Referred Pain Manifestation and Its Impact on Patients With Temporomandibular Disorder.

Objective: To investigate whether a higher number of sites eliciting referred pain upon palpation is associated with greater impairment in biopsychosocial aspects in TMD patients and identify variables that predict increased referred pain.

Methods: This cross-sectional study analyzed data from 77 women with myalgia, assessing the number of sites eliciting referred pain upon palpation in relation to clinical (duration, frequency, intensity, painful body sites, pain-related disability), psychological (stress, anxiety, depression, catastrophizing, sleep quality), and psychophysical variables (mechanical and pressure pain thresholds, temporal summation and conditioned pain modulation).

Results: Spearman's correlation revealed a significant correlation between the number of sites eliciting referred pain upon palpation in the orofacial region and both pain intensity and frequency (p < 0.

Interplay of Psychosocial, Clinical and Modulation Mechanisms in Chronic TMD-Related Disability.

Background: Temporomandibular disorder (TMD) is a multifactorial condition characterised by pain and functional impairment in the orofacial region. Although psychosocial and psychophysical factors significantly influence chronic pain, their combined impact on functional disability remains poorly understood.

Objectives: To investigate the influence of clinical, psychosocial and psychophysical variables on functional disability related to chronic pain in muscular TMD, utilising principal component analysis (PCA) and logistic regression.

Duloxetine in addition to self-management for painful temporomandibular disorders: a post hoc responder analysis of a randomized, placebo-controlled clinical trial.

Aim: To identify the phenotypic characteristics of individuals with temporomandibular disorders (TMD) who may benefit from adding duloxetine to self-management (SM) strategies.

Methodology: This was a post hoc exploratory analysis of a randomized, placebo-controlled clinical trial with SM-duloxetine (duloxetine 60 mg/day plus SM strategies for 12 weeks) in adult participants with painful TMD. The primary outcome was the proportion of responders to treatment (individuals with ≥ 30% reduction in pain intensity) in SM-duloxetine and SM-placebo group at week 12.

Who is the patient with resistant myofascial temporomandibular disorders pain? A somatosensory, psychosocial, and genetic characterization.

Background: Resistance to treatments have been assessed in chronic conditions such as migraine, but not in temporomandibular disorders (TMD). This study aimed to identify factors that influence treatment outcome in patients with myofascial TMD pain.

Methods: Seventy-two females were divided into three groups: TMD successfully treated (TMD-S, n = 24), TMD resistant to treatment (TMD-R, n = 24) and Controls without TMD (n = 24).

Association between generalized joint hypermobility, temporomandibular joint hypertranslation and temporomandibular disorders: a scoping review.

Generalized Joint Hypermobility (GJH) is one of the pathophysiological contributing factors for the development of temporomandibular disorders (TMD). There are, however, several counterpoints on the potential relation between TMD and joint hypermobility, especially when considering the temporomandibular joint (TMJ), event known as TMJ hypertranslation. Additionally, there is no consensus regarding the clinical and imaging diagnostic criteria for such condition.

Dietary Profile of Women With Chronic Muscle Temporomandibular Disorder: An Observational Study.

Background: Temporomandibular disorder (TMD) is the main chronic pain that affects the face, and it is associated with dietary changes due to pain and dysfunction. However, there is a scarcity of studies on its impact on nutrition and vice versa.

Objectives: To assess and compare the intake of energy and nutrients among chronic TMD myalgia and asymptomatic women and to evaluate data according to dietary reference intakes (DRI) and the World Health Organization (WHO) values.

Auriculotemporal neuralgia overlapped with chronic orofacial myofascial pain: A case report of a challenging diagnosis.

Aim: Auriculotemporal neuralgia (AN) is a rare condition characterized by severe, stabbing, unilateral pain inadequately described in the literature. Often coexisting with other conditions sharing the same innervation, and this overlap complicates clinical interpretation, leading to diagnostic errors and inappropriate therapeutic choices. The absence of AN in headache and facial pain diagnostic criteria hampers access to crucial information for diagnostic reasoning.

Central sensitization inventory is associated with psychological functioning but not with psychophysical assessment of pain amplification.

Background: The central sensitization inventory (CSI) is a questionnaire that has been widely used as a tool for assessing symptoms associated with sensitization. However, its ability to identify individuals with this phenomenon has recently been questioned. The aim of this study was to assess the correlation of CSI with psychosocial and psychophysical factors in patients with painful TMD diagnosed according to diagnostic criteria for temporomandibular disorders (DC/TMD) and asymptomatic controls, as well as to determine the influence of these variables on the CSI scores variations.

Impact of streptozotocin-induced diabetes on experimental masseter pain in rats.

This study aimed to assess the influence of streptozotocin (STZ)-induced diabetes on the nociceptive behavior evoked by the injection of hypertonic saline (HS) into the masseter muscle of rats. Forty male rats were equally divided into four groups: a) isotonic saline control, which received 0.9% isotonic saline (IS), (Ctrl-IS); b) hypertonic saline control, which received 5% HS (Ctrl-HS); c) STZ-induced diabetic, which received IS, (STZ-IS); d) STZ-induced diabetic, which received HS (STZ-HS).

Somatosensory alterations after single-unit dental implant immediate loading: A 1-year follow-up study.

Objective: This cohort study aimed to assess the incidence of somatosensory alterations after implant surgery using standardized quantitative and qualitative sensory testing.

Methods: 33 participants with single-tooth loss, undergoing immediate implant loading were included. Quantitative Sensory Testing (QST) and Qualitative Sensory Testing (QualST) were conducted at eight time points over a year (baseline to 1 year).

Referred pain is associated with greater odontogenic spontaneous pain and a heightened pain sensitivity in patients with symptomatic irreversible pulpitis.

Background: Symptomatic irreversible pulpitis often results in heightened reactions to thermal stimuli such as pain evoked by a cold stimulus, and spontaneous odontogenic pain (unprovoked pain).

Objective: This study primarily compared the clinical manifestations of odontogenic spontaneous pain and pain provoked by cold stimulus specifically focusing on their sensory discriminative characteristics (intensity, duration and quality) between symptomatic irreversible pulpitis patients with and without referred pain.

Methods: Twenty-three patients with symptomatic irreversible pulpitis with referred pain and 12 patients without referred pain were included in this cross-sectional study.

Nutrition and chronic musculoskeletal pain: A narrative review and directions for temporomandibular disorder research and management.

Background: Recent evidence suggests neuro-immune mechanisms may link dietary patterns to chronic painful conditions (CPC). In the research field of oro-facial pain (OFP), studies focuses primarily on dietary mechanical limitations due to pain and dysfunction.

Objective: This narrative review aimed to overview the role of nutrition on CPC, with emphasis on temporomandibular disorder (TMD), enlightening OFP researcher on dietary assessment possibilities and providing directions for studies in the field of OFP and nutrition.

Influence of psychometric and sleep quality features on painful mechanical sensitivity and pain modulation in patients with temporomandibular disorders.

Unlabelled: Investigating the collective impact of psychometric properties and sleep quality on pain sensitivity in temporomandibular disorder (TMD) patients could improve clinical management strategies.

Objective: Assessing whether combined psychometric properties and sleep quality impact painful mechanical sensitivity and pain modulation in TMD patients.

Materials And Methods: A cross-sectional study using secondary data analysis of 77 TMD patients and 101 controls.

Botulinum toxin-A effects on pain, somatosensory and psychosocial features of patients with refractory masticatory myofascial pain: a randomized double-blind clinical trial.

The antinociceptive effect of BoNT-A have been well documented in animal studies; however, results of few but well-designed randomized placebo-controlled clinical trials about BoNT-A efficacy in masticatory myofascial pain (MFP) are inconsistent. Therefore, the present randomized, double-blind, placebo-controlled clinical trial evaluated the efficacy of BoNT-A in patients with refractory MFP. Twenty-eight patients with pain reduction of less than 30% despite conservative treatment and with an average pain intensity of > 50 mm on the visual analogue scale (VAS) participated.

Prediction of duloxetine efficacy in addition to self-management in painful temporomandibular disorders: A randomised, placebo-controlled clinical trial.

Background: Conditioned pain modulation (CPM) is a potential predictor of treatment response that has not been studied in temporomandibular disorders (TMD).

Objectives: We conducted a randomised, double-blind, placebo-controlled trial (RCT) of duloxetine in addition to self-management (SM) strategies to investigate its efficacy to reduce pain intensity in painful TMD patients. Moreover, we investigated whether baseline CPM would predict the duloxetine efficacy to reduce TMD pain intensity.

Divergence between confidence and knowledge of endodontists regarding non-odontogenic pain.

Introduction: This study aimed to assess the self-reported levels of confidence and knowledge related to non-odontogenic pain among a group of Brazilian endodontists.

Methodology: A total of one hundred and forty-six endodontists affiliated with the Brazilian Society of Endodontics participated in the survey. The questionnaire, distributed via email or WhatsApp, contained inquiries designed to gauge self-perceived confidence and knowledge concerning non-odontogenic pain.

Real time evaluation of awake bruxism behaviors in young asymptomatic students and its impact on the masticatory muscles.

Statement Of Problem: The relationship of awake bruxism with pain is still unclear.

Purpose: The purpose of this clinical study was to evaluate awake bruxism behavior for 1 week in healthy young adults with ecological momentary assessment, assess its relationship with masticatory muscle tenderness, and the participation of endogenous analgesia.

Material And Methods: A total of 150 healthy participants were provided with a smartphone application that sent 10 alerts at random intervals every day.

Catastrophizing and Hypervigilance Influence Subjective Sleep Quality in Painful TMD Patients.

To determine sleep quality and associated factors in a group of patients with painful TMDs. The medical records of 80 patients with arthralgia and/or myofascial pain were reviewed and compared to a healthy control group. Data about sex, age, subjective pain, physical activity, social activity, subjective sleep quality (Pittsburgh Sleep Quality Index [PSQI]), pain vigilance (Pain Vigilance and Awareness Questionnaire [PVAQ]), and pain catastrophizing (Pain Catastrophizing Scale [PCS]) were collected.

Ecological Momentary Assessment of Awake Bruxism Behaviors: A Scoping Review of Findings from Smartphone-Based Studies in Healthy Young Adults.

Background: The recent introduction of ecological momentary assessment (EMA) smartphone-based strategies has allowed achieving some interesting data on the frequency of different awake bruxism (AB) behaviors reported by an individual in the natural environment.

Objective: The present paper aims to review the literature on the reported frequency of AB based on data gathered via smartphone EMA technology.

Methods: On September 2022, a systematic search in the Pubmed, Scopus and Google Scholar databases was performed to identify all peer-reviewed English-language studies assessing awake bruxism behaviors using a smartphone-based Ecological Momentary Assessment.

Painful Temporomandibular Joint Clicking: Genetic Point of View.

Aims: To determine whether there is an association between gene polymorphisms and patients with painful temporomandibular joint (TMJ) clicking when compared to patients with painless TMJ clicking and a healthy control group.

Methods: In this pilot study, the genotypic and allelic frequencies of candidate single-nucleotide polymorphisms (SNP) were compared among 60 individuals divided equally into three groups: patients with painful TMJ clicking (n = 20); patients with painless TMJ clicking (n = 20); and healthy controls (n = 20). Participants were genotyped for the following SNPs using real-time polymerase chain reaction: MMP1 -16071G/2G, COMT Val158Met, TNFα -308, IL1β +3954, IL6 -174, and IL10 -1082.

Long-Term Effects of a Single Application of Botulinum Toxin Type A in Temporomandibular Myofascial Pain Patients: A Controlled Clinical Trial.

This study assessed the long-term effects of botulinum toxin type A (BoNT-A) in subjective pain, pain sensibility, and muscle thickness in persistent myofascial temporomandibular-disorder pain (MFP-TMD) patients. Fourteen female subjects with persistent MFP received BoNT-A treatment with different doses (10U-25U for temporalis muscle and 30U-75U for masseter muscle). The treatment was injected bilaterally in the masseter and anterior temporalis muscles in a single session.

Influence of genetic polymorphisms on mechanical pain sensitivity and endogenous pain modulation of trigeminal and spinal areas.

Background: Previous evidence indicates significant association between genetic polymorphisms and phenotypes related to pain sensitivity in patients with temporomandibular disorders (TMD). Despite the important advances in cataloguing diverse factors such as sleep disorders, anxiety and depression, the interrelated mechanisms of painful TMD aetiopathogenesis still need investigation.

Objectives: This case-control study aimed to evaluate the influence of genetic polymorphisms (rs6296, rs6295, rs1799971, rs4680, rs4633, rs4818) and psychosocial factors on the mechanical pain sensitivity and endogenous pain modulation in women with painful TMD and asymptomatic controls.