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1.
Int J Mol Sci ; 22(11)2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34071720

RESUMO

The oral cavity is a portal into the digestive system, which exhibits unique sensory properties. Like facial skin, the oral mucosa needs to be exquisitely sensitive and selective, in order to detect harmful toxins versus edible food. Chemosensation and somatosensation by multiple receptors, including transient receptor potential channels, are well-developed to meet these needs. In contrast to facial skin, however, the oral mucosa rarely exhibits itch responses. Like the gut, the oral cavity performs mechanical and chemical digestion. Therefore, the oral mucosa needs to be insensitive, to some degree, in order to endure noxious irritation. Persistent pain from the oral mucosa is often due to ulcers, involving both tissue injury and infection. Trigeminal nerve injury and trigeminal neuralgia produce intractable pain in the orofacial skin and the oral mucosa, through mechanisms distinct from those seen in the spinal area, which is particularly difficult to predict or treat. The diagnosis and treatment of idiopathic chronic pain, such as atypical odontalgia (idiopathic painful trigeminal neuropathy or post-traumatic trigeminal neuropathy) and burning mouth syndrome, remain especially challenging. The central integration of gustatory inputs might modulate chronic oral and facial pain. A lack of pain in chronic inflammation inside the oral cavity, such as chronic periodontitis, involves the specialized functioning of oral bacteria. A more detailed understanding of the unique neurobiology of pain from the orofacial skin and the oral mucosa should help us develop novel methods for better treating persistent orofacial pain.


Assuntos
Dor Crônica , Mucosa Bucal , Boca , Animais , Face/fisiologia , Dor Facial , Humanos , Camundongos , Boca/patologia , Boca/fisiologia , Mucosa Bucal/patologia , Mucosa Bucal/fisiologia , Neuralgia , Periodontite , Pele , Fenômenos Fisiológicos da Pele , Traumatismos do Nervo Trigêmeo , Neuralgia do Trigêmeo
2.
Ned Tijdschr Tandheelkd ; 128(5): 277-283, 2021 May.
Artigo em Holandês | MEDLINE | ID: mdl-34009214

RESUMO

The orofacial pain discipline is on the brink of a new era. The introduction of a new definition of pain that, unlike the previous definition, also applies to individuals who cannot verbally express their pain, as well as the publication of the new international classification for orofacial pain, will contribute significantly to the improvement of the quality of the diagnostic process, thus increasing the chance of a successful treatment. Ultimately, the orofacial pain patient will emerge as the winner. The purpose of this article is to introduce the reader to these important recent developments and to provide him/her with an understanding of the implications of these developments for orofacial pain diagnosis and treatment in general and specialized dental practice.


Assuntos
Dor Facial , Dor Facial/diagnóstico , Dor Facial/etiologia , Dor Facial/terapia , Feminino , Humanos , Masculino
3.
J Headache Pain ; 22(1): 42, 2021 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-34022805

RESUMO

BACKGROUND: Headache attributed to Temporomandibular Disorder (HATMD) is a secondary headache that may have features resulting in diagnostic overlap with primary headaches, namely, tension-type (TTH) or migraine. This cross-sectional study of people with both chronic myogenous TMD and primary headaches evaluated characteristics associated with HATMD. METHODS: From a clinical trial of adults, baseline data were used from a subset with diagnoses of both TMD myalgia according to the Diagnostic Criteria for TMD (DC/TMD) and TTH or migraine according to the International Classification of Headache Disorders, 3rd edition. HATMD was classified based on the DC/TMD. Questionnaires and examinations evaluated 42 characteristics of facial pain, headache, general health, psychological distress, and experimental pain sensitivity. Univariate regression models quantified the associations of each characteristic with HATMD (present versus absent), headache type (TTH versus migraine), and their interaction in a factorial design. Multivariable lasso regression identified the most important predictors of HATMD. RESULTS: Of 185 participants, 114 (61.6%) had HATMD, while the numbers with TTH (n = 98, 53.0%) and migraine (n = 87, 47.0%) were similar. HATMD was more likely among migraineurs (61/87 = 70.1%) than participants with TTH (53/98 = 54.1%; odds ratio = 2.0; 95%CL = 1.1, 3.7). In univariate analyses, characteristics associated with HATMD included pain-free jaw opening and examination-evoked pain in masticatory muscles and temporomandibular joints (TMJ) as well as frequency and impact of headache, but not frequency or impact of facial pain. Lowered blood pressure but not psychological or sensory characteristics was associated with HATMD. Multiple characteristics of facial pain, headache, general health, and psychological distress differed between TTH or migraine groups. Few interactions were observed, demonstrating that most characteristics' associations with HATMD were consistent in TTH and migraine groups. The lasso model identified headache frequency and examination-evoked muscle pain as the most important predictors of HATMD. CONCLUSIONS: HATMD is highly prevalent among patients with chronic myogenous TMD and headaches and often presents as migraine. In contrast to primary headaches, HATMD is associated with higher headache frequency and examination-evoked masticatory muscle pain, but with surprisingly few measures of facial pain, general health, and psychological distress. A better understanding of HATMD is necessary for developing targeted strategies for its management. TRIAL IDENTIFICATION AND REGISTRATION: SOPPRANO; NCT02437383 . Registered May 7, 2015.


Assuntos
Transtornos de Enxaqueca , Transtornos da Articulação Temporomandibular , Adulto , Estudos Transversais , Dor Facial , Cefaleia , Humanos , Transtornos de Enxaqueca/complicações , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/epidemiologia
4.
Rev. Odontol. Araçatuba (Impr.) ; 42(1): 49-53, jan.-abr. 2021. graf, tab
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1252876

RESUMO

Objetivo: Objetivou-se investigar as possíveis relações entre as Disfunções Temporomandibulares com alterações do Sistema Vestibular (SV). Métodos: Estudo descritivo com abordagem quantitativa realizado em 09 pacientes com idade média entre 18 e 40 anos. Os participantes foram recrutados no grupo de estudo e pesquisa em Fisioterapia e Odontologia na Dor Orofacial (FISIODOF) da Universidade de Fortaleza. O presente estudo foi aprovado pelo comitê de ética, com parecer N° 1.310.583. Resultados: De acordo com o RDC/TMD, 3 casos são do grupo G1, 1 caso é do grupo G2, 1 casos é do grupo G1 e G2, e os outros 4 casos como grupos G1 e G3. Todos os pacientes apresentaram resultados negativo no teste de Fukuda. Já na Manobra de Dix-Hallpike 3 pacientes apresentaram resultado positivo. Discussão: A hipertonia muscular é descrita como principal responsável pelos sintomas auditivos e vestibulares de pacientes com DTM. Entretanto, não existe uma relação precisa descrita na literatura entre DTM e disfunção do sistema vestibular. Conclusão: A DTM pode causar alterações no sistema vestibular, explicadas pelo fato das estruturas da articulação temporomandibular e sistema vestibular serem anatomicamente próximas. No entanto, outras pesquisas se fazem necessárias para caracterizar os achados vestibulares em portadores de disfunção temporomandibular(AU)


Objective: The objective was to investigate the possible relationships between Temporomandibular Disorders with changes in the Vestibular System (SV). Methods: Descriptive study with a quantitative approach conducted in 09 patients with a mean age between 18 and 40 years. Participants were recruited from the study and research group in Physiotherapy and Dentistry in Orofacial Pain at the University of Fortaleza. This study was approved by the ethics committee, No. 1,310,583. Results: According to the RDC / TMD, 3 cases are from the G1 group, 1 case is from the G2 group, 1 case are from the G1 and G2 group, and the 4 other cases are from the G1 and G3 groups. All patients had a negative Fukuda test result. In the Dix-Hallpike maneuver, 3 patients had a positive result. Discussion: Muscular hypertonia is described as the main responsible for the auditory and vestibular symptoms of patients with TMD. However, there is no precise relationship described in the literature between TMD and vestibular system dysfunction. Conclusion: TMD can cause changes in the vestibular system, explained by the fact that the structures of the temporomandibular joint and the vestibular system are anatomically close. However, further research is necessary to characterize vestibular findings in patients with temporomandibular disorders(AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Dor Facial , Síndrome da Disfunção da Articulação Temporomandibular , Vestíbulo do Labirinto , Articulação Temporomandibular , Transtornos da Articulação Temporomandibular , Especialidade de Fisioterapia , Hipertonia Muscular
5.
J Oral Rehabil ; 48(7): 836-845, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33817818

RESUMO

BACKGROUND: Since in children and adolescence prevalence is assessed mainly on self-reported or proxy-reported signs and symptoms; there is a need to develop a more comprehensive standardised process for the collection of clinical information and the diagnosis of TMD in these populations. OBJECTIVE: To develop new instruments and to adapt the diagnostic criteria for temporomandibular disorders (DC/TMD) for the evaluation of TMD in children and adolescents. METHOD: A modified Delphi method was used to seek international consensus among TMD experts. Fourteen clinicians and researchers in the field of oro-facial pain and TMD worldwide were invited to participate in a workshop initiated by the International Network for Orofacial Pain and Related Disorders Methodology (INfORM scientific network) at the General Session of the International Association for Dental Research (IADR, London 2018), as the first step in the Delphi process. Participants discussed the protocols required to make physical diagnoses included in the Axis I of the DC/TMD. Thereafter, nine experts in the field were added, and the first Delphi round was created. This survey included 60 statements for Axis I, and the experts were asked to respond to each statement on a five-item Likert scale ranging from 'Strongly disagree' to 'Strongly agree'. Consensus level was set at 80% agreement for the first round, and at 70% for the next. RESULTS: After three rounds of the Delphi process, a consensus among TMD experts was achieved and two adapted DC/TMD protocols for Axis I physical diagnoses for children and adolescents were developed. CONCLUSION: Through international consensus among TMD experts, this study adapted the Axis I of the DC/TMD for use in evaluating TMD in children and adolescents.


Assuntos
Transtornos da Articulação Temporomandibular , Adolescente , Criança , Consenso , Técnica Delfos , Dor Facial/diagnóstico , Humanos , Londres , Transtornos da Articulação Temporomandibular/diagnóstico
6.
J Headache Pain ; 22(1): 31, 2021 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-33902429

RESUMO

BACKGROUND: Trigeminal neuralgia is a characteristic disease that manifests as orofacial phasic or continuous severe pain triggered by innocuous orofacial stimulation; its mechanisms are not fully understood. In this study, we established a new animal model of trigeminal neuralgia and investigated the role of P2X3 receptor (P2X3R) alteration in the trigeminal ganglion (TG) via tumor necrosis factor alpha (TNFα) signaling in persistent orofacial pain. METHODS: Trigeminal nerve root compression (TNC) was performed in male Sprague-Dawley rats. Changes in the mechanical sensitivity of whisker pad skin, amount of TNFα in the TG, and number of P2X3R and TNF receptor-2 (TNFR2)-positive TG neurons were assessed following TNC. The effects of TNFR2 antagonism in TG and subcutaneous P2X3R antagonism on mechanical hypersensitivity following TNC were examined. RESULTS: TNC induced unilateral continuous orofacial mechanical allodynia, which was depressed by carbamazepine. The accumulation of macrophages showing amoeboid-like morphological changes and expression of TNFα in the TG was remarkably increased following TNC treatment. The number of P2X3R- and TNFR2-positive TG neurons innervating the orofacial skin was significantly increased following TNC. TNFα was released from activated macrophages that occurred in the TG following TNC, and TNFR2 antagonism in the TG significantly diminished the TNC-induced increase in P2X3R-immunoreactive TG neurons. Moreover, subcutaneous P2X3R antagonism in the whisker pad skin significantly depressed TNC-induced mechanical allodynia. CONCLUSIONS: Therefore, it can be concluded that the signaling of TNFα released from activated macrophages in the TG induces the upregulation of P2X3R expression in TG neurons innervating the orofacial region, resulting in orofacial mechanical allodynia following TNC.


Assuntos
Neuralgia , Neuralgia do Trigêmeo , Animais , Dor Facial , Hiperalgesia , Macrófagos , Masculino , Neurônios , Ratos , Ratos Sprague-Dawley , Gânglio Trigeminal , Fator de Necrose Tumoral alfa , Regulação para Cima
7.
Dtsch Arztebl Int ; 118(6): 81-87, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33827748

RESUMO

BACKGROUND: Idiopathic facial pain syndromes are relatively rare. A uniform classification system for facial pain became available only recently, and many physicians and dentists are still unfamiliar with these conditions. As a result, patients frequently do not receive appropriate treatment. METHODS: This article is based on pertinent publications retrieved by a selective search in PubMed, focusing on current international guidelines and the International Classification of Orofacial Pain (ICOP). RESULTS: The ICOP subdivides orofacial pain syndromes into six major groups, the first three of which consist of diseases of the teeth, the periodontium, and the temporomandibular joint. The remaining three groups (non-dental facial pain) are discussed in the present review. Attack-like facial pain syndromes most closely resemble the well-known primary headache syndromes, such as migraine, but with pain located below the orbitomeatal line. These syndromes are treated in accordance with the guidelines for the corresponding types of headache. Persistent idiopathic facial pain (PIFP) is a chronic pain disorder with persistent, undulating pain in the face and/or teeth, without any structural correlate. Since this type of pain tends to become chronified after invasive procedures, no dental procedures should be performed to treat it if the teeth are healthy; rather, the treatmentis similar to that of neuropathic pain, e.g., with antidepressant and anticonvulsive drugs. Neuropathic facial pain is also undulating and persistent. It is often described as a burning sensation, and neuralgiform attacks may additionally be present. Trigeminal neuralgia is a distinct condition involving short-lasting, lancinating pain of high intensity with a maximum duration of two minutes. The first line of treatment is with medications; invasive treatment options should be considered only if pharmacotherapy is ineffective or poorly tolerated. CONCLUSION: With the aid of this pragmatic classification system, the clinician can distinguish persistent and attack-like primary facial pain syndromes rather easily and treat each syndrome appropriately.


Assuntos
Neuralgia Facial , Neuralgia , Neuralgia do Trigêmeo , Neuralgia Facial/diagnóstico , Neuralgia Facial/terapia , Dor Facial/diagnóstico , Dor Facial/terapia , Cefaleia , Humanos
8.
BMC Oral Health ; 21(1): 211, 2021 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-33902543

RESUMO

BACKGROUND: Temporomandibular disorders (TMD) are a broad category of conditions arising from the various components of the temporomandibular joint complex. Bio-psychosocial model is the most accepted theory describing the etiopathogenesis of TMD. Dental students are vulnerable to psychological disorders, including anxiety, depression, and stress. Hence, the aim of the current study was to evaluate the prevalence and possible risk factors of TMD among dental students of various academic levels and explore the association of TMDs with demographic, academic, and psychosocial parameters. METHODS: A total of 246 students of a Saudi Arabia dental school were chosen for the study. After getting consent, all students were examined according to the Diagnostic Criteria for Temporomandibular Disorders, including Axis I and II components. RESULTS: The overall cross-sectional prevalence of TMD was found to be 36.99%. Pain arising from the jaw, temple, and the peri-auricular area were the most commonly reported symptoms and elicited signs during examination. Among the pain-related TMD, myalgia was the commonest diagnosed condition, whereas disc displacement with reduction was found prevalent in the intra-articular disorder category. Female (OR = 1.94; P = 0.004), married (OR = 1.74; P = 0.04), and students in clinical academic levels (OR = 1.65; P = 0.03) were found to have significantly increased risk of TMD. Among the psychosocial parameters, anxiety (OR = 1.55; P = 0.04) and parafunctional behaviours (OR = 2.10; P < 0.001) were shown to increase the risk of developing TMD. Students with any TMD reported to have significantly higher pain intensity levels (OR = 1.68; P = 0.01) and jaw functional limitations (OR = 1.45; P = 0.008). CONCLUSION: Dental students, especially in clinical levels were shown to pose a higher risk of developing TMD, hence strategies such as academic counselling and objective evaluation via rubrics should be planned to modify the administration of the curriculum, training methods and evaluation process.


Assuntos
Estudantes de Odontologia , Transtornos da Articulação Temporomandibular , Estudos Transversais , Dor Facial/epidemiologia , Dor Facial/etiologia , Feminino , Humanos , Arábia Saudita/epidemiologia , Transtornos da Articulação Temporomandibular/diagnóstico , Transtornos da Articulação Temporomandibular/epidemiologia , Transtornos da Articulação Temporomandibular/etiologia
9.
J Headache Pain ; 22(1): 22, 2021 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-33832438

RESUMO

Headache and facial pain are among the most common, disabling and costly diseases in Europe, which demands for high quality health care on all levels within the health system. The role of the Danish Headache Society is to educate and advocate for the needs of patients with headache and facial pain. Therefore, the Danish Headache Society has launched a third version of the guideline for the diagnosis, organization and treatment of the most common types of headaches and facial pain in Denmark. The second edition was published in Danish in 2010 and has been a great success, but as new knowledge and treatments have emerged it was timely to revise the guideline. The recommendations for the primary headaches and facial pain are largely in accordance with the European guidelines produced by the European Academy of Neurology. The guideline should be used a practical tool for use in daily clinical practice for primary care physicians, neurologists with a common interest in headache, as well as other health-care professionals treating headache patients. The guideline first describes how to examine and diagnose the headache patient and how headache treatment is organized in Denmark. This description is followed by sections on the characteristics, diagnosis and treatment of each of the most common primary and secondary headache disorders and trigeminal neuralgia. The guideline includes many tables to facilitate a quick overview. Finally, the particular challenges regarding migraine and female hormones as well as headache in children are addressed.


Assuntos
Transtornos da Cefaleia , Cefaleia , Criança , Dinamarca , Europa (Continente) , Dor Facial/diagnóstico , Dor Facial/terapia , Feminino , Cefaleia/diagnóstico , Cefaleia/terapia , Transtornos da Cefaleia/diagnóstico , Transtornos da Cefaleia/terapia , Humanos
10.
Dent Med Probl ; 58(1): 17-25, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33847470

RESUMO

BACKGROUND: It is of utmost importance to identify and treat groups susceptible to psychological problems during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVES: This study aimed to compare the psychological status between the general population and subjects with orofacial pain (OFP) during the COVID-19 pandemic. MATERIAL AND METHODS: A total of 509 young adults were recruited based on the inclusion and exclusion criteria, using the convenient sampling approach. They were assigned to 2 study groups: group 1 - individuals with OFP; and group 2 - the general population. Their background variables, knowledge, perception, attitude, concerns, and Kessler scale scores were recorded through an online questionnaire. Student's t test, the χ2 test, Pearson's correlation coefficient, and one-way analysis of variance (ANOVA) were used for the statistical analysis. RESULTS: Some of the background variables were significantly different between the study groups (p < 0.05). The knowledge, perception and attitude scores of the respondents were not significantly different between the study groups (p > 0.05). Females exhibited significantly higher adjusted Kessler scores as compared to males (p < 0.05). Group 1 exhibited the highest adjusted Kessler scores (p < 0.05). CONCLUSIONS: Individuals with OFP exhibited higher psychological distress, depressive symptoms and anxiety during the rapid rise of the COVID-19 outbreak, representing a moderate psychological disorder. Females suffered more from psychological distress as compared to males. Therefore, psychological interventions should be focused on this group.


Assuntos
Angústia Psicológica , Depressão/epidemiologia , Dor Facial/epidemiologia , Feminino , Humanos , Masculino , Pandemias , Adulto Jovem
11.
J Oral Rehabil ; 48(7): 765-773, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33774844

RESUMO

BACKGROUND: Temporomandibular disorders (TMDs) are multifactorial, and high levels of stress seem to increase symptoms. The association with exposure to violence has not been explored in adolescent populations. OBJECTIVE: To examine the association of self-reported symptoms of temporomandibular pain and jaw dysfunction with child physical abuse, intimate partner violence, forced sexual intercourse, and bullying victimisation. METHODS: An epidemiological, cross-sectional, school-based study was conducted in Olinda, northeast Brazil. The sample comprised 2,431 adolescents aged 14-19 years. TMD-related symptoms and exposure to violence were assessed with questions from the 3Q/TMD screener and queries on exposure to different forms of violence. Multilevel logistic regressions were conducted to evaluate how 3Q screen-positive responses are associated with self-reported exposure to violence. RESULTS: Self-reported TMD-related symptoms had a prevalence of 40.5%. Significantly more females than males screened positive to all 3Q/TMD questions (p < .001). Adolescents experiencing intimate partner violence (p = .012) and bullying (p < .001) had significantly higher odds of 3Q positive responses than those who reported no exposure to violence. Significant associations of TMD-related symptoms with forced sexual intercourse (p = .014) and with bullying (p = .007) were observed. CONCLUSION: Adolescents with self-reported symptoms of temporomandibular pain and jaw dysfunction were significantly more often exposed to some type of violence. The number of adolescents reporting TMD-related symptoms increased in a dose-response manner with the number of violence forms the individual had experienced.


Assuntos
Exposição à Violência , Adolescente , Brasil/epidemiologia , Criança , Estudos Transversais , Dor Facial/epidemiologia , Dor Facial/etiologia , Feminino , Humanos , Masculino , Prevalência , Autorrelato
12.
J Oral Rehabil ; 48(5): 542-550, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33682178

RESUMO

INTRODUCTION: Clinical presentation of oromandibular dystonia (OMD) is variable that can be further complicated by the presence of temporomandibular disorder (TMD) symptoms. We sought to evaluate variations in the clinical presentation of OMD patients, particularly TMD-related characteristics, in two clinical settings. METHODS: In a cross-sectional study design, a Web-based data collection survey was provided to eligible patients with OMD from movement disorder (MD) and oro-facial pain (OFP) clinics. The survey questionnaire was designed to collect information on demographic characteristics, clinical presentation particularly related to TMD, quality of life and treatment outcomes. Validated questionnaires were used when available such as the TMD Pain Screener, EuroQol 5-Dimensions 5-Levels (EQ-5D-5L), Jaw Functional Limitation Scale and Global Rating of Change Scale. RESULTS: Of 53 eligible patients, 31 responded to the survey for a 58% response rate. Forty-eight per cent of patients in the MD clinic and 60% of patients in the OFP clinic reported jaw pain along with involuntary movements. Of those, 90% from the MD group and 83% from the OFP group screened positive with the TMD Pain Screener at the onset of symptoms based on recall. Positive TMD Pain Screener response was observed in about 40% of patients in both clinics within 30 days of questionnaire response. No statistically significant differences were observed between two groups for any measured variables. CONCLUSION: Patients with OMD have features of TMD, irrespective of the clinical setting in which they seek and receive care. OMD patients from both clinics were similar in terms of clinical presentation, quality of life and treatment outcomes.


Assuntos
Distonia , Transtornos da Articulação Temporomandibular , Estudos Transversais , Dor Facial , Humanos , Qualidade de Vida , Transtornos da Articulação Temporomandibular/complicações , Resultado do Tratamento
13.
J Oral Rehabil ; 48(6): 643-653, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33710632

RESUMO

BACKGROUND: Pain catastrophising is a maladaptive cognitive response characterised by an exaggerated negative interpretation of pain experiences. It has been associated with greater disability and poorer outcomes in chronic pain, to include several specific oro-facial pain conditions. The goal of this study was to examine pain catastrophising at a military oro-facial pain specialty clinic. METHODS: This retrospective chart review (RCR) examined information collected at initial examination from 699 new patients seen between September 2016 and August 2019 at the Orofacial Pain Center at the Naval Postgraduate Dental School (Bethesda, MD). Pain catastrophising, pain characteristics, psychosocial factors and sleep were assessed using standardised scales. Linear regression was used to evaluate associations of patient characteristics and pain intensity with pain catastrophising. Mediation analyses were done to characterise the extent to which the relationship between pain intensity and pain catastrophising may be explained by anxiety, depression and insomnia. RESULTS: Higher pain intensity, depression, anxiety, insomnia and younger age were each associated with higher pain catastrophising (all p < .05). A primary diagnosis of neuropathic pain was the strongest independent predictor of higher pain catastrophising. The relationship between pain intensity and pain catastrophising was partially mediated by anxiety, depression and insomnia. CONCLUSIONS: In this RCR of a population of oro-facial pain patients, those diagnosed with neuropathic pain were most likely to display high levels of pain catastrophising, a characteristic which is associated with poor long-term pain outcomes. This is the first study to show that, independent of other patient characteristics, those suffering from neuropathic pains displayed the highest levels of pain catastrophising. This highlights the importance of also addressing psychosocial factors in the treatment of neuropathic pain conditions, which are commonly treated using a predominantly biomedical approach. Additionally, anxiety, depression and insomnia each partially explains the relationship between pain intensity and pain catastrophising.


Assuntos
Dor Crônica , Dor Facial , Ansiedade , Dor Facial/epidemiologia , Humanos , Medição da Dor , Estudos Retrospectivos
14.
J Oral Sci ; 63(2): 170-173, 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33731507

RESUMO

PURPOSE: Infantile tissue injury induces sensory deficits in adulthood. Infantile facial incision (IFI) was reported to cause an enhancement of incision-induced mechanical hypersensitivity in adulthood due to acceleration of the trigeminal ganglion neuronal excitability. However, the effects of IFI on activation of microglia in the spinal trigeminal nucleus and its involvement in facial pain sensitivity is not well known. METHODS: A facial skin incision was made in the left whisker pad in infant (IFI) and/or adult rats (AFI). Mechanical head withdrawal threshold and microglial activation in the trigeminal spinal nucleus were analyzed. RESULTS: Mechanical pain hypersensitivity induced by AFI was significantly exacerbated and prolonged by IFI. The number of Iba1-immunoreactive cells in the trigeminal spinal nucleus following AFI was increased by IFI, suggesting that IFI facilitates microglial hyperactivation following AFI. Intraperitoneal administration of minocycline, a microglial activation inhibitor, suppressed the facial incision-induced microglial hyperactivation in the trigeminal spinal nucleus and the exacerbation of the facial mechanical pain hypersensitivity induced by IFI. CONCLUSION: These results suggest that facial trauma in infants causes hyperactivation of microglia in the trigeminal spinal nucleus following AFI, leading to the prolongation of the facial mechanical pain hypersensitivity.


Assuntos
Hiperalgesia , Microglia , Animais , Dor Facial/etiologia , Hiperalgesia/etiologia , Ratos , Ratos Sprague-Dawley , Gânglio Trigeminal
15.
J Am Dent Assoc ; 152(4): 257-258, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33775283
16.
FP Essent ; 501: 17-23, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33595264

RESUMO

Temporomandibular disorders (TMDs) is a collective term for a group of heterogeneous musculoskeletal and neuromuscular conditions involving the temporomandibular joint (TMJ) complex, masticatory muscles, and surrounding osseous structures. TMDs affect 5% to 12% of the US population, with a peak incidence at ages 45 to 65 years. Common clinical manifestations include facial pain, ear pain, headache, TMJ discomfort, and adventitious sounds. The etiologies of TMDs are multifactorial and include behavioral, social, emotional, and occlusive factors. Common causes of TMDs are myofascial pain and dysfunction, articular disk displacement, and degenerative joint conditions. In most cases, the diagnosis can be made based on the history and physical examination. In the absence of trauma, imaging typically is reserved for patients with chronic TMDs. Initial management includes education, self-management, behavioral therapy, and physical therapy. Occlusal devices are recommended for management of sleep bruxism or diurnal clenching. Adjunctive pharmacotherapies include nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines, antidepressants, and anticonvulsants. (This is an off-label use of some NSAIDs and an off-label use of benzodiazepines, antidepressants, and anticonvulsants.) Intra-articular injections have been used alone or with arthrocentesis. Patients who do not benefit from these therapies should be referred to an oral and maxillofacial surgeon.


Assuntos
Transtornos da Articulação Temporomandibular , Idoso , Dor Facial/diagnóstico , Dor Facial/etiologia , Dor Facial/terapia , Cefaleia/etiologia , Cefaleia/terapia , Humanos , Injeções Intra-Articulares , Pessoa de Meia-Idade , Articulação Temporomandibular , Transtornos da Articulação Temporomandibular/tratamento farmacológico , Transtornos da Articulação Temporomandibular/terapia
18.
Pain Res Manag ; 2021: 6664736, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33628353

RESUMO

Trigeminal neuralgia is often misdiagnosed at initial presentation due to close connotation with dental pain and is often over diagnosed for the very same reasons leading to numerous unnecessary surgical procedures such as peripheral neurectomy and alcohol injections, while the actual cause may remain elusive for decades. Evaluation of the neurosensory system may disclose the correct anatomical location of the etiology. The neurological examination may be clouded by the sensory deficits subsequent to previous peripheral surgical procedures. The corneal and blink reflexes are integral measures of the trigeminal and facial neurosensory assessment, and their abnormal function may facilitate the identification of intrinsic disease of the brain stem. These reflexes can be employed to discover pathological lesions including intracranial space-occupying trigeminal, lateral medullary, cerebral hemispheric lesions, and degenerative diseases of the central nervous system. Dental surgeons and oral and maxillofacial surgeons should consider corneal reflex in neurological assessment of patient presenting with trigeminal neuralgia-like symptoms. Failure to evaluate corneal sensitivity may lead to delayed or inaccurate diagnosis and unsuitable or redundant treatment interventions. This simple noninvasive reflex can be performed by chair-side and may provide significant information regarding the origin of facial pain and is an invaluable part of clinical methods especially in remote and peripheral healthcare center practitioners where sophisticated radiographic investigations such as computed tomography and magnetic resonance imaging may not be available.


Assuntos
Piscadela/fisiologia , Córnea/fisiologia , Dor Facial/diagnóstico , Exame Neurológico/métodos , Reflexo/fisiologia , Neuralgia do Trigêmeo/diagnóstico , Humanos , Imageamento por Ressonância Magnética
19.
Pain Res Manag ; 2021: 6674102, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33628354

RESUMO

Objective: First bite syndrome (FBS) is a condition in which the first bite of each meal causes parotid pain. Etiologies of FBS include prior surgery of the upper cervical region and, rarely, head and neck tumors. Idiopathic FBS rarely presents in patients without a history of surgery or evidence of an underlying tumor. Idiopathic FBS may be categorized into two subtypes: that in patients with diabetes and that in patients without diabetes. Idiopathic FBS in patients without diabetes may be overlooked or misdiagnosed because the condition has been described only in a few case reports. We aimed to identify the clinical and pain-related characteristics of idiopathic FBS in patients without diabetes. Methods: We retrospectively analyzed the clinical data of five patients without diabetes who were diagnosed with idiopathic FBS in our department between January 2010 and December 2016. Results: Four of the five patients were female, and the overall median age was 52 years (range: 13-61). All patients immediately experienced parotid pain upon tasting food without chewing. Addition of an acidic solution to the ipsilateral posterior third of the tongue evoked parotid pain. The median degree of pain intensity and interference with eating due to pain was 9 (range: 3-10) and 9 (range: 5-10) on a numerical rating scale of 0-10, respectively. Idiopathic FBS was bilateral in two patients. Two patients had tenderness on mild pressure over the affected parotid region. Two patients presented with ipsilateral idiopathic Horner's syndrome. Conclusions: Our findings indicate that the characteristics of idiopathic FBS in patients without diabetes are largely consistent with those previously reported in postoperative FBS, supporting the notion that idiopathic FBS is a subtype of FBS. Thus, it is necessary to consider idiopathic FBS during the evaluation of facial pain triggered at the beginning of a meal.


Assuntos
Dor Facial/fisiopatologia , Glândula Parótida/fisiopatologia , Paladar/fisiologia , Adolescente , Adulto , Dor Facial/diagnóstico , Dor Facial/etiologia , Dor Facial/patologia , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Síndrome , Adulto Jovem
20.
BMJ Case Rep ; 14(1)2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33414118

RESUMO

Eagle Syndrome (ES), also termed stylohyoid syndrome or styloid syndrome, is a rare condition characterised by a cluster of symptoms related to an elongation of the styloid process (SP) of the temporal bone. These may range from mild pharyngeal foreign body sensation and dysphagia to severe orofacial pain. High clinical suspicion is necessary owing to the unspecific clinical picture and limited diagnostic clues. Until a definitive diagnosis is achieved, these patients may develop symptoms which significantly impact their quality of life. The aim of this article is to report a case of ES in which a considerable length of SP was documented. Diagnosis was made years after the initial complaints and several medical workups by different specialties. Surgical resection of the elongated process by cervical approach was the adopted treatment modality. Patient recovery and follow-up was satisfactory, with remission of the afflicting symptoms.


Assuntos
Dor Facial/etiologia , Ossificação Heterotópica/complicações , Ossificação Heterotópica/diagnóstico , Osso Temporal/anormalidades , Diagnóstico Tardio , Feminino , Humanos , Pessoa de Meia-Idade , Ossificação Heterotópica/cirurgia , Osso Temporal/cirurgia
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