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1.
J Oral Facial Pain Headache ; 34(3): 206-216, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32870949

RESUMO

Within the orofacial pain discipline, the most common group of afflictions is temporomandibular disorders (TMD). The pathologic and functional disorders included in this condition closely resemble those that are seen in the orthopedic medicine branch of the medical profession, so it would be expected that the same principles of orthopedic diagnosis and treatment are applied. Traditional orthopedic therapy relies on a "Two Pathway" approach involving conservative and/or surgical treatments. However, over the course of the 20th century, some members of the dental community have created another way of approaching these disorders- referred to in this paper as the "Third Pathway"-based on the assumption that signs and symptoms of TMD are due to a "bad" relationship between the mandible and skull, leading to a variety of irreversible occlusal or surgical corrective treatments. Since no other human joint is discussed in these terms within the orthopedic medicine communities, it has become progressively clear that the Third Pathway is a unique and artificial conceptual creation of the dental profession. However, many clinical studies have utilized the medically oriented conservative/surgical Two-Pathway model to diagnose and treat TMD within a biopsychosocial model of pain. These studies have shown that TMD comprise another domain of orthopedic illness that requires a medically oriented approach for good outcomes while avoiding the irreversible aspects of the Third Pathway. This review presents historical and current evidence that the Third Pathway is an example of unorthodox medicine that leads to unnecessary overtreatment and further proposes that it is time to abandon this approach as we move forward in the TMD field.


Assuntos
Transtornos da Articulação Temporomandibular , Dor Facial , Humanos , Mandíbula
2.
J Oral Facial Pain Headache ; 34(3): 255-264, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32870954

RESUMO

Entrustable professional activities (EPAs) are a curriculum development and learner assessment tool that ensure a trainee is able to safely translate the skills they have learned during residency into unsupervised clinical practice. Although EPAs are used extensively across various health professions worldwide, dentistry is just beginning to call for their development at both the predoctoral and postgraduate levels. Given the complex, multifactorial nature of orofacial pain disorders and the need for an interdisciplinary approach to management, the specialty of orofacial pain is well suited to embracing EPAs to ensure program graduates are prepared for practice. Therefore, 10 EPAs have been developed in a combined effort from program directors from every CODA-accredited postgraduate orofacial pain residency program.


Assuntos
Educação Baseada em Competências , Internato e Residência , Competência Clínica , Dor Facial , Humanos
3.
J Oral Facial Pain Headache ; 34(3): 265-272, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32870955

RESUMO

AIMS: To examine the associations of self-reported presence of tinnitus with subtypes of temporomandibular disorders (TMD) as assessed by Axis I of the Diagnostic Criteria for TMD (DC/TMD) and with psychologic characteristics as assessed by Axis II. METHODS: This retrospective controlled study included 108 consecutive TMD patients referred to the Tel Aviv University Orofacial Pain Clinic. Each patient received full Axis I and Axis II diagnoses according to the DC/TMD. The patients were asked about currently experiencing tinnitus. Pearson chi-square test and Fisher exact test were used to test the associations between categorical variables. Mann-Whitney test was used to assess differences in continuous variables between categories. A P value < .05 was considered statistically significant. RESULTS: Thirty-three (30.6%) TMD patients reported experiencing tinnitus. There was a significantly higher prevalence of myofascial pain with referral (P = .008) and nonspecific physical symptoms (P = .014) among the TMD patients who reported tinnitus. In addition, those patients reported significantly longer pain duration compared to TMD patients without tinnitus (P = .039). CONCLUSION: This study emphasizes the necessity of assessing both Axes I and II according to the DC/TMD in future studies and supports creating a standardized tinnitus screener tailored to TMD patients for future studies on tinnitus in TMD patients.


Assuntos
Transtornos da Articulação Temporomandibular , Zumbido , Dor Facial , Humanos , Estudos Retrospectivos , Autorrelato
4.
J Oral Facial Pain Headache ; 34(3): 273-280, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32870956

RESUMO

AIMS: To examine if the existence of an association between self-reported awake oral behaviors and orofacial pain depends on the belief of patients that these behaviors are harmful to the jaw and to investigate if an additional variable (ie, somatic symptoms, depression, and/or anxiety) indirectly affects the association between the causal attribution belief and the report of awake oral behaviors. METHODS: Prior to the first clinical visit, patients referred to a specialized clinic for complaints of orofacial pain and dysfunction completed a digital questionnaire. Data of 329 patients diagnosed with myalgia according to the Diagnostic Criteria for Temporomandibular Disorders (82.4% women; mean ± SD age = 41.9 ± 14.7 years) were analyzed. RESULTS: Causal attribution belief moderated the association between awake oral behaviors and orofacial pain intensity. In addition, the relationship between causal attribution belief and self-reported oral behaviors was partially mediated by the presence of somatic symptoms (8%), depression (9%), and anxiety (16%). CONCLUSION: Awake oral behaviors were positively associated with orofacial pain, but only under the condition of a strong belief of the patients in causal attribution of these behaviors to the jaw pain complaint. No such association was present in case of a low causal attribution belief. It appeared that, within this patient cohort, the relationship between causal attribution belief and self-reported oral behaviors was (in part) the result of shared psychologic risk factors.


Assuntos
Transtornos da Articulação Temporomandibular , Vigília , Dor Facial , Feminino , Humanos , Masculino , Autorrelato , Inquéritos e Questionários
5.
Braz Dent J ; 31(4): 360-367, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32901710

RESUMO

The aim of this study was to construct a predictive model that uses classification tree statistical analysis to predict the occurrence of temporomandibular disorder, by dividing the sample into groups of high and low risk for the development of the disease. The use of predictive statistical approaches that facilitate the process of recognizing and/or predicting the occurrence of temporomandibular disorder is of interest to the scientific community, for the purpose of providing patients with more adequate solutions in each case. This was a cross-sectional analytical population-based study that involved a sample of 776 individuals who had sought medical or dental attendance at the Family Health Units in Recife, PE, Brazil. The sample was submitted to anamnesis using the instrument Research Diagnostic Criteria for Temporomandibular Disorders. The data were inserted into the software Statistical Package for the Social Sciences 20.0 and analyzed by the Pearson Chi-square test for bivariate analysis, and by the classification tree method for the multivariate analysis. Temporomandibular disorder could be predicted by orofacial pain, age and depression. The high-risk group was composed of individuals with orofacial pain, those between the ages of 25 and 59 years and those who presented depression. The low risk group was composed of individuals without orofacial pain. The authors were able to conclude that the best predictor for temporomandibular disorder was orofacial pain, and that the predictive model proposed by the classification tree could be applied as a tool for simplifying decision making relative to the occurrence of temporomandibular disorder.


Assuntos
Dor Facial , Transtornos da Articulação Temporomandibular , Adulto , Brasil , Estudos Transversais , Humanos , Pessoa de Meia-Idade , Fatores de Risco
7.
Swiss Dent J ; (7-8): 593-598, 2020 Jul 20.
Artigo em Alemão | MEDLINE | ID: mdl-32674531

RESUMO

The interdisciplinary Orofacial Pain Unit at the Center of Dental Medicine of the University of Zurich celebrates its 15th anniversary. This article outlines the evidence-based integrative treatment concept with a focus on psychosocial aspects of pain. We exemplify how the evaluation and treatment by a pain psychologist complements the dental therapy. For example, self-management techniques can assist in reducing apprehension, worries and fears, which are often associated with an increased tone of the masticatory muscles. Manifestations include clenching and grinding of teeth, orofacial pain, and other less specific symptoms such as tinnitus. The clinical relevance is illustrated by selected case studies from routine clinical practice.


Assuntos
Dor Facial , Transtornos da Articulação Temporomandibular , Humanos , Músculos da Mastigação
8.
Ned Tijdschr Tandheelkd ; 127(6): 352-357, 2020 Jun.
Artigo em Holandês | MEDLINE | ID: mdl-32716398

RESUMO

In the context of the growing knowledge about the influence of psychosocial factors on health, this article focuses on the role of stress in painful temporomandibular disorder and oral habits. Knowledge about the influence of stress on health, oral habits, and painful temporomandibular disorders is summarized, making clear that although knowledge is increasing, there is a lot still unclear. With regards to oral habits, it turns out that awake oral habits are, but oral habits during sleep are not influenced by stress, but better diagnostic procedures and more research distinguishing the different types of oral habits are needed in order to further our understanding. Increasing knowledge about the aetiology of painful temporomandibular disorders is showing a complex interplay of aetiological factors. Stress and oral habits are part of this, but much remains to be discovered about the way in which the aetiological factors interact and influence outcomes. When it comes to stress, especially childhood adversity appears to be a promising focus for further research.


Assuntos
Hábitos , Transtornos da Articulação Temporomandibular , Criança , Dor Facial , Humanos , Dor
9.
J Oral Rehabil ; 47(8): 939-943, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32484972

RESUMO

BACKGROUND: Patients with Down syndrome (DS) present functional and anatomical alterations that may negatively impact their health and quality of life. Down syndrome patients have been shown to have a high prevalence of temporomandibular disorder (TMD), but little is known about the diagnosis, treatment and prevention in these individuals. OBJECTIVE: To evaluate the impact of a home-based multidisciplinary programme on muscular TMD in DS adults. METHODS: After being diagnosed with TMD-related masticatory muscle disorder, 20 adult men and 20 adult women with DS received an educational material with instructions on how to perform daily home facial self-massage and exercises for orofacial and masticatory muscles. Participants were also provided with educational information on TMD. Those who failed to perform at least 50% of the programme (23 days) were considered non-adherent. Oral parafunctional behaviours, facial pressure-pain threshold and maximum mouth opening were assessed at baseline and after the intervention. RESULTS: Twenty-five patients adhered to the programme as opposed to 15 non-adherent patients. Statistically significant improvements in all parameters were observed among adherent patients, except for the number of parafunctions. CONCLUSION: The proposed home-based multidisciplinary programme seemed to be effective in improving some aspects related to muscular TMD in DS adults.


Assuntos
Síndrome de Down , Transtornos da Articulação Temporomandibular , Adulto , Dor Facial , Feminino , Humanos , Masculino , Músculos da Mastigação , Qualidade de Vida
10.
J Am Dent Assoc ; 151(7): 469-471, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32593342
11.
Artigo em Inglês | MEDLINE | ID: mdl-32540317

RESUMO

OBJECTIVE: The aim of this study was to describe the prevalence and clinical characteristics of patients with oromandibular dystonia (OMD) presenting to an academic orofacial pain clinic. OMD diagnosis was based on clinical signs and symptoms, presenting in varied forms and severities. Knowledge of clinical characteristics would help in early diagnosis and treatment of OMD. STUDY DESIGN: In this retrospective study, we identified patients with OMD (International Classification of Diseases [ICD]-9 diagnostic code 333.82 and ICD-10 code G24.4) who presented at the clinic from October 2012 to December 2017. Additional selection criteria were age greater than 18 years and confirmation of OMD diagnosis with at least 1 follow-up visit. RESULTS: Over a 5-year period, 22 patients with OMD were identified according to the ICD diagnostic codes, and of those, 6 patients met the selection criteria corresponding to a prevalence of 170 per 100,000 (95% confidence interval [CI] 70-390). The most common chief complaint was jaw pain (67%), and all patients had associated diagnosis of myofascial pain of masticatory muscles. CONCLUSIONS: The prevalence of patients with OMD in an academic orofacial pain clinic is higher than previously reported in population-based studies. The presentation of OMD often includes temporomandibular disorders (TMDs), with involvement of various masticatory muscles.


Assuntos
Distonia , Distúrbios Distônicos , Dor Facial , Humanos , Prevalência , Estudos Retrospectivos
12.
J Oral Rehabil ; 47(8): 923-929, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32433776

RESUMO

OBJECTIVE: To compare the smallest thickness that can be perceived between occluding teeth (occlusal tactile acuity, OTA) of temporomandibular disorder pain (TMD-P) patients with that of control (CTR) individuals. METHODS: Twenty TMD-P patients (17 women and 3 men, mean age: 31.3 ± 10.4 years) diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol and 20 age- and gender-matched controls (17 women and 3 men, mean age: 31.4 ± 10.5 years) were enrolled. The OTA was tested with 10 different thicknesses: 9 aluminium foils (8 µm-72 µm with a constant increment of 8 µm) and 1 sham test (without foil), each thickness being tested 10 times in random order (100 tests in total). The participants were instructed to close their mouth once and to report whether they felt the foil between their molar teeth. A between-group comparison (TMD-P vs CTR) was performed for each testing thickness (analysis of variance for repeated measurements, with Bonferroni multiple correction) (P < .005). RESULTS: Significantly increased OTA was observed in the TMD-P group for the thicknesses between 8 µm and 40 µm, while no significant differences were found for the sham test and for the larger thicknesses tested (from 48 µm to 72 µm). CONCLUSIONS: TMD-pain subjects presented an increased OTA as compared to controls.


Assuntos
Transtornos da Articulação Temporomandibular , Adulto , Estudos de Casos e Controles , Dor Facial , Feminino , Humanos , Masculino , Dor , Transtornos Somatoformes , Tato , Adulto Jovem
14.
Ann Otol Rhinol Laryngol ; 129(10): 969-976, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32456442

RESUMO

OBJECTIVE: Previous investigations suggest the use of extract from the root of Pelargonium sidoides (EPs 7630) for the therapy of uncomplicated acute upper airway inflammations, due to its strong antimicrobial and immunomodulatory effect. We aimed to compare clinical efficacy, safety and bactericidal effect of EPs 7630 and amoxicillin monotherapy in treatment of patients with mild to moderate acute bacterial rhinosinusitis (ABRS). METHODS: Fifty ABRS patients were divided into two groups by randomization. Group 1 (n = 25) received EPs 7630 tablets, 3 × 20 mg/day per os for 10 days. Group 2 (n = 25) received amoxicillin tablets 3 × 500 mg/day per os, for 10 days. We assessed total symptom score (TSS), individual symptom scores for each symptom (nasal obstruction, rhinorrhea, postnasal drip, facial pain/pressure, loss of the sense of smell), endoscopic findings, including total endoscopic score (TES) and individual endoscopic signs (mucosal edema, mucopurulent secretion), before and after treatment. Samples of discharge taken from the middle meatus of all patients were cultivated for bacteria before and after therapy. RESULTS: Higher absolute improvement after treatment was found for TSS, nasal obstruction, facial pain/pressure, impaired sense of smell, TES, mucosal edema and mucopurulent secretion in EPs 7630 group compared to amoxicillin group (P < .001 for all parameters). However, there were no differences in absolute improvement of rhinorrhea score and postnasal drip score between groups (P = .248; P = .679, respectively). Fewer types of bacteria grew on culture from middle meatal samples in EPs 7630 group compared to amoxicillin group. There were no reported adverse events from patients from either group. CONCLUSION: Our results demonstrated better clinical and antimicrobial efficacy of EPs 7630 than amoxicillin. EPs 7630 was shown as a potent agent and good alternative to antibiotic treatment of uncomplicated ABRS.


Assuntos
Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Fitoterapia , Extratos Vegetais/uso terapêutico , Rinite/tratamento farmacológico , Sinusite/tratamento farmacológico , Doença Aguda , Adolescente , Adulto , Infecções Bacterianas/fisiopatologia , Edema/fisiopatologia , Dor Facial/fisiopatologia , Feminino , Infecções por Haemophilus/tratamento farmacológico , Haemophilus influenzae , Humanos , Masculino , Pessoa de Meia-Idade , Moraxella catarrhalis , Infecções por Moraxellaceae/tratamento farmacológico , Mucosa Nasal , Obstrução Nasal/fisiopatologia , Transtornos do Olfato/fisiopatologia , Infecções Pneumocócicas/tratamento farmacológico , Rinite/fisiopatologia , Sinusite/fisiopatologia , Streptococcus pneumoniae , Adulto Jovem
15.
J Oral Rehabil ; 47(8): 1052-1064, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32415993

RESUMO

Pain in the oro-facial region is one of the most common reasons for patients to seek dental treatment. Oral health-related quality of life (OHRQoL) can be affected not only by pain, but also by other oral disorders. Four main dimensions, Oral Function, Orofacial Pain, Orofacial Appearance and Psychosocial Impact, have been suggested to cover different areas of OHRQoL. The aim of this systematic review was to map the impact of oro-facial pain conditions on the Orofacial Pain dimension of OHRQoL (PROSPERO registration: CRD42017064033). Studies were included if they reported Oral Health Impact Profile (OHIP) mean or median domain scores for patients with odontogenic pain, oral mucosal pain/burning mouth syndrome (BMS), third molar extractions or temporomandibular disorders (TMD). A search in PubMed (MEDLINE), EMBASE, Cochrane, CINAHL and PsycINFO on 8 June 2017, updated 14 January 2019, combined with a hand search identified 2104 articles. After screening of abstracts, 1607 articles were reviewed in full text and 36 articles were included that reported OHIP data for 44 patient populations including 5849 patients. Typical Orofacial Pain impact for all four conditions (odontogenic pain, oral mucosal pain/BMS, pain after third molar extractions and TMD) was between 2 and 3 on a 0-8 converted OHIP scale with the highest reported impact for pain after 3rd molar extractions. This review provides standardised information about OHRQoL impact from four oro-facial pain conditions as a model for the Orofacial Pain dimension. The results show moderate impact for the pain dimension of OHRQoL in patients with common oro-facial pain conditions.


Assuntos
Dor Facial , Saúde Bucal , Qualidade de Vida , Transtornos da Articulação Temporomandibular , Humanos , Inquéritos e Questionários
16.
Spec Care Dentist ; 40(3): 303-307, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32384226

RESUMO

AIM: The present study aimed to report a case of orofacial pain secondary to acoustic neuroma (AN). METHODS AND RESULTS: A 66-year-old female presented with unilateral facial pain and odontalgia. The pain was described as throbbing, dull, and constant. Tinnitus, hearing loss, dizziness, and others symptoms were also present. Due to the characteristics of the pain and clinical or radiographic findings, other possible diagnoses, such as temporomadibular disorder, tooth-related pain, sinusitis, and primary headaches, were excluded. Somatosensory tests for allodynia and hyperalgesia showed extraoral and intraoral hypersensitivity. Magnetic resonance imaging revealed a lesion located on the right cerebellopontine angle extending into and obliterating the internal auditory canal and compressing the middle cerebral peduncle, the pons, and the cisternal segment of cranial nerve V. The patient was diagnosed with a brainstem tumor compatible with AN and trigeminal neuralgia secondary to cranial nerve V compression. CONCLUSION: Although uncommon, intracranial tumors should be considered during orofacial pain evaluation to avoid iatrogenic treatment and delayed diagnosis.


Assuntos
Neuroma Acústico , Neuralgia do Trigêmeo , Idoso , Ângulo Cerebelopontino , Dor Facial , Feminino , Humanos , Imagem por Ressonância Magnética
17.
J Headache Pain ; 21(1): 35, 2020 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-32316909

RESUMO

BACKGROUND: The neurochemical background of the evolution of headache disorders, still remains partially undiscovered. Accordingly, our aim was to further explore the neurochemical profile of Complete Freund's adjuvant (CFA)-induced orofacial pain, involving finding the shift point regarding small molecule neurotransmitter concentrations changes vs. that of the previously characterized headache-related neuropeptides. The investigated neurotransmitters consisted of glutamate, γ-aminobutyric acid, noradrenalin and serotonin. Furthermore, in light of its influence on glutamatergic neurotransmission, we measured the level of kynurenic acid (KYNA) and its precursors in the kynurenine (KYN) pathway (KP) of tryptophan metabolism. METHODS: The effect of CFA was evaluated in male Sprague Dawley rats. Animals were injected with CFA (1 mg/ml, 50 µl/animal) into the right whisker pad. We applied high-performance liquid chromatography to determine the concentrations of the above-mentioned compounds from the trigeminal nucleus caudalis (TNC) and somatosensory cortex (ssCX) of rats. Furthermore, we measured some of these metabolites from the cerebrospinal fluid and plasma as well. Afterwards, we carried out permutation t-tests as post hoc analysis for pairwise comparison. RESULTS: Our results demonstrated that 24 h after CFA treatment, the level of glutamate, KYNA and that of its precursor, KYN was still elevated in the TNC, all diminishing by 48 h. In the ssCX, significant concentration increases of KYNA and serotonin were found. CONCLUSION: This is the first study assessing neurotransmitter changes in the TNC and ssCX following CFA treatment, confirming the dominant role of glutamate in early pain processing and a compensatory elevation of KYNA with anti-glutamatergic properties. Furthermore, the current findings draw attention to the limited time interval where medications can target the glutamatergic pathways.


Assuntos
Dor Facial/metabolismo , Ácido Glutâmico/metabolismo , Ácido Cinurênico/metabolismo , Norepinefrina/metabolismo , Serotonina/metabolismo , Triptofano/metabolismo , Ácido gama-Aminobutírico/metabolismo , Animais , Dor Facial/induzido quimicamente , Adjuvante de Freund , Masculino , Ratos , Ratos Sprague-Dawley , Núcleo Inferior Caudal do Nervo Trigêmeo/metabolismo , Vibrissas/efeitos dos fármacos
18.
World Neurosurg ; 138: 454-456, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32251825

RESUMO

BACKGROUND: Microvascular decompression (MVD) is a commonly performed procedure to treat trigeminal neuralgia and hemifacial spasm. Knowledge of the variable anatomy of the cerebellopontine angle is crucial to avoid injury to cranial nerves. CASE DESCRIPTION: A 76-year-old lady with right V1 (ophthalmic division of the trigeminal nerve) and V2 (maxillary division of the trigeminal nerve) trigeminal neuralgia, refractory to medical treatment, underwent elective MVD. Intraoperatively, a distorted course of the cisternal component of the abducent nerve was noticed, caused by an ectatic anterior inferior cerebellar artery. Careful mobilization of the offending vessel to decompress the trigeminal nerve was carried out; however, abducent nerve decompression was not attempted since its function was not compromised. Facial pain resolved postoperatively without new diplopia. CONCLUSIONS: Careful review of imaging before surgery is recommended in order to preempt such unusual anatomic variations.


Assuntos
Nervo Abducente/anormalidades , Cirurgia de Descompressão Microvascular/métodos , Procedimentos Neurocirúrgicos/métodos , Neuralgia do Trigêmeo/cirurgia , Nervo Abducente/diagnóstico por imagem , Idoso , Artérias Cerebrais/anormalidades , Artérias Cerebrais/diagnóstico por imagem , Artérias Cerebrais/cirurgia , Dor Facial/etiologia , Dor Facial/cirurgia , Feminino , Humanos , Imagem por Ressonância Magnética , Síndromes de Compressão Nervosa/cirurgia , Resultado do Tratamento , Neuralgia do Trigêmeo/complicações , Neuralgia do Trigêmeo/diagnóstico por imagem
19.
J Oral Facial Pain Headache ; 34(2): 174-186, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32255583

RESUMO

AIMS: To test for the possible antinociceptive effect of nifedipine in rodent models of acute and chronic neuropathic orofacial pain and the possible involvement of TRP- and NMDA-related processes in this effect. METHODS: Acute nociceptive behavior was induced by administering formalin, cinnamaldehyde, glutamate, capsaicin, or acidified saline to the upper lip or hypertonic saline to the cornea of Swiss mice. Acute nociceptive behavior was also induced by formalin injected into the TMJ or mustard oil injected into the masseter muscle of Wistar rats. The chronic pain model involved infraorbital nerve transection (IONX) in Wistar rats to induce mechanical hypersensitivity, which was assessed with von Frey hair stimulation of the upper lip. The effects of pretreatment with nifedipine or vehicle (control) were tested on the nociceptive behaviors. Docking experiments were also performed. Statistical analysis included one-way ANOVA followed by Tukey post hoc test and two-way ANOVA followed by Bonferroni post hoc test (statistical significance P < .05). RESULTS: Nifedipine produced significant antinociceptive effects in all of the acute nociceptive behaviors except that induced by capsaicin. The antinociceptive effects were attenuated by NMDA, TRPA1, or TRPM3 receptor antagonists. The IONX animals developed facial mechanical hypersensitivity, which was significantly reduced by nifedipine. The docking experiments suggested that nifedipine may interact with TRPM3 and NMDA receptors. CONCLUSION: The present study has provided novel findings in a variety of acute and chronic orofacial pain models showing that nifedipine, a selective inhibitor of L-type Ca2+ channels, can suppress orofacial nociceptive behavior through NMDA, TRPA1, and TRPM3 receptor systems.


Assuntos
Roedores , Canais de Cátion TRPM , Analgésicos , Animais , Dor Facial , Camundongos , N-Metilaspartato , Nifedipino , Ratos , Ratos Wistar , Canal de Cátion TRPA1
20.
J Oral Sci ; 62(2): 156-159, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32224568

RESUMO

Swallowing has a vital function in airway protection and is the next step after mastication. Swallowing impairment, which is known as dysphagia, is frequently accompanied by pain. Previous clinical studies have shown that orofacial pain affects swallowing function. Thus, it was hypothesized that orofacial noxious inputs may modulate swallowing function. Previous studies using anesthetized animals has proposed that the facial skin-nucleus tractus solitarii (NTS), masseter muscle-NTS, lingual muscle-NTS, and lingual muscle-paratrigeminal nucleus-NTS pathways may be involved in the inhibition of swallowing caused by facial, masseter, and lingual pain. Moreover, the activation of gamma-aminobutyric acidergic NTS neurons is involved in the inhibition of the swallowing reflex following trigeminal noxious inputs. This review focused on the recent management of dysphagia, neural mechanisms of swallowing, and relationship between orofacial pain and swallowing function. This and other future studies in this field can provide a better understanding of both normal and impaired swallowing and can help develop a new approach to treat patients with dysphagia and orofacial pain.


Assuntos
Transtornos de Deglutição , Animais , Deglutição , Dor Facial , Humanos , Músculo Masseter , Núcleo Solitário
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