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1.
Am J Case Rep ; 23: e937511, 2022 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-36117309

RESUMO

BACKGROUND Bell's palsy, also called facial nerve palsy, occasionally co-occurs with trigeminal neuropathy, which presents as additional facial sensory symptoms and/or neck pain. Bell's palsy has a proposed viral etiology, in particular when occurring after dental manipulation. CASE REPORT A 52-year-old Asian woman presented to a chiropractor with a 3-year history of constant neck pain and left-sided maxillary, eyebrow, and temporomandibular facial pain, paresis, and paresthesia, which began after using a toothpick, causing possible gum trauma. She had previously been treated with antiviral medication and prednisone, Chinese herbal medicine, and acupuncture, but her recovery plateaued at 60% after 1 year. The chiropractor ordered cervical spine magnetic resonance imaging, which demonstrated cervical spondylosis, with no evidence of myelopathy or major pathology. Treatment involved cervical and thoracic spinal manipulation, cervical traction, soft-tissue therapy, and neck exercises. The patient responded positively. At 1-month follow-up, face and neck pain and facial paresis were resolved aside from residual eyelid synkinesis. A literature review identified 12 additional cases in which chiropractic spinal manipulation with multimodal therapies was reported to improve Bell's palsy. Including the current case, 85% of these patients also had pain in the face or neck. CONCLUSIONS This case illustrates improvement of Bell's palsy and concurrent trigeminal neuropathy with multimodal chiropractic care including spinal manipulation. Limited evidence from other similar cases suggests a role of the trigeminal pathway in these positive treatment responses of Bell's palsy with concurrent face/neck pain. These findings should be explored with research designs accounting for the natural history of Bell's palsy.


Assuntos
Paralisia de Bell , Quiroprática , Medicamentos de Ervas Chinesas , Paralisia Facial , Doenças do Nervo Trigêmeo , Antivirais/uso terapêutico , Paralisia de Bell/complicações , Paralisia de Bell/diagnóstico , Paralisia de Bell/terapia , Dor Facial , Feminino , Humanos , Pessoa de Meia-Idade , Cervicalgia/etiologia , Cervicalgia/terapia , Prednisona/uso terapêutico , Doenças do Nervo Trigêmeo/complicações , Doenças do Nervo Trigêmeo/tratamento farmacológico
2.
Neural Plast ; 2022: 6131696, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36061584

RESUMO

Background: Repetitive transcranial magnetic stimulation (rTMS) has been widely used in the treatment of neuropathic orofacial pain (NOP). The consistency of its therapeutic efficacy with the optimal protocol is highly debatable. Objective: To assess the effectiveness of rTMS on pain intensity, psychological conditions, and quality of life (QOL) in individuals with NOP based on randomized controlled trials (RCTs). Methods: We carefully screened and browsed 5 medical databases from inception to January 1, 2022. The study will be included that use of rTMS as the intervention for patients with NOP. Two researchers independently completed record retrieval, data processing, and evaluation of methodological quality. Quality and evidence were assessed using the PEDro scores and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results: Six RCTs with 214 participants were included in this systematic review: 2 studies were considered level 1 evidence, and 4 were considered level 2 evidence. Six studies found that high-frequency rTMS had a pain-relieving effect, while 4 studies found no improvement in psychological conditions and QOL. Quality of evidence (GRADE system) ranged from moderate to high. No significant side effects were found. Conclusions: There is moderate-to-high evidence to prove that high-frequency rTMS is effective in reducing pain in individuals with NOP, but it has no significant positive effect on psychological conditions and QOL. High-frequency rTMS can be used as an alternative treatment for pain in individuals with NOP, but further studies will be conducted to unify treatment parameters, and the sample size will be expanded to explore its influence on psychological conditions and QOL.


Assuntos
Neuralgia , Estimulação Magnética Transcraniana , Dor Facial/etiologia , Dor Facial/terapia , Humanos , Neuralgia/etiologia , Neuralgia/terapia , Medição da Dor , Ensaios Clínicos Controlados Aleatórios como Assunto , Estimulação Magnética Transcraniana/métodos , Resultado do Tratamento
3.
J Headache Pain ; 23(1): 114, 2022 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-36057552

RESUMO

BACKGROUND: Trigeminal neuralgia is an episodic severe neuralgic pain and can be managed both medically and surgically. If possible, this should be directed by a Multidisciplinary Team (MDT) of specialised surgeons, physicians, dentists, psychologists and specialist nurses with access to all treatment modalities, which enables patients to make an informed decision about their future management. OBJECTIVE: The aim of this study was to review the outcomes of patients managed by an MDT clinic, in a single institute over an eleven-year period. METHODS: A prospective database was used to identify patients with trigeminal neuralgia or its variants who had attended a joint MDT clinic. The electronic notes were examined for demographics, onset and duration of trigeminal neuralgia, medications history, pain scores and details of surgical procedures if any by two independent assessors. RESULTS: Three hundred thirty-four patients attended the MDT between 2008-2019. Forty-nine of them had surgery before being referred to the service and were included but analysed as a subgroup. Of the remaining patients, 54% opted to have surgery following the MDT either immediately or at a later date. At the last reported visit 55% of patients who opted to have surgery were pain free and off medications, compared to 15.5% of medically managed patients. Surgical complications were mostly attributable to numbness and in the majority of cases this was temporary. All patients who were not pain free, had complications after surgery or opted to remain on medical therapy were followed up in a facial pain clinic which has access to pain physicians, clinical nurse specialists and a tailored pain management program. Regular patient related outcome measures are collected to evaluate outcomes. CONCLUSION: An MDT clinic offers an opportunity for shared decision making with patients deciding on their personal care pathway which is valued by patients. Not all patients opt for surgery, and some continue to attend a multidisciplinary follow up program. Providing a full range of services including psychological support, improves outcomes.


Assuntos
Radiocirurgia , Neuralgia do Trigêmeo , Dor Facial , Seguimentos , Humanos , Clínicas de Dor , Resultado do Tratamento , Neuralgia do Trigêmeo/diagnóstico , Neuralgia do Trigêmeo/cirurgia
4.
Rev. neurol. (Ed. impr.) ; 75(3): 67-69, agosto 2022. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-207235

RESUMO

Introducción. La cefalea es uno de los motivos más frecuentes de consulta médica. La de tipo SUNCT forma parte de las cefaleas primarias de tipo trigeminoautonómico y debe considerarse en casos de dolor hemifacial de corta duración asociado a signos disautonómicos. Adicionalmente, dentro del enfoque de esta enfermedad se deben descartar causas secundarias que faciliten su aparición. Caso clínico. Se describe un caso de cefalea de novo de tipo SUNCT en el cual se documentó afectación de la primera rama del nervio trigémino por infección del virus herpes zóster tras seis días de aparición del dolor. Conclusión. Habitualmente, las cefaleas trigeminoautonómicas son primarias; sin embargo, existen múltiples entidades descritas asociadas a cefalea de tipo SUNCT de etiología secundaria. Dentro de éstas debe considerarse la infección por el virus herpes zóster en el inicio de episodios compatibles con cefalea de tipo SUNCT que no respondan al tratamiento médico.(AU)


Introduction. Headache is one of the most frequent reasons for medical consultation. The SUNCT type is classified as a primary trigeminal-autonomic headache and should be considered in cases of short-lasting, hemifacial pain associated with autonomic dysfunction. Additionally, in the approach to this disease, secondary causes that facilitate its onset must be ruled out. Case report. We describe a case of a new-onset SUNCT-type headache in which involvement of the first branch of the trigeminal nerve due to herpes zoster virus infection was documented six days after the onset of pain. Conclusion. Trigeminal autonomic headaches are usually primary; yet, multiple conditions have been described that are associated with SUNCT-type headaches and have a secondary etiology. Among these, herpes zoster virus infection should be considered at the onset of episodes consistent with SUNCT-type headache unresponsive to medical treatment.(AU)


Assuntos
Humanos , Cefaleia , Síndrome SUNCT , Herpes Zoster , Cefalalgias Autonômicas do Trigêmeo , Nervo Trigêmeo , Dor Facial
5.
A A Pract ; 16(8): e01612, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35952333

RESUMO

Bilateral facial pain is associated with temporomandibular joint dysfunction and rarely, trigeminal neuralgia. In the absence of clinical and radiological signs, a diagnosis of persistent idiopathic facial pain is often made. Standard management of persistent idiopathic facial pain includes pharmacotherapy and psychotherapy with variable therapeutic efficacy. Whiplash can result in persistent facial pain although its clinical presentation and management are poorly defined. This report includes 3 patients with refractory bilateral facial pain. A detailed review of history revealed whiplash before the onset of the symptoms. The authors present a novel intervention, an intermediate cervical plexus block that produced durable analgesia.


Assuntos
Bloqueio do Plexo Cervical , Dor Intratável , Neuralgia do Trigêmeo , Traumatismos em Chicotada , Bloqueio do Plexo Cervical/efeitos adversos , Dor Facial/complicações , Dor Facial/terapia , Humanos , Traumatismos em Chicotada/complicações , Traumatismos em Chicotada/terapia
6.
J Vis Exp ; (185)2022 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-35969082

RESUMO

Pain has sensory and affective components. Unlike traditional, reflex-based pain assays, operant pain assays can produce more clinically relevant results by addressing the cognitive and motivational aspects of pain in rodents. This paper presents a protocol for assessing mechanical hypersensitivity following chronic constriction injury of the infraorbital nerves (CCI-ION) in rats using an orofacial operant pain system. Before CCI-ION surgery, rats were trained in an orofacial pain assessment device (OPAD) to drink sweetened condensed milk while making facial contact with the metal spiked bars and lick-tube. In this assay, rats can choose between receiving milk as a positive reinforcer or escaping an aversive mechanical stimulus that is produced by a vertical row of small pyramid-shaped spikes on each side of the reward access hole. Following 2 weeks of training in the OPAD and before the CCI-ION surgery, baseline mechanical sensitivity data were recorded for 5 days for each rat during a 10 min testing session. During a session, the operant system automatically records the number of reward bottle activations (licks) and facial contacts, contact duration, and latency to the first lick, among other measures. Following baseline measurements, rats underwent either CCI-ION or sham surgery. In this protocol, mechanical hypersensitivity was quantified by measuring the number of licks, latency to the first lick, the number of contacts, and the ratio of licks to facial contacts (L/F). The data showed that CCI-ION resulted in a significant decrease in the number of licks and the L/F ratio and an increase in the latency to the first lick, indicating mechanical hypersensitivity. These data support the use of operant-based pain assays to assess mechanical pain sensitivity in preclinical pain research.


Assuntos
Dor Facial , Hiperalgesia , Animais , Dor Facial/diagnóstico , Dor Facial/etiologia , Hiperalgesia/diagnóstico , Hiperalgesia/etiologia , Medição da Dor/métodos , Limiar da Dor/fisiologia , Ratos , Ratos Sprague-Dawley
7.
Dermatologie (Heidelb) ; 73(9): 701-707, 2022 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-35997968

RESUMO

Glossodynia or orofacial pain disorder is known as burning mouth syndrome. It is a therapeutic challenge. Its etiology is not well defined. Recent studies show not only a correlation with neuropathic changes, but there are also indications of comorbidities such as depression, anxiety, and carcinophobia. These can also manifest as a reaction to the disease and are not necessarily considered causative. Burning mouth syndrome poses a diagnostic challenge since its differential diagnosis is broad. With regard to dermatological aspects, lichen planus mucosae, oral leucoplakia, pemphigus vulgaris, and aphthous mouth ulcers should be considered. Diabetes, anemia, vitamin deficiency, and endocrinological influences should be considered regarding the predominance of elderly and female patients. Meta-analyses of treatment studies usually show a low level of evidence of the randomized, controlled trials. According to the literature mainly psychotherapy and antidepressants are proposed for therapy. Alpha lipoic acid as a dietary supplement shows short-term improvement and low-level laser therapy might have some benefit.


Assuntos
Síndrome da Ardência Bucal , Dor Facial , Glossalgia , Língua , Idoso , Síndrome da Ardência Bucal/complicações , Síndrome da Ardência Bucal/diagnóstico , Síndrome da Ardência Bucal/terapia , Dor Facial/complicações , Dor Facial/diagnóstico , Dor Facial/terapia , Feminino , Glossalgia/complicações , Glossalgia/diagnóstico , Glossalgia/terapia , Humanos , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Língua/patologia
8.
Artigo em Inglês | MEDLINE | ID: mdl-36012029

RESUMO

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.


Assuntos
Comunicação , Atenção à Saúde , Adulto , Estudos Transversais , Empatia , Dor Facial/terapia , Humanos
9.
Sci Rep ; 12(1): 14357, 2022 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-35999356

RESUMO

We aimed to evaluate the radiographic and clinical outcomes after gamma knife radiosurgery (GKRS) for trigeminal schwannomas (TSs). A total of 87 patients who underwent GKRS for TSs between 1990 and 2020 were enrolled. The mean tumor volume was 4.3 cm3. The median prescribed dose for the margins of the tumor was 13 Gy. The median follow-up duration was 64.3 months (range 12.0-311.5 months). The overall local tumor control rate was 90%, and the symptom response rate was 93%. The response rate for each symptom was 88% for facial pain, 97% for facial sensory change, and 86% for cranial nerve deficits. Nineteen (22%) patients showed transient swelling, which had regressed at the time of the last follow-up. Cystic tumors were associated with transient swelling (p = 0.04). A tumor volume of < 2.7 cm3 was associated with local tumor control in univariable analysis. Transient swelling was associated with symptom control failure in both univariable and multivariable analyses (p = 0.04, odds ratio 14.538). GKRS is an effective treatment for TSs, both for local control and symptom control.


Assuntos
Neoplasias dos Nervos Cranianos/cirurgia , Neurilemoma/cirurgia , Radiocirurgia/instrumentação , Doenças do Nervo Trigêmeo/cirurgia , Neoplasias dos Nervos Cranianos/diagnóstico por imagem , Neoplasias dos Nervos Cranianos/radioterapia , Dor Facial/radioterapia , Dor Facial/cirurgia , Seguimentos , Humanos , Neurilemoma/diagnóstico por imagem , Neurilemoma/radioterapia , Estudos Retrospectivos , Resultado do Tratamento , Doenças do Nervo Trigêmeo/diagnóstico por imagem , Doenças do Nervo Trigêmeo/radioterapia , Carga Tumoral
10.
Eur J Pharmacol ; 931: 175211, 2022 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-35981606

RESUMO

Trigeminal nerve injury is a common complication of various dental and oral procedures, which could induce trigeminal neuropathic pain but lack effective treatments. P2 purinergic receptors have emerged as novel therapeutic targets for such pain. Recent reports implied that the P2Y14 receptor (P2Y14R) was activated and promoted orofacial inflammatory pain and migraine. However, the role and mechanism of P2Y14R in trigeminal neuropathic pain remain unknown. We induced an orofacial neuropathic pain model by chronic constriction injury of the infraorbital nerve (CCI-ION). Von-Frey tests showed that CCI-ION induced orofacial mechanical hypersensitivity. The increased activating transcription factor 3 (ATF3) expression in the trigeminal ganglion (TG) measured by immunofluorescence confirmed trigeminal nerve injury. Immunofluorescence showed that P2Y14R was expressed in trigeminal ganglion neurons (TGNs) and satellite glial cells (SGCs). RT-qPCR and Western blot identified increased expression of P2Y14R in TG after CCI-ION. CCI-ION also upregulated interleukin-1ß (IL-1ß), interleukin-6 (IL-6), C-C motif chemokine ligand 2 (CCL2), and tumor necrosis factor-α (TNF-α) in TG. Notably, CCI-ION-induced mechanical hypersensitivity and pro-inflammatory cytokines production were decreased by a P2Y14R antagonist (PPTN). Trigeminal administration of P2Y14R agonist (UDP-glucose) evoked orofacial mechanical hypersensitivity and increased pro-inflammatory cytokines above in TG. Furthermore, CCI-ION induced activation of extracellular signal-regulated kinase 1/2 (ERK1/2) and p38 in TG, which also were reduced by PPTN. The inhibitors of ERK1/2 (U0126) and p38 (SB203580) decreased these upregulated pro-inflammatory cytokines after CCI-ION. Collectively, this study revealed that P2Y14R in TG contributed to trigeminal neuropathic pain via ERK- and p38-dependent neuroinflammation. Thus, P2Y14R may be a potential drug target against trigeminal neuropathic pain.


Assuntos
Neuralgia , Traumatismos do Nervo Trigêmeo , Animais , Dor Facial/metabolismo , Hiperalgesia/metabolismo , Camundongos , Neuralgia/etiologia , Neuralgia/metabolismo , Ratos , Ratos Sprague-Dawley , Gânglio Trigeminal , Traumatismos do Nervo Trigêmeo/metabolismo
11.
Otolaryngol Clin North Am ; 55(3S): e1-e8, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35987560

RESUMO

Otolaryngologists will frequently encounter patients with head and facial pain. The headache may be a primary disorder or a symptom of a secondary pathology. Understanding diagnostic criteria and the autonomic and otologic manifestations of primary headaches is imperative for accurate diagnosis and treatment. This article summarizes key points in the issue "Comprehensive Management of Headache for the Otolaryngologist" and can be used as a cursory reference.


Assuntos
Cefaleia , Otorrinolaringologistas , Dor Facial/diagnóstico , Cefaleia/diagnóstico , Cefaleia/etiologia , Cefaleia/terapia , Humanos
12.
J Oral Facial Pain Headache ; 36(2): 85-102, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35943322

RESUMO

AIMS: (1) To summarize current knowledge on the prevalence, intensity, and descriptors of orofacial pain and snoring/obstructive sleep apnea (OSA) before and after head and neck cancer (HNC) treatment; and (2) to propose future directions for research. METHODS: The median prevalence for each condition was estimated from the most recent systematic reviews (SRs) and updated with new findings retrieved from the PubMed, Web of Science, Embase, and Cochrane databases up to December 2021. RESULTS: The prevalence of HNC pain seems relatively stable over time, with a median of 31% before treatment in three studies to a median of 39% at 1 month to 16 years after treatment in six studies. HNC pain intensity remains mild to moderate. There was a threefold increase in temporomandibular pain prevalence after surgery (median 7.25% before to 21.3% after). The data for snoring prevalence are unreliable. The OSA/HNC prevalence seems relatively stable over time, with a median of 72% before treatment in three studies to 77% after treatment in 14 studies. CONCLUSION: With the exception of temporomandibular pain, the prevalence of HNC pain and OSA seems to be stable over time. Future studies should: (1) compare the trajectory of change over time according to each treatment; (2) compare individuals with HNC to healthy subjects; (3) use a standardized and comparable method of data collection; and (4) assess tolerance to oral or breathing devices, since HNC individuals may have mucosal sensitivity or pain.


Assuntos
Neoplasias de Cabeça e Pescoço , Apneia Obstrutiva do Sono , Dor Facial/epidemiologia , Dor Facial/etiologia , Neoplasias de Cabeça e Pescoço/complicações , Humanos , Prevalência , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/terapia , Ronco/epidemiologia , Ronco/terapia
13.
Magn Reson Imaging Clin N Am ; 30(3): 425-439, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35995471

RESUMO

The use of magnetic resonance (MR) imaging in the emergency department continues to increase. Although computed tomography is the first-line imaging modality for most head and neck emergencies, MR is superior in some situations and imparts no ionizing radiation. This article provides a symptom-based approach to nontraumatic head and neck pathologic conditions most relevant to emergency head and neck MR imaging, emphasizing relevant anatomy, "do not miss" findings affecting clinical management, and features that may aid differentiation from potential mimics. Essential MR sequences and strategies for obtaining high-quality images when faced with patient motion and other technical challenges are also discussed.


Assuntos
Neoplasias de Cabeça e Pescoço , Imageamento por Ressonância Magnética , Emergências , Dor Facial , Cabeça/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética/métodos , Pescoço/diagnóstico por imagem
14.
J Oral Facial Pain Headache ; 36(2): 103-140, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35943323

RESUMO

AIMS: To explore the prevalence of clinically significant anxiety and depression in adult patients with chronic orofacial pain (COFP) conditions. METHODS: A systematic online search of the Medline (PubMed) and Ovid databases was performed for articles published from 2006 to 2019. Observational studies- including cross-sectional, case-control, and case series-and longitudinal prospective studies were included. A total of 118 articles were selected for inclusion, and the prevalence rates of clinically significant anxiety and depression were summarized. RESULTS: Most studies focused on temporomandibular disorder (TMD) pain and less often on neuropathic COFP conditions. Prevalence rates varied widely across studies according to OFP condition and assessment measure; most questionnaire-based assessments yielded rates of clinically significant depression and anxiety in, respectively, 40% to 60% and 40% to 65% of individuals with TMD and in 20% to 50% and 25% to 55% of patients with neuropathic, mixed, or idiopathic/atypical COFP conditions. Rates of anxiety and depression were lower in studies using diagnostic instruments and in TMD studies with nonpatient samples. Most controlled studies showed a higher prevalence of anxiety and depression in individuals with COFP than in those without. Higher COFP pain levels and the presence of comorbid conditions such as migraines or widespread pain increased the likelihood of anxiety and/or depressive symptoms in individuals. CONCLUSION: Clinically significant anxiety and depression were commonly observed in patients with COFP, were present at higher rates than in pain-free participants in controlled studies, and were closely linked to pain severity. More research is needed to evaluate the psychologic impact of multiple COFP conditions in an individual and the prevalence of precondition psychologic morbidity.


Assuntos
Dor Crônica , Transtornos da Articulação Temporomandibular , Adulto , Ansiedade/epidemiologia , Dor Crônica/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Dor Facial/diagnóstico , Humanos , Estudos Prospectivos , Transtornos da Articulação Temporomandibular/diagnóstico
15.
J Contemp Dent Pract ; 23(4): 393-398, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35945831

RESUMO

AIM: The aim of the study was to assess the symptoms associated with temporomandibular disorders (TMD) and bruxism among elderly population in Ranchi, India. MATERIALS AND METHODS: A cross-sectional study was done on 600 elderly subjects; data regarding the signs and symptoms associated with temporomandibular disorder and bruxism were recorded using both structured questionnaire and clinical examination. Spearman correlation analysis was done to find the association between TMD and bruxism. RESULTS: Out of 600 subjects, 49% were males and 51% were females. The overall prevalence of TMD-related symptoms like temporomandibular joint (TMJ) pain, difficulty in jaw opening, TMJ sounds, and bruxism were 10.5, 11.2, 14, and 17% among elderly subjects. TMD symptoms and bruxism were relatively more commonly seen among females when compared to males. According to logistic regression (significantly correlated independent variables, i.e., TMD symptoms among analyzed variables), the dependent variable like bruxism had highest odds ratio, i.e., 8 for 60-70 years age-group and 15.1 for 70-80 year age-group. CONCLUSION: There was a lesser prevalence of symptoms related to TMD and bruxism among the study population, and bruxism had the highest odds ratio in TMD between the analyzed variables. CLINICAL SIGNIFICANCE: Human aging contributes too many oral problems, while resolving these, the felt needs of the population are sometimes ignored which adds up to the growing list of issues. Studies have shown inconclusive evidence regarding the prevalence of symptoms related to TMD and bruxism as these are known to trouble elderly populations.


Assuntos
Bruxismo , Transtornos da Articulação Temporomandibular , Idoso , Bruxismo/complicações , Bruxismo/epidemiologia , Estudos Transversais , Dor Facial/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Inquéritos e Questionários , Transtornos da Articulação Temporomandibular/complicações
16.
Braz Oral Res ; 36: e109, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35946737

RESUMO

This study evaluated the orofacial antinociceptive effect of (S)-(-)-perillyl alcohol (PA) associated with codeine (C) and investigated the possible molecular anchorage mechanisms of PA. Mice (n = 5 per group) were treated with PA alone and associated with codeine and assigned to the following groups: 75.0 mg/kg PA; 75.0 mg/kg PA + C 30 mg/kg; PA 37.5 mg/kg + C 15.0 mg/kg; C 30.0 mg/kg; and control. Nociception was induced by formalin, capsaicin, and glutamate, and was quantified based on the duration (in seconds) of face grooming. The possible mechanisms of action were evaluated by molecular docking study. In the formalin test, PA75/C30 presented an effect in the neurogenic (p < 0.0001) and inflammatory (p < 0.005) phases. Mice treated with PA75 (p < 0.0001) and PA75/C30 (p < 0.0005) showed a reduced nociceptive behavior in the capsaicin test. Glutamate-induced nociception also was blocked by PA75 (p < 0.0005) and C30 (p < 0.0005). The molecular anchorage analysis indicated high negative binding energy values for the evaluated receptors, especially glutamate receptors (AMPA -79.57 Kcal/mol, mGLUR6 -71.25, and NMDA -66.33 Kcal/mol). PA associated with codeine showed orofacial antinociceptive activity, with theoretical evidence of interaction with glutamate receptors.


Assuntos
Analgésicos , Capsaicina , Analgésicos/farmacologia , Animais , Capsaicina/farmacologia , Codeína/farmacologia , Dor Facial/induzido quimicamente , Dor Facial/tratamento farmacológico , Ácido Glutâmico , Camundongos , Simulação de Acoplamento Molecular , Monoterpenos , Receptores de Glutamato
17.
AAPS PharmSciTech ; 23(7): 239, 2022 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-36002707

RESUMO

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.


Assuntos
Nanocápsulas , Neuralgia , Administração Oral , Analgésicos , Animais , Modelos Animais de Doenças , Dor Facial/tratamento farmacológico , Dor Facial/metabolismo , Nociceptividade/fisiologia
18.
Acta Cir Bras ; 37(5): e370506, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35976283

RESUMO

PURPOSE: To evaluate the effect of a selective cyclooxygenase 2 (COX-2) inhibitor on trigeminal ganglion changes and orofacial discomfort/nociception in rats submitted to an experimental model of dental occlusal interference (DOI). METHODS: Female Wistar rats (180-200 g) were divided into five groups: a sham group (without DOI) (n=15); and four experimental groups with DOI treated daily with 0.1 mL/kg saline (DOI+SAL), 8, 16, or 32 mg/kg celecoxib (DOI+cel -8, -16, -32) (n=30/group). The animals were euthanized after one, three, and seven days. The bilateral trigeminal ganglia were analyzed histomorphometrically (neuron cell body area) and immunohistochemically (COX-2, nuclear factor-kappa B [NFkB], and peroxisome proliferator-activated receptor-y [PPARy]). A bilateral nociception assay of the masseter muscle was performed. The number of bites/scratches, weight, and grimace scale scores were determined daily. One-way/two-way analysis of variance (ANOVA)/Bonferroni post hoc tests were used (P < .05, GraphPad Prism 5.0). RESULTS: DOI+SAL showed a reduction in neuron cell body area bilaterally, whereas DOI+cel-32 exhibited a significative increase in neuron cell body area compared with DOI+SAL group (P < 0.05). The ipsilateral (P=0.007 and P=0.039) and contralateral (P < 0.001 and P=0.005) overexpression of COX-2 and NFkB and downregulation of PPARy (P=0.016 and P < 0.001) occurred in DOI+SAL, but DOI+cel-32 reverted this alteration. DOI+SAL showed increase in isplateral (P < 0.001) and contralateral (P < 0.001) nociception, an increased number of bites (P=0.010), scratches (P < 0.001), and grimace scores (P=0.032). In the group of DOI+cel-32, these parameters were reduced. CONCLUSIONS: Celecoxib attenuated DOI-induced transitory nociception/orofacial discomfort resulting from trigeminal COX-2 overexpression.


Assuntos
Dor Facial , Gânglio Trigeminal , Animais , Anti-Inflamatórios não Esteroides/farmacologia , Celecoxib/farmacologia , Celecoxib/uso terapêutico , Ciclo-Oxigenase 2/farmacologia , Oclusão Dentária , Modelos Animais de Doenças , Dor Facial/tratamento farmacológico , Feminino , Ratos , Ratos Wistar
19.
PLoS One ; 17(8): e0272715, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35980894

RESUMO

BACKGROUND: Artificial intelligence (AI) algorithms have been applied to diagnose temporomandibular disorders (TMDs). However, studies have used different patient selection criteria, disease subtypes, input data, and outcome measures. Resultantly, the performance of the AI models varies. OBJECTIVE: This study aimed to systematically summarize the current literature on the application of AI technologies for diagnosis of different TMD subtypes, evaluate the quality of these studies, and assess the diagnostic accuracy of existing AI models. MATERIALS AND METHODS: The study protocol was carried out based on the preferred reporting items for systematic review and meta-analysis protocols (PRISMA). The PubMed, Embase, and Web of Science databases were searched to find relevant articles from database inception to June 2022. Studies that used AI algorithms to diagnose at least one subtype of TMD and those that assessed the performance of AI algorithms were included. We excluded studies on orofacial pain that were not directly related to the TMD, such as studies on atypical facial pain and neuropathic pain, editorials, book chapters, and excerpts without detailed empirical data. The risk of bias was assessed using the QUADAS-2 tool. We used Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) to provide certainty of evidence. RESULTS: A total of 17 articles for automated diagnosis of masticatory muscle disorders, TMJ osteoarthrosis, internal derangement, and disc perforation were included; they were retrospective studies, case-control studies, cohort studies, and a pilot study. Seven studies were subjected to a meta-analysis for diagnostic accuracy. According to the GRADE, the certainty of evidence was very low. The performance of the AI models had accuracy and specificity ranging from 84% to 99.9% and 73% to 100%, respectively. The pooled accuracy was 0.91 (95% CI 0.76-0.99), I2 = 97% (95% CI 0.96-0.98), p < 0.001. CONCLUSIONS: Various AI algorithms developed for diagnosing TMDs may provide additional clinical expertise to increase diagnostic accuracy. However, it should be noted that a high risk of bias was present in the included studies. Also, certainty of evidence was very low. Future research of higher quality is strongly recommended.


Assuntos
Inteligência Artificial , Transtornos da Articulação Temporomandibular , Dor Facial , Humanos , Projetos Piloto , Estudos Retrospectivos , Transtornos da Articulação Temporomandibular/diagnóstico
20.
Molecules ; 27(14)2022 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-35889535

RESUMO

BACKGROUND: the endocannabinoid system (ECS) participates in many physiological and pathological processes including pain generation, modulation, and sensation. Its involvement in chronic orofacial pain (OFP) in general, and the reflection of its involvement in OFP in salivary endocannabinoid (eCBs) levels in particular, has not been examined. OBJECTIVES: to evaluate the association between salivary (eCBs) levels and chronic OFP. METHODS: salivary levels of 2 eCBs, anandamide (AEA), 2-arachidonoylglycerol (2-AG), 2 endocannabinoid-like compoundsN-palmitoylethanolamine (PEA), N-oleoylethanolamine (OEA), and their endogenous precursor and breakdown product, arachidonic acid (AA), were analyzed using liquid chromatography/tandem mass spectrometry in 83 chronic OFP patients and 43 pain-free controls. The chronic OFP patients were divided according to diagnosis into musculoskeletal, neurovascular/migraine, and neuropathic pain types. RESULTS: chronic OFP patients had lower levels of OEA (p = 0.02) and 2-AG (p = 0.01). Analyzing specific pain types revealed lower levels of AEA and OEA in the neurovascular group (p = 0.04, 0.02, respectively), and 2-AG in the neuropathic group compared to controls (p = 0.05). No significant differences were found between the musculoskeletal pain group and controls. Higher pain intensity was accompanied by lower levels of AA (p = 0.028), in neuropathic group. CONCLUSIONS: lower levels of eCBs were found in the saliva of chronic OFP patients compared to controls, specifically those with neurovascular/migraine, and neuropathic pain. The detection of changes in salivary endocannabinoids levels related to OFP adds a new dimension to our understanding of OFP mechanisms, and may have diagnostic as well as therapeutic implications for pain.


Assuntos
Transtornos de Enxaqueca , Neuralgia , Endocanabinoides/metabolismo , Dor Facial , Humanos , Saliva/metabolismo
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