RESUMO
This study aimed to assess the influence of streptozotocin (STZ)-induced diabetes on the nociceptive behavior evoked by the injection of hypertonic saline (HS) into the masseter muscle of rats. Forty male rats were equally divided into four groups: a) isotonic saline control, which received 0.9% isotonic saline (IS), (Ctrl-IS); b) hypertonic saline control, which received 5% HS (Ctrl-HS); c) STZ-induced diabetic, which received IS, (STZ-IS); d) STZ-induced diabetic, which received HS (STZ-HS). Experimental diabetes was induced by a single intraperitoneal injection of STZ at dose of 60 mg/kg dissolved in 0.1 M citrate buffer, and 100 µL of HS or IS were injected into the left masseter to measure the nociceptive behavior. Later on, muscle RNA was extracted to measure the relative expression of the following cytokines: cyclooxygenase-2 (COX-2), tumor necrosis factor (TNF-α), and interleukins (IL)-1ß, -2, -6, and -10. One-way analysis of variance (ANOVA) was applied to the data (p < 0.050). We observed a main effect of group on the nociceptive response (ANOVA: F = 11.60, p < 0.001), where the Ctrl-HS group presented the highest response (p < 0.001). However, nociceptive response was similar among the Ctrl-IS, STZ-IS, and STZ-HS group (p > 0.050). In addition, the highest relative gene expression of TNF-α and IL-6 was found in the masseter of control rats following experimental muscle pain (p < 0.050). In conclusion, the loss of somatosensory function can be observed in deep orofacial tissues of STZ-induced diabetic rats.
Assuntos
Citocinas , Diabetes Mellitus Experimental , Músculo Masseter , Ratos Wistar , Estreptozocina , Animais , Masculino , Músculo Masseter/efeitos dos fármacos , Músculo Masseter/fisiopatologia , Diabetes Mellitus Experimental/complicações , Diabetes Mellitus Experimental/fisiopatologia , Análise de Variância , Citocinas/análise , Solução Salina Hipertônica/farmacologia , Medição da Dor , Fatores de Tempo , Reprodutibilidade dos Testes , Dor Facial/fisiopatologia , Distribuição Aleatória , RatosRESUMO
OBJECTIVES: Studies exploring variations in peripheral muscle oxygenation and pressure pain thresholds (PPT) of masticatory muscles in individuals with Temporomandibular Disorders (TMDs) are limited. The purpose of this study was to compare variations in peripheral oxygenation of the masseter muscle; PPT of the masseter and temporal muscles and correlate peripheral muscle oxygenation and PPT of the masseter muscle in individuals with different types of TMDs. MATERIALS AND METHODS: Cross-sectional study involving 116 participants classified into three groups: muscle group (MG, n = 32), joint group (JG, n = 30) and muscle-joint group (MJG, n = 54). Individuals aged 26.97 ± 6.93, 68.97% female, 31,03% males were included. All participants were evaluated using the Diagnostic Criteria for Temporomandibular Disorders, Near-infrared spectroscopy (NIRS) for peripheral muscle oxygenation and pressure algometer for PPT. RESULTS: There was no difference in masseter muscle oxygenation among groups. In the masseter muscle, a weakly positive correlation was observed between PPT and variation in tissue saturation index in the MG (rho = 0.365) and JG (rho = 0.317). In addition, the MJG expressed lower PPT (p = 0.004) than JG, demonstrating that MJG had more pain in this muscle. CONCLUSIONS: MJG have lower PPT in the masseter muscle. Although the PPT is dependent on the type of TMDs, the correlation between PPT and oxygenation is weak. All TMDs groups evaluated (MG, JG, MJG) showed hemodynamic similarities of the masseter muscle. CLINICAL RELEVANCE: Understanding pain thresholds and the hemodynamic behavior of the masticatory muscles contributes to a more assertive physiotherapeutic assessment in TMDs, serving as a basis for careful and individualized interventions.
Assuntos
Músculo Masseter , Medição da Dor , Limiar da Dor , Espectroscopia de Luz Próxima ao Infravermelho , Transtornos da Articulação Temporomandibular , Humanos , Masculino , Transtornos da Articulação Temporomandibular/fisiopatologia , Feminino , Estudos Transversais , Adulto , Limiar da Dor/fisiologia , Músculo Masseter/fisiopatologia , Dor Facial/fisiopatologia , Oxigênio/metabolismo , Músculo Temporal/fisiopatologiaRESUMO
BACKGROUND: Recent evidence suggests neuro-immune mechanisms may link dietary patterns to chronic painful conditions (CPC). In the research field of oro-facial pain (OFP), studies focuses primarily on dietary mechanical limitations due to pain and dysfunction. OBJECTIVE: This narrative review aimed to overview the role of nutrition on CPC, with emphasis on temporomandibular disorder (TMD), enlightening OFP researcher on dietary assessment possibilities and providing directions for studies in the field of OFP and nutrition. METHODS: A PubMed database search was performed using the MeSH and non-MeSH descriptors: "temporomandibular joint disorder"; "orofacial pain"; "musculoskeletal pain"; "chronic pain disorders"; "nutrition"; "diet"; "dietary therapy"; "dietary intake" and "inflammation". No time restrictions were applied. Literature reviews, systematic reviews, meta-analyses and clinical and pre-clinical trials were included. RESULTS: Exogenous oxidants from unhealthy dietary patterns may contribute to peripheral and central pro-inflammatory immune signalling leading to peripheral and central sensitization. Furthermore, diets rich in bioactive compounds are suggested to contribute to pain management of CPC. High dietary intake of ultra-processed foods impacts the quality of the diet and shows adverse health outcomes. In this context, the role of nutrition on TMD remains overlooked. CONCLUSION: Considering diet may influence CPC, allied with the scarcity of studies evaluating the role of nutrition on TMD, well-designed clinical trials based on dietary assessments and measurements capable of evaluating food quality, UPF consumption and nutrient adequacy-added to serum nutrient levels evaluation-are suggested.
Assuntos
Dor Crônica , Dor Musculoesquelética , Transtornos da Articulação Temporomandibular , Humanos , Transtornos da Articulação Temporomandibular/terapia , Transtornos da Articulação Temporomandibular/dietoterapia , Transtornos da Articulação Temporomandibular/fisiopatologia , Dor Crônica/terapia , Dor Crônica/dietoterapia , Dor Musculoesquelética/dietoterapia , Dor Musculoesquelética/terapia , Dor Facial/terapia , Dor Facial/dietoterapia , Dor Facial/fisiopatologia , Dor Facial/etiologia , Estado Nutricional , Dieta , Manejo da Dor/métodosRESUMO
PURPOSE: To analyze the sensation of pain and the range of mandibular movements of adult individuals with temporomandibular disorder, before and after the application of the athletic tape. METHOD: This is a double-blind randomized clinical trial, in which 22 adults with temporomandibular disorder participated, randomly allocated into two groups, with group A comprising 10 women and one man (mean age 28.2±8.3 years) and group B comprising nine women and two men (mean age 26.2±3.9 years). Group A was submitted to the application of the athletic tape on the masseter with 40% stretch and the group B to the application of the athletic tape on the masseter without stretching. All participants underwent the application of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Pain threshold assessment was performed using an algometer to apply pressure to measurement points. The measurement of mandibular movements was performed using a caliper. The athletic tape was glued using the I technique, with a fixed point over the insertion and a movable point over the origin of the masseter muscle. Participants remained with the athletic tape for 24 hours and were re-evaluated. RESULTS: There was pain relief in the group A in the temporomandibular joint on the right and at the origin of the masseter on the left. The group B showed a reduction in pain in the left anterior temporal region. No differences were found in mandibular movements after intervention, as well as no difference was found in the comparison by groups. CONCLUSION: The use of the athletic tape over the masseter muscle, with stretching, for 24 hours produced relief from the sensation of pain, on the origin of the right masseter and in the right temporomandibular joint, and, without stretching, in the left anterior temporal muscle. There was no difference in the range of mandibular movements.
OBJETIVO: Analisar a sensação de dor e amplitude dos movimentos mandibulares de indivíduos adultos com disfunção temporomandibular, antes e após aplicação da bandagem elástica por 24 horas. MÉTODO: Trata-se de um ensaio clínico randomizado duplo-cego, do qual participaram 22 sujeitos adultos com disfunção temporomandibular, alocados aleatoriamente em dois grupos, sendo grupo A composto por 10 mulheres e um homem (média de idade de 28,2±8,3 anos) e grupo B por nove mulheres e dois homens (média de idade de 26,2±3,9 anos). Todos os participantes foram submetidos à aplicação do Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Foi realizada a avaliação do limiar da dor, com uso de um algômetro, para aplicação da pressão no masseter e temporal e medição dos movimentos mandibulares, com paquímetro. O grupo A foi submetido à aplicação da bandagem sobre o músculo masseter com estiramento de 40% e o grupo B sem estiramento. A colagem da bandagem foi realizada, com corte em "I", com ponto fixo sobre a inserção e ponto móvel sobre a origem do músculo masseter. Os participantes permaneceram com a bandagem por 24 horas e foram reavaliados. RESULTADOS: Houve alívio da dor no grupo A na articulação temporomandibular à direita e na origem do masseter à esquerda. O grupo B apresentou redução da dor em região de temporal anterior à esquerda. Não foram encontradas diferenças nos movimentos mandibulares após intervenção, bem como não houve diferença na comparação entre os grupos. CONCLUSÃO: O uso da bandagem sobre o masseter, por 24 horas, com estiramento, produziu alívio da dor na origem do masseter direito e na região da articulação temporomandibular direita e, sem estiramento, no temporal anterior esquerdo. Não houve diferença na amplitude de movimentos mandibulares.
Assuntos
Fita Atlética , Dor Facial , Músculo Masseter , Medição da Dor , Amplitude de Movimento Articular , Transtornos da Articulação Temporomandibular , Humanos , Feminino , Adulto , Método Duplo-Cego , Masculino , Dor Facial/fisiopatologia , Dor Facial/diagnóstico , Transtornos da Articulação Temporomandibular/fisiopatologia , Músculo Masseter/fisiopatologia , Adulto Jovem , Amplitude de Movimento Articular/fisiologia , Limiar da Dor/fisiologia , Mandíbula/fisiopatologiaRESUMO
Investigating the collective impact of psychometric properties and sleep quality on pain sensitivity in temporomandibular disorder (TMD) patients could improve clinical management strategies. OBJECTIVE: Assessing whether combined psychometric properties and sleep quality impact painful mechanical sensitivity and pain modulation in TMD patients. MATERIALS AND METHODS: A cross-sectional study using secondary data analysis of 77 TMD patients and 101 controls. All participants completed questionnaires characterizing their psychometric profile (anxiety, depression, stress and catastrophizing) and sleep quality, alongside psychophysical tests for painful mechanical sensory (mechanical pain threshold (MPT), pressure pain threshold (PPT), and wind-up ratio (WUR)) and conditioned pain modulation (CPM). Participants were grouped into "High distress" or "Low distress" categories based on psychometric properties and sleep quality using hierarchical cluster and k-means analyses. Multiple linear regression evaluated the influence of TMD, age, and the distress cluster on MPT, WUR, PPT, and CPM in masseter and thenar muscles. Differences were statistically significant when p < 0.05. RESULTS: The presence of TMD was the strongest predictor of mechanical painful sensitivity in the trigeminal region (MPT[F(3,174) = 51.902;p < .001;R2 = .463]; TMD presence (ß = -.682) / PPT[F(3,174) = 15.573;p < .001;R2 = .198] TMD presence (ß = -.452), and extra-trigeminal (MPT[F(3,174) = 35.897;p < .001;R2 = .382] TMD (ß = -.647) / CPM [F(3,174) = 4.106;p < .05;R2 = .050] TMD presence (ß = .197). Furthermore, neither the high distress group nor the low distress group were able to significantly influence the variation of the values of any of the psychophysical variables evaluated (p > .05). CONCLUSIONS: There is not a significant influence of impairment clusters based on psychological variables and sleep quality on painful mechanical sensitivity and pain modulation, regardless of the presence of TMD. CLINICAL RELEVANCE: This outcome suggests that psychosocial factors and sleep quality may not play a decisive role in the sensory-discriminative aspect of pain, particularly concerning painful TMD.
Assuntos
Medição da Dor , Limiar da Dor , Psicometria , Qualidade do Sono , Transtornos da Articulação Temporomandibular , Humanos , Feminino , Masculino , Estudos Transversais , Limiar da Dor/fisiologia , Adulto , Transtornos da Articulação Temporomandibular/fisiopatologia , Transtornos da Articulação Temporomandibular/psicologia , Inquéritos e Questionários , Pessoa de Meia-Idade , Dor Facial/fisiopatologia , Dor Facial/psicologiaRESUMO
BACKGROUND: Chronic pain is persistent or recurrent pain lasting longer than 3 months. The experience of temporomandibular disorder (TMD)-related pain is modulated by emotional and social factors, with mindfulness encapsulating these aspects. OBJECTIVE: To investigate the association between cognitive-behavioural-emotional characteristics, mindfulness and the painful experience in women with chronic pain-related TMD. METHODS: A cross-sectional study was conducted, including 90 women aged between 18 and 61 years old, diagnosed with chronic pain-related TMD according to the Diagnostic Criteria for Temporomandibular Disorder, considering both temporomandibular joint and muscle pain. Specific instruments were employed to assess cognitive-behavioural-emotional aspects. The Mindful Attention Awareness Scale and the Five Facets of Mindfulness Questionnaire scales evaluated the level and construct of mindfulness. The relationship between variables was analysed using bivariate association tests (.05 > p < .20), followed by multiple regression tests (p < .05). RESULTS: The heightened experience of pain correlated with increasing age, a low level of education, the attribution of the locus of control by chance, and lower levels of mindfulness (p < .05). The heightened experience of pain was negatively influenced by mindfulness levels (p < .05). On the other hand, the painful experience was mainly influenced by facets describing negative formulation, distraction, non-reactivity and non-judgement (p < .05). CONCLUSION: Demographic, cognitive-behavioural-emotional data and levels of mindfulness and its facets presented different influence weights on the painful experience. These findings provide support for future studies focusing on mindfulness strategies, education and pain management in women with chronic pain-related TMD.
Assuntos
Dor Crônica , Emoções , Dor Facial , Atenção Plena , Medição da Dor , Transtornos da Articulação Temporomandibular , Humanos , Feminino , Transtornos da Articulação Temporomandibular/psicologia , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/fisiopatologia , Adulto , Estudos Transversais , Pessoa de Meia-Idade , Dor Crônica/psicologia , Dor Crônica/fisiopatologia , Adulto Jovem , Dor Facial/psicologia , Dor Facial/fisiopatologia , Emoções/fisiologia , Adolescente , Inquéritos e QuestionáriosRESUMO
The musculoskeletal orofacial pain is a complex symptom of Parkinson's disease (PD) resulting in stomatognathic system dysfunctions aggravated by the disease rigidity and postural instability. We tested the effect of cannabidiol (CBD), a non-psychotomimetic constituent of Cannabis sativa, in PD-related myofascial pain. Wistar adult female and male rats orofacial allodynic and hyperalgesic responses were tested by Von Frey and formalin tests, before and 21 days past 6-OHDA lesion. Algesic response was tested after masseter muscle injection of CBD (10, 50, 100 µg in 10 µL) or vehicle. Males compared to females in all estrous cycles' phases presented reduced orofacial allodynia and hyperalgesia. According to the estrous cycle's phases, females presented distinct orofacial nociceptive responses, being the estrus phase well-chosen for nociceptive analysis after 6-OHDA lesion (phase with fewer hormone alterations and adequate length). Dopaminergic neuron lesion decreased mechanical and inflammatory nociceptive thresholds in females and males in a higher proportion in females. CBD local treatment reduced the increased orofacial allodynia and hyperalgesia, in males and females. The female rats were more sensitive to CBD effect considering allodynia, responding to the lowest dose. Although females and males respond to the effect of three doses of CBD in the formalin test, males showed a superior reduction in the hyperalgesic response. These results indicate that hemiparkinsonian female in the estrus phase and male answer differently to the different doses of CBD therapy and nociceptive tests. CBD therapy is effective for parkinsonism-induced orofacial nociception.
Assuntos
Anticonvulsivantes/farmacologia , Canabidiol/farmacologia , Dor Facial/fisiopatologia , Hiperalgesia/fisiopatologia , Nociceptividade/efeitos dos fármacos , Transtornos Parkinsonianos/fisiopatologia , Analgésicos/farmacologia , Animais , Ciclo Estral/efeitos dos fármacos , Ciclo Estral/fisiologia , Feminino , Masculino , Oxidopamina/toxicidade , Ratos , Ratos WistarRESUMO
OBJECTIVE: The purpose of this study was to assess the effects of 4-week protocol of diacutaneous fibrolysis (DF) compared with simulated DF (sham-DF) on myalgia and mouth opening. METHODS: In a sham randomized controlled trial, 34 women with temporomandibular disorders and myofascial pain were randomly divided as intervention group (IG) and sham-DF group (SG). The IG received 4 weeks of real DF, and the SG received sham. Pain was assessed through the visual analog scale and pressure pain thresholds (PPTs) on the temporomandibular joint (TMJ), and over the temporal and masseter muscles. The Mandibular Function Impairment Questionnaire was used to classify the participants regarding to the severity of the functional limitation related to TMD. RESULTS: Pain scores decreased for both groups, but the IG showed lower values at week 4, with between-group differences. Bilateral temporal PPT showed higher values at week 4, with between-group differences. The SG had lower PPTs but the IG had higher PPTs, both compared to baseline results. The time-by-group interaction and the frequency of participants above 40 mm of mouth opening showed a significant difference for the IG over time with higher results at the 4-week assessment compared to its own baseline. Both groups showed lower MFIQ scores from baseline to 4-week assessment. There was a lower frequency of a moderate level of severity for the IG. No differences were observed for TMJ or for the masseter muscles PPT. CONCLUSION: Improvements were observed for visual analog scale scores and PPTs on temporal muscles. There was a group-by-time interaction in the IG, suggesting a possible potential use of DF for mouth opening.
Assuntos
Dor Facial/terapia , Músculos da Mastigação/fisiopatologia , Mialgia/terapia , Síndromes da Dor Miofascial/terapia , Modalidades de Fisioterapia , Transtornos da Articulação Temporomandibular/terapia , Articulação Temporomandibular/fisiopatologia , Adulto , Dor Facial/patologia , Dor Facial/fisiopatologia , Feminino , Humanos , Mandíbula/patologia , Mandíbula/fisiopatologia , Massagem , Músculo Masseter/patologia , Músculo Masseter/fisiopatologia , Músculos da Mastigação/patologia , Boca , Mialgia/fisiopatologia , Síndromes da Dor Miofascial/fisiopatologia , Medição da Dor , Limiar da Dor , Índice de Gravidade de Doença , Músculo Temporal/patologia , Músculo Temporal/fisiopatologia , Articulação Temporomandibular/patologia , Transtornos da Articulação Temporomandibular/patologia , Transtornos da Articulação Temporomandibular/fisiopatologia , Resultado do Tratamento , Adulto JovemRESUMO
Objetivo: realizar uma revisão da literatura a fim de traçar um panorama atual sobre o papel do estrogênio nas disfunções temporomandibulares. Metodologia: foram realizadas buscas nas plataformas digitais Pub- Med, SciELO e Google Acadêmico, durante os meses de setembro de 2018 a maio de 2019, sem filtros para determinar período de tempo, sendo excluídos aqueles trabalhos em que não foi possível identificar relação com o tema. Resultados: na análise dos estudos encontrados, foi observada a relação entre o estrogênio e a prevalência de disfunções temporomandibulares em mulheres. O estrogênio atua central e perifericamente no sistema nervoso central, influenciando no processamento dos receptores pró e antinoceptivos da articulação temporomandibular. Considerações finais: a modulação estrogênica da dor é um mecanismo complexo. Diversos estudos associam o hormônio estrogênio às disfunções temporomandibulares. Embora não haja um consenso entre os autores do papel exato deste hormônio, há evidências comprovadas de que as mulheres possuem uma susceptibilidade a dores em geral, com prevalência tanto em frequência quanto em intensidade.(AU)
Objective: to carry out an integrative review of the literature in order to outline the role of estrogen in temporomandibular disorders. Methodology: the study searched studies in the digital platforms PubMed, SciELO and Google Acadêmico, from September 2018 to May 2019, without filters to determine the time period, excluding those works in which it was not possible to identify relation with the theme. Results: among the analysis of the studies found, the relationship between estrogen and the prevalence of temporomandibular disorders in women was observed. Estrogen acts centrally and peripherally in the central nervous system, influencing the processing of the pro and antinoceptive receptors of the temporomandibular joint. Final considerations: estrogenic modulation of pain is a complex mechanism. Several studies associate the estrogen hormone with temporomandibular disorders. Although there is no consensus among authors of the exact role of this hormone, there is proven evidence that women have a susceptibility to pain in general, with prevalence both in frequency and intensity.(AU)
Assuntos
Humanos , Masculino , Feminino , Dor Facial/fisiopatologia , Transtornos da Articulação Temporomandibular/fisiopatologia , Estrogênios/fisiologia , Receptores de Estrogênio/fisiologia , Fatores SexuaisRESUMO
BACKGROUND: Diagnostic tools are necessary for the anamnesis and examination of orofacial pain, in order to fulfill diagnostic criteria and to screen potential causes of pain. OBJECTIVE: To evaluate the Orofacial Pain Clinic Questionnaire (EDOF-HC) in the assessment and diagnosis of orofacial pain. METHODS: Overall, 142 patients were evaluated and classified according to the criteria of the International Headache Society and International Association for the Study of Pain. All of them were evaluated with the EDOF-HC questionnaire, which consists of the orofacial and medical history, as well as the orofacial examination. Data were statistically analyzed with chi-square test and Bonferroni correction, one-way ANOVA with Tukey post hoc test, the two-step cluster and decision tree methods. RESULTS: There were diferences in pain descriptors, pain in maximum mouth opening, number of trigger points, and history of previous surgery between the groups, which were classified into trigeminal neuralgia, burning mouth syndrome, temporomandibular disorders and trigeminal posttraumatic neuropathic pain with classification analysis. CONCLUSIONS: The EDOF-HC is a clinical supportive tool for the assessment of orofacial pain. The instrument may be used to support data collection from anamnesis and examination of patients according to the diagnostic criteria of most common orofacial conditions. It is also useful in the investigation of local and systemic abnormalities and contributes for the diagnosis of conditions that depend on exclusion criteria.