumar S, Hawkins J, Akerman S. Pharmacological Management of Orofacial Pain. Drugs 2023; 83:1269-1292. [PMID: 37632671 DOI: 10.1007/s40265-023-01927-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 08/28/2023]
Abstract
Orofacial pain is a category of complex disorders, including musculoskeletal, neuropathic and neurovascular disorders, that greatly affect the quality of life of the patient. These disorders are within the fields of dentistry and medicine and management can be challenging, requiring a referral to an orofacial pain specialist, essential for adequate evaluation, diagnosis, and care. Management is specific to the diagnosis and a treatment plan is developed with diverse pharmacological and non-pharmacological modalities. The pharmacological management of orofacial pain encompasses a vast array of medication classes and approaches. This includes anti-inflammatory drugs, muscle relaxants, anticonvulsants, antidepressants, and anesthetics. In addition, as adjunct therapy, different injections can be integrated into the management plan depending on the diagnosis and needs. These include trigger point injections, temporomandibular joint (TMJ) injections, and neurotoxin injections with botulinum toxin and nerve blocks. Multidisciplinary management is key for optimal care. New and safer therapeutic targets exclusively for the management of orofacial pain disorders are needed to offer better care for this patient population.
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Affiliation(s)
- Marcela Romero-Reyes
- Brotman Facial Pain Clinic, School of Dentistry, University of Maryland, 650 W. Baltimore St, 1st Floor, Baltimore, MD, 21201, USA.
- Department of Pain and Neural Sciences, School of Dentistry, University of Maryland, 650 W. Baltimore St, 8th Floor, Baltimore, MD, 21201, USA.
| | - Sherwin Arman
- Orofacial Pain Program, Section of Oral Medicine, Oral Pathology and Orofacial Pain, University of California, Los Angeles, School of Dentistry, Los Angeles, CA, USA
| | | | - Satish Kumar
- Department of Periodontics, Arizona School of Dentistry and Oral Health, A.T. Still University, Mesa, AZ, USA
| | - James Hawkins
- Naval Postgraduate Dental School, Naval Medical Leader and Professional Development Command, Uniformed Services University of the Health Sciences Postgraduate Dental College, Baltimore, MD, USA
| | - Simon Akerman
- Department of Pain and Neural Sciences, School of Dentistry, University of Maryland, 650 W. Baltimore St, 8th Floor, Baltimore, MD, 21201, USA
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Wu Y, Lan Y, Mao J, Shen J, Kang T, Xie Z. The interaction between the nervous system and the stomatognathic system: from development to diseases. Int J Oral Sci 2023; 15:34. [PMID: 37580325 PMCID: PMC10425412 DOI: 10.1038/s41368-023-00241-4] [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: 03/29/2023] [Revised: 07/30/2023] [Accepted: 07/31/2023] [Indexed: 08/16/2023] Open
Abstract
The crosstalk between the nerve and stomatognathic systems plays a more important role in organismal health than previously appreciated with the presence of emerging concept of the "brain-oral axis". A deeper understanding of the intricate interaction between the nervous system and the stomatognathic system is warranted, considering their significant developmental homology and anatomical proximity, and the more complex innervation of the jawbone compared to other skeletons. In this review, we provide an in-depth look at studies concerning neurodevelopment, craniofacial development, and congenital anomalies that occur when the two systems develop abnormally. It summarizes the cross-regulation between nerves and jawbones and the effects of various states of the jawbone on intrabony nerve distribution. Diseases closely related to both the nervous system and the stomatognathic system are divided into craniofacial diseases caused by neurological illnesses, and neurological diseases caused by an aberrant stomatognathic system. The two-way relationships between common diseases, such as periodontitis and neurodegenerative disorders, and depression and oral diseases were also discussed. This review provides valuable insights into novel strategies for neuro-skeletal tissue engineering and early prevention and treatment of orofacial and neurological diseases.
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Affiliation(s)
- Yuzhu Wu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Yanhua Lan
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Jiajie Mao
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Jiahui Shen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Ting Kang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China.
| | - Zhijian Xie
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China.
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Shimada A, Ogawa T, Sammour SR, Narihara T, Kinomura S, Koide R, Noma N, Sasaki K. Effectiveness of exercise therapy on pain relief and jaw mobility in patients with pain-related temporomandibular disorders: a systematic review. FRONTIERS IN ORAL HEALTH 2023; 4:1170966. [PMID: 37521175 PMCID: PMC10382173 DOI: 10.3389/froh.2023.1170966] [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: 02/21/2023] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Background Orofacial pain conditions are complex disorders that involve biological, social, and psychological factors. Temporomandibular Disorders (TMDs) are one of the most common orofacial pain conditions, and our previous literature review indicated that exercise therapy has shown promise in reducing TMD-related pain. However, more evidence is needed to firmly establish its effectiveness. Objectives This systematic review aims to investigate the effectiveness of exercise therapy on pain relief and jaw mobility in patients with pain-related TMDs. Methods To include randomized controlled trials (RCTs) written in English, a literature search was performed using PubMed, Scopus, Web of Science, Cochrane Library, Ovid, EBM reviews, and Academic Search Complete initially from 4th November 2020 until March 2022. A PICOS for this review was as follows; P: Patients with TMD myalgia or arthralgia, I: Excursion exercise, Stretch exercises, Resistance exercise, or Coordination exercise, C: No treatment or education only. O: Pain intensity and Range of Motion (ROM), S: RCTs. After title screening, a full-text assessment was done to extract data. According to Risk of Bias (RoB) 2.0, risk of bias was assessed in each included paper by 2 reviewers independently. Results A total of 3,388 titles were identified from the electronic database search. After the screening and full-text evaluation, only 5 studies (145 participants) were eligible to be included. Among the exercise modalities, coordination exercise showed a significant effect on pain relief and improvement of joint mobility. Discussion Due to the heterogeneity and small sample size of the included studies, a meta-analysis was not feasible. However, this systematic review suggested that exercise therapy, especially coordinate exercise, can be effective in managing painful TMD conditions. Further research is needed to establish optimal parameters for this patient population, as well as standardization and consistency in terminology and treatment structure.
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Affiliation(s)
- Akiko Shimada
- Department of Oral Health Sciences, Faculty of Health Sciences, Osaka Dental University, Osaka, Japan
- Department of Geriatric Dentistry, Osaka Dental University, Osaka, Japan
| | - Toru Ogawa
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Sara Reda Sammour
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Prosthodontic Department, Faculty of Dentistry, Tanta University, Tanta, Egypt
| | - Taichi Narihara
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Shiori Kinomura
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Rie Koide
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Noboru Noma
- Department of Oral Medicine, Nihon University School of Dentistry, Tokyo, Japan
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Priyank H, Shankar Prasad R, Shivakumar S, Sayed Abdul N, Pathak A, Cervino G, Cicciù M, Minervini G. Management protocols of chronic Orofacial Pain: A Systematic Review. Saudi Dent J 2023; 35:395-402. [PMID: 37520608 PMCID: PMC10373074 DOI: 10.1016/j.sdentj.2023.04.003] [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: 02/28/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 08/01/2023] Open
Abstract
Objective Chronic orofacial pain (CP) is a persistent and debilitating condition that affects the face, mouth, and jaw and can have a significant impact on an individual's quality of life by posing problems to eat, speak, and perform everyday activities. By the means of this narrative review, we aim to assess different types of management modalities that exist to combat chronic orofacial pain. Design Various databases were explored with MeSH keywords of chronic orofacial pain, orofacial pain, and interventions and treatment protocols for eligible articles. After an extensive literature search, it was ascertained that this review identified four major categories of treatment modalities for the management of chronic orofacial pain, namely pharmacological management, psychological management, lifestyle interventions-based management, and current stimulation-based management. Results Of the four categories discussed, although pharmacological intervention offered the most immediate relief-especially from orofacial pain that was of a sudden, stab-like in nature-psychological management demonstrated a remarkable ability to reduce/alleviate the more serious aspect of chronic orofacial pain and was deemed better in comparison to the rest. Lifestyle-based techniques and current stimulation-based management were of limited use since they tended to focus more on the causal and not the symptomatic aspect of orofacial pain. Conclusions Many patients with persistent orofacial discomfort can experience notable improvements in their symptoms and general well-being by all the treatment modalities evaluated.
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Affiliation(s)
- Harsh Priyank
- Department of Conservative, Endodontics & Aesthetic Dentistry, Dental College, Rajendra Institute of Medical Sciences, India
| | - Ravi Shankar Prasad
- Department of Conservative, Endodontics & Aesthetic Dentistry, Dental College, Rajendra Institute of Medical Sciences, India
| | - Sahana Shivakumar
- Public Health Dentistry, Peoples College of Dental Sciences and Research Centre, Peoples University, Bhopal, India
| | - Nishath Sayed Abdul
- Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Anuja Pathak
- Public Health Dentistry, Peoples College of Dental Sciences and Research Centre, Peoples University, Bhopal, India
| | - Gabriele Cervino
- School of Dentistry Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, via Consolare Valeria, 1, 98125 Messina, Italy
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania, Luigi Vanvitelli, 80138 Naples, Italy
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13
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Nattapon R, Aree W, Sompol T, Anchalee V, Chit C, Wongsathit C, Kanokwan T, Mayuree TH, Narawut P. Standardized Centella asiatica (ECa 233) extract decreased pain hypersensitivity development in a male mouse model of chronic inflammatory temporomandibular disorder. Sci Rep 2023; 13:6642. [PMID: 37095163 PMCID: PMC10126003 DOI: 10.1038/s41598-023-33769-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 04/18/2023] [Indexed: 04/26/2023] Open
Abstract
Chronic inflammatory temporomandibular disorder (TMD) pain has a high prevalence, and available nonspecific treatments have adverse side effects. ECa 233, a standardized Centella asiatica extract, is highly anti-inflammatory and safe. We investigated its therapeutic effects by injecting complete Freund's adjuvant (CFA) into right temporomandibular joint of mice and administering either ibuprofen or ECa 233 (30, 100, and 300 mg/kg) for 28 days. Inflammatory and nociceptive markers, bone density, and pain hypersensitivity were examined. CFA decreased ipsilateral bone density, suggesting inflammation localization, which ipsilaterally caused immediate calcitonin gene-related peptide elevation in the trigeminal ganglia (TG) and trigeminal subnucleus caudalis (TNC), followed by late increase of NaV1.7 in TG and of p-CREB and activation of microglia in TNC. Contralaterally, only p-CREB and activated microglia in TNC showed delayed increase. Pain hypersensitivity, which developed early ipsilaterally, but late contralaterally, was reduced by ibuprofen and ECa 233 (30 or 100 mg/kg). However, ibuprofen and only 100-mg/kg ECa 233 effectively mitigated marker elevation. This suggests 30-mg/kg ECa 233 was antinociceptive, whereas 100-mg/kg ECa 233 was both anti-inflammatory and antinociceptive. ECa 233 may be alternatively and safely used for treating chronic inflammatory TMD pain, showing an inverted U-shaped dose-response relationship with maximal effect at 100 mg/kg.
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Affiliation(s)
- Rotpenpian Nattapon
- Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Srisavarindhira Bldg., 13Th Floor, Wanglang Road, Siriraj Subdistrict, Bangkoknoi District, Bangkok, 10700, Thailand
- Department of Oral Biology and Occlusion, Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand
| | - Wanasuntronwong Aree
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Tapechum Sompol
- Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Srisavarindhira Bldg., 13Th Floor, Wanglang Road, Siriraj Subdistrict, Bangkoknoi District, Bangkok, 10700, Thailand
| | - Vattarakorn Anchalee
- Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Srisavarindhira Bldg., 13Th Floor, Wanglang Road, Siriraj Subdistrict, Bangkoknoi District, Bangkok, 10700, Thailand
| | - Care Chit
- Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Srisavarindhira Bldg., 13Th Floor, Wanglang Road, Siriraj Subdistrict, Bangkoknoi District, Bangkok, 10700, Thailand
| | - Chindasri Wongsathit
- Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Srisavarindhira Bldg., 13Th Floor, Wanglang Road, Siriraj Subdistrict, Bangkoknoi District, Bangkok, 10700, Thailand
| | - Tilokskulchai Kanokwan
- Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Srisavarindhira Bldg., 13Th Floor, Wanglang Road, Siriraj Subdistrict, Bangkoknoi District, Bangkok, 10700, Thailand
| | | | - Pakaprot Narawut
- Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Srisavarindhira Bldg., 13Th Floor, Wanglang Road, Siriraj Subdistrict, Bangkoknoi District, Bangkok, 10700, Thailand.
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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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Nair K, Bhat AR. Applications of Gene Therapy in Dentistry: A Review Article. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2023. [DOI: 10.1055/s-0042-1759711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
AbstractGene therapy promises to possess a good prospect in bridging the gap between dental applications and medicine. The dynamic therapeutic modalities of gene therapy have been advancing rapidly. Conventional approaches are being revamped to be more comprehensive and pre-emptive, which could do away with the need for surgery and medicine altogether. The complementary base sequences known as genes convey the instructions required to manufacture proteins. The oral cavity is one of the most accessible locations for the therapeutic intervention of gene therapy for several oral tissues. In 1990, the first significant trial of gene therapy was overseen to alleviate adenosine deaminase deficiency. The notion of genetic engineering has become increasingly appealing as a reflection of its benefits over conventional treatment modalities. An example of how this technology may alter dentistry is the implementation of gene therapy for dental and oral ailments. The objective of this article is to examine the effects of gene therapy on the field of dentistry, periodontology and implantology. Furthermore, the therapeutic factors of disease therapy, minimal invasion, and appropriate outcome have indeed been taken into consideration.
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Affiliation(s)
- Karthika Nair
- Department of Periodontology, A B Shetty Memorial Institute of Dental Sciences, NITTE Deemed to be University, Mangaluru, Karnataka, India
| | - Amitha Ramesh Bhat
- Department of Periodontology, A B Shetty Memorial Institute of Dental Sciences, NITTE Deemed to be University, Mangaluru, Karnataka, India
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Viñals Narváez AC, Sánchez-Sánchez T, García-González M, Ardizone García I, Cid-Verdejo R, Sánchez Romero EA, Jiménez-Ortega L. Psychological and Behavioral Factors Involved in Temporomandibular Myalgia and Migraine: Common but Differentiated Profiles. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1545. [PMID: 36674300 PMCID: PMC9863553 DOI: 10.3390/ijerph20021545] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Many studies have revealed high comorbidity and a clear association between temporomandibular disorders (TMD) and migraine. Furthermore, evidence points out that common psychological and behavioral factors might be related to the observed TMD and migraine association. However, this association and the underlying psychological factors are poorly understood. OBJECTIVE The main goal of this study was to describe the psychological and behavioral factors involved in TMD myalgia and migraine. METHODS A sample of 142 participants were recruited to form 4 groups: migraine patients (ICHD-III criteria), painful-TMD patients (Myalgia DC/TMD criteria), patients suffering from both pathologies according to the same criteria, and control patients. After a dental and neurological examination, the patients filled several psychological questionnaires validated for the Spanish population to assess anxiety (STAI), depression (DEP), stress coping (CRI), and somatic, anxiety, and depression symptoms (BSI-18). RESULTS The TMD myalgia patients, in general, showed a state of elevated anxiety, somatization, and reduced coping strategies, while the patients with migraine presented greater anxiety symptoms, depression (dysthymia trait and state), and somatization. CONCLUSIONS According to the data of the present study, situational anxiety (transient emotional state), together with the lack of coping strategies, could be more associated with TMD myalgia, while anxiety, as a more stable and long-lasting emotional state, together with depression, might be more related to migraine. Further longitudinal studies are needed to unravel whether these differentiated profiles are a consequence or possible risk factors for migraine and TMD.
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Affiliation(s)
- Ana Cristina Viñals Narváez
- Department of Psychobiology and Behavioral Sciences Methods, Faculty of Odontology, Complutense University of Madrid, 28040 Madrid, Spain
- Department of Conservative and Prosthetic Dentistry, Faculty of Odontology, Complutense University of Madrid, 28040 Madrid, Spain
| | - Teresa Sánchez-Sánchez
- Department of Psychobiology and Behavioral Sciences Methods, Faculty of Odontology, Complutense University of Madrid, 28040 Madrid, Spain
| | - Maria García-González
- Department of Psychobiology and Behavioral Sciences Methods, Faculty of Odontology, Complutense University of Madrid, 28040 Madrid, Spain
- Department of Clinical Dentistry, Faculty of Biomedical Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Ignacio Ardizone García
- Department of Conservative and Prosthetic Dentistry, Faculty of Odontology, Complutense University of Madrid, 28040 Madrid, Spain
| | - Rosana Cid-Verdejo
- Department of Conservative and Prosthetic Dentistry, Faculty of Odontology, Complutense University of Madrid, 28040 Madrid, Spain
- Department of Clinical Dentistry, Faculty of Biomedical Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Eleuterio A. Sánchez Romero
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Physiotherapy and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), 28009 Madrid, Spain
| | - Laura Jiménez-Ortega
- Department of Psychobiology and Behavioral Sciences Methods, Faculty of Odontology, Complutense University of Madrid, 28040 Madrid, Spain
- Center of Human Evolution and Behavior, UCM-ISCIII, 28029 Madrid, Spain
- Psychology and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), 28009 Madrid, Spain
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Exploring the Tryptophan Metabolic Pathways in Migraine-Related Mechanisms. Cells 2022; 11:cells11233795. [PMID: 36497053 PMCID: PMC9736455 DOI: 10.3390/cells11233795] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/16/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
Migraine is a complex neurovascular disorder, which causes intense socioeconomic problems worldwide. The pathophysiology of disease is enigmatic; accordingly, therapy is not sufficient. In recent years, migraine research focused on tryptophan, which is metabolized via two main pathways, the serotonin and kynurenine pathways, both of which produce neuroactive molecules that influence pain processing and stress response by disturbing neural and brain hypersensitivity and by interacting with molecules that control vascular and inflammatory actions. Serotonin has a role in trigeminal pain processing, and melatonin, which is another product of this pathway, also has a role in these processes. One of the end products of the kynurenine pathway is kynurenic acid (KYNA), which can decrease the overexpression of migraine-related neuropeptides in experimental conditions. However, the ability of KYNA to cross the blood-brain barrier is minimal, necessitating the development of synthetic analogs with potentially better pharmacokinetic properties to exploit its therapeutic potential. This review summarizes the main translational and clinical findings on tryptophan metabolism and certain neuropeptides, as well as therapeutic options that may be useful in the prevention and treatment of migraine.
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Lisboa RO, Sekula RF, Bezamat M, Deeley K, Santana-da-Silva LC, Vieira AR. Pain perception genes, asthma, and oral health: A reverse genetics study. PLoS One 2022; 17:e0277036. [PMID: 36395102 PMCID: PMC9671307 DOI: 10.1371/journal.pone.0277036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 10/18/2022] [Indexed: 11/19/2022] Open
Abstract
Pain is an experience of a subjective nature, interpreted in a personal way and according to an extensive palette of factors unique to each individual. Orofacial pain can be acute or chronic and it is usually the main reason for the patient to seek dental care. Pain perception varies widely among individuals. This variability is considered a mosaic of factors, which include biopsychosocial factors and genetic factors. Understanding these differences can be extremely beneficial for pain management in a personalized and more efficient way. We performed association studies to investigate phenotypes associated with genetic markers in pain-related genes in two groups of patients who received more or less anesthesia during dental treatment. The study group was comprised of 1289 individuals participating in the Dental Registry and DNA Repository Project (DRDR) of the University of Pittsburgh, with 900 participants in the group that received the most anesthesia and 389 constituting the comparison group that received less anesthesia. We tested 58 phenotypes and genotypic data of seven SNPs in genes that are associated with pain perception, pain modulation and response to drugs used in pain treatment: COMT (rs4818 and rs6269), GCH1 (rs3783641), DRD2 (rs6276), OPRM1 (rs1799971), SCN9A (rs6746030) and SCN10A (rs6795970). The analysis revealed a protective effect of rs1799971 on asthma in the total sample. rs3783641 was associated with salivary secretion disorders in females who received more anesthesia. rs1799971 was also associated with periodontitis in Whites who received less anesthesia. rs4818 was associated with disease and other tongue conditions in the group composed of Blacks who received less anesthesia. In conclusion, our study implicated variants in pain-related genes in asthma and oral phenotypes.
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Affiliation(s)
- Rosany O. Lisboa
- Laboratory of Inborn Errors of Metabolism, Institute of Biological Sciences, Federal University of Pará, Pará, Brazil
- Departments of Oral and Craniofacial Sciences, Pediatric Dentistry and Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Graduate Program in Oncology and Medical Sciences, Federal University of Pará, Pará, Brazil
| | - Raymond F. Sekula
- Department of Neurological Surgery, Columbia University Vagelos School of Medicine, New York, New York, United States of America
| | - Mariana Bezamat
- Departments of Oral and Craniofacial Sciences, Pediatric Dentistry and Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Kathleen Deeley
- Departments of Oral and Craniofacial Sciences, Pediatric Dentistry and Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Luiz Carlos Santana-da-Silva
- Laboratory of Inborn Errors of Metabolism, Institute of Biological Sciences, Federal University of Pará, Pará, Brazil
- Graduate Program in Oncology and Medical Sciences, Federal University of Pará, Pará, Brazil
| | - Alexandre R. Vieira
- Departments of Oral and Craniofacial Sciences, Pediatric Dentistry and Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail:
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Singla RK, Guimarães AG, Zengin G. Editorial: Application of plant secondary metabolites to pain neuromodulation, volume II. Front Pharmacol 2022; 13:1013063. [PMID: 36225584 PMCID: PMC9549320 DOI: 10.3389/fphar.2022.1013063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 08/15/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Rajeev K. Singla
- Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, India
- *Correspondence: Rajeev K. Singla, ; Adriana Gibara Guimarães, ; Gokhan Zengin,
| | - Adriana Gibara Guimarães
- Federal University of Sergipe, São Cristóvão, Brazil
- *Correspondence: Rajeev K. Singla, ; Adriana Gibara Guimarães, ; Gokhan Zengin,
| | - Gokhan Zengin
- Selçuk University, Konya, Turkey
- *Correspondence: Rajeev K. Singla, ; Adriana Gibara Guimarães, ; Gokhan Zengin,
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Refahee SM, Mahrous AI, Shabaan AA. Clinical efficacy of magnesium sulfate injection in the treatment of masseter muscle trigger points: a randomized clinical study. BMC Oral Health 2022; 22:408. [PMID: 36123724 PMCID: PMC9484239 DOI: 10.1186/s12903-022-02452-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/12/2022] [Indexed: 12/02/2022] Open
Abstract
Objective Myofascial pain syndrome with trigger points is the most common cause of nonodontogenic pain. Although injection of the trigger points is the most effective pain reduction treatment, many patients exhibit recurrence after a short period. Therefore, the aim of the current study was to evaluate the clinical efficacy of magnesium sulfate injections in the treatment of the masseter muscle trigger points when compared to saline injections.
Material and method This study randomly (1:1) assigned 180 patients to one of two treatment groups based on whether their trigger points were injected with 2 ml of saline or magnesium sulfate. Pain scores, maximum mouth opening (MMO), and quality of life were measured at the pre-injection and 1, 3, and 6 months post-injection.
Results The pain scores were significantly higher in the saline group during all follow-up assessments, whereas the MMO was significantly higher in the magnesium sulfate group up to 3 months of follow-up (p < 0.001). However, the difference in MMO ceased to be statistically significant after 6 months of follow-up (p = 0.121). Additionally, the patient’s quality of life score was significantly higher in the magnesium sulfate group compared to the saline group (p < 0.001). Conclusion Injection of magnesium sulfate is an effective treatment measure for myofascial trigger points. However, further studies with a proper design addressing the limitations of the current study are necessary. ClinicalTrials: org (ID: NCT04742140) 5/2/2021.
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Affiliation(s)
- Shaimaa Mohsen Refahee
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Fayoum University, Fayoum, Egypt.
| | - Aliaa Ibrahim Mahrous
- Fixed Prosthodontic Department, Faculty of Dentistry, Fayoum University, Fayoum, Egypt
| | - Alshaimaa Ahmed Shabaan
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Fayoum University, Fayoum, Egypt
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Li Z, Liu L, Bai Q, Huang L, Li B, Yang L, Liang T, Sun H, Li D. Evaluation of the effect of T-Scan™ as an adjunct to stabilization splint in the treatment of temporomandibular joint disorders. Cranio 2022:1-10. [PMID: 36094222 DOI: 10.1080/08869634.2022.2113272] [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: 10/14/2022]
Abstract
OBJECTIVE To assess the effectiveness of the stabilization splint (SS) combined with the T-Scan™ III system in the treatment of temporomandibular joint disorder (TMD) with myofascial pain. METHODS Forty-eight enrolled patients were randomly assigned to the SS group or T-Scan™-guided SS group. Mandibular Function Impairment Questionnaire (MFIQ), Maximum Comfortable Opening (MCO), Visual Analog Scale (VAS), and Patient Health Questionnaire-9 (PHQ-9) were used as the outcome variables. RESULTS The occlusal contacts of patients in the SS plus T-Scan™ group showed lower Occlusal Time (OT), Disocclusion Time (DT), and Asymmetry Index of Occlusal Force (AOF) after occlusal adjustment under the guidance of the T-Scan™. Importantly, the TMD symptoms were alleviated more obviously in SS plus T-Scan™ group, with better scores for MCO and MFIQ. CONCLUSION T-Scan™-guided occlusal adjustment of SS can obtain better OT, DT, and AOF, which furthers improvement of the therapeutic effects on TMD with myofascial pain.
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Affiliation(s)
- Zhe Li
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, P. R. China
| | - Lijun Liu
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, P. R. China
| | - Qinzhu Bai
- Department of Radiology, Jilin University Second Hospital, Changchun City, JL, China
| | - Lei Huang
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, P. R. China
| | - Baoquan Li
- Department of Temporomandibular Joint, Hospital of Stomatology, Jilin University, Changchun, P. R. China
| | - Liu Yang
- Department of Temporomandibular Joint, Hospital of Stomatology, Jilin University, Changchun, P. R. China
| | - Ting Liang
- Department of Temporomandibular Joint, Hospital of Stomatology, Jilin University, Changchun, P. R. China
| | - Hongchen Sun
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, P. R. China
| | - Daowei Li
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, P. R. China
- Department of Temporomandibular Joint, Hospital of Stomatology, Jilin University, Changchun, P. R. China
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22
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de Barros Mamede Vidal Damasceno M, Santos SAAR, Araújo JRC, Barroso LKV, Benevides SC, Magalhães FEA, Tavares KCS, de Azevedo Moreira R, de Oliveira Monteiro-Moreira AC, Silva ARAE, Campos AR. Development of a Nanoformulation for Oral Protein Administration: Characterization and Preclinical Orofacial Antinociceptive Effect. AAPS PharmSciTech 2022; 23:239. [PMID: 36002707 DOI: 10.1208/s12249-022-02396-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/08/2022] [Indexed: 11/30/2022] Open
Abstract
Nanoencapsulation is a valid alternative for the oral administration of peptide drugs and proteins, as nanoparticles protect them from proteolytic degradation in the gastrointestinal tract and promote the absorption of these macromolecules. The orofacial antinociceptive effect of frutalin (FTL), through the intraperitoneal route, has already been proven. This study aimed to develop, characterize, and evaluate the orofacial antinociceptive activity of an oral formulation containing FTL in acute and neuropathic preclinical tests. Nanoencapsulated FTL was administered by oral route. The acute nociceptive behavior was induced by administering capsaicin to the upper lip and NaCl to the right cornea. The nociceptive behavior was also induced by formalin injected into the temporomandibular joint. The neuropathic pain model involved infraorbital nerve transection (IONX), which induced mechanical hypersensitivity and was assessed by von Frey stimulation. Trpv1 gene expression was analyzed in the trigeminal ganglion. The analyzed sample did not show any cytotoxicity; 52.2% of the FTL was encapsulated, and the size of the nanocapsule was less than 200 nm, the polydispersion was 0.361, and the zeta potential was - 5.87 and - 12.8 mV, with and without FTL, respectively. Nanoencapsulated FTL administered by oral route had an orofacial antinociceptive effect in acute and neuropathic rodent models. The antinociceptive effect of FTL was prevented by ruthenium red, but not by camphor. FTL reduced Trpv1 gene expression. FTL promotes orofacial antinociception, probably due to the antagonism of TRPV1 channels, and the nanoformulation represents an effective method for the oral administration of this protein. HIGHLIGHTS: • Nanoformulation for oral protein administration. • Nanocapsule containing FTL prevents orofacial nociceptive acute and neuropathic pain. • Frutalin promotes orofacial antinociception behavior antagonism of TRPV1 channels.
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Affiliation(s)
| | | | - João Ronielly Campêlo Araújo
- Experimental Biology Center, University of Fortaleza, Av. Washington Soares, 1321, CEP 60811-905 - Edson Queiroz, Fortaleza, Ceará, Brazil
| | - Lana Karine Vasconcelos Barroso
- Experimental Biology Center, University of Fortaleza, Av. Washington Soares, 1321, CEP 60811-905 - Edson Queiroz, Fortaleza, Ceará, Brazil
| | - Samara Casemiro Benevides
- Experimental Biology Center, University of Fortaleza, Av. Washington Soares, 1321, CEP 60811-905 - Edson Queiroz, Fortaleza, Ceará, Brazil
| | - Francisco Ernani Alves Magalhães
- Experimental Biology Center, University of Fortaleza, Av. Washington Soares, 1321, CEP 60811-905 - Edson Queiroz, Fortaleza, Ceará, Brazil.,State University of Ceará, Tauá, Brazil
| | - Kaio César Simiano Tavares
- Experimental Biology Center, University of Fortaleza, Av. Washington Soares, 1321, CEP 60811-905 - Edson Queiroz, Fortaleza, Ceará, Brazil
| | - Renato de Azevedo Moreira
- Experimental Biology Center, University of Fortaleza, Av. Washington Soares, 1321, CEP 60811-905 - Edson Queiroz, Fortaleza, Ceará, Brazil
| | | | - Angelo Roncalli Alves E Silva
- Experimental Biology Center, University of Fortaleza, Av. Washington Soares, 1321, CEP 60811-905 - Edson Queiroz, Fortaleza, Ceará, Brazil
| | - Adriana Rolim Campos
- Experimental Biology Center, University of Fortaleza, Av. Washington Soares, 1321, CEP 60811-905 - Edson Queiroz, Fortaleza, Ceará, Brazil.
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23
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Grunberg VA, Reichman M, Lovette BC, Vranceanu AM, Greenberg J. "No One Truly Understands What We Go through and How to Treat It": Lived Experiences with Medical Providers among Patients with Orofacial Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10396. [PMID: 36012029 PMCID: PMC9408497 DOI: 10.3390/ijerph191610396] [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: 07/20/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
UNLABELLED Orofacial pain affects 10-15% of adults, yet treatments are limited. The gaps in care are frustrating for both patients and providers and can negatively impact patient-provider interactions. These interactions are key because they impact patient-reported outcomes and satisfaction with care. PURPOSE Our study aims to understand the nuanced experiences with medical providers among patients with orofacial pain. METHODS In a cross-sectional survey, 260 patients provided written responses describing their experiences with medical providers. Using an inductive-deductive approach to thematic analysis, we identified themes and subthemes and organized them into four domains based on the Patient-Centered Model of Communication. RESULTS Patients reported feeling hopeless about treatment options, frustrated with lack of provider knowledge, disappointed in ineffective care, and stigmatized and dismissed by providers. Patients also said they learned to advocate for their health, were grateful for effective care, and felt lucky when providers listened and showed compassion. Patients identified key barriers that interfere with care (e.g., insurance, transportation, limited providers, lack of team coordination). CONCLUSIONS Findings can help inform training programs and psychoeducation that target patient-provider communication to improve patient-reported outcomes, the quality of care delivered, and health care utilization and costs.
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Affiliation(s)
- Victoria A. Grunberg
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA 02114, USA
- Division of Newborn Medicine, MassGeneral for Children, Boston, MA 02114, USA
| | - Mira Reichman
- Department of Psychology, University of Washington, Seattle, WA 98195, USA
| | - Brenda C. Lovette
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA 02114, USA
- Department of Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA 02129, USA
| | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA 02114, USA
| | - Jonathan Greenberg
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA 02114, USA
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Fernandez-Vial D, Sangalli L, Perez C. A Rare Case of Idiopathic Painful Nervus Intermedius Neuropathy in a 13-Year-Old Female: A Case Report and Discussion in the Context of the Literature. CHILDREN 2022; 9:children9081234. [PMID: 36010124 PMCID: PMC9406721 DOI: 10.3390/children9081234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022]
Abstract
(1) Background: Painful nervus intermedius neuropathy involves continuous or near-continuous pain affecting the distribution of the intermedius nerve(s). The diagnosis of this entity is challenging, particularly when the clinical and demographic features do not resemble the typical presentation of this condition. To the best of our knowledge, only three case reports have described the occurrence of nervus intermedius neuropathy in young patients. (2) Case Description: A 13-year-old female referred to the orofacial pain clinic with a complaint of pain located deep in the right ear and mastoid area. The pain was described as constant, throbbing and dull, with an intensity of 7/10 on numerical rating scale, characterized by superimposed brief paroxysms of severe sharp pain. The past treatments included ineffective pharmacological and irreversible surgical approaches. After a comprehensive evaluation, a diagnosis of idiopathic painful nervus intermedius neuropathy was given, which was successfully managed with the use of gabapentin. (3) Conclusions and Practical Implications: The diagnosis and treatment of neuropathic pain affecting the nervus intermedius can be challenging due to the complex nature of the sensory innervation of the ear. The diagnosis can be even more challenging in cases of atypical clinical and demographic presentations, which in turn may result in unsuccessful, unnecessary, and irreversible treatments. Multidisciplinary teams and constant knowledge update are fundamental to provide good quality of care to our patients and not to overlook any relevant signs or symptoms.
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25
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The Role of Pain Inflexibility and Acceptance among Headache and Temporomandibular Disorders Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137974. [PMID: 35805650 PMCID: PMC9265370 DOI: 10.3390/ijerph19137974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 01/27/2023]
Abstract
Temporomandibular disorders (TMD) and headache are complex. This study aims to assess the association between TMD, headache, and psychological dimensions such as psychological inflexibility and pain acceptance. The sample consisted of 120 participants following a non-probabilistic convenience sampling strategy through a direct invitation to the patients attending our facilities and their relatives (n = 61 diagnosed with headache, n = 34 diagnosed with TMD-headache, n = 25 control group). Diagnostic Criteria for Temporomandibular Disorders (DC-TMD), International Classification of Headache Disorders (ICHD-3 beta version), Chronic Pain Acceptance Questionnaire (CPAQ-8), and Psychological Inflexibility in Pain Scale (PIPS) were used as assessment tools. One-way ANOVA, multiple regression analysis (MRA), and the Johnson-Neyman approach were run by IBM SPSS, version 27 (IBM® Company, Chicago, IL, USA). The significance level was 0.05. One third of our sample presented with headache with TMD. Females were predominant. Males with headache, no systemic disease, less pain severity but higher frequency, living longer with the disease and having sensitive changes, showed higher pain acceptance. When headache occurs with TMD, women with higher education, no headache family history, less pain, and no motor changes showed higher pain acceptance. Patients with both conditions are more liable to have chronic pain and pain inflexibility. Pain intensity and willingness explain 50% of the psychological inflexibility in the headache group. In our sample, individuals suffering from both conditions show greater pain inflexibility, implicating more vivid suffering experiences, leading to altered daily decisions and actions. However, further studies are needed to highlight this possible association.
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26
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Facial Pain: RCT between Conventional Treatment and Fascial Manipulation ® for Temporomandibular Disorders. Bioengineering (Basel) 2022; 9:bioengineering9070279. [PMID: 35877330 PMCID: PMC9312324 DOI: 10.3390/bioengineering9070279] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background: To investigate the effectiveness of a specific manual therapy, Fascial Manipulation® (FM), in comparison with conventional treatments in temporomandibular disorders (TMD) patients using a two-arm randomized controlled trial. Methods: The study consisted of 28 patients that were divided in two groups (Group 1: Fascial Manipulation® vs. Group 2: conventional TMD treatment). The Verbal Rating Scale (VRS), RDC/TMD, electromyography (EMG) and Pression/Pain Evaluation on Masseter and Temporalis Muscle were assessed with different times. Results: In both groups, the improvement in pain was evident on the VRS scale (p < 0.0001) and pain-free opening (p < 0.001). In Group 1, the recovery of the function was faster; maximum unassisted opening T0 vs. T1 (p = 0.001). Conclusions: FM® can be used as an effective method for facial pain, being a rapid, safe and cost-effective approach to reduce pain, gain function and mouth opening that can be used prior to occlusion stabilization appliances.
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Alves Rodrigues Santos SA, de Barros Mamede Vidal Damasceno M, Alves Magalhães FE, Sessle BJ, Amaro de Oliveira B, Alves Batista FL, Vieira-Neto AE, Rolim Campos A. Transient receptor potential channel involvement in antinociceptive effect of citral in orofacial acute and chronic pain models. EXCLI JOURNAL 2022; 21:869-887. [PMID: 36172071 PMCID: PMC9489894 DOI: 10.17179/excli2022-5042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 06/15/2022] [Indexed: 11/10/2022]
Abstract
This study aimed to test for the possible antinociceptive effect of the naturally occurring terpene citral in rodent models of acute and chronic orofacial pain and to test for the possible involvement of transient receptor potential (TRP) channels in this effect. Acute nociceptive behavior was induced in one series of experiments by administering formalin, cinnamaldehyde, menthol or capsaicin to the upper lip. Nociceptive behavior was assessed by orofacial rubbing, and the effects of pre-treatment with citral (0.1, 0.3 or 1.0 mg/Kg) or vehicle (control) were tested on the behavior. Nociceptive behavior was also induced by formalin injected into the temporomandibular joint or mustard oil injected into the masseter muscle, preceded by citral or vehicle (control) treatment. The chronic pain model involved infraorbital nerve transection (IONX) that induced mechanical hypersensitivity which was assessed by von Frey hair stimulation of the upper lip. Motor activity was also evaluated. Docking experiments were performed using TRPV1 and TRPM8 channels. Citral but not vehicle produced significant (p<0.01, ANOVA) antinociception on all the acute nociceptive behaviors, and these effects were attenuated by TRPV1 antagonist capsazepine, TRPM3 antagonist mefenamic acid and by TRPM8 desensitization, but not by ruthenium red and TRPA1 antagonist HC-030031. The IONX animals developed facial mechanical hypersensitivity that was significantly reduced by citral but not by vehicle. The docking experiments revealed that citral may interact with TRPV1 and TRPM8 channels. These results indicate the potential use of citral as an inhibitor of orofacial nociception in both acute and chronic pain states through TRPV1, TRPM3 and TRPM8 channels. See also Figure 1(Fig. 1).
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Affiliation(s)
- Sacha Aubrey Alves Rodrigues Santos
- Experimental Biology Center, University of Fortaleza, Fortaleza, Brazil,*To whom correspondence should be addressed: Sacha Aubrey Alves Rodrigues Santos, Universidade de Fortaleza, Núcleo de Biologia Experimental, Av. Washington Soares, 1321, Edson Queiroz – Fortaleza, Ceará, Brasil; Tel. +55 85 3477 3846, E-mail:
| | | | - Francisco Ernani Alves Magalhães
- Experimental Biology Center, University of Fortaleza, Fortaleza, Brazil,Department of Nutrition and Health, State University of Ceará, Fortaleza, Brazil
| | - Barry John Sessle
- Department of Physiology and Faculty of Dentistry, University of Toronto, Toronto, Canada
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28
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Peng KP, Oppermann T. Orofacial pain disorders: An overview and diagnostic approach. CEPHALALGIA REPORTS 2022. [DOI: 10.1177/25158163221097349] [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
Background: Non-dental orofacial pain disorders are not uncommon, but idiopathic or primary facial pain syndromes are rare. Inadequate recognition of these disorders usually leads to unsatisfactory and unmet treatment needs. Methods: We conducted a narrative review with a literature search in PubMed until December 2021, focusing on current guidelines and the recently published International Classification of Orofacial Pain (ICOP). Results: In this paper, we provide an updated overview of the common orofacial pain disorders following the ICOP, covering the classification, epidemiology, pathophysiology, clinical approaches, and treatment options. Additionally, we propose a pragmatic approach focusing on the attack duration to improve distinguishing orofacial disorders. Conclusion: The introduction of ICOP offers the opportunity to better coordinate and concentrate scientific efforts, which lays the foundation for the identification of the disease mechanism of facial pain disorders and the optimization of the currently still insufficient therapeutic strategies.
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Affiliation(s)
- Kuan-Po Peng
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thalea Oppermann
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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29
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Renton T, Beke A. A Narrative Review of Therapeutic Peripheral Nerve Blocks for Chronic Orofacial Pain Conditions. J Oral Facial Pain Headache 2022; 36:49-58. [PMID: 35298575 PMCID: PMC10586588 DOI: 10.11607/ofph.3017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/14/2021] [Indexed: 11/12/2022]
Abstract
AIMS To provide an analysis of the different therapeutic peripheral nerve blocks (PNBs), as well as their limitations and the related evidence base for their use in chronic orofacial pain (OFP) conditions, excluding migraine and other headache conditions. METHODS/RESULTS The evidence base for therapeutic PNBs for chronic OFP is poor and highlights the need for improved research in this area. The diagnostic criteria and interventional PNB definitions and techniques varied between studies. In addition, the placebo effect of a peripheral injection and its resultant bias was rarely considered. Most of the PNB interventions for temporomandibular disorders were for arthrogenous disorders (arthritis and disc entrapment with pain). However, there is emerging evidence for the use of onabotulinum toxin (BTX-A) in trigeminal neuralgia, with four prospective randomized controlled trials (pRCTs), and for postherpetic neuralgia. However, despite high-level evidence for BTX-A in posttraumatic neuropathic pain outside the trigeminal system, there is no evidence for its use for PTNP within the trigeminal system. CONCLUSION There may be emerging evidence for treating trigeminal neuralgia with BTX-A injections; however, there is a need for future clinical studies of therapeutic PNBs in orofacial pain conditions.
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Abdalla HB, Napimoga MH, Teixeira JM, Trindade-da-Silva CA, Pieroni VL, Dos Santos Araújo FSM, Hammock BD, Clemente-Napimoga JT. Soluble epoxide hydrolase inhibition avoid formalin-induced inflammatory hyperalgesia in the temporomandibular joint. Inflammopharmacology 2022; 30:981-990. [PMID: 35303234 DOI: 10.1007/s10787-022-00965-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 03/02/2022] [Indexed: 11/27/2022]
Abstract
Epoxyeicosatrienoic acids (EETs) are endogenous molecules that exerts effective antinociceptive and resolutive actions. However, because of their rapid metabolism by the soluble epoxide hydrolase (sEH), EETs are unable to remain bioavailable. Therefore, the aim of this study was to investigate whether local sEH inhibition could prevent inflammatory hyperalgesia in the temporomandibular joint (TMJ) of rats. For that, rats were pre-treated with an intra-TMJ injection of TPPU, followed by the noxious stimulus (1.5% of formalin intra-articular) to evaluate nociceptive behavior. Histological analysis was conducted to explore the inflammatory exudate and mast cell degranulation. Periarticular tissue over the TMJ was used to measure inflammatory lipids and cytokines/chemokine by Enzyme-Linked Immunosorbent Assay (ELISA). We demonstrated that peripheral pretreatment with TPPU prevents formalin-induced inflammatory hyperalgesia in the TMJ, and this effect is strictly local. Moreover, TPPU mitigates the leukocyte exudate in the TMJ, as well as inflammatory lipids mediators. Mast cell number and degranulation were abrogated by TPPU, and the inflammatory cytokine levels were decreased by TPPU. On the other hand, TPPU up-regulated the release of interleukin 10 (IL-10), an anti-inflammatory cytokine. We provide evidence that locally sEH by intra-TMJ injection of TPPU produces an antinociceptive and anti-inflammatory effect on rats' TMJ.
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Affiliation(s)
- Henrique Ballassini Abdalla
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Laboratoy of Neuroimmune Interface of Pain Research, Rua José Rocha Junqueira, 13-Swift, Campinas, SP, CEP: 13405-755, Brazil
| | - Marcelo Henrique Napimoga
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Laboratoy of Neuroimmune Interface of Pain Research, Rua José Rocha Junqueira, 13-Swift, Campinas, SP, CEP: 13405-755, Brazil
| | - Juliana Maia Teixeira
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Laboratoy of Neuroimmune Interface of Pain Research, Rua José Rocha Junqueira, 13-Swift, Campinas, SP, CEP: 13405-755, Brazil
| | - Carlos Antônio Trindade-da-Silva
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Laboratoy of Neuroimmune Interface of Pain Research, Rua José Rocha Junqueira, 13-Swift, Campinas, SP, CEP: 13405-755, Brazil
- Department of Entomology and Nematology and UC Davis Comprehensive Cancer Center, University of California, Davis, CA, USA
| | - Victor Luís Pieroni
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Laboratoy of Neuroimmune Interface of Pain Research, Rua José Rocha Junqueira, 13-Swift, Campinas, SP, CEP: 13405-755, Brazil
| | - Fernanda Souto Maior Dos Santos Araújo
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Laboratoy of Neuroimmune Interface of Pain Research, Rua José Rocha Junqueira, 13-Swift, Campinas, SP, CEP: 13405-755, Brazil
| | - Bruce D Hammock
- Department of Entomology and Nematology and UC Davis Comprehensive Cancer Center, University of California, Davis, CA, USA
| | - Juliana Trindade Clemente-Napimoga
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Laboratoy of Neuroimmune Interface of Pain Research, Rua José Rocha Junqueira, 13-Swift, Campinas, SP, CEP: 13405-755, Brazil.
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Headache Because of Problems with Teeth, Mouth, Jaws, or Dentures in Chronic Temporomandibular Disorder Patients: A Case–Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053052. [PMID: 35270743 PMCID: PMC8910597 DOI: 10.3390/ijerph19053052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 11/16/2022]
Abstract
This study aimed to characterize self-reported headaches because of problems with the teeth, mouth, jaws, or dentures (HATMJD) in chronic patients with temporomandibular disorders (TMDs) in order to compare their results with those of TMD patients without such headaches and to investigate the associations of HATMJD with depression, anxiety, physical symptoms, oral behaviors, and sleep quality. We conducted a case–control study on consecutive chronic TMD patients referred to the University Medical Center of Ljubljana, Slovenia. A self-reported HATMJD was extracted from item #12 in the 49-item version of the Oral Health Impact Profile questionnaire. Axis II instruments of the Diagnostic Criteria for TMD (i.e., for screening of depression, anxiety, specific comorbid functional disorders, and oral behaviors) and the Pittsburgh Sleep Quality Index were used in this study. In total, 177 TMD patients (77.4% women; mean age: 36.3 years) participated in this study; 109 (61.6%) patients were classified as TMD patients with HATMJD. TMD patients with at least mild depressive and anxiety symptoms, with at least low somatic symptom severity, and a high number of parafunctional behaviors had more HATMJD. Parafunctional behavior and sleep quality were the most prominent predictive factors of the occurrence of HATMJD. TMD patients with HATMJD have more psychosocial dysfunction, a higher frequency of oral behaviors, and poorer sleep quality than TMD patients without such headaches.
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Muñoz-Lora VRM, Dugonjić Okroša A, Matak I, Del Bel Cury AA, Kalinichev M, Lacković Z. Antinociceptive Actions of Botulinum Toxin A1 on Immunogenic Hypersensitivity in Temporomandibular Joint of Rats. Toxins (Basel) 2022; 14:toxins14030161. [PMID: 35324657 PMCID: PMC8953731 DOI: 10.3390/toxins14030161] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 12/29/2022] Open
Abstract
Botulinum neurotoxin type A1 (BoNT-A) reduces the peripheral peptide and cytokine upregulation in rats with antigen-evoked persistent immunogenic hypersensitivity (PIH) of the temporomandibular joint (TMJ). Herein, we examined the effects of two preparations of BoNT-A, abobotulinumtoxinA (aboBoNT-A; Dysport) and onabotulinumtoxinA (onaBoNT-A; Botox), on spontaneous and evoked nociceptive behaviors, as well as on central neuronal and astroglial activation. The antigen-evoked PIH was induced in rats via repeated systemic and unilateral intra-articular (i.a.) injections of methylated bovine serum albumin (mBSA). Rats were subsequently injected with unilateral i.a. aboBoNT-A (14 U/kg), onaBoNT-A (7 U/kg), or the vehicle (saline). After i.a. treatments, spontaneous and mechanically evoked nocifensive behaviors were assessed before and after the low-dose i.a. formalin (0.5%) challenge. The central effects of BoNT-A were assessed by an immunohistochemical analysis of cleaved synaptosomal-associated protein 25 (cSNAP-25) presence, c-Fos, GFAP, and CGRP expression in the trigeminal nucleus caudalis (TNC). Both BoNT-A preparations similarly reduced the formalin-induced spontaneous pain-related behaviors and mechanical allodynia of the hypernociceptive rats. Likewise, their effects were associated with the central occurrence of cSNAP-25 and reduction of c-Fos and GFAP upregulation in the TNC. BoNT-A antinociceptive activity on the PIH is associated with the toxin axonal transport to trigeminal sensory areas and reduction of neuronal and glial activation in central nociceptive regions.
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Affiliation(s)
- Victor Ricardo Manuel Muñoz-Lora
- Laboratory of Molecular Neuropharmacology, Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (V.R.M.M.-L.); (I.M.)
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba 13414-903, Brazil;
- Dental Research Division, School of Dentistry, Ibirapuera University, São Paulo 04661-100, Brazil
| | - Ana Dugonjić Okroša
- Department of Pharmacology, Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia;
| | - Ivica Matak
- Laboratory of Molecular Neuropharmacology, Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (V.R.M.M.-L.); (I.M.)
| | - Altair Antoninha Del Bel Cury
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba 13414-903, Brazil;
| | | | - Zdravko Lacković
- Laboratory of Molecular Neuropharmacology, Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (V.R.M.M.-L.); (I.M.)
- Correspondence: ; Tel.: +385-1-4566-843
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Pereira EWM, Heimfarth L, Santos TK, Passos FRS, Siqueira-Lima P, Scotti L, Scotti MT, Almeida JRGDS, Campos AR, Coutinho HDM, Martin P, Quintans-Júnior LJ, Quintans JSS. Limonene, a citrus monoterpene, non-complexed and complexed with hydroxypropyl-β-cyclodextrin attenuates acute and chronic orofacial nociception in rodents: Evidence for involvement of the PKA and PKC pathway. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 96:153893. [PMID: 35026511 DOI: 10.1016/j.phymed.2021.153893] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 12/05/2021] [Accepted: 12/11/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Chronic orofacial pain is a serious public health problem with a prevalence of 7-11% in the population. This disorder has different etiologies and characteristics that make pharmacological treatment difficult. Natural products have been shown to be a promising source of treatments for the management of chronic pain, as an example the terpenes. PURPOSE The aim of this study was to evaluate the anti-nociceptive and anti-inflammatory effects of one of these terpenes, d-limonene (LIM - a common monoterpene found in citrus fruits) alone and complexed with hydroxypropyl-β-cyclodextrin (LIM/HPβCD) in preclinical animal models. METHODS Orofacial pain was induced by the administration of hypertonic saline on the corneal surface, the injection of formalin into the temporomandibular joint (TMJ), or chronic constriction injury of the infraorbital nerve (CCI-IoN). The study used male Wistar rats and Swiss mice treated with LIM (50 mg/kg), LIM/HPβCD (50 mg/kg), vehicle (control), gabapentin or morphine, and eyes wiping (induced by hypertonic saline), face rubbing (formalin-induced in TMJ) or mechanical hyperalgesia (provoked by CCI-IoN) were assessed. Additionally, ELISA was used to measure TNF-α, and western blot analysis to assess levels of PKAcα, NFκB, p38MAPK and phosphorylated PKC substrates. Serum levels of aspartate aminotransferase (AST) and alanine transferase (ALT) were also evaluated. RESULTS LIM and LIM/HPβCD significantly reduced (p < 0.001) corneal nociception and formalin-induced TMJ nociception. In addition, both substances attenuated (p < 0.001) mechanical hyperalgesia in the CCI-IoN model. The antinociceptive effect induced by LIM and HPβCD/LIM was associated with decreased TNF-α levels, downregulation of the NFκB and p38MAPK signalling pathways and reduced PKC substrate phosphorylation and PKA immunocontent. Moreover, the results demonstrated that complexation with HPβCD was able to decrease the therapeutic dose of LIM. CONCLUSION LIM was found to be a promising molecule for the treatment of orofacial pain due to its capacity to modulate some important mediators essential to the establishment of pain, and HPβCD can be a key tool to improve the profile of LIM.
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Affiliation(s)
- Erik W M Pereira
- Department of Physiology, Laboratory of Neuroscience and Pharmacological Assays (LANEF), Federal University of Sergipe, São Cristóvão, SE, Brazil; Health Sciences Graduate Program (PPGCS), Federal University of Sergipe, Aracaju, SE, Brazil
| | - Luana Heimfarth
- Department of Physiology, Laboratory of Neuroscience and Pharmacological Assays (LANEF), Federal University of Sergipe, São Cristóvão, SE, Brazil
| | - Tiffany Kb Santos
- Department of Physiology, Laboratory of Neuroscience and Pharmacological Assays (LANEF), Federal University of Sergipe, São Cristóvão, SE, Brazil
| | - Fabiolla R S Passos
- Department of Physiology, Laboratory of Neuroscience and Pharmacological Assays (LANEF), Federal University of Sergipe, São Cristóvão, SE, Brazil; Health Sciences Graduate Program (PPGCS), Federal University of Sergipe, Aracaju, SE, Brazil
| | | | | | | | | | - Adriana R Campos
- Experimental Biology Centre (NUBEX). University of Fortaleza, Fortaleza, CE, Brazil
| | | | - Patrick Martin
- Univ Artois, UniLaSalle, Unité Transformations & Agroressources, Béthune, France
| | - Lucindo J Quintans-Júnior
- Department of Physiology, Laboratory of Neuroscience and Pharmacological Assays (LANEF), Federal University of Sergipe, São Cristóvão, SE, Brazil; Health Sciences Graduate Program (PPGCS), Federal University of Sergipe, Aracaju, SE, Brazil
| | - Jullyana S S Quintans
- Department of Physiology, Laboratory of Neuroscience and Pharmacological Assays (LANEF), Federal University of Sergipe, São Cristóvão, SE, Brazil; Health Sciences Graduate Program (PPGCS), Federal University of Sergipe, Aracaju, SE, Brazil
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Kalladka M, Al-Azzawi O, Heir GM, Kodapala S, Nainan MT, Khan J. Hemicrania continua secondary to neurogenic paravertebral tumor- a case report. Scand J Pain 2022; 22:204-209. [PMID: 34432971 DOI: 10.1515/sjpain-2021-0089] [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: 05/23/2021] [Accepted: 08/09/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Hemicrania continua (HC) is one of the trigeminal autonomic cephalalgias (TAC), where sympathetic dysfunction and autonomic dysfunction resulting in parasympathetic over activation with some evidence of sympathetic inhibition have been suggested as probable causes. However, cases of hemicrania continua secondary to sympathetic dysfunction due to neurogenic paravertebral tumor impinging on the sympathetic chain has not been previously reported. In this case, the probability of the sympathetic dysfunction was more likely based on the clinical features and management. CASE PRESENTATION A 23-year-old female presented with a chief complaint of right unilateral pain in the retro-bulbar, head and facial region for the past three years. An initial MRI of the brain was negative, whereas an MRI of the spine was advised to rule out a cervicogenic origin of the pain. The MRI revealed a well-defined mass lesion within right paravertebral region at T3 indicative of a neurogenic tumor. The patient was diagnosed with probable hemicrania continua secondary to neurogenic tumor impinging on adjacent sympathetic chain. A trial of indomethacin 75 mg/day was advised, which provided complete relief of the headache. The patient was referred to a neurologist for management of the neurogenic tumor. CONCLUSIONS Headache disorders may be secondary to pathologies and comprehensive evaluation and accurate diagnosis are essential. Knowledge of neuroanatomy is paramount to understand and explain underlying pathophysiological mechanisms. Multidisciplinary management is essential in complex orofacial cases.
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Affiliation(s)
- Mythili Kalladka
- Eastman Institute for Oral Health, Orofacial Pain and Temporomandibular Joint Disorders, Rochester, NY, USA
| | - Osamah Al-Azzawi
- Eastman Institute for Oral Health, Orofacial Pain and Temporomandibular Joint Disorders, Rochester, NY, USA
| | - Gary M Heir
- Program and Clinical Director Center for Temporomandibular, Disorders and Orofacial Pain Rutgers, School of Dental Medicine, Newark, NJ, USA
| | - Suresha Kodapala
- Department of Neurology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, India
| | | | - Junad Khan
- Eastman Institute for Oral Health, Orofacial Pain and Temporomandibular Joint Disorders, Rochester, NY, USA
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Woodman SE, Antonopoulos SR, Durham PL. Inhibition of Nociception in a Preclinical Episodic Migraine Model by Dietary Supplementation of Grape Seed Extract Involves Activation of Endocannabinoid Receptors. FRONTIERS IN PAIN RESEARCH 2022; 3:809352. [PMID: 35295808 PMCID: PMC8915558 DOI: 10.3389/fpain.2022.809352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/04/2022] [Indexed: 01/15/2023] Open
Abstract
Migraine is associated with peripheral and central sensitization of the trigeminal system and dysfunction of descending pain modulation pathways. Recently, dietary inclusion of grape seed extract (GSE) was shown to inhibit mechanical nociception in a preclinical model of chronic temporomandibular joint disorder, a condition often comorbid with migraine, with the antinociceptive effect mediated, in part, by activation of 5-HT3/7 and GABAB receptors. This study further investigated the mechanisms by which GSE inhibits mechanical nociception in a preclinical model of episodic migraine. Hyperalgesic priming of female and male Sprague Dawley rats was induced by three consecutive daily two-hour episodes of restraint stress. Seven days after the final restraint stress, rats were exposed to pungent odors from an oil extract that contains the compound umbellulone, which stimulates CGRP release and induces migraine-like pain. Some animals received dietary supplementation of GSE in their drinking water beginning one week prior to restraint stress. Changes in mechanical sensitivity in the orofacial region and hindpaw were determined using von Frey filaments. To investigate the role of the endocannabinoid receptors in the effect of GSE, some animals were injected intracisternally with the CB1 antagonist AM 251 or the CB2 antagonist AM 630 prior to odor inhalation. Changes in CGRP expression in the spinal trigeminal nucleus (STN) in response to stress, odor and GSE supplementation were studied using immunohistochemistry. Exposure of stress-primed animals to the odor caused a significant increase in the average number of withdrawal responses to mechanical stimulation in both the orofacial region and hindpaw, and the effect was significantly suppressed by daily supplementation with GSE. The anti-nociceptive effect of GSE was inhibited by intracisternal administration of antagonists of CB1 and CB2 receptors. GSE supplementation inhibited odor-mediated stimulation of CGRP expression in the STN in sensitized animals. These results demonstrate that GSE supplementation inhibits trigeminal pain signaling in an injury-free model of migraine-like pain via activation of endocannabinoid receptors and repression of CGRP expression centrally. Hence, we propose that GSE may be beneficial as a complementary migraine therapeutic.
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Assessments of Muscle Thickness and Tonicity of the Masseter and Sternocleidomastoid Muscles and Maximum Mouth Opening in Patients with Temporomandibular Disorder. Healthcare (Basel) 2021; 9:healthcare9121640. [PMID: 34946366 PMCID: PMC8701159 DOI: 10.3390/healthcare9121640] [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: 10/25/2021] [Revised: 11/16/2021] [Accepted: 11/25/2021] [Indexed: 11/21/2022] Open
Abstract
The purpose of this study was to compare the muscle thickness and tone of the masseter and sternocleidomastoid (SCM) muscles and maximum mouth opening (MMO) in subjects with and without temporomandibular disorders (TMD), and perform a correlation comparison on the results of the TMD group. Sixty patients were allocated to the TMD group (n = 30) or the non-TMD group (n = 30). Ultrasound imaging, myotonometer, and vernier calipers were used to determine the related changes in muscle thickness and muscle tone in masseter and SCM, and MMO, respectively. The TMD group revealed a significant decrease than the non-TMD group in the muscle thickness of masseter and SCM, respectively (p < 0.001), with a significant increase in frequency (p < 0.001) and stiffness (p < 0.001) in the masseter muscle tone, with a significant increase in frequency (p < 0.001) and stiffness (p = 0.005) in the SCM muscle tone, a significant decrease in the MMO (p < 0.001). There was a moderate negative correlation between the relaxed state of masseter muscle thickness and stiffness of SCM muscle tone (r = −0.40, p = 0.002), and a moderate negative correlation between the relaxed state of SCM muscle thickness and frequency of SCM muscle tone (r = −0.42, p = 0.001). There was a moderate negative correlation between the clenching state of SCM muscle thickness and the frequency of SCM muscle tone (r = −0.47, p < 0.001). In addition, a moderate negative correlation between MMO and frequency of SCM muscle tone (r = −0.44, p < 0.001). The muscle thickness was decreased, and the muscle tone was increased in the masseter and SCM muscle, respectively. Additionally, MMO was decreased in patients with TMD compared with non-TMD.
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Pyo CY, Kim TH, Kim DH. Association between masticatory muscle activity and oral conditions in young female college students. Anat Cell Biol 2021; 54:479-488. [PMID: 34552039 PMCID: PMC8693132 DOI: 10.5115/acb.21.107] [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: 05/25/2021] [Revised: 07/12/2021] [Accepted: 07/26/2021] [Indexed: 11/27/2022] Open
Abstract
The purpose of this study was to determine the characteristics of masticatory muscle activity and various oral condition factors, and to analyze their associations in order to improve the prevention and diagnosis of masticatory muscle-related diseases. This study included 30 Korean females (mean age of 20 years, age range of 19-21 years). Participants were instructed to complete a self-written questionnaire on factors that may affect their muscle activity. Surface electromyography was used to measure the activity of the masseter and temporalis muscles. We also observed the buccal mucosa ridge, tongue indentation, tooth cracks and fractures, and mandibular tori in the oral cavity. Spearman correlation analysis and the nonparametric Mann-Whitney U test were applied to the data. When subjects had temporomandibular disorder, the right temporalis muscle exhibited significantly lower activity (P<0.05). Those who had received orthodontic treatment within the previous 2 years showed significantly lower activity of the left masseter muscle (P<0.05). Those who had a left buccal mucosa ridge exhibited lower activity of the left masseter muscle and higher activity of the right temporalis muscle compared with those without such a ridge (P<0.05). Participants with no tongue indentation showed significantly higher activity in the left masseter muscle (P<0.05). These results indicate that there are relationships between masticatory muscle activity and various factors related to the oral condition.
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Affiliation(s)
| | - Tae-Hoon Kim
- Department of Occupational Therapy, Division of Health Sciences, Dongseo University, Busan, Korea
| | - Da-Hye Kim
- Department of Dental Hygiene, Division of Health Sciences, Dongseo University, Busan, Korea
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Phuong TNT, Jang SH, Rijal S, Jung WK, Kim J, Park SJ, Han SK. GABA- and Glycine-Mimetic Responses of Linalool on the Substantia Gelatinosa of the Trigeminal Subnucleus Caudalis in Juvenile Mice: Pain Management through Linalool-Mediated Inhibitory Neurotransmission. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2021; 49:1437-1448. [PMID: 34247560 DOI: 10.1142/s0192415x21500671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Linalool, a major odorous constituent in essential oils extracted from lavender, is known to have a wide range of physiological effects on humans including pain management. The substantia gelatinosa (SG) of the trigeminal subnucleus caudalis (Vc) is involved in transmission of orofacial nociceptive responses through thin myelinated A[Formula: see text] and unmyelinated C primary afferent fibers. Up to date, the orofacial antinociceptive mechanism of linalool concerning SG neurons of the Vc has not been completely clarified yet. To fill this knowledge gap, whole-cell patch-clamp technique was used in this study to examine how linalool acted on SG neurons of the Vc in mice. Under a high chloride pipette solution, non-desensitizing and repeatable linalool-induced inward currents were preserved in the presence of tetrodotoxin (a voltage-gated Na[Formula: see text]channel blocker), CNQX (a non-NMDA glutamate receptor antagonist), and DL-AP5 (an NMDA receptor antagonist). However, linalool-induced inward currents were partially suppressed by picrotoxin (a GABA[Formula: see text] receptor antagonist) or strychnine (a glycine receptor antagonist). These responses were almost blocked in the presence of picrotoxin and strychnine. It was also found that linalool exhibited potentiation with GABA- and glycine-induced responses. Taken together, these data show that linalool has GABA- and glycine-mimetic effects, suggesting that it can be a promising target molecule for orofacial pain management by activating inhibitory neurotransmission in the SG area of the Vc.
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Affiliation(s)
- Thao Nguyen Thi Phuong
- Department of Oral Physiology, School of Dentistry & Institute of Oral Bioscience, Jeonbuk National University, Jeonju, Republic of Korea.,Faculty of Odonto-Stomatology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Seon Hui Jang
- Department of Oral Physiology, School of Dentistry & Institute of Oral Bioscience, Jeonbuk National University, Jeonju, Republic of Korea
| | - Santosh Rijal
- Department of Oral Physiology, School of Dentistry & Institute of Oral Bioscience, Jeonbuk National University, Jeonju, Republic of Korea
| | - Woo Kwon Jung
- Department of Oral Pathology, School of Dentistry & Institute of Oral Bioscience, Jeonbuk National University, Jeonju, Republic of Korea
| | - Junghyun Kim
- Department of Oral Pathology, School of Dentistry & Institute of Oral Bioscience, Jeonbuk National University, Jeonju, Republic of Korea
| | - Soo Joung Park
- Department of Oral Physiology, School of Dentistry & Institute of Oral Bioscience, Jeonbuk National University, Jeonju, Republic of Korea
| | - Seong Kyu Han
- Department of Oral Physiology, School of Dentistry & Institute of Oral Bioscience, Jeonbuk National University, Jeonju, Republic of Korea
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Ahmad SA, Hasan S, Saeed S, Khan A, Khan M. Low-level laser therapy in temporomandibular joint disorders: a systematic review. J Med Life 2021; 14:148-164. [PMID: 34104237 PMCID: PMC8169142 DOI: 10.25122/jml-2020-0169] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Temporomandibular joint disorders (TMDs) encompass a wide array of ailments affecting the temporomandibular joint (TMJ), muscles of mastication, and the allied structural framework. Myofascial pain, internal derangement of the joint, and degenerative joint diseases constitute the majority of TMDs. TMDs usually have a multifactorial etiology, and treatment modalities range from conservative therapies to surgical interventions. Low-level laser therapy (LLLT) has evolved as an efficient non-invasive therapeutic modality in TMDs. Previously conducted systematic reviews and meta-analyses have shown variable results regarding the efficiency of LLLT in TMJ disorder patients. Hence, this systematic review was carried out as an attempt to evaluate the efficacy of LLLT in the treatment of temporomandibular joint disorder patients.
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Affiliation(s)
- Syed Ansar Ahmad
- Department of Oral Surgery, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Shamimul Hasan
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Shazina Saeed
- Laboratory of Disease Dynamics and Molecular Epidemiology, Amity Institute of Public Health, Amity university, Noida, Uttar Pradesh, India
| | - Ateeba Khan
- Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Munna Khan
- Department of Electrical Engineering, Jamia Millia Islamia, New Delhi, India
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Glia and Orofacial Pain: Progress and Future Directions. Int J Mol Sci 2021; 22:ijms22105345. [PMID: 34069553 PMCID: PMC8160907 DOI: 10.3390/ijms22105345] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/12/2021] [Accepted: 05/14/2021] [Indexed: 12/14/2022] Open
Abstract
Orofacial pain is a universal predicament, afflicting millions of individuals worldwide. Research on the molecular mechanisms of orofacial pain has predominately focused on the role of neurons underlying nociception. However, aside from neural mechanisms, non-neuronal cells, such as Schwann cells and satellite ganglion cells in the peripheral nervous system, and microglia and astrocytes in the central nervous system, are important players in both peripheral and central processing of pain in the orofacial region. This review highlights recent molecular and cellular findings of the glia involvement and glia–neuron interactions in four common orofacial pain conditions such as headache, dental pulp injury, temporomandibular joint dysfunction/inflammation, and head and neck cancer. We will discuss the remaining questions and future directions on glial involvement in these four orofacial pain conditions.
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Srivastava KC, Shrivastava D, Khan ZA, Nagarajappa AK, Mousa MA, Hamza MO, Al-Johani K, Alam MK. Evaluation of temporomandibular disorders among dental students of Saudi Arabia using Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): a cross-sectional study. BMC Oral Health 2021; 21:211. [PMID: 33902543 PMCID: PMC8077893 DOI: 10.1186/s12903-021-01578-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/15/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Temporomandibular disorders (TMD) are a broad category of conditions arising from the various components of the temporomandibular joint complex. Bio-psychosocial model is the most accepted theory describing the etiopathogenesis of TMD. Dental students are vulnerable to psychological disorders, including anxiety, depression, and stress. Hence, the aim of the current study was to evaluate the prevalence and possible risk factors of TMD among dental students of various academic levels and explore the association of TMDs with demographic, academic, and psychosocial parameters. METHODS A total of 246 students of a Saudi Arabia dental school were chosen for the study. After getting consent, all students were examined according to the Diagnostic Criteria for Temporomandibular Disorders, including Axis I and II components. RESULTS The overall cross-sectional prevalence of TMD was found to be 36.99%. Pain arising from the jaw, temple, and the peri-auricular area were the most commonly reported symptoms and elicited signs during examination. Among the pain-related TMD, myalgia was the commonest diagnosed condition, whereas disc displacement with reduction was found prevalent in the intra-articular disorder category. Female (OR = 1.94; P = 0.004), married (OR = 1.74; P = 0.04), and students in clinical academic levels (OR = 1.65; P = 0.03) were found to have significantly increased risk of TMD. Among the psychosocial parameters, anxiety (OR = 1.55; P = 0.04) and parafunctional behaviours (OR = 2.10; P < 0.001) were shown to increase the risk of developing TMD. Students with any TMD reported to have significantly higher pain intensity levels (OR = 1.68; P = 0.01) and jaw functional limitations (OR = 1.45; P = 0.008). CONCLUSION Dental students, especially in clinical levels were shown to pose a higher risk of developing TMD, hence strategies such as academic counselling and objective evaluation via rubrics should be planned to modify the administration of the curriculum, training methods and evaluation process.
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Affiliation(s)
- Kumar Chandan Srivastava
- Oral Medicine and Radiology, Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia.
| | - Deepti Shrivastava
- Periodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Zafar Ali Khan
- Oral Surgery, Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Anil Kumar Nagarajappa
- Oral Medicine and Radiology, Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Mohammed Assayed Mousa
- Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - May Othman Hamza
- Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Khalid Al-Johani
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad Khursheed Alam
- Orthodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
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Cornelison LE, Woodman SE, Durham PL. 5-HT3/7 and GABA B receptors mediate inhibition of trigeminal nociception by dietary supplementation of grape seed extract. Nutr Neurosci 2021; 25:1565-1576. [PMID: 33544064 PMCID: PMC8339147 DOI: 10.1080/1028415x.2021.1880211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Temporomandibular joint disorder is a prevalent orofacial pain condition involving sensitization and activation of trigeminal nociceptive neurons. Dietary supplementation with a proanthocyanin-enriched grape seed extract (GSE) was found to inhibit trigeminal nociception in a chronic TMD model. In this study, the cellular mechanisms by which GSE inhibits sustained trigeminal nociception in male and female Sprague Dawley rats were investigated.Methods: Some animals were supplemented with 0.5% GSE dissolved in their water one week prior to neck muscle inflammation induced by injection of complete Freund's adjuvant into the trapezius. To investigate the mechanism of GSE, some animals were injected intracisternally with antagonists of 5-HT3, 5-HT7, GABAA, or GABAB, receptor prior to jaw opening.Results: In males and females, trapezius inflammation prior to jaw opening resulted in sustained mechanical hypersensitivity of trigeminal nociceptors that was significantly inhibited by GSE. Further, GSE beginning 14 days post jaw opening also inhibited trigeminal nociception. Intracisternal injection of antagonists of the 5-HT3/7 and GABAB, but not GABAA receptors reduced the anti-nocifensive effect of GSE in both sexes. Neuronal expression of GABAB protein and mRNA in the spinal cord and trigeminal ganglion were detected.Conclusions: The inhibitory effect of GSE is mediated via activation of 5-HT3/7 receptors and GABAB to enhance central descending inhibitory pain pathways and suppress ongoing trigeminal nociception. Further, our findings support the use of GSE as a dietary supplement in the management of pain associated with TMD and other orofacial pain conditions involving central sensitization and dysfunction of descending pain modulation.
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Dasukil S, Arora G, Shetty S, Degala S. Impact of prolotherapy in temporomandibular joint disorder: a quality of life assessment. Br J Oral Maxillofac Surg 2020; 59:599-604. [PMID: 33750579 DOI: 10.1016/j.bjoms.2020.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/18/2020] [Indexed: 11/28/2022]
Abstract
Chronic pain and functional impairment associated with temporomandibular joint (TMJ) disorders (TMD) considerably reduce oral health-related quality of life (OHRQoL). In the present study we have assessed the influence of prolotherapy in patients with TMD by the subjective measurement of QoL using the Oral Health Impact Profile-14 (OHIP-14). Twenty-five patients diagnosed with TMD (mean (range) age 38 (18 - 70) years) were included. They had all undergone dextrose prolotherapy to the TMJ at regular time intervals (four times at intervals of two weeks) using the method suggested by Hemwall-Hackett. They were asked to answer the OHIP-14 questionnaire before and two years after prolotherapy. Seven domains of OHRQoL were rated on a 5-point Likert scale from 0 (never) to 4 (very often). Domain scores and total OHIP-14 scores were compared using inferential statistics (chi squared and Wilcoxon signed rank tests). Prolotherapy was effective over time, as all the domains' mean scores decreased considerably after treatment. The total mean score before prolotherapy was 21.20, which was extensively reduced to 13.08 after prolotherapy (p=0.001). There was statistically significant improvement in all domains, including functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap (p≤0.005 in all cases). We concluded that prolotherapy has a promising role in the improvement of OHRQoL of patients with TMD, and its beneficial effects persist at least two years after treatment.
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Affiliation(s)
- S Dasukil
- Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences(AIIMS), Bhubaneswar, Odisha, India.
| | - G Arora
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, SGT University, Gurugram.
| | - S Shetty
- Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital, Mysore.
| | - S Degala
- Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital, Mysore.
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de Oliveira Leite G, Santos SAAR, Bezerra FMDH, Sena E Silva FE, de Castro Ribeiro AD, Roma RR, Silva RRS, Santos MHC, Santos ALE, Teixeira CS, Campos AR. Is the orofacial antinociceptive effect of lectins intrinsically related to their specificity to monosaccharides? Int J Biol Macromol 2020; 161:1079-1085. [PMID: 32561277 DOI: 10.1016/j.ijbiomac.2020.06.132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 03/23/2020] [Accepted: 06/14/2020] [Indexed: 01/24/2023]
Abstract
Lectins are proteins of non-immunological origin that may play several biological applications, of which we can highlight the anti-inflammatory and antinociceptive activities. In this work, we evaluated the possible effect of orofacial antinociceptive activity of three plant lectins, Dioclea violacea (DVL - Man/Glc-binding), Vatairea macrocarpa (VML - Gal-binding) and PPL (Parkia platycephala - Man/Glc-binding) in adult zebrafish. Acute nociception was induced by menthol (1.2 μM), or capsaicin (4.93 μM) applied into in the upper lip (5.0 μL) of adult wild zebrafish. Zebrafish were pretreated by intraperitoneal injection (20 μL) with vehicle (Control) or lectins (0.025; 0.05 or 0.1 mg/mL) 30 min before induction. The effect of lectins on zebrafish locomotor behavior was evaluated with the open field test. Naive groups (n = 8) were included in all tests. Our results indicate that only PPL presented antinociceptive induced by capsaicin, suggesting the potential clinical application of PPL as inhibitor of orofacial nociception and that this effect may be due to the modulation of TRPV1 channel. In conclusion, lectins that exhibit affinity to the same or different carbohydrates do not necessarily have an antinociceptive effect on the orofacial nociception model, indicating that the glycan carbohydrate binding pattern may be related to the effect on nociception inhibition.
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Affiliation(s)
| | | | | | | | | | - Renato Rodrigues Roma
- Centro de Ciências Agrárias e Ambientais, Universidade Federal do Maranhão, Chapadinha, Maranhão, Brazil
| | | | - Maria Helena Cruz Santos
- Centro de Ciências Agrárias e Ambientais, Universidade Federal do Maranhão, Chapadinha, Maranhão, Brazil
| | - Ana Lucia Estevam Santos
- Centro de Ciências Agrárias e Ambientais, Universidade Federal do Maranhão, Chapadinha, Maranhão, Brazil
| | - Claudener Souza Teixeira
- Centro de Ciências Agrárias e Ambientais, Universidade Federal do Maranhão, Chapadinha, Maranhão, Brazil
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Comparison of the Efficacy of Botulinum Toxin, Local Anesthesia, and Platelet-Rich Plasma Injections in Patients With Myofascial Trigger Points in the Masseter Muscle. J Oral Maxillofac Surg 2020; 79:88.e1-88.e9. [PMID: 33045182 DOI: 10.1016/j.joms.2020.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE Masticatory myofascial trigger points (TrP) are one of the major causes of nondental pain in the orofacial region. Intramuscular injections are considered the first-line treatment for myofascial TrPs. The objectives of this study were to evaluate and compare the effectiveness of local anesthesia (LA), botulinum toxin (BTX), and platelet-rich plasma (PRP) injections for the treatment of myofascial TrPs in the masseter muscle. METHODS In this retrospective study, the sample was composed of patients with myofascial TrPs in masseter muscle who were treated between 2016 and 2019. Patients were divided into 3 groups according to treatment methods: group I (LA injection), group II (BTX injection), and group III (PRP injection). Primary outcome variable was the average pain level at rest and while chewing, and pressure pain intensity (PPI), Jaw Functional Limitation Scale (JFLS) value, and quality-of-life (measured using Oral Health Impact Profile-14 (OHIP-14)) were secondary outcomes. The outcome variables were assessed at diagnosis, and 1, 3, and 6 months post-treatment. RESULTS The study consisted of 82 patients (group I, 27; group II, 26; group III, 29). At 1 and 3 months, improvement in all parameters was recorded in all groups. Groups I and II showed superior improvement in all parameters compared with group III at 3 months. Improvements in VAS pain, JFLS, and OHIP-14 values were significantly better in group II than group I at 3 months (P = .009; P = .004; P = .002). At 6 months, significant improvement in VAS pain, JFLS, and OHIP-14 (P = .008; P < .001; P < .01) values was recorded only in group II. CONCLUSIONS All procedures successfully improved the symptoms of TrPs in the masseter muscle at 1 and 3 months. However, BTX injection seemed superior at the 3-month follow-up and remained effective up to 6 months.
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Li J, Ma K, Yi D, Oh CD, Chen D. Nociceptive behavioural assessments in mouse models of temporomandibular joint disorders. Int J Oral Sci 2020; 12:26. [PMID: 32989215 PMCID: PMC7522224 DOI: 10.1038/s41368-020-00095-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 08/24/2020] [Accepted: 08/31/2020] [Indexed: 11/22/2022] Open
Abstract
Orofacial pain or tenderness is a primary symptom associated with temporomandibular joint (TMJ) disorders (TMDs). To understand the pathological mechanisms underlying TMDs, several mouse models have been developed, including mechanical stimulus-induced TMD and genetic mouse models. However, a lack of feasible approaches for assessing TMD-related nociceptive behaviours in the orofacial region of mice has hindered the in-depth study of TMD-associated mechanisms. This study aimed to explore modifications of three existing methods to analyse nociceptive behaviours using two TMD mouse models: (1) mechanical allodynia was tested using von Frey filaments in the mouse TMJ region by placing mice in specially designed chambers; (2) bite force was measured using the Economical Load and Force (ELF) system; and (3) spontaneous feeding behaviour tests, including eating duration and frequency, were analysed using the Laboratory Animal Behaviour Observation Registration and Analysis System (LABORAS). We successfully assessed changes in nociceptive behaviours in two TMD mouse models, a unilateral anterior crossbite (UAC)-induced TMD mouse model and a β-catenin conditional activation mouse model. We found that the UAC model and β-catenin conditional activation mouse model were significantly associated with signs of increased mechanical allodynia, lower bite force, and decreased spontaneous feeding behaviour, indicating manifestations of TMD. These behavioural changes were consistent with the cartilage degradation phenotype observed in these mouse models. Our studies have shown reliable methods to analyse nociceptive behaviours in mice and may indicate that these methods are valid to assess signs of TMD in mice.
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Affiliation(s)
- Jun Li
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Kaige Ma
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Dan Yi
- Research Center for Human Tissues and Organs Degeneration, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Chun-do Oh
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA.
| | - Di Chen
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, 60612, USA. .,Research Center for Human Tissues and Organs Degeneration, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
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Nguyen PTT, Jang SH, Rijal S, Park SJ, Han SK. Inhibitory actions of borneol on the substantia gelatinosa neurons of the trigeminal subnucleus caudalis in mice. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2020; 24:433-440. [PMID: 32830150 PMCID: PMC7445480 DOI: 10.4196/kjpp.2020.24.5.433] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/02/2020] [Accepted: 07/17/2020] [Indexed: 11/15/2022]
Abstract
The substantia gelatinosa (SG) of the trigeminal subnucleus caudalis (Vc) is the first relay site for the orofacial nociceptive inputs via the thin myelinated Aδ and unmyelinated C primary afferent fibers. Borneol, one of the valuable timehonored herbal ingredients in traditional Chinese medicine, is a popular treatment for anxiety, anesthesia, and antinociception. However, to date, little is known as to how borneol acts on the SG neurons of the Vc. To close this gap, the whole-cell patch-clamp technique was applied to elucidate the antinociceptive mechanism responding for the actions of borneol on the SG neurons of the Vc in mice. In the voltage-clamp mode, holding at -60 mV, the borneol-induced non-desensitizing inward currents were not affected by tetrodotoxin, a voltage-gated Na+ channel blocker, 6-cyano-7-nitro-quinoxaline-2,3-dione, a non-N-methyl-D-aspartate (NMDA) glutamate receptor antagonist and DL-2-amino-5-phosphonopentanoic acid, an NMDA receptor antagonist. However, borneol-induced inward currents were partially decreased in the presence of picrotoxin, a γ-aminobutyric acid (GABA)A receptor antagonist, or strychnine, a glycine receptor antagonist, and was almost suppressed in the presence of picrotoxin and strychnine. Though borneol did not show any effect on the glycine-induced inward currents, borneol enhanced GABA-mediated responses. Beside, borneol enhanced the GABA-induced hyperpolarization under the current-clamp mode. Altogether, we suggest that borneol contributes in part toward mediating the inhibitory GABA and glycine transmission on the SG neurons of the Vc and may serve as an herbal therapeutic for orofacial pain ailments.
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Affiliation(s)
- Phuong Thao Thi Nguyen
- Department of Oral Physiology, School of Dentistry & Institute of Oral Bioscience, Jeonbuk National University, Jeonju 54896, Korea.,Faculty of Odonto- Stomatology, Hue University of Medicine and Pharmacy, Hue University, Hue 53000, Vietnam
| | - Seon Hui Jang
- Department of Oral Physiology, School of Dentistry & Institute of Oral Bioscience, Jeonbuk National University, Jeonju 54896, Korea
| | - Santosh Rijal
- Department of Oral Physiology, School of Dentistry & Institute of Oral Bioscience, Jeonbuk National University, Jeonju 54896, Korea
| | - Soo Joung Park
- Department of Oral Physiology, School of Dentistry & Institute of Oral Bioscience, Jeonbuk National University, Jeonju 54896, Korea
| | - Seong Kyu Han
- Department of Oral Physiology, School of Dentistry & Institute of Oral Bioscience, Jeonbuk National University, Jeonju 54896, Korea
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Mai L, Huang F, Zhu X, He H, Fan W. Role of Nerve Growth Factor in Orofacial Pain. J Pain Res 2020; 13:1875-1882. [PMID: 32801845 PMCID: PMC7399448 DOI: 10.2147/jpr.s250030] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 07/06/2020] [Indexed: 12/18/2022] Open
Abstract
Some chronic pain conditions in the orofacial region are common and the mechanisms underlying orofacial pain are unresolved. Nerve growth factor (NGF) is a member of a family of neurotrophins and regulates the growth, maintenance and development of neurons. Increasing evidence suggests that NGF plays a crucial role in the generation of pain and hyperalgesia in different pain states. This review investigates the role of NGF in orofacial pain and their underlying cellular mechanisms, which may provide essential guidance to drug-discovery programmes. A systemic literature search was conducted in Pubmed focusing on NGF and orofacial pain. Articles were reviewed, and those discussing in vitro studies, animal evidence, clinical course, and possible mechanisms were summarized. We found a hyperalgesic effect of NGF in peripheral sensitization in orofacial pain models. We also summarize the current knowledge regarding NGF-dependent pain mechanism, which is initiated by retrograde transport of the ligand-receptor complex, ensuing transcriptional regulation of many important nociceptor genes involved in nociceptive processing. Phase III trials suggest that anti-NGF drug is endorsed with anti-inflammatory and pain-relieving effects with good tolerance in a variety of pain conditions, including pain associated with osteoarthritis and chronic lower back pain. Based on the data reviewed herein, NGF is believed to be an important hyperalgesic mediator in orofacial pain. The identification of underlying mechanisms and pathways of orofacial pain opens new frontiers for pain management.
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Affiliation(s)
- Lijia Mai
- Department of Anesthesiology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510080, People's Republic of China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, 510080, People's Republic of China
| | - Fang Huang
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, 510080, People's Republic of China
| | - Xiao Zhu
- The Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang 524023, People's Republic of China
| | - Hongwen He
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, 510080, People's Republic of China
| | - Wenguo Fan
- Department of Anesthesiology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510080, People's Republic of China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, 510080, People's Republic of China
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Effectiveness of Cervical Spine High-Velocity, Low-Amplitude Thrust Added to Behavioral Education, Soft Tissue Mobilization, and Exercise for People With Temporomandibular Disorder With Myalgia: A Randomized Clinical Trial. J Orthop Sports Phys Ther 2020; 50:455-465. [PMID: 31905097 DOI: 10.2519/jospt.2020.9175] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine the immediate and short-term effects of adding cervical spine high-velocity, low-amplitude thrust (HVLAT) to behavioral education, soft tissue mobilization, and a home exercise program on pain and dysfunction for people with a primary complaint of temporomandibular disorder (TMD) with myalgia. DESIGN Randomized clinical trial. METHODS Fifty individuals with TMD were randomly assigned to receive cervical HVLAT or sham manipulation for 4 visits over 4 weeks. Participants in both groups received other treatments, including standardized behavioral education, soft tissue mobilization, and a home exercise program. Primary outcomes included maximal mouth opening, the numeric pain-rating scale, the Jaw Functional Limitation Scale (JFLS), the Tampa Scale of Kinesiophobia for TMD (TSK-TMD), and a global rating of change (GROC). Self-report and objective measurements were taken at baseline, immediately after initial treatment, and follow-ups of 1 week and 4 weeks. A 2-by-4 mixed-model analysis of variance was used, with intervention group as the between-subjects factor and time as the within-subject factor. Separate analyses of variance were performed for dependent variables, and the hypothesis of interest was the group-by-time interaction. RESULTS There was no significant interaction for maximal mouth opening, the numeric pain-rating scale, or secondary measures. There were significant 2-way interactions for the JFLS (d = 0.60) and TSK-TMD (d = 0.80). The HVLAT group had lower fear at 4 weeks and improved jaw function earlier (1 week). The GROC favored the HVLAT group, with significant differences in successful outcomes noted immediately after baseline treatment (thrust, 6/25; sham, 0/25) and at 4 weeks (thrust, 17/25; sham, 10/25). CONCLUSION Both groups improved over time; however, differences between groups were small. There were significant differences between groups for the JFLS, TSK-TMD, and GROC. The additive clinical effect of cervical HVLAT to standard care remains unclear for treating TMD. J Orthop Sports Phys Ther 2020;50(8):455-465. Epub 6 Jan 2020. doi:10.2519/jospt.2020.9175.
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50
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Oliveira JP, Souza MTS, Cercato LM, Souza AW, Nampo FK, Camargo EA. Natural products for orofacial nociception in pre-clinical studies: A systematic review. Arch Oral Biol 2020; 117:104748. [PMID: 32599517 DOI: 10.1016/j.archoralbio.2020.104748] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 04/17/2020] [Accepted: 04/29/2020] [Indexed: 12/09/2022]
Abstract
OBJECTIVE The aim of this systematic review was to summarize the use of natural products (NP) in the treatment of orofacial nociception in animal models. METHODS Pre-clinical studies that have evaluated the efficacy of NPs in experimental orofacial nociception were sought in the Medline, Web of Science, Scopus, Embase, SciELO, LILACS and Scholar databases in January 2020, covering the period since the inception of each one. Two reviewers independently selected the studies, extracted the data and evaluated the risk of bias of the included studies. RESULTS We included 41 records in qualitative synthesis. Fifty different NPs were investigated. All studies presented positive results for at least one orofacial nociception test. Regarding the risk of bias, most studies presented poor experimental design, mainly lack of randomization and blinding. The main class of isolated compounds tested was terpenes, of which monoterpenes were investigated in the majority of the studies. CONCLUSION These results indicate that NPs are effective in treating experimental orofacial nociception and highlight some of these NPs, mainly terpenes, suggesting their potential for translational research.
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Affiliation(s)
- Janaíne P Oliveira
- Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, Brazil; Graduate Programme in Physiological Sciences, Federal University of Sergipe, São Cristóvão, SE, Brazil
| | - Marilia T S Souza
- Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, Brazil
| | - Luana M Cercato
- Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, Brazil
| | - Astrid W Souza
- Departament of Pharmacy, Federal University of Paraná, Curitiba, PR, Brazil
| | - Fernando K Nampo
- Latin American Institute of Life and Natural Sciences, Federal University of Latin American Integration, Foz do Iguaçu, PR, Brazil
| | - Enilton A Camargo
- Department of Physiology, Federal University of Sergipe, São Cristóvão, SE, Brazil; Graduate Programme in Physiological Sciences, Federal University of Sergipe, São Cristóvão, SE, Brazil.
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