RESUMEN
INTRODUCTION: Bruxism is defined as a repetitive masticatory muscle activity that can manifest it upon awakening (awake bruxism-AB) or during sleep (sleep bruxism-SB). Some forms of both, AB and SB can be associated to many other coexistent factors, considered of risk for the initiation and maintenance of the bruxism. Although controversial, the term 'secondary bruxism' has frequently been used to label these cases. The absence of an adequate definition of bruxism, the non-distinction between the circadian manifestations and the report of many different measurement techniques, however, are important factors to be considered when judging the literature findings. The use (and abuse) of drugs, caffeine, nicotine, alcohol and psychoactive substances, the presence of respiratory disorders during sleep, gastroesophageal reflux disorders and movement, neurological and psychiatric disorders are among these factors. The scarcity of controlled studies and the complexity and interactions among all aforementioned factors, unfortunately, does not allow to establish any causality or temporal association with SB and AB. The supposition that variables are related depends on different parameters, not clearly demonstrated in the available studies. OBJECTIVES: This narrative review aims at providing oral health care professionals with an update on the co-risk factors and disorders possibly associated with bruxism. In addition, the authors discuss the appropriateness of the term 'secondary bruxism' as a valid diagnostic category based on the available evidence. CONCLUSION: The absence of an adequate definition of bruxism, the non-distinction between the circadian manifestations and the report of many different measurement techniques found in many studies preclude any solid and convincing conclusion on the existence of the 'secondary' bruxism.
Asunto(s)
Bruxismo , Bruxismo del Sueño , Humanos , Bruxismo/complicaciones , Sueño , Bruxismo del Sueño/diagnóstico , Bruxismo del Sueño/complicaciones , Músculos Masticadores , Factores de Riesgo , Músculo MaseteroRESUMEN
AIM: This topical review presents common patients' misbeliefs about temporomandibular disorders (TMD) and discusses their possible impact on the diagnosis, treatment and prognosis. We also discussed the possible influence of the beliefs and behaviours of healthcare providers on the beliefs of patients with TMD and suggested possible strategies to overcome the negative impacts of such misbeliefs. METHODS: This topical review was based on a non-systematic search for studies about the beliefs of patients and healthcare professionals about TMD in PubMed and Embase. RESULTS: Patients' beliefs can negatively impact the diagnosis, treatment and prognosis of TMD. These beliefs can be modulated by several factors such as culture, psychosocial aspects, gender, level of knowledge and previous experiences. Moreover, primary healthcare professionals, including dentists, may lack sufficient experience and skills regarding TMD diagnosis and treatment. Misbeliefs of the healthcare professionals can be based on outdated evidence that is not supported by rigorous methodological investigations. Education and dissemination of knowledge to patients and the general population are effective for prevention, promotion of health and disruption of the cycle of misinformation and dissemination of misbeliefs. CONCLUSION: The lack of basic information about TMD and the dissemination of mistaken and outdated concepts may delay the diagnosis, hinder the treatment, and consequently increase the risk of worsening the condition. Education is key to overcome TMD misbeliefs.
Asunto(s)
Dolor Facial , Trastornos de la Articulación Temporomandibular , Dolor Facial/terapia , Humanos , Trastornos de la Articulación Temporomandibular/psicologíaRESUMEN
PURPOSE: This study hypothesized that drugs accumulate in the bloodstream of poor-metabolizing patients and may have more adverse effects and different pain perceptions and aimed to investigate the influence of CYP450 polymorphisms on acute postoperative pain, swelling, and trismus controlled by ibuprofen (600 mg) in 200 volunteers after dental extraction. In addition, surgical outcomes can determine pain, edema, and trismus and indicate inflammatory reactions after oral surgeries. METHODS: Genetic sequencing was performed to identify CYP450 polymorphisms and the surgical parameters evaluated: pre and postoperative swelling, trismus, and temperature; self-reported postoperative pain with visual analog scale (VAS); rescue medication consumed; and severity of adverse reactions. RESULTS: A multiple linear regression model with independent variables [single nucleotide polymorphisms (SNPs), BMI (body mass index), duration, and difficulty of surgery] and dependent variables [postoperative pain by sum of pain intensity difference (SPID), trismus, and swelling] was used for analysis. The duration of surgery was a predictor for pain at 8 h and 96 h after surgery, and BMI was a predictor for both swelling and trismus on the 2nd postoperative day. When evaluating CYP2C8 and C9 genotyped SNPs, it was observed that normal metabolizers showed higher pain levels than the intermediate/poor metabolizers on the postoperative periods as compared with time 0 h. In another analysis, the poor metabolizers for CYP2C8 and C9 presented lower levels of postoperative pain after 8 h and used rescue medication earlier than normal metabolizers. CONCLUSION: Ibuprofen 600 mg was very effective in controlling inflammatory pain after lower third molar surgeries, without relevant adverse reactions; although in a very subtle way, patients with poor metabolism had higher levels of pain in the first hours, and no longer after 8 h, and used pain relief medication earlier. TRIAL REGISTRATION: The study was registered with ClinicalTrials.gov ID (NCT03169127), on March 16th, 2017.
Asunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Sistema Enzimático del Citocromo P-450/genética , Ibuprofeno/uso terapéutico , Dolor Postoperatorio/tratamiento farmacológico , Extracción Dental/efectos adversos , Adolescente , Adulto , Índice de Masa Corporal , Citocromo P-450 CYP2C8/genética , Citocromo P-450 CYP2C9/genética , Método Doble Ciego , Edema/tratamiento farmacológico , Edema/etiología , Femenino , Humanos , Masculino , Tercer Molar/cirugía , Tempo Operativo , Dimensión del Dolor , Farmacogenética , Polimorfismo de Nucleótido Simple , Trismo/tratamiento farmacológico , Trismo/etiología , Adulto JovenRESUMEN
AIM: This critical review describes key methodological aspects for a successful oro-facial psychophysical evaluation of the somatosensory system and highlights the diagnostic value of somatosensory assessment and management perspectives based on somatosensory profiling. METHODS: This topical review was based on a non-systematic search for studies about somatosensory evaluation in oro-facial pain in PubMed and Embase. RESULTS: The recent progress regarding the psychophysical evaluation of somatosensory function was largely possible due to the development and application of valid, reliable and standardised psychophysical methods. Qualitative sensory testing may be useful as a screening tool to rule out relevant somatosensory abnormalities. Nevertheless, the patient should preferably be referred to a more comprehensive assessment with the quantitative sensory testing battery if confirmation of somatosensory abnormalities is necessary. Moreover, the identification of relevant somatosensory alterations in chronic pain disorders that do not fulfil the current criteria to be regarded as neuropathic has also increased the usefulness of somatosensory evaluation as a feasible method to better characterise the patients and perhaps elucidate some underpinnings of the so-called 'nociplastic' pain disorders. Finally, an additional benefit of oro-facial pain treatment based on somatosensory profiling still needs to be demonstrated and convincing evidence of somatosensory findings as predictors of treatment efficacy in chronic oro-facial pain awaits further studies. CONCLUSION: Psychophysical evaluation of somatosensory function in oro-facial pain is still in its infancy but with a clear potential to continue to improve the assessment, diagnosis and management of oro-facial pain patients.
Asunto(s)
Dolor Crónico , Dolor Facial , Dolor Facial/diagnóstico , Humanos , Manejo del Dolor , Dimensión del Dolor , Reproducibilidad de los ResultadosRESUMEN
INTRODUCTION: The influence of aligners on the activity of the masticatory muscles is still controversial, especially regarding the behaviour associated with awake bruxism (AB). OBJECTIVE: To compare the frequency of AB behaviours between patients treated with aligners and fixed appliances. METHODS: The sample comprised 38 Class I patients (mean age 22.08 years), divided by simple randomisation into two groups: OA group; orthodontic aligners (n 19) and FA group; fixed appliance (n 19). The frequency of AB was investigated by the ecological momentary assessment using an online device (mentimeter), during 7 following days at different timepoints, before and after appliance placement and in the 2nd, 3rd, 4th and 6th months of orthodontic treatment. These variables were also evaluated: level of anxiety by the State-Trait Anxiety Inventory, stress by the Perceived Stress Scale, catastrophising related to pain and degree of hypervigilance by the Pain Vigilance and Awareness Questionnaire, and the presence of facial pain evaluated by the DC/TMD. RESULTS: There was no difference between groups in the frequency of AB behaviours, with mean of 53.5% for group OA and 51.3% for FA. The most frequent behaviour was slightly touching the teeth, and in FA group, there was a significant reduction in this behaviour soon after appliance placement. The groups did not differ concerning the degree of anxiety, stress, catastrophising, hypervigilance and facial pain. CONCLUSION: The orthodontic treatment performed with aligners or fixed appliances did not influence the frequency of AB during the 6 months of treatment. REGISTRY OF CLINICAL TRIALS: (REBEC): RBR-9zytwf.
Asunto(s)
Bruxismo , Adulto , Ansiedad , Bruxismo/terapia , Humanos , Músculos Masticadores , Aparatos Ortodóncicos Fijos , Vigilia , Adulto JovenRESUMEN
BACKGROUND: Changes in quantitative sensory testing (QST) parameters following topical anaesthesia could contribute to better elucidate underlying mechanisms of somatosensory alterations in temporomandibular disorder (TMD) pain patients. This placebo-controlled crossover investigation compared the somatosensory profile following topical anaesthesia between TMD patients (n = 20) and healthy participants (n = 20). METHODS: Cold detection threshold, warm detection threshold, cold pain threshold, heat pain threshold, mechanical detection threshold, mechanical pain threshold, wind-up ratio and pressure pain threshold were assessed on the skin overlying the masseter at three consecutive days (baseline and immediately after lidocaine 4%/placebo cream). Mixed ANOVA and a coding system that accounts for the diversity of types of peripheral axons associated with the somatosensory parameters were applied for data analysis. RESULTS: The lidocaine application caused no changes in the somatosensory sensitivity in the masseter region in TMD patients (P > .050), but sensitivity to cold, cold pain, touch and pinprick stimuli were reduced after topical anaesthesia in healthy participants (P < .050). Also, the degree of topical anaesthesia was greater in healthy participants (P = .008). The coding system suggested that TMD patients presented only Aδ-fibre block, whereas a combination of either Aß- and/or C-fibre block was observed in 35% of healthy participants in addition to Aδ-fibre block following lidocaine application. CONCLUSION: Quantitative sensory testing can be successfully applied to identify meaningful differences in the degree of hypoalgesia and hypoesthesia following short-time topical anaesthesia.
Asunto(s)
Anestesia Local , Lidocaína , Umbral del Dolor , Trastornos de la Articulación Temporomandibular , Humanos , Dolor , Dimensión del DolorRESUMEN
BACKGROUND: Although inflammation can alter cytokines release and nerve function, it is not yet fully established if orthodontic-induced inflammation can cause significant extraoral trigeminal somatosensory alterations and release of inflammatory chemical mediators. OBJECTIVE: The primary aim of this study was to investigate the impact of orthodontic separator and short-term fixed orthodontic appliance on the extraoral trigeminal somatosensory function and concentrations of cytokines in the gingival crevicular fluid (GCF). METHODS: Twenty-two female patients were evaluated as follow: baseline, 24 hour-after elastomeric separator (-aES), 24 hour- and 1 month-after bonding brackets (-aBB) at both arches. The outcome variables were as follows: self-reported pain (Visual Analog Scale), QSTs (current perception threshold-CPT, cold detection threshold-CDT, warm detection threshold-WDT, mechanical detection threshold-MDT, mechanical suprathreshold-MST and wind-up ratio-WUR. All QSTs were performed at infra-orbital and mental nerve entry zone at patient`s dominant side. In addition, GCF samples in order to assess cytokines profile (IL-1ß,IL-8,IL-6 and TNF-α) were collected. ANOVA and Tukey's post hoc analyses were performed (a = 5%). RESULTS: Patients reported higher pain intensity 24 hour-aBB compared to baseline and 24 hour-aES (P < 0.050). Patients were less sensitive to pin-prick pain (MST) at 24 hour-aBB and 1 month-aBB compared to baseline (P < 0.006). Significant increases in IL-6 levels were observed 24 hour-aBB (P < 0.001). Multiple comparison analysis showed significant increase in IL-1ß levels (P < 0.001) and TNF-α (P < 0.001) 1 month-aBB compared to baseline. CONCLUSION: Elastomeric separators only induced mild pain and were not able to significantly increase proinflammatory cytokines level in the GCF. In addition, orthodontic fixed appliance may induce only minor somatosensory changes at extraoral trigeminal locations.
Asunto(s)
Citocinas/metabolismo , Dolor Facial/fisiopatología , Líquido del Surco Gingival/metabolismo , Mediadores de Inflamación/metabolismo , Aparatos Ortodóncicos Fijos/efectos adversos , Técnicas de Movimiento Dental/efectos adversos , Adolescente , Niño , Dolor Facial/metabolismo , Femenino , Humanos , Dimensión del Dolor , Umbral Sensorial/fisiología , Adulto JovenRESUMEN
Annona vepretorum Mart. (Annonaceae) is a species popularly known in Brazil as "araticum" and "pinha da Caatinga". We have evaluated the antinociceptive effects of A. vepretorum in formalin-, capsaicin-, and glutamate-induced orofacial nociception in mice. Male Swiss mice were pretreated with either saline (p.o.), A. vepretorum ethanol extract (Av-EtOH 25, 50 and 100 mg/kg, p.o.), or morphine (10 mg/kg, i.p.), before formalin, capsaicin, or glutamate was injected into the right upper lip. Pre-treatment with Av-EtOH at all doses produced a reduction in face-rubbing behavior induced by formalin in both phases, and these pre-treatments also produced a significant antinociceptive effect in the capsaicin and glutamate tests. Pre-treatment with naloxone (1.5 mg/kg, i.p.) did not reverse the antinociceptive activity of the extract at the dose of 100 mg/kg in the first phase of this test. Our results suggest that Av-EtOH might be useful in the treatment of orofacial pain.
Asunto(s)
Analgésicos/farmacología , Annona/química , Dolor Facial/prevención & control , Extractos Vegetales/farmacología , Hojas de la Planta/química , Analgésicos/química , Animales , Capsaicina , Relación Dosis-Respuesta a Droga , Antagonismo de Drogas , Etanol/química , Dolor Facial/inducido químicamente , Formaldehído , Ácido Glutámico , Masculino , Ratones , Naloxona/farmacología , Antagonistas de Narcóticos/farmacología , Dimensión del Dolor/métodos , Fitoterapia , Extractos Vegetales/químicaRESUMEN
BACKGROUND: The aim of this study was to evaluate the oral health status of temporomandibular disorders (TMD) and bruxism, as well as to measure masticatory performance of subjects with Charcot-Marie-Tooth type 2 (CMT2). METHODS AND RESULTS: The average number of decayed, missing, and filled teeth (DMFT) for both groups, control (CG) and CMT2, was considered low (CG = 2.46; CMT2 = 1.85, P = 0.227). The OHIP-14 score was considered low (CG = 2.86, CMT2 = 5.83, P = 0.899). The prevalence of self-reported TMD was 33.3% and 38.9% (P = 0.718) in CG and CMT2 respectively and for self-reported bruxism was 4.8% (CG) and 22.2% (CMT2), without significant difference between groups (P = 0.162). The most common clinical sign of TMD was masseter (CG = 38.1%; CMT2 = 66.7%) and temporalis (CG = 19.0%; GCMT2 = 33.3%) muscle pain. The geometric mean diameter (GMD) was not significantly different between groups (CG = 4369; CMT2 = 4627, P = 0.157). CONCLUSION: We conclude that the CMT2 disease did not negatively have influence either on oral health status in the presence and severity of TMD and bruxism or on masticatory performance.
Asunto(s)
Bruxismo/epidemiología , Enfermedad de Charcot-Marie-Tooth/epidemiología , Enfermedad de Charcot-Marie-Tooth/fisiopatología , Masticación/fisiología , Salud Bucal/estadística & datos numéricos , Trastornos de la Articulación Temporomandibular/epidemiología , Brasil/epidemiología , Bruxismo/etiología , Bruxismo/fisiopatología , Enfermedad de Charcot-Marie-Tooth/complicaciones , Humanos , Prevalencia , Saliva/química , Trastornos de la Articulación Temporomandibular/etiología , Trastornos de la Articulación Temporomandibular/patologíaRESUMEN
OBJECTIVE: This study aimed to evaluate the influence of the frequency of rhythmic masticatory muscle activity per hour (RMMA/h) scored by polysomnography (PSG) recordings on sleep-related factors and orofacial pain symptoms. METHODS: According to RMMA/h frequency, participants were assigned either to the control group (i.e., CRMMA, n = 40); or the case group according to high (i.e., HRMMA, n = 12) or low (LRMMA, n = 28) RMMA/h frequency. Fisher's exact (nominal variables), One-way Analysis of Variance followed by post-hoc Tukey (continuous variables) and Poisson Regression tests were used to calculate orofacial pain symptoms and sleep-related breathing, behavior, and architecture differences between controls versus cases at a significance level of 5%. RESULTS: The CRMMA differed from HRMMA and LRMMA subgroups considering orofacial pain, self-reported tooth clenching or grinding, obstructive sleep apnea (OSA), snoring, and most variables considering sleep architecture (P ≤ 0.05). Multivariate adjusted Poisson regression analysis revealed that bruxers, regardless of RMMA/h frequency, presented a significantly higher prevalence rate (PR) related to orofacial pain (PR 1.68; P = 0.025) and self-reported behavior (PR 1.71; P = 0.012). CONCLUSION: Significant differences in N1, N2 and N3 stages, arousals, arousal per hour, and sleep onset latency variables were found comparing bruxer with high or low RMMA/h frequency. Compared to controls, bruxers presented higher PR related to headache and self-reported tooth clenching or grinding.
Asunto(s)
Bruxismo del Sueño , Humanos , Polisomnografía , Estudios de Casos y Controles , Bruxismo del Sueño/complicaciones , Bruxismo del Sueño/diagnóstico , Sueño , Músculos Masticadores/fisiología , Dolor Facial/complicacionesRESUMEN
OBJECTIVE: The objective of this study was to determine the frequency of signs and symptoms of temporomandibular disorder (TMD) in fibromyalgic patients. METHODS: Sixty subjects of both sexes (mean age, 49.2 ± 13.8 years) with fibromyalgia (FM) diagnosis were included in this study. All patients were examined by a calibrated investigator to identify the presence of TMD using the Research Diagnostic Criteria for TMD. RESULTS: The most common signs (A) and symptoms (B) reported by FM patients were (A) pain in the masticatory muscles (masseter, 80%; posterior digastric, 76.7%), pain in the temporomandibular joint (83.3%), and 33.3% and 28.3%, respectively, presented joint sounds when opening and closing the mouth; (B) headache (97%) and facial pain (81.7%). In regard to the classic triad for the diagnosis of the TMD, it was found that 35% of the FM patients presented, at the same time, pain, joint sounds, and alteration of the mandibular movements. It was verified that myofascial pain without limitation of mouth opening was the most prevalent diagnosis (47%) for the RDC subgroup I. For the subgroup II, the disk displacement with reduction was the most prevalent diagnosis (21.6%). For the subgroup III, 36.7% of the subjects presented osteoarthritis. CONCLUSIONS: Thus, there is a high prevalence of signs and symptoms of TMD in FM patients, indicating the need for an integrated diagnosis and treatment of these patients, which suggest that the FM could be a medium- or long-term risk factor for the development of TMD.
Asunto(s)
Fibromialgia/complicaciones , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/etiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Prevalencia , Trastornos de la Articulación Temporomandibular/epidemiologíaRESUMEN
We attempted to identify the antinociceptive and anti-inflammatory actions of the monoterpene p-cymene. Firstly, behavioural screening was carried out to verify the influence of p-cymene [25, 50, and 100 mg/kg intraperitoneal (i.p.)] on the central nervous system (CNS) activity. The antinociceptive activity of p-cymene was evaluated by the acetic acid-induced writhing response, formalin, and hot-plate test, respectively. The leukocyte migration induced by injection of carrageenan was used to assess the anti-inflammatory activity. p-Cymene showed depressant activity on CNS after 4 h of treatment and also a possible action on the autonomous nervous system (ANS), mainly at the dose of 100 mg/kg (i.p.). It was found that p-cymene (50 and 100 mg/kg, i.p.) significantly (p < 0.05) reduced the writhing responses induced by acetic acid. p-Cymene also decreased the licking time in the first and second phase, respectively, of the formalin test. The results of the hot-plate test showed that all doses of p-cymene increased significantly the latency time of the response to the thermal stimulus in both licking and jumping parameters. In addition, there was a significantly (p < 0.05) decreased leukocyte migration at all doses of p-cymene. The experimental data demonstrate that p-cymene possesses antinociceptive and anti-inflammatory activities.
Asunto(s)
Analgésicos/farmacología , Antiinflamatorios/farmacología , Monoterpenos/farmacología , Animales , Conducta Animal/efectos de los fármacos , Quimiotaxis de Leucocito/efectos de los fármacos , Cimenos , Masculino , RatonesRESUMEN
The aim of this study was assess the effect of collagen-based films containing usnic acid as a wound dressing for dermal burn healing. Second-degree burn wounds were performed in forty-five Wistar rats, assigned into nine groups: COL-animals treated with collagen-based films; PHO-animals treated with collagen films containing empty liposomes; UAL-animals treated with collagen-based films containing usnic acid incorporated into liposomes. After 7, 14, and 21 days the animals were euthanized. On 7th day there was a moderate infiltration of neutrophils, in UAL, distributed throughout the burn wounds, whereas in COL and PHO, the severity of the reaction was slighter and still limited to the margins of the burn wounds. On the 14th day, the inflammatory reaction was less intense in UAL, with remarkable plasma cells infiltration. On the 21st day, there was reduction of the inflammation, which was predominantly composed of plasma cells in all groups, particularly in UAL. The use of the usnic acid provided more rapid substitution of type-III for type-I collagen on the 14th day, and improved the collagenization density on the 21st day. It was concluded that the use of reconstituted bovine type-I collagen-based films containing usnic acid improved burn healing process in rats.
Asunto(s)
Benzofuranos/administración & dosificación , Apósitos Biológicos , Quemaduras/terapia , Colágeno/administración & dosificación , Liposomas/administración & dosificación , Cicatrización de Heridas/efectos de los fármacos , Actinas/metabolismo , Animales , Quemaduras/metabolismo , Quemaduras/patología , Colágeno Tipo I/metabolismo , Colágeno Tipo III/metabolismo , Inmunohistoquímica , Inflamación/patología , Inflamación/prevención & control , Masculino , Miofibroblastos/metabolismo , Ratas , Ratas WistarRESUMEN
The aims of the present study were to assess the influence of: a) trait anxiety on orofacial pain; and b) orofacial pain on state anxiety. Forty-four rats were initially exposed to the free-exploratory paradigm for the evaluation of their anxiety profiles. In accordance to the parameter "Percentage of time in the novel side", the animals were considered as presenting high or low levels of trait anxiety when presenting values below the 1st quartile, or above the 3rd quartile, respectively. A week later, formalin-1.5% was injected into the upper lip of each animal. The behavioural nociceptive response, characterized by increased orofacial rubbing (OR), was quantified for 30 minutes, as follows: Total time OR (0-30 minutes: total pain), 1st phase OR (0-6 minutes: neurogenic pain), and 2nd phase OR (12-30 minutes: inflammatory pain). Immediately after this test, but still under the effect of formalin, the rats were submitted to the Elevated Plus-maze test (EPM). The results showed that the high trait anxiety individuals presented higher frequency of OR than the low trait anxiety ones, except during the neurogenic pain period. However, no correlation was found between OR frequency and levels of state anxiety presented on the EPM. In conclusion, the animals presenting higher anxiety profiles were the most susceptible to orofacial pain, nevertheless, orofacial pain did not influence state anxiety.
Asunto(s)
Ansiedad/psicología , Dolor Facial/psicología , Animales , Modelos Animales de Enfermedad , Conducta Exploratoria , Masculino , Dimensión del Dolor , Ratas , Ratas WistarRESUMEN
We investigated the antinociceptive and nerve excitability effects of the N-salicyloyltryptamine (NST) NST-treated mice exhibited a significant decrease in the number of writhes when 100 and 200 mg/kg (i.p.) were administered (i.p.). This effect was not antagonized by naloxone (1.5 mg/kg, i.p.). NST inhibited the licking response of the injected paw when 100 and 200 mg/kg were administered (i.p.) to mice in the first and second phases of the formalin test. Because the antinociceptive effects could be associated with neuronal excitability inhibition, we performed the single sucrose gap technique and showed that NST (3.57 mM) significantly reduced (29.2%) amplitude of the compound action potential (CAP) suggesting a sodium channel effect induced by NST. Our results demonstrated an antinociceptive activity of the NST that could be, at least in part, associated to the reduction of the action potential amplitude. NST might represent an important tool for pain management.
Asunto(s)
Analgésicos/farmacología , Conducta Animal/efectos de los fármacos , Bioensayo/métodos , Fenómenos Electrofisiológicos/efectos de los fármacos , Salicilatos/farmacología , Triptaminas/farmacología , Ácido Acético , Potenciales de Acción/efectos de los fármacos , Analgésicos/uso terapéutico , Animales , Diazepam/uso terapéutico , Formaldehído , Indometacina/farmacología , Masculino , Ratones , Dolor/tratamiento farmacológico , Prueba de Desempeño de Rotación con Aceleración Constante , Salicilatos/química , Salicilatos/uso terapéutico , Factores de Tiempo , Triptaminas/química , Triptaminas/uso terapéuticoRESUMEN
AIMS: To evaluate the antinociceptive effects of citronellal (CTL) on formalin-, capsaicin-, and glutamate-induced orofacial nociception in mice and to investigate whether such effects might involve a change in neural excitability. METHODS: Male mice were pretreated with CTL (50, 100, and 200 mg/kg, ip), morphine (5 mg/kg, ip), or vehicle (distilled water plus one drop of Tween 80 0.2%) before formalin (20 microL, 2%), capsaicin (20 microL, 2.5 microg) or glutamate (40 microL, 25 microM) injection into the right vibrissa. Sciatic nerve recordings were made using the single sucrose gap technique in rats. The data obtained were analyzed by ANOVA followed by Dunnett's test for the behavioral analyses and by the Student t test for CAP evaluation. RESULTS: Pretreatment with CTL was effective in reducing nociceptive face-rubbing behavior in both phases of the formalin test, which was also naloxone-sensitive. CTL produced significantly antinociceptive effect at all doses in the capsaicin- and glutamate- tests. Rota-rod testing indicated that such results were unlikely to be provoked by motor abnormality. Recordings using the single sucrose gap technique revealed that CTL (10 mM) could reduce the excitability of the isolated sciatic nerve through a diminution of the compound action potential amplitude by about 42.4% from control recordings. CONCLUSION: These results suggest that CTL might represent an important tool for management and/or treatment of orofacial pain.
Asunto(s)
Aldehídos/uso terapéutico , Analgésicos/uso terapéutico , Capsaicina/efectos adversos , Dolor Facial/tratamiento farmacológico , Formaldehído/efectos adversos , Glutamatos/efectos adversos , Monoterpenos/uso terapéutico , Nociceptores/efectos de los fármacos , Dolor/prevención & control , Fármacos del Sistema Sensorial/efectos adversos , Potenciales de Acción/efectos de los fármacos , Monoterpenos Acíclicos , Animales , Dolor Facial/inducido químicamente , Masculino , Ratones , Morfina/uso terapéutico , Actividad Motora/efectos de los fármacos , Narcóticos/uso terapéutico , Conducción Nerviosa/efectos de los fármacos , Ratas , Ratas Wistar , Nervio Ciático/efectos de los fármacosRESUMEN
AIM OF STUDY: To analyze dental prescribing errors in Aracaju, Brazil, and to suggest feasible improvements for patient safety. METHODS: A descriptive study was conducted at nine Primary Health Care Units (PHCUs) in the northeast region of Brazil. A convenience sample of 300 dental prescriptions was selected during the period February-May 2007. The World Health Organization (WHO) prescribing criteria were used to measure the quality of the prescriptions. MAIN OUTCOME MEASURES: All medications were prescribed by generic name; 98.3% of prescription information contained abbreviations and 26% of them were classified as having low legibility or as being illegible. The most commonly prescribed medications were diclofenac (35%), both sodium and potassium, and amoxicillin (26%). CONCLUSIONS: Dental prescribing errors should be considered as a potential area for improvement in the medication management process and patient safety. We suggest that a pharmacist should be available for medication dispensing at all units and that dentists are trained continuously so that medication orders may become more legible and complete. Improving the quality of dental prescriptions will reduce the risks for medication errors and will promote the rational use of pharmacotherapy, and patient safety.
Asunto(s)
Servicio Odontológico Hospitalario , Prescripciones de Medicamentos/estadística & datos numéricos , Errores de Medicación/estadística & datos numéricos , Preparaciones Farmacéuticas Odontológicas/uso terapéutico , Atención Primaria de Salud , Abreviaturas como Asunto , Brasil , Medicamentos Genéricos , Escritura Manual , Humanos , Relaciones Interprofesionales , Errores de Medicación/prevención & control , Medicamentos bajo Prescripción/uso terapéuticoRESUMEN
Physicochemical characterization and antinociceptive and anti-inflammatory activities of atranorin (AT) extracted from Cladina kalbii Ahti in formalin- and capsaicin-induced orofacial pain and anti-inflammatory tests in rodents were studied. Physicochemical characterization showed that AT has the general formula C19H18O8. Male Swiss mice were pretreated with AT (100, 200, and 400 mg/kg, i.p.), morphine (3 mg/kg, i.p.), or vehicle (0.9% saline with two drops of 0.2% Tween 80) before formalin (20 microl, 2%) or capsaicin (20 microl, 2.5 microg) were injected into the right vibrissa. Our results showed that i.p. treatment with AT displayed marked inhibitory effects in different orofacial pain tests in mice. AT (400 mg/kg, i.p.) was effective in reducing the nociceptive face-rubbing behavioural response in both phases of the formalin test, which was also naloxone-sensitive. Additionally, AT produced a significant antinociceptive effect at all doses in the capsaicin test. Such results were unlikely to be provoked by motor abnormality, since AT-treated mice exhibited no performance alteration on the rota rod apparatus. AT exhibited significant anti-inflammatory activity in the acute model of inflammation (leukocyte migration to the peritoneal cavity), carrageenan- and arachidonic acid-induced hind paw edema in rats. Additionally, AT exhibited a dose-dependent antioxidant activity in vitro, as assessed by total radical-trapping antioxidant parameter and total antioxidant reactivity assays. All these findings suggest that AT might represent an important tool for the management of orofacial pain and/or inflammatory disorders.
Asunto(s)
Hidroxibenzoatos/farmacología , Dimensión del Dolor/efectos de los fármacos , Dolor/tratamiento farmacológico , Alérgenos/farmacología , Animales , Carragenina , Edema/inducido químicamente , Edema/tratamiento farmacológico , Dolor Facial/inducido químicamente , Dolor Facial/tratamiento farmacológico , Hidroxibenzoatos/química , Hidroxibenzoatos/uso terapéutico , Hipnóticos y Sedantes/farmacología , Masculino , Ratones , Morfina/farmacología , Morfina/uso terapéutico , Fármacos Neuromusculares Despolarizantes/farmacología , Extractos Vegetales/farmacología , Extractos Vegetales/uso terapéutico , Prueba de Desempeño de Rotación con Aceleración ConstanteRESUMEN
The present study investigated the antinociceptive, anti-inflammatory and antioxidant effects of the leaf essential oil (LEO) of Cymbopogon winterianus Jowitt (Poaceae). In the acetic acid-induced writhing and formalin tests, the LEO (50, 100, and 200 mg/kg, p.o.) significantly reduced (p < 0.05) the number of writhings and paw licking times in the first (0-5 min) and second (15-30 min) phases, respectively. In contrast, the LEO did not alter the latency time for mice licking the rear paws in hot-plate test. The LEO inhibited the carrageenan-induced neutrophil migration to the peritoneal cavity in a dose-dependent manner (35.5%, 42.8%, and 66.1% at doses of 50, 100, and 200 mg/kg, respectively, p < 0.001). Moreover, LEO exhibited higher scavenging activity toward 1,1-diphenyl-2-picrylhydrazyl (DPPH) radicals with an IC(50) (12.66 ± 0.56 µg/mL). Our present results demonstrated that the LEO has antinociceptive, anti-inflammatory, and antioxidant properties.
Asunto(s)
Analgésicos/farmacología , Antiinflamatorios/farmacología , Antioxidantes/farmacología , Cymbopogon/química , Aceites Volátiles/farmacología , Aceites de Plantas/farmacología , Ácido Acético , Analgésicos/química , Animales , Antiinflamatorios/química , Antioxidantes/química , Compuestos de Bifenilo/química , Carragenina , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Edema/inducido químicamente , Edema/tratamiento farmacológico , Calor , Masculino , Ratones , Aceites Volátiles/química , Dolor/inducido químicamente , Dolor/tratamiento farmacológico , Dimensión del Dolor , Fitoterapia , Picratos/química , Hojas de la Planta/química , Aceites de Plantas/química , Ratas , Ratas WistarRESUMEN
AIMS: To evaluate the influence of self-reported physical activity level on painful mechanical somatosensory profile and psychosocial characteristics. METHODS: A total of 90 participants, male and female, were divided into three groups based on the frequency, duration, and intensity of physical activity over the last 3 months. The classification followed a modified criterion of the short version of the International Physical Activity Questionnaire (IPAQ). Mechanical quantitative sensory tests were performed in the region of the anterior temporalis muscle and on the thenar area of the dominant hand, and psychosocial aspects were assessed using questionnaires measuring state and trait anxiety, pain catastrophizing, lifestyle, and quality of life. RESULTS: There was no significant main effect of group on any of the somatosensory variables (F < 0.34 and P > .416). As for psychosocial aspects, the low level of physical activity group had the lowest scores on the lifestyle questionnaire (P < .009). CONCLUSION: Level of physical activity did not significantly influence mechanical somatosensory thresholds or temporal summation in the orofacial region, and worse quality of life was found in participants reporting a low level of physical activity.