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McCormick, Emma, and Magdalena Sjöwall. "Central sensitization in orofacial pain." Thesis, Malmö högskola, Odontologiska fakulteten (OD), 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-19833.
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Syfte. Att retrospektivt undersöka relationen mellan central sensitisering i det orofacialaområdet och refererad smärta, som kliniskt fynd, samt psykosociala faktorer hos patienter medDC/TMD-muskeldiagnosen myofasciell smärta med refererad smärta (MPR). Studien syftadeäven till att undersöka skillnader gällande psykosociala faktorer mellan patienter somdiagnostiserats med DC/TMD muskeldiagnoserna myofasciell smärta med refererad smärta(MPR), lokal myalgi (LM) och patienter med orofacial smärta eller käkdysfunktion men ejkäkmuskeldiagnos (WMD) som kontrollgrupper.Material och metod. Information från 85 patienters DC/TMD-undersökning utförd påOrofaciala smärtenheten vid Malmö högskola mellan september 2012 till årsslutet 2013insamlades retrospektivt. Undersökta variabler inkluderade smärtintensitet, smärt-relateraddysfunktion, psykosociala faktorer (depression, ångest och stress) samt refererad smärta.Patienterna indelades i grupper baserade på muskeldiagnos enligt DC/TMD samt utbredning avsmärta. Non-parametrisk statistik användes och P < 0,05 betraktades som signifikant.Resultat. Patienter med MPR uppvisade en signifikant korrelation mellan totala antaletrefererade smärtlokalisationer och smärt-relaterad dysfunktion (rs = 0,43, n = 49, p = 0,002),depression (rs = 0,32, n = 49, p = 0,023) och stress (rs = 0,39, n = 49, p = 0,006). Patienter meden generell smärtutbredning uppvisade en signifikant högre grad av stress (p = 0,020) samt flerantal refererade smärtlokalisationer (p = 0,019) jämfört med patienter med lokal och/ellerregional orofacial smärta.Konklusion. Studien indikerar att grad av central sensitisering kan bedömas med hjälp avutbredningen av refererad smärta, undersökt enligt DC/TMD, hos patienter med diagnosenmyofasciell smärta med refererad smärta i det orofaciala området. Studien kunde inte påvisaskillnader gällande psykosociala faktorer mellan de undersökta grupperna.Objective. The aim of this study was to retrospectively investigate the relation between referredpain, as a clinical finding, and psychosocial factors versus central sensitization in patients withmyofascial pain with referral (MPR) as assessed according to DC/TMD. The study also aimedto investigate differences regarding psychosocial factors between patients demonstratingmyofascial pain with referral (MPR) and patients diagnosed with the DC/TMD muscle diagnoselocal myalgia (LM) as well as OFP/TMD patients without masticatory muscular diagnose(WMD) as control patients.Material and methods. Patients’ medical records of 85 patients examined at the Orofacial PainUnit at Malmö University during September 2012 till the end of 2013 were retrospectivelyexamined for DC/TMD data. Examined variables included pain intensity, pain-related disability,psychosocial factors (depression, anxiety and stress) and referred pain. The patients weredivided into groups based on DC/TMD muscle diagnosis as well as extension of pain. Nonparametricstatistics were used and a probability level of P < 0.05 was considered as significant.Results. Patients with MPR demonstrated significant correlations between the total number ofreferred pain sites and disability score (rs = 0.43, n = 49, p = 0.002), depression (rs = 0.32, n =49, p = 0.023) as well as stress (rs = 0.39, n = 49, p = 0.006). Patients with generalized paindistribution demonstrated a significantly higher degree of stress (p = 0.020) as well as highernumber of referred pain sites (p = 0.019) than patients with local and/or regional orofacial pain.Conclusion. This study indicates that the degree of central sensitization can be estimated bythe extent of referred pain, as assessed according to DC/TMD, in patients with myofascial painwith referred pain in the orofacial region. This study could not detect a difference inpsychosocial factors between the three groups, myofascial pain with referral (MPR), localmyalgia (LM) and no masticatory muscle diagnosis (WMD).
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Mills, Emily. "Pain-modulation neural circuits underlying chronic orofacial pain." Thesis, The University of Sydney, 2019. https://hdl.handle.net/2123/21813.
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We have all experienced short-term pain that results from a brief noxious (harmful) stimulus. When we encounter noxious stimuli, the intensity of our pain response is modulated through the activation of pain-modulation neural circuits in the brain. Specifically, systems within the brainstem can both inhibit and facilitate nociceptive (i.e. pain-related) information when it first enters the central nervous system, either in the spinal cord dorsal horn or in the spinal trigeminal nucleus (SpV) in the brainstem for information relating to orofacial (face and mouth) regions. Pain-modulation systems serve a clear biological purpose – in some situations, pain inhibition is highly beneficial as it allows us to focus on escape or defensive behaviours; in other circumstances, pain facilitation can be helpful as it encourages us to rest and recover from potential tissue damage. Despite many of us experiencing short-term pain that is associated with an injury, for reasons that are unclear, some individuals experience long-lasting chronic pain that persists for months or years after the initial injury has healed. There is growing evidence from experimental animal investigations to suggest that the functioning of the pain-modulation circuits, particularly those centred around the rostral ventromedial medulla (RVM) and locus coeruleus in the brainstem, is compromised in chronic pain conditions. These preclinical studies suggest that both neuropathic pain (i.e. pain related to somatosensory nervous system damage) and non-neuropathic pain (i.e. pain related to non-nervous tissue injury) are associated with a functional shift in the pain-modulation system such that it favours an overall facilitation of pain processing. This may contribute to the maintenance of long-term pain in some individuals even after the initial injury has resolved. In humans, there is emerging evidence from psychophysical studies to suggest that some chronic pain conditions, including orofacial conditions, are associated with altered pain-modulation capacities. However, to date, pain-modulation circuit functioning has not been directly explored in individuals with chronic pain. The overall aim of this thesis was to use resting-state functional magnetic resonance imaging (fMRI) to explore the ongoing function of brainstem pain-modulation neural circuits in humans with chronic neuropathic and non-neuropathic orofacial pain. The first investigation (Chapter 2) aimed to determine whether a neuropathic pain condition, painful trigeminal neuropathy (PTN), is associated with altered ongoing functioning in RVM and locus coeruleus pain-modulation pathways. We performed functional connectivity analyses to investigate whether there is an altered coupling of fMRI signals between the RVM, locus coeruleus and other pain-modulation regions in PTN patients compared with pain-free controls. We identified that individuals with PTN display enhanced functional connectivity (signal coupling) between the RVM and other pain-modulation sites, including the midbrain periaqueductal gray (PAG), locus coeruleus and subnucleus reticularis dorsalis (SRD). Additionally, we found that PTN patients display enhanced RVM functional connectivity with the SpV, the region that first receives nociceptive information from orofacial regions. Together, these results show that PTN is associated with functional alterations within the brainstem pain-modulation network and the SpV. Considering the existing experimental animal literature, it is likely that this represents an ongoing and enhanced engagement of brainstem pain-facilitating processes that may contribute to persistent pain in individuals with neuropathic pain conditions. The second investigation (Chapter 3) aimed to explore whether painful temporomandibular disorder (TMD), a non-neuropathic pain condition characterised by pain around the temporomandibular joint, is also associated with alterations in signal coupling between the RVM and other brainstem pain-modulation regions. In this investigation, we employed two functional connectivity techniques to explore the coupling of fMRI signals averaged over the entire scan (“static” functional connectivity) in addition to changes in signal coupling over the course of the scan (“dynamic” functional connectivity) to explore pain-modulation circuit function in TMD patients compared with pain-free controls. We identified that, compared to controls, TMD patients display enhanced RVM static and dynamic connectivity with the SpV and SRD, and no change in RVM connections with the PAG and locus coeruleus. These findings show that TMD is associated with functional alterations within specific brainstem pain-modulation circuits that regulate nociceptive processing at the SpV. Consistent with the findings from preclinical studies, and similar to neuropathic conditions, these ongoing functional changes in TMD likely reflect an enhanced descending facilitation of nociceptive processing at the SpV that contributes to the maintenance of pain in these individuals. The first two investigations (Chapters 2 and 3) revealed that individuals with both neuropathic and non-neuropathic pain display functional alterations within pain-modulation circuits that likely contribute to the presence of ongoing pain. In addition to persistent pain, many patients with neuropathic pain report spontaneous fluctuations in their pain intensity. It is possible that moment-to-moment variations in pain-modulation system functioning can contribute to these spontaneous fluctuations in chronic pain intensity. As such, the third investigation (Chapter 4) aimed to determine whether, within PTN individuals, there are differences in RVM functional connectivity strengths with other brainstem regions during scan periods in which patients experience high versus low pain. We found that PTN patients displayed stronger RVM connectivity strengths with both the PAG and SpV during the period of highest compared with lowest reported pain. These findings show that moment-to-moment fluctuations in spontaneous neuropathic pain intensity are associated with functional changes in the pain-modulation system. Given that this system can both facilitate and inhibit nociception, these findings may reflect short-term variations in descending pain-modulation output at the SpV that contribute to short-term changes in spontaneous pain intensity. Overall, this series of investigations reveals that both neuropathic and non-neuropathic orofacial pain conditions are associated with ongoing functional changes in the brainstem pain-modulation circuits. Additionally, in neuropathic pain, short-term variations in brainstem system functioning are associated with spontaneous fluctuations in ongoing pain intensity. Together, these findings suggest that functional alterations within the pain-modulation neural circuits are associated with the presence and intensity of ongoing chronic orofacial pain in humans. Considering these data alongside the existing experimental animal research, it is likely that, following injury, some individuals experience a change in pain-modulation circuit functioning such that it favours the facilitation of nociceptive processing. This may contribute to the maintenance and intensity of persistent orofacial pain in some individuals following injury.
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Maulina, Tantry. "ASSOCIATIONS BETWEEN COMMUNITY OROFACIAL PAIN AND EXPERIMENTAL OROFACIAL PAIN WITH PHYSICAL, SOCIAL AND/OR PSYCHOLOGICAL VARIABLES." Thesis, The University of Sydney, 2013. http://hdl.handle.net/2123/9789.
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Chronic orofacial pain can influence the quality of life of the sufferer by interfering with physical, social, and psychological functions. The aim of the study was to investigate the effect of orofacial pain on muscle activity and its association with physical and social functioning as well as psychological variables. The study was conducted in two consecutive phases. The first phase of the study was an epidemiological study that involved 700 participants and that was conducted in Indonesia. The second phase of the study was an experimental orofacial pain study in 14 participants, and this was conducted in Australia. The results of the first phase of the study revealed that there is a high prevalence of orofacial pain in an Indonesian patient sample with a high level of interference in social functioning and several physical activities including mastication. The results of the second phase of the study revealed some significant effects of experimental muscle pain on jaw muscle activity and some of these effects correlated with some psychological variables. In conclusion, this study has demonstrated the biopsychosocial effects of orofacial pain through study of a community based patient sample and through a study of experimental pain.
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Galli, Ursula. "Stress and pain (dys)regulation in chronic orofacial pain." Göttingen Cuvillier, 2008. http://d-nb.info/99103158X/04.
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Öjstedt, Erik, and Simon Pankalla. "Clinical Assessment of Disturbed Central Pain Modulation in Orofacial Pain." Thesis, Malmö universitet, Odontologiska fakulteten (OD), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-19798.
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Syfte. Studiens syfte var att retrospektivt undersöka vilka kliniska variabler, bedömda under specialistundersökning av orofacial smärta, som kan förutsäga närvaro av en störd central smärtmodulering (DCPM). Material och metod. DC/TMD-data hämtades ur patientjournaler från 86 patienter som undersökts på Orofaciala smärtenheten på Malmö Universitet under perioden september 2012 till och med december 2013. Undersökta variabler omfattade smärtintensitet, smärtutbredning, smärtrelaterad nedsatthet, psykosociala variabler, refererad smärta samt kliniska fynd under somatosensoriska undersökningar. Baserat på denna data delades patienterna upp i en DCPM-grupp och en grupp utan DCPM. Allodyni, hyperalgesi, dysestesi, wind-up, regional/generell smärtutbredning samt eftersensation ansågs vara markörer för DCPM. Icke-parametriska statistiska analyser användes och en sannolikhetsnivå på P<0,05 ansågs vara signifikant. Resultat. Graden av ospecifika fysiska symptom och antalet refererande smärtor var signifikant högre i DCPM-gruppen. Den multivariata logistiska regressionen visade att ospecifika fysiska symptom, stress, smärtduration, smärtintensitet, smärtrelaterad nedsatthet, antalet refererande smärtpunkter, maximal gapning med och utan smärta, ångest samt antalet smärtinducerande käkrörelser var signifikanta marörer för DCPM (LR Chi2 = 26.89, p = 0.003, Pseudo R2 = 0.29). Slutsats. Denna studie indikerar att stress, ångest, smärtduration, smärtintensitet, smärtrelaterad nedsatthet, antalet refererande smärtpunkter, maximal gapning med och utan smärta samt antalet smärtinducerande käkrörelser är associerat med DCPM hos patienter med orofacial smärta.Objective. To retrospectively investigate clinical variables that can predict the presence of disturbed central pain modulation (DCPM). Material and methods Medical records of 86 patients examined at the Orofacial Pain Unit at Malmö University from September 2012 to December 2013 were examined regarding pain intensity, pain distribution, pain-related disability, psychosocial variables, referred pain as well as somatosensory changes. Based on these variables, the patients were divided into a disturbed central pain modulation (DCPM) group and a non-DCPM group. Allodynia, hyperalgesia, dysesthesia, increased wind-up, regional/general pain distribution and aftersensation were considered as markers for DCPM. Non-parametric statistics were used and a probability level of P<0.05 was considered as significant. Results. The degree of unspecific physical symptoms and the number of sites eliciting pain referral were significantly higher in the DCPM group. In the multivariate regression model, the independent variables physical symptoms, stress, pain duration, characteristic pain intensity, pain-related disability, number of sites with referred pain, maximum mouth opening with and without pain, anxiety, and number of pain eliciting jaw movements significantly predicted DCPM (LR Chi2 = 26.89, p = 0.003, Pseudo R2 = 0.29). Conclusion. This study indicates that stress, anxiety, orofacial pain and its consequences, unspecific physical symptoms and jaw dysfunction are clinical signs of DCPM in patients with orofacial pain. Also, high number of palpations sites with referred pain over the masseter and temporal muscles and the TMJ indicate presence of DCPM.
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Hampf, Göran. "Somatic and psychic aspects of orofacial dysaesthesia." Helsinki : [s.n.], 1987. http://catalog.hathitrust.org/api/volumes/oclc/15667812.html.
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Thesis--University of Helsinki, 1987.At head of title: Department of Oral and Maxillofacial Surgery, University of Helsinki ... Department of Psychiatry of Helsinki University Central Hospital. Also published in: Proceedings of the Finnish Dental Society, 1986, Vol. 83, Suppl. II. Includes bibliographical references (p. 63-72).
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Vickers, Edward Russell. "Clinical and pharmacological studies of orofacial pain." University of Sydney. Anaesthesia and Pain Management, 2000. http://hdl.handle.net/2123/845.
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For pain research, the orofacial region is unique in a number of ways. The region has complex local anatomy, including substantial sensory innervation from neural pathways, and muscles of facial expression that convey important information concerning pain intensity and associated psychological traits. Although chronic orofacial pain conditions appear prevalent, useful documentation on pain intensity ratings using well established instruments is sparse. In particular, two conditions, atypical facial pain and atypical odontalgia, are poorly understood in aetiology so that definitive treatment modalities are severely limited. The region's local biofluid, saliva, has been used to diagnose various local and systemic disease states, and to quantitate drug concentrations. However, recent studies indicate that saliva also contains some of the same peptides, e.g. bradykinin, that are involved in pain mechanisms. It may be that pharmacological-pharmacokinetic studies of these peptides could shed more information on thesignificance of their presence in saliva. This thesis consists of four major sections. Section 1 comprises of three clinical studies investigating orofacial pain. Section 2 deals with clinical laboratory studies of saliva. Section 3 is concerned with the development of chromatographic methods to assay bradykinin and its pharmacokinetics in saliva. Section 4 uses chromatography for the identification of novel salivary peptides. This thesis, then, presents clinical studies of orofacial pain and pharmacological investigations of saliva as the local biofluid.
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Bonathan, C. J. "How do patients understand chronic orofacial pain?" Thesis, University College London (University of London), 2011. http://discovery.ucl.ac.uk/1329456/.
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Part one of this volume presents a review of the literature on the relationship between chronic pain and socioeconomic status. It examines the evidence supporting the association and considers the psychological meaning of the findings. Part two consists of a qualitative empirical paper which samples patients with chronic orofacial pain to explore their understanding of their pain and their beliefs and fears about the causes and maintenance of their pain, both before and after an initial consultation at a specialist pain clinic. The final section is a critical appraisal of conducting this thesis. It contains a personal reflection of conducting both the literature review and empirical paper and describes some of the obstacles encountered during the process.
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Vickers, E. R. "Clinical and pharmacological studies of orofacial pain." Connect to full text, 1999. http://hdl.handle.net/2123/845.
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Thesis (Ph. D.)--University of Sydney, 1999.Title from title screen (viewed Apr. 21, 2008). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Dept. of Anaesthesia and Pain Management, Faculty of Medicine. Includes bibliography. Also available in print form.
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Vickers, Edward Russell. "Clinical and pharmacological studies of orofacial pain." Thesis, The University of Sydney, 1999. http://hdl.handle.net/2123/845.
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For pain research, the orofacial region is unique in a number of ways. The region has complex local anatomy, including substantial sensory innervation from neural pathways, and muscles of facial expression that convey important information concerning pain intensity and associated psychological traits. Although chronic orofacial pain conditions appear prevalent, useful documentation on pain intensity ratings using well established instruments is sparse. In particular, two conditions, atypical facial pain and atypical odontalgia, are poorly understood in aetiology so that definitive treatment modalities are severely limited. The region's local biofluid, saliva, has been used to diagnose various local and systemic disease states, and to quantitate drug concentrations. However, recent studies indicate that saliva also contains some of the same peptides, e.g. bradykinin, that are involved in pain mechanisms. It may be that pharmacological-pharmacokinetic studies of these peptides could shed more information on thesignificance of their presence in saliva. This thesis consists of four major sections. Section 1 comprises of three clinical studies investigating orofacial pain. Section 2 deals with clinical laboratory studies of saliva. Section 3 is concerned with the development of chromatographic methods to assay bradykinin and its pharmacokinetics in saliva. Section 4 uses chromatography for the identification of novel salivary peptides. This thesis, then, presents clinical studies of orofacial pain and pharmacological investigations of saliva as the local biofluid.
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Vickers, E. R. "Neuropathic orofacial pain a review and guidelines for diagnosis and management /." Connect to full text, 2001. http://hdl.handle.net/2123/806.
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Thesis (M. Sc. Med.)--University of Sydney, 2001.Title from title screen (viewed Apr. 23, 2008). Submitted in fulfilment of the requirements for the degree of Master of Science in Medicine to the Dept. of Anaesthesia and Pain Management, Faculty of Medicine. Includes bibliography. Also available in print form.
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Maity, Krupal Robeshkumar. "Targeting the trigeminal nerve system for orofacial pain treatment." Thesis, University of Iowa, 2013. https://ir.uiowa.edu/etd/2576.
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Orofacial pain is associated with various pathologies such as headache, dental pain and ophthalmic pain. The trigeminal system innervates a large section of the head, including the nasal and oral cavities, the cornea and facial skin, and is responsible for the transmission of pain signals from the orofacial regions to the brain.
These investigations were undertaken to study the effect of intranasal delivery of analgesics on orofacial pain using an operant testing method in mice. Doses of either lidocaine HCl or butorphanol tartrate were administered to mice, and the analgesic effectiveness was measured using a thermal operant behavior test involving a facial heat stimulus. Two parameters were measured in the operant assay: the number of licks and the duration of facial contact. Pain response was measured at two different temperatures: 37 ºC and 49 ºC. The magnitude of analgesic response was also compared between intranasal and intraperitoneal drug administration at 49 ºC.
Mice showed a significant decrease in the number of licks and duration of facial contact for both treatment and control groups as the temperature was increased from 37 ºC to 49 ºC. A significant difference in the duration of facial contact was observed following either lidocaine or butorphanol by nasal administration. One group of animals receiving intranasal lidocaine did exhibit an increase in the duration of facial contact compared to the control. Two doses of butorphanol were tested and increases in the duration of facial contact were observed at both levels, but no significant difference was observed in the number of licks recorded.
No convincing differences were observed in the mice behaviors for intranasal or intraperitoneal dosing of lidocaine or butorphanol. This suggests that nasal administration of these two analgesics at the doses tested did not provide superior pain relief compared to systemic delivery of the agents.
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Harendrababu, Kavitha. "Changes to Jaw Movement after Experimental Pain." Thesis, The University of Sydney, 2016. http://hdl.handle.net/2123/15572.
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To determine whether is any resolution of a brief episode of orofacial pain, and significant changes in jaw motor activity that persist beyond the period of pain, the experiment was conducted. Chewing jaw movements were recorded during free chewing and chewing standardized for rate, in 10 asymptomatic participants. The same procedure without injection was done in 10 control group. Participants completed clinical examination of horizontal and vertical jaw excursions, and also both DASS-21 and the PCS. Pain intensity was maintained (40-60/100 mm) level throughout the continuous infusion period. The mean velocity and the mean amplitude of the opening and return closing phases of the chewing cycles were analyzed using ANOVA. The data was analyzed for main effects of block and for interaction between block and group and also for each of the outgoing and closing phases for each of the free and the standardized chewing movements. The data suggest that there were no significant differences (p>0.05) between the experimental pain and control groups for age, measurements of maximum jaw opening, for the total score of the (PCS) or for the scores of depression, anxiety or stress.
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Leong, Sook Ling. "The prevalence of phantom tooth pain/atypical odontalgia." Master's thesis, Faculty of Dentistry, 2003. http://hdl.handle.net/2123/4891.
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This work was digitised and made available on open access by the University of Sydney, Faculty of Dentistry and Sydney eScholarship . It may only be used for the purposes of research and study. Where possible, the Faculty will try to notify the author of this work. If you have any inquiries or issues regarding this work being made available please contact the Sydney eScholarship Repository Coordinator - ses@library.usyd.edu.au
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Kniffin, Tracey Christine. "CHRONIC OROFACIAL PAIN INFLUENCES SELF-REGULATION IN A RODENT MODEL." UKnowledge, 2012. http://uknowledge.uky.edu/psychology_etds/10.
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Self-regulation is the capacity to exert control over cognition, emotion, behavior, and physiology. Since chronic pain interferes with the ability to self-regulate, the primary goal of this study was to examine, in rodents, the effects of chronic pain on self-regulation processes. Sixteen male Sprague-Dawley rats were divided into two groups: (1) chronic constriction injury of the infraorbital nerve (CCI-ION) and (2) naïve. Testing confirmed that CCI-ION animals had significant mechanical allodynia compared to naïve animals (p<0.001). A two-part self-regulation behavioral paradigm consisting of a cued go/no-go task and a subsequent persistence task was developed based on human paradigms. In the cued task, both groups made fewer incorrect lever presses in post-surgery trials (p<0.001); naive animals had a greater decrease in number of incorrect presses than CCI-ION animals (p=0.06). Similarly, both groups had a larger correct to total lever presses ratio in post-surgery trials (p<0.001); naïve animals had a greater increase than CCI-ION animals (p=0.06). In the persistence task, naïve animals experienced a greater decrease in lever presses (p=0.08) than did CCI-ION animals (p=0.66). These results suggest that animals experiencing chronic pain were not able to learn as well as naïve animals, and may have difficulty responding to novel environmental demands.
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Alattar, Ali. "INFLUENCE OF OROFACIAL PAIN AND PSYCHOLOGICAL FACTORS ON SLEEP QUALITY." Thesis, Malmö högskola, Odontologiska fakulteten (OD), 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-19956.
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SyfteUndersöka påverkan av kronisk orofacial smärta och psykologiska faktorer på sömnkvalitet vid käkmuskelmyalgi.Material och metoderDenna retrospektiva studie omfattade 37 patienter (6 män, 31 kvinnor, medelålder: 49 år) med käkmuskelmyalgi. Sömnkvalitet (Pittsburgh Sleep Quality Index), smärtintensitet och smärtrelaterad funktionsnedsättning (Graded Chronic Pain Scale), depression (Patient Health Questionnaire-9), ångest (General Anxiety Disorder-7), stress (Perceived Stress Scale-10) och katastrofiering (Patient Catastrophizing Scale) undersöktes med varierade formulär. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) användes för att identifiera patienter med myalgi i käkmuskulatur.Resultat75% av patienterna rapporterade dålig sömnkvalitet, 73% rapporterade minst mild depressionsgrad, 54% rapporterade minst mild ångest, 59% rapporterade måttlig stressnivå och 38% rapporterade kliniskt relevant katastrofiering. Försämrad sömnkvalitet var relaterad till depression (rs = 0.45, n = 37, p = 0.008) ångest (rs = 0.46, n = 37, p = 0.007), stress (rs = 0.43, n = 37, p = 0.014) och katastrofiering (rs = 0.37, n = 37, p = 0.034). Multivariat logistisk regression visade att smärtintensitet, smartrelaterad funktionsnedsättning, depression, ångest, stress, katastrofiering och antal käkmuskler med refererad palpationssmärta förklarade dålig sömnkvalitet signifikant (p = 0.031).KonklusionSömnkvaliteten hos patienter med käkmuskelmyalgi påverkas i hög grad av kronisk smärtintensitet, smärtrelaterad funktionsnedsättning, antal käkmuskler med refererad palpationssmärta och depression samt ångest, stress och katastrofiering.AimInvestigate the influence of chronic orofacial pain and psychological factors on sleep quality in patients with myalgia of the masticatory muscles.Material and methodsThis retrospective study included 37 patients (6 men, 31 women, mean age: 49 years) with masticatory muscle myalgia. Sleep quality (Pittsburgh Sleep Quality Index), pain intensity and pain-related disability (Graded Chronic Pain Scale), depression (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder-7), stress (Perceived Stress Scale-10) and catastrophizing (Patient Catastrophizing Scale) were assessed by questionnaires. The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were used to identify patients with myalgia.Results75% of the patients reported poor sleep quality, 73% reported at least mild depression degree, 54% reported at least mild degree of anxiety, 59% reported at least a moderate stress level and 38% reported a clinically relevant degree of catastrophizing. Impaired sleep quality was related to degree of depression (rs = 0.45, n = 37, p = 0.008), anxiety (rs = 0.46, n = 37, p = 0.007), stress (rs = 0.43, n = 37, p = 0.014) and catastrophizing (rs = 0.37, n = 37, p = 0.034). Multivariate logistic regression showed that characteristic pain intensity, degree of pain-related disability, depression, anxiety, stress, catastrophizing and number of masticatory muscle sites with referred pain significantly explained poor sleep quality (p = 0.031).ConclusionSleep quality in patients with masticatory myalgia is influenced by chronic pain intensity and related disability, number of masticatory muscle sites with referred pain as well as depression, anxiety, stress and catastrophizing.
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Vickers, Edward Russell. "Neuropathic orofacial pain: a review and guidelines for diagnosis and management." Thesis, The University of Sydney, 2001. http://hdl.handle.net/2123/806.
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Neuropathic pain is defined as "pain initiated or caused by a primary lesion or dysfunction in the nervous system". In contrast to physiological pain that warns of noxious stimuli likely to result in tissue damage, neuropathic pain serves no protective function. Examples of neuropathic pain states include postherpetic neuralgia (shingles) and phantom limb / stump pain. This pain state also exists in the orofacial region, with the possibility of several variants including atypical odontalgia and burning mouth syndrome. There is a paucity of information on the prevalence of neuropathic pain in the orofacial region. One study assessed patients following endodontic treatment and found that approximately 3 to 6percent of patients reported persistent pain. Patients predisposed to the condition atypical odontalgia (phantom tooth pain) include those suffering from recurrent cluster or migraine headaches. Biochemical and neurobiological processes leading to a neuropathic pain state are complex and involve peripheral sensitisation, and neuronal plasticity of the central and peripheral nervous systems. Subsequent associated pathophysiology includes regional muscle spasm, sympathetic hyperfunction, and centralisation of pain. The relevant clinical features of neuropathic pain are: (i) precipitating factors such as trauma or disease (infection), (ii) pain that is frequently described as having burning, paroxysmal, and lancinating or sharp qualities, and (iii) physical examination may indicate hyperalgesia, allodynia and sympathetic hyperfunction. The typical patient complains of persistent, severe pain, yet there are no clearly identifiable clinical or radiographic abnormalities. Often, due to the chronicity of the problem, afflicted patients exhibit significant distress and are poor pain historians, thus complicating the clinician's task of obtaining a detailed and relevant clinical and psychosocial history. An appropriate analgetic blockade test for intraoral sites of neuropathic pain is mucosal application of topical anaesthetics. Other, more specific, tests include placebo controlled lignocaine infusions for assessing neuropathic pain, and placebo controlled phentolamine infusions for sympathetically maintained pain. The treatment and management of neuropathic pain is multidisciplinary. Medication rationalisation utilises first-line antineuropathic drugs including tricyclic antidepressants, and possibly an anticonvulsant. Topical applications of capsaicin to the gingivae and oral mucosa are a simple and effective treatment. Neuropathic pain responds poorly to opioid medication. Psychological assessment is often crucial in developing strategies for pain management. Psychological variables include distress, depression, expectations of treatment, motivation to improve, and background environmental factors. To enable a greater understanding of neuropathic pain, thereby leading to improved treatments, high-performance liquid chromatography-mass spectrometry is one analytical technique that has the potential to contribute to our knowledge base. This technique allows drugs and endogenous substances to be assayed from one sample in a relatively short time. The technique can identify, confirm, and measure the concentrations of multiple analytes from a single sample.
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Vickers, Edward Russell. "Neuropathic orofacial pain: a review and guidelines for diagnosis and management." University of Sydney. Anaesthesia and Pain Management, 2001. http://hdl.handle.net/2123/806.
Full textAbstract:
Neuropathic pain is defined as "pain initiated or caused by a primary lesion or dysfunction in the nervous system". In contrast to physiological pain that warns of noxious stimuli likely to result in tissue damage, neuropathic pain serves no protective function. Examples of neuropathic pain states include postherpetic neuralgia (shingles) and phantom limb / stump pain. This pain state also exists in the orofacial region, with the possibility of several variants including atypical odontalgia and burning mouth syndrome. There is a paucity of information on the prevalence of neuropathic pain in the orofacial region. One study assessed patients following endodontic treatment and found that approximately 3 to 6percent of patients reported persistent pain. Patients predisposed to the condition atypical odontalgia (phantom tooth pain) include those suffering from recurrent cluster or migraine headaches. Biochemical and neurobiological processes leading to a neuropathic pain state are complex and involve peripheral sensitisation, and neuronal plasticity of the central and peripheral nervous systems. Subsequent associated pathophysiology includes regional muscle spasm, sympathetic hyperfunction, and centralisation of pain. The relevant clinical features of neuropathic pain are: (i) precipitating factors such as trauma or disease (infection), (ii) pain that is frequently described as having burning, paroxysmal, and lancinating or sharp qualities, and (iii) physical examination may indicate hyperalgesia, allodynia and sympathetic hyperfunction. The typical patient complains of persistent, severe pain, yet there are no clearly identifiable clinical or radiographic abnormalities. Often, due to the chronicity of the problem, afflicted patients exhibit significant distress and are poor pain historians, thus complicating the clinician's task of obtaining a detailed and relevant clinical and psychosocial history. An appropriate analgetic blockade test for intraoral sites of neuropathic pain is mucosal application of topical anaesthetics. Other, more specific, tests include placebo controlled lignocaine infusions for assessing neuropathic pain, and placebo controlled phentolamine infusions for sympathetically maintained pain. The treatment and management of neuropathic pain is multidisciplinary. Medication rationalisation utilises first-line antineuropathic drugs including tricyclic antidepressants, and possibly an anticonvulsant. Topical applications of capsaicin to the gingivae and oral mucosa are a simple and effective treatment. Neuropathic pain responds poorly to opioid medication. Psychological assessment is often crucial in developing strategies for pain management. Psychological variables include distress, depression, expectations of treatment, motivation to improve, and background environmental factors. To enable a greater understanding of neuropathic pain, thereby leading to improved treatments, high-performance liquid chromatography-mass spectrometry is one analytical technique that has the potential to contribute to our knowledge base. This technique allows drugs and endogenous substances to be assayed from one sample in a relatively short time. The technique can identify, confirm, and measure the concentrations of multiple analytes from a single sample.
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Vickers, Edward Russell. "Neuropathic orofacial pain: a review and guidelines for diagnosis and management." Thesis, The University of Sydney, 2001. https://hdl.handle.net/2123/806.2.
Full textAbstract:
Neuropathic pain is defined as "pain initiated or caused by a primary lesion or dysfunction in the nervous system". In contrast to physiological pain that warns of noxious stimuli likely to result in tissue damage, neuropathic pain serves no protective function. Examples of neuropathic pain states include postherpetic neuralgia (shingles) and phantom limb / stump pain. This pain state also exists in the orofacial region, with the possibility of several variants including atypical odontalgia and burning mouth syndrome. There is a paucity of information on the prevalence of neuropathic pain in the orofacial region. One study assessed patients following endodontic treatment and found that approximately 3 to 6percent of patients reported persistent pain. Patients predisposed to the condition atypical odontalgia (phantom tooth pain) include those suffering from recurrent cluster or migraine headaches. Biochemical and neurobiological processes leading to a neuropathic pain state are complex and involve peripheral sensitisation, and neuronal plasticity of the central and peripheral nervous systems. Subsequent associated pathophysiology includes regional muscle spasm, sympathetic hyperfunction, and centralisation of pain. The relevant clinical features of neuropathic pain are: (i) precipitating factors such as trauma or disease (infection), (ii) pain that is frequently described as having burning, paroxysmal, and lancinating or sharp qualities, and (iii) physical examination may indicate hyperalgesia, allodynia and sympathetic hyperfunction. The typical patient complains of persistent, severe pain, yet there are no clearly identifiable clinical or radiographic abnormalities. Often, due to the chronicity of the problem, afflicted patients exhibit significant distress and are poor pain historians, thus complicating the clinician's task of obtaining a detailed and relevant clinical and psychosocial history. An appropriate analgetic blockade test for intraoral sites of neuropathic pain is mucosal application of topical anaesthetics. Other, more specific, tests include placebo controlled lignocaine infusions for assessing neuropathic pain, and placebo controlled phentolamine infusions for sympathetically maintained pain. The treatment and management of neuropathic pain is multidisciplinary. Medication rationalisation utilises first-line antineuropathic drugs including tricyclic antidepressants, and possibly an anticonvulsant. Topical applications of capsaicin to the gingivae and oral mucosa are a simple and effective treatment. Neuropathic pain responds poorly to opioid medication. Psychological assessment is often crucial in developing strategies for pain management. Psychological variables include distress, depression, expectations of treatment, motivation to improve, and background environmental factors. To enable a greater understanding of neuropathic pain, thereby leading to improved treatments, high-performance liquid chromatography-mass spectrometry is one analytical technique that has the potential to contribute to our knowledge base. This technique allows drugs and endogenous substances to be assayed from one sample in a relatively short time. The technique can identify, confirm, and measure the concentrations of multiple analytes from a single sample.
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Goldthorpe, Joanna. "Developing and evaluating a complex intervention to treat chronic orofacial pain." Thesis, University of Manchester, 2012. https://www.research.manchester.ac.uk/portal/en/theses/developing-and-evaluating-a-complex-intervention-to-treat-chronic-orofacial-pain(29158f44-c916-41c4-a84f-c6481437dc9e).html.
Full textAbstract:
Introduction: Chronic orofacial pain (COFP) is distressing and disabling to sufferers and can be costly to patients, health services and society. Frequently, no underlying medical pathology can be found to account for the condition. Despite this, patients are treated according to a biomedical model, often by mechanistic and invasive procedures, which tend to be unsuccessful and not evidence based. Evidence suggests that cognitive behavioural therapy (CBT) based management may produce improved outcomes for patients. However, published studies can tell us little about which intervention components are effective, or recommend an optimum way for these components to be applied. Aim: To develop an evidence based intervention for the management of COFP that is feasible and acceptable to patients and practitioners. Method: The Medical Research Council’s guidelines for developing complex interventions were used as a framework for the research. Evidence from multiple sources was synthesised to produce the draft components of an intervention to manage COFP. An exploratory trial investigated preliminary outcomes, acceptability, feasibility and explored parameters for a full scale randomised control trial. Results: The intervention was acceptable to participants and could be feasibly implemented. No conclusions could be drawn relating to the effectiveness of the intervention. Participants were not affected at baseline for a number of outcomes, which implies that cut off points should be introduced into the inclusion and exclusion criteria of any future studies. Conclusion: The study produced an intervention which is acceptable and feasible to participants, however it is not known if it is effective. A number of recommendations are made for progression to a larger, definitive trial.
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Madland, Roderick Geir. "Cognitions, chronicity, distress and disability in temporomandibular disorder (idiopathic orofacial pain)." Thesis, University College London (University of London), 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.402172.
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Sae-Lee, Daraporn. "Effects Of Experimentally Induced Jaw Muscle Pain On Jaw Muscle Activity And Jaw Movement During Standardized Jaw Tasks." Thesis, The University of Sydney, 2007. http://hdl.handle.net/2123/4969.
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Barbosa, Breno Ferreira. "Ação antinociceptiva do Cyclo(Gly-Pro) sobre a dor orofacial em roedores." Universidade Federal de Sergipe, 2014. https://ri.ufs.br/handle/riufs/5888.
Full textAbstract:
Cyclo(Gly-Pro)(CGP) is a dipeptide that can be extracted from the fungus Rhizoctonia
sp. or synthesized. The Rhizoctonia is a derived the kingdom Fungi, whose representatives
inhabiting endophytic soil organisms of various vegetables genre. Among the plants
possessing this fungus, deserves mastic-red (Schinus terebinthifolius Raddi) which is
popularly used for different purposes, including inflammation. Thus, the aim of this study was
to evaluate the possible antinocicetivo action on orofacial pain of Cyclo(Gly-Pro) in rodents.
To this end, 90 male Swiss mice (25 to 35g) with 2 to 3 months were used. The animals were
divided into groups and were treated with CGP concentrations of 0.1 , 1 and 10 mg / kg
administered intraperitoneally (i.p.) , vehicle (0.9% saline solution, i.p.) or standard drug (i.p.)
. In order to evaluate the effects of CGP on orofacial nociception tests orofacial pain formalin
(2%), capsaicin and glutamate - induced were performed. The motor coordination of the
animals was assessed by testing the spontaneous movement. Results were expressed as mean
± SEM Differences between groups were analyzed using the analysis of variance ANOVA,
one-way, and followed by Tukey test. P values < 0.05 were considered statistically significant.
In the three nociceptive orofacial test, CGP produced a significant reduction (p < 0.001) in the
orofacial region of friction time when compared to the control goup, plus there is some
significant difference between groups (p <0.01). No changes were observed in the test of
spontaneous movement. Thus, it is concluded that the CGP has antinociceptive and that the
spontaneous movement test, the CGP was not able to alter motor coordination of animals in
the doses evaluated.Cyclo(Gly-Pro) (CGP) é um dipeptídeo que pode ser extraído do fungo Rhizoctonia sp. ou sintetizado. A Rhizoctonia é um gênero pertecente ao reino Fungi, cujos representantes habitam o solo endofítico de vários organismos vegetais. Dentre as plantas que possuem este fungo, merece destaque a aroeira-vermelha (Schinus terebinthifolius Raddi) que é utilizada popularmente para diferentes finalidades, incluindo inflamação. Desta forma, o objetivo do presente estudo foi avaliar a possível ação antinociceptiva sobre dor orofacial do Cyclo(Gly- Pro) em roedores. Para tanto, foram utilizados 90 camundongos Swiss machos (25 a 35 g) com 2 a 3 meses. Os animais foram divididos em grupos e foram tratados com CGP nas concentrações de 0,1, 1 e 10 mg/kg administrados via intra-peritoneal (i.p.), controle (solução salina 0,9% , i.p.) ou droga padrão (i.p.). Com o intuito de avaliar a ação do CGP sobre a nocicepção orofacial, foram realizados os testes de dor orofacial induzida por formalina (2%), capsaicina e glutamato. A coordenação motora dos animais foi avaliada através do teste da movimentação espontânea. Os resultados foram expressos como média ± E.P.M. As diferenças entre os grupos foram analisadas através do teste de variância ANOVA, uma via, seguido pelo teste de Tukey. Valores de p < 0,05 foram considerados estatisticamente significantes. Nos três testes de nocicepção orofacial, o CGP produziu uma redução significativa (p < 0,001) no tempo de fricção da região orofacial quando comparado ao grupo controle, além de haver diferença significativa entre alguns grupos (p < 0,01). Não foram observadas alterações motoras no teste da movimentação espontânea. Conclui-se, assim, que o CGP apresenta ação antinociceptiva e que no teste de movimentação espontânea, o CGP não foi capaz de alterar a coordenação motora dos animais, nas doses avaliadas.
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Santos, Diego Junior da Silva. "Avaliação da percepção da dor no tratamento ortodôntico: ensaio clínico randomizado." Universidade do Estado do Rio de Janeiro, 2014. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=8436.
Full textAbstract:
Conselho Nacional de Desenvolvimento Científico e TecnológicoO objetivo deste trabalho foi avaliar através de questionários de escalas visuais analógicas a percepção da dor após a inserção do primeiro arco ortodôntico, comparando-se o efeito analgésico de ibuprofeno, acetaminofeno, placebo e goma de mascar. Este trabalho também partiu da hipótese de que ibuprofeno, acetaminofeno e gomas de mascar seriam mais eficazes que placebo no controle da dor de origem ortodôntica e que gomas de mascar poderiam ser uma alternativa ao uso de ibuprofeno e acetaminofeno no manejo da dor dentária de origem ortodôntica. Neste estudo, tomaram parte 41 pacientes da Clínica de Ortodontia da Faculdade de Odontologia da Universidade do Estado do Rio de Janeiro. Os pacientes foram aleatoriamente distribuídos em cinco diferentes grupos: placebo, acetaminofeno 500 miligramas, ibuprofeno 400 miligramas, goma de mascar e controle. Todos os indivíduos tiveram bráquetes com slots .022" colados em seus dentes e molares bandados em uma das arcadas. Os grupos placebo, ibuprofeno e acetaminofeno foram orientados a tomar 01 cápsula do respectivo composto logo após a inserção do arco inicial de liga de níquel-titânio de dimensão .014 e, se a dor persistisse, a cada 6 horas por uma semana.O grupo goma de mascar foi orientado a mascar um tablete de goma por 5 minutos imediatamente após a inserção do arco inicial de liga de níquel-titânio de dimensão .014 e a cada 6 horas por 5 minutos durante uma semana, caso a dor persistisse. O grupo controle recebeu nenhum método de controle da dor. Os indivíduos foram orientados a marcar nas escalas visuais analógicas nas primeiras 24 horas, às 09:00, 13:00, 17:00, 21:00 a percepção de dor espontânea e durante a mastigação. Do terceiro até o vigésimo primeiro dia as marcações foram feitas somente em dois tempos às 09:00 e 21:00. Através da análise estatística descritiva, concluiu-se que o placebo foi mais eficiente que ibuprofeno, acetaminofeno e goma de mascar no controle da dor ortodôntica, tanto em dor espontânea quanto em dor durante a mastigação. O grupo goma de mascar foi tão eficiente quanto o acetaminofeno no controle da dor espontânea 24 horas após a inserção do arco inicial. Para alívio da dor durante a mastigação, a goma de mascar pode ser uma alternativa à atuação medicamentosa no controle da dor ortodôntica.
The aim of this study was to evaluate the pain perception after orthodontics adjustment by visual analogue scale questionaires. Thus, were compared the analgesic effect of ibuprofen, acetaminophen, placebo and chewing gum. The initial hypothesis was that ibuprofen, acetaminophen, and chewing gum would be more effective than placebo in controlling orthodontic pain and that chewing gum could be an effective alternative to the use of ibuprofen and acetaminophen in the management of dental pain of orthodontic origin. Patients were randomly assigned to one of five groups: placebo, acetaminophen 500 milligrams, ibuprofen 400 mg, chewing gum and control. All subjects had brackets with slots .022 bonded to their teeth and banded molars in one of the arches. The placebo, ibuprofen and acetaminophen groups were instructed to take 1 capsule of the respective compound shortly after the insertion of the initial .014" nickel-titanium arch and every 6 hours for a week if the pain persisted, the chewing gum group was instructed to chew a stick of gum for 5 minutes immediately after insertion of the initial arch of nickel-titanium .014 dimension and every 6 hours for 5 minutes for a week if the pain persisted and the control group received no method of pain control. The subjects were instructed to mark the visual analogue scales in the first 24 hours, at 9am, 1pm, 5 pm and 9 pm their perception of spontaneous pain and pain during chewing. From the third to the twenty-first day the markings were made only at two times: 9:00 and 21:00. According to the descriptive statistics analysis, placebo was more effective than ibuprofen, acetaminophen and chewing gum in the control of orthodontic pain in both spontaneous pain and in pain during masticatory function. Chewing gum was as effective as acetaminophen in the control of spontaneous pain 24 hours after initial arch insertion. For pain relief during masticatory function, the chewing gum can be an alternative to ibuprofen and acetaminophen in the control of orthodontic pain.
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Palesy, Peter D. "The involvement of the styloid process in head and neck pain : a preliminary study." Thesis, The University of Sydney, 2000. http://hdl.handle.net/2123/4830.
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Alshelh, Zeynab. "Infra-slow oscillations in chronic orofacial neuropathic pain and the effects of palmitoylethanolamide." Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/18655.
Full textAbstract:
For centuries, chronic pain was denied as being real by physicians, mainly because there was no evidence of tissue damage. The lack of understanding of the neural mechanisms underlying chronic pain, particular that arising from nervous system damage, has hindered treatment development which has led to the over-prescription of opioids. Whilst the brain circuitry responsible for the perception of acute painful stimuli have been mapped in both animal studies and studies using brain imaging in awake humans, the circuitry responsible for the initiation and maintenance of chronic pain remain unknown. Over the past few decades, many human brain imaging investigations have shown that neuropathic pain is associated with altered brain rhythms and in particular thalamocortical dysrhythmia. In addition, animal studies have shown that neuropathic pain is associated with altered non-neural function including microglial and astrocyte activation at the level of the primary afferent synapse. These results have led to theories that non-neuronal cells may be crucial for the initiation and maintenance of chronic pain, particularly chronic neuropathic pain. It has been a long held view that astrocytes mainly play the role of neural support in the central nervous system, however, these cells are also capable of controlling neural function. In fact, astrocytes have access to every neural synapse and animal models of chronic neuropathic pain have shown that targeting astrocytes can control pain intensity. As such, the focus of this thesis is to identify the role of astrocytes in modulating neural function in chronic neuropathic pain and to determine whether reducing astrocyte activity can reduce pain intensity. There are three main investigations that make up this thesis, the first describes an experimental procedure whereby on-going patterns of neural activity were assessed in patients with orofacial neuropathic pain using resting state functional magnetic resonance imaging. The second attempts to measure an anatomical marker of astrocyte activation. And the final investigation describes an experimental procedure whereby patients with orofacial neuropathic pain were administered an astrocyte modulator, palmitoylethanolamide (PEA) and neural activity was compared before and after treatment.
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Deshpande, Suhas. "A Retrospective Analysis Of Orofacial Pain Patients At Westmead Centre For Oral Health." Thesis, Faculty of Dentistry, 2004. http://hdl.handle.net/2123/4191.
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Polido, Aline. "Eletromiografia de superfície dos músculos orbicular da boca, bucinador, supra-hióideos e masseteres de pacientes com disfunção temporomandibular durante exercícios miofuncionais orais." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/5/5160/tde-18022010-132843/.
Full textAbstract:
O objetivo deste estudo foi avaliar a atividade elétrica dos músculos da mímica de pacientes com dor muscular mastigatória utilizando eletromiografia de superfície. Foram avaliadas 15 mulheres com dor muscular mastigatória (idade média de 33.4, variando de 22-44), grupo de estudo (GMM) e 21 mulheres (idade média de 28.5, variando de 21-45), do grupo controle (GC) Foram realizadas avaliação clínica fonoaudiológica e eletromiográfica (eletromiógrafo ADS 1200, da Lynx Tecnologia Eletrônica Ltda, eletrodos de disco de prata, descartáveis, gel condutor, auto-adesivos com 10mm de diâmetro por HAL Ind. e Com. LTDA) dos músculos: orbicular dos lábios, bucinador, supra-hióideos e masseter em repouso e nos movimentos: protrusão dos lábios, apertamento dos lábios, inflar bochechas, sorriso fechado e sorriso aberto. Houve diferença significativa entre os grupos: os valores da eletromiografia de repouso foram inferiores para o músculo masseter direito (p=0.012) e esquerdo (p=0.019); nos movimentos, os valores eletromiográficos foram superiores no grupo controle durante os movimentos: protrusão dos lábios bucinador esquerdo (p=0.005); suprahióideo esquerdo (p=0.011); apertamento dos lábios bucinador esquerdo (p=0.005); bucinador direito (p=0.007); supra-hióideo esquerdo (p=0.046); supra-hióideo direito (p=0.039); orbicular superior (p=0.042); inflar as bochechas masseter esquerdo (p=0.021); bucinador esquerdo (p=0.007); bucinador direito (p=0.002); orbicular superior (p=0.039); sorriso fechado masseter esquerdo (p=0.004); masseter direito (p=0.019); bucinador esquerdo (p=0.013); supra-hióideo esquerdo (p=0.046) e no sorriso aberto masseter esquerdo (p=0.030). Desta forma, o músculo de maior atividade eletromiográfica foi o orbicular da boca. No repouso, os valores foram inferiores para o masseter e superiores para os demais músculos e nos movimentos, os valores foram superiores em todos os músculos para o grupo de estudoThe objective this study is assess the electric activity of mimic muscles in patients with masticatory muscle pain using surface electromyography (EMG). Was evaluated 15 women with masticatory muscle pain (mean age 33.4, ranging between 22 44 years old), study group (GMM) and 21 women (mean age 28.5, ranging between 21 45 years old), control group (CG). Clinical phonoaudiological and electromyographic assessments were performed (electromyograph ADS 1200 of Lynx Tecnologia Eletrônica Ltda, 10mm disposable pregelled self-adhesive silver disk electrodes of HAL Ind. e Com. LTDA) in the muscles: orbicularis oris, buccinator, suprahyoid and masseter, both at rest and in movement: lip protrusion, lip contraction, cheek inflation, close smile and open smile. There was significant difference between the groups: the values of the electromyography at rest were lower for the right and left masseter muscle (p=0.012 and p=0.019, respectively); in movement, the eletromyographic values were higher in the group control during movement: lip protrusion right buccinator (p=0.005); left suprahyoid (p=0.011); lip contraction left buccinator (p=0.005); right buccinator (p=0.007); left suprahyoid (p=0.046); right suprahyoid (p=0.039); orbicularis oris (p=0.042); cheek inflation left masseter (p=0.021); left buccinator (p=0.007); right buccinator (p=0.002); orbicularis oris (p=0.039); closed smile left masseter (p=0.004); right masseter (p=0.019); left buccinator (p=0.013); left suprahyoid (p=0.046); open smile left masseter (p=0.030). Thus, the orbicularis oris muscle presented the highest EMG activity. At rest, the values were lower for the masseter and higher for the other muscles and, in movement, the values were higher for all the muscles in the study group
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Hadsel, Morten. "COGNITIVE AND SOMATIC ITEM RESPONSE PATTERN OF OROFACIAL PAIN PATIENTS COMPARED TO FIBROMYALGIA PATIENTS AND A NON-PAIN CONTROL GROUP." UKnowledge, 2002. http://uknowledge.uky.edu/gradschool_theses/235.
Full textAbstract:
Previous work has suggested that chronic pain patients report psychological distress through higher endorsement of somatic rather than cognitive signs of anxiety and depression. The present study compared female Non-Pain (11=52), Orofacial Pain (n=3 17) and Fibromyalgia (n=50) groups. on SCL-90-R Somatization, Anxiety and Depression raw scores and cognitive-somatic symptom patterning of the Anxiety and Depression scales. Comparisons were also made amongst orofacial pain diagnostic subgroups and subgroups based on Multidimensional Pain Inventory (MPI) classification groups. The Somatization. Anxiety and Depression scores were higher in the OroFacial Pain and Fibromyalgia than Non-Pain group and higher in the Dysfunctional than Adaptive Coper MPI Profile group. No differences in somatic-cognitive symptom patterning existed among the diagnostic or the MPI groups/subgroups. OroFacial pain patients endorsing cognitive items stronger than somatic items on the Anxiety and/or Depression scales showed a tendency towards more psychopathology (higher SCL-90-R scale scores) than the participants endorsing somatic items more so than cognitive items. I n conclusion, study results indicate that differentiation of cognitive-somatic patterns does not contribute to increased understanding of chronic pain conditions.
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Schmidt, John E. "A CONTROLLED COMPARISON OF EMOTIONAL REACTIVITY AND PHYSIOLOGICAL RESPONSE IN CHRONIC OROFACIAL PAIN PATIENTS." UKnowledge, 2007. http://uknowledge.uky.edu/gradschool_diss/502.
Full textAbstract:
This study examined the emotional and physiological differences between masticatory muscle pain patients and age, height, and weight matched pain-free controls. Physiological activation and emotional reactivity were assessed in the 22 muscle pain patients and 23 pain-free controls during a baseline rest period, while discussing a personally relevant stressor, and during a post-stressor recovery period. Physiological activity was assessed through the use of the frequency domain heart rate variability indices. Activity in the high frequency heart rate variability range is an index of parasympathetic activity while activity in the low frequency heart rate variability range is an index of both sympathetic and parasympathetic activity (Akselrod, 1981). The muscle pain patients showed significantly more physiological activation during both the baseline rest and the post-stressor recovery periods. These physiological differences were quantified by higher low frequency heart rate variability and lower high frequency heart rate variability during these study periods. This pattern of higher activation was also present in the report of emotional reactivity in the muscle pain patients. The emotional and physiological differences between the groups across study periods were more pronounced in muscle pain patients who reported a traumatic life experience. These results provide evidence of physiological activation and emotional responding in masticatory muscle pain patients that differentiates them from matched pain-free controls. The use of HRV indices to measure physiological functioning quantifies the degree of sympathetic and parasympathetic activation. Study results suggest the use of these HRV indices will improve understanding of the role that excitatory and inhibitory mechanisms play in the onset and maintenance of chronic masticatory muscle pain conditions.
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Gillborg, Susanna. "Orofacial pain and tooth wear in swedish adults : cross-sectional studies in southern Sweden." Licentiate thesis, Malmö universitet, Odontologiska fakulteten (OD), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-7757.
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Aim. The present licentiate thesis investigated the prevalence of TMDpainand related factors, the prevalence and severity of tooth wear, andthe etiology and factors related to tooth wear in adults in southern Sweden.Methods. The methods used included a questionnaire, history, clinical examination,intraoral photographs, and saliva sample. In Paper I, twoscreening questions for TMD pain were used to query a study samplecomprising 6123 questionnaire participants about their pain experience.In Paper II, a clinical examination and intraoral photographs helped determinethe presence and severity of tooth wear. Information from a questionnaire,patient histories, and participant saliva samples were analyzedregarding tooth wear-related factors. The study sample comprised 831 individuals.Results. Paper I found a prevalence of TMD pain once a week or moreoften in 11% of the study sample. Related factors were female gender,subjects under 50 years of age, weekly headache, self-reports of poor generalhealth, impaired oral health-related quality of life, and tooth wear.Paper II showed tooth wear in all individuals. Attrition, the most commontooth wear, was found in over 90% of the study sample. Signs of erosionwere found in almost 80% of the individuals. Men had more tooth wearthan women, but none of the factors that were investigated as related factorsdiffered between the genders. Only some of the individuals, includingthe group with severe tooth wear reported having received information about tooth wear from their clinician. Participants reported receiving informationabout tooth wear due to extensive tooth brushing more thanabout erosion.Conclusions. Paper I found a prevalence of TMD pain in 11% of the studysample. In Paper II, attrition was found in over 90% of the study sample.Almost 80% of the individuals exhibited signs of erosion. Only a few reportedhaving received information about tooth wear due to erosion fromtheir clinician.
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Albuquerque, Romulo Jose Cunha. "Cerebral activation during thermal stimulation of burning mouth disorder patients an fMRI study /." Lexington, Ky. : [University of Kentucky Libraries], 2004. http://lib.uky.edu/ETD/ukydent2004t00219/fMRI%5FBMD.pdf.
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Thesis (M.S.)--University of Kentucky, 2004.Title from document title page (viewed January 7, 2005). Document formatted into pages; contains: viii, 71p. : ill. Includes abstract and vita. Includes bibliographical references (p. 58-70).
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Nassar, Afnan Anas. "Understanding temporomandibular disorders through prevalence and associated risk factors: An epidemiological and clinical analysis." Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/19944.
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This study aimed to determine the prevalence and characteristics of orofacial pain (OFP) with a focus on temporomandibular disorders (TMD) like symptoms in the population attending Westmead Hospital Centre for Oral Health (WHCOH). The second aim was to determine the frequency of TMD diagnostic groups and possible associated risk factors in treatment-seeking patients. For the first aim: 400 questionnaires were completed which deveolped from the Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD). For the second aim: 44 TMD patients and 30 matching controls were assessed with the RDC/TMD, Symptoms Checklist-90-Revised, clinical occlusal analysis and lateral cephalometric radiographs. Of the 400 surveyed participants, 61.5% reported at least one symptom of OFP while the most common were toothache (31.3%), jaw joint pain (23%) and muscle tenderness (17%). 35% of the pain participants reported that social and functional activities were significantly affected which encouraged treatment seeking behavior. Significant association between reporting OFP and socioeconomic factors were found (female (p<0.03) , age group of 40-50 years old (p<0.002), less than school education (p<0.002)). Clinically, the most frequent condition diagnosed with RDC/TMD in the 44 cases was right joint arthralgia (59%) and myofascial pain without limited opening (50%). Radiographically, TMD patients had longer anterior face heights (p=0.036) compared with controls. There was no significant difference between the skeletal classes across the RDC/TMD diagnostic groups. TMD cases showed significantly elevated psychological parameters (p≤0.001), number of mediotrusive contact (p=0.024) and bruxofacets (p=0.001) compared to controls. Prevalence of OFP was found higher than expected while TMD-like symptoms showed similar prevalence to the reported in Western countries. Association between OFP and socioeconomic factors were found. These findings can serve as base line information in the Australian population attending major dental hospital. Further population level surveys on the prevalence of TMD-like symptoms are still needed. Clinically, some risk factors were identified, however, there is still a need for larger longitudinal studies to confirm the results.
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Gomes, Cristina Manuela Ferreira. "Dor dentária não odontogénica." Master's thesis, [s.n.], 2015. http://hdl.handle.net/10284/5097.
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Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina DentáriaA odontalgia é a causa mais frequente de procura da medicina dentária. No entanto as dores sentidas nos dentes nem sempre têm origem dentária (dores odontogénicas) mas podem ser dores referidas, com origens muito diversas (dores não odontogénicas), pelo que o controlo ou a eliminação destas dores tem de estar suportado num diagnóstico abrangente e rigoroso sobre a sua origem, diagnóstico este difícil de fazer dada a similitude clínica que, muitas vezes, existe entre ambas. Do rigor deste diagnóstico, no entanto, dependerá a correção e eficácia do tratamento e, sobretudo, a prevenção da prescrição de tratamentos inadequados e com consequências que podem irreparáveis. Foi feita uma revisão bibliográfica narrativa sobre as dores orofaciais mais comuns e, em particular, sobre as dores dentárias não odontogénicas. Toothache is the most frequent cause of consultation in dentistry. The pains felt in the teeth, however, are not always of dental origin (odontogenic pain) but can be referred pain from many different sources (not odontogenic pain). The control or elimination of pain involves, however, an accurate diagnosis of the origin, but this is usually difficult to do given the appearance of clinical symptoms between them. From the accuracy of this diagnosis will depend on the correctness and effectiveness of the treatment and, above all, prevention of prescription of inappropriate treatment and irreparable consequences. It was made a narrative bibliographical review of the most common orofacial pain and especially about non-odontogenic dental pain.
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Nascimento, Glauce Crivelaro do. "Caracterização das gelatinases no gânglio trigeminal durante o desenvolvimento de inflamação crônica temporomandibular em ratos." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/58/58137/tde-09052011-134157/.
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A dor é um importante sintoma que sinaliza danos teciduais ou agentes potencialmente prejudiciais ao organismo, evocando respostas sensoriais e motoras de proteção. A dor orofacial apresenta alta prevalência na sociedade atual, sendo esta condição associada a tecidos duros e moles da cabeça, face, pescoço e a estruturas intraorais. Considerando as dores orofaciais de origem músculo-esquelética, destacam-se àquelas causadas pela Disfunção Temporomandibular (DTM). A DTM apresenta etiologia multifatorial, caracterizada por quadros crônicos envolvendo a região cervical, a musculatura mastigatória e a articulação temporomandibular (ATM). Desde que a inflamação das ATMs é considerada a principal causa da dor em pacientes portadores de DTM, a busca por novas opções terapêuticas para esta disfunção envolve estudos desta articulação, abrangendo aspectos fisiológicos, morfológicos e moleculares. Considerando o processo inflamatório e os aspectos moleculares envolvidos no desenvolvimento desta condição, é possível que as enzimas proteolíticas extracelulares, destacando-se as Metaloproteinases da Matriz (MMPs), as quais estão envolvidas na reabsorção de colágeno e de outras macromoléculas, tenham participação ativa neste processo. Em particular, estudos demonstraram que as MMPs estão envolvidas na modulação da dor neuropática, bem como estão presentes no líquido sinovial de portadores de inflamação da ATM. Sendo assim, o objetivo deste trabalho foi avaliar a influência da administração do Adjuvant de Freund (CFA) intraarticular, bilateralmente nas ATMs de ratos, na sensibilidade mecânica e nociceptiva, bem como avaliar a expressão das MMPs, em particular da MMP-2 e MMP-9, no gânglio trigeminal, nas diferentes fases de desenvolvimento da inflamação. Os resultados mostraram que a inflamação das ATMs promoveu alodinia mecânica e hiperalgesia orofacial. Em adição, a administração de doxiciclina (inibidor inespecífico das MMPs) reduziu as alterações na sensibilidade mecânica e nociceptiva. A quantificação das MMPs no gânglio trigeminal demonstrou que o início da inflamação promove aumento da MMP-9 (1 e 3 dias), enquanto que nas fases tardias do processo inflamatório acompanha-se o aumento da expressão da MMP-2 (3, 7 e 10 dias).Pain is an important symptom that signals tissue damage or potentially harmful agents to the body and evokes sensory and motor protection. The orofacial pain is a type of symptoms that appears in high prevalence in modern society. This painful condition is associated with hard and soft tissues of the head, face, neck and intraoral structures. Considering the pain of musculoskeletal origin, we can highlight those caused by temporomandibular dysfunction (TMD). The TMD has a multifactorial etiology, characterized primarily by chronic conditions involving the neck, the chewing muscles and temporomandibular joint (TMJ). Inflammation of the TMJ is considered the main cause of pain in patients with TMD. Thus, the search for new therapeutic options for this disorder involves studies in the TMJ region encompassing physiological, morphological and molecular aspects. Considering the inflammatory process as the main cause of pain present in TMD, it is extremely important to understand the molecular aspects involved in developing this condition. In this context, extracellular proteolytic enzymes, highlighting the metaloproteniases matrix metalloproteinases (MMPs) play major role in the resorption of collagen and other macromolecules. The proteolytic activity of these MMPs is controlled by tissue inhibitors of metalloproteinases (TIMPs), which contribute to the maintenance of metabolic balance and structure of the extracellular matrix. Therefore, the objective of this study was to assess whether the type MMP gelatinases (MMP-2 and MMP-9) of the trigeminal ganglion participate in the development of mechanical allodynia and hyperalgesia in rats orofacial chronic inflammation bilateral TMJ. Our results demonstrated the presence of orofacial hyperalgesia, as well as mechanical allodynia in animals with temporomandibular inflammation induced by CFA and an increase in the expression and activity of gelatinases in the trigeminal ganglion of these animals. Still, there was a decrease in nociceptive orofacial hipersensitivity in animals that received a non-specific inhibitor for MMPs (doxycycline, 30mg/kg/day) for 10 days.
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Machado, Laila Aguiar. "Influência do nível de atividade física no perfil somatossensorial mecânico orofacial." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/25/25146/tde-01102018-174257/.
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Não está esclarecido sobre o real papel da prática regular de atividade física em diferentes níveis de intensidade sobre o perfil somatossensorial mecânico doloroso na região orofacial em indivíduos saudáveis. Adicionalmente, aspectos psicossociais e comportamentais também têm sido descritos como capazes de interferir na percepção da dor. Este estudo buscou avaliar a influência do nível autorrelatado de atividade física no perfil somatossensorial mecânico doloroso e na qualidade de vida. 90 participantes adultos, com idade entre 18-40 anos, de ambos os sexos foram classificados em três grupos que se diferenciaram quanto à frequência, duração e intensidade de atividade física que realizaram nos últimos três meses. A classificação foi feita de acordo com alguns critérios modificados da versão resumida do Questionário Internacional de Atividade Física (IPAQ). Para avaliar a presença de alterações no perfil somatossensorial mecânico doloroso, foram realizados testes sensoriais quantitativos de limiar de dor mecânica (LDM), limiar de dor de pressão (LDP) e teste de somação temporal (WUR) na região do músculo temporal anterior e no músculo tenar da mão não dominante. Uma análise de variância (ANOVA) com os fatores intra-sujeito sítio (2 níveis) e os fatores inter-sujeitos sexo (2 níveis), nível de atividade física (3 níveis) e estilo de vida (2 níveis categorizados de acordo com a mediana da amostra total) foi aplicada para comparação das variáveis somatossensoriais. Para comparação das variáveis psicossociais entre os grupos, foi aplicado uma ANOVA com os fatores inter-sujeito nível de atividade física para avaliação da catastrofização e o teste de H de Kruskal-Wallis para comparar os níveis de ansiedade, estilo de vida e qualidade de vida. Os aspectos psicossociais diferiram de forma significativa entre os grupos, sendo que o grupo com baixo nível de atividade física apresentou os escores mais baixos no questionário sobre estilo de vida (p<0,009), e nos seguintes domínios da avaliação da qualidade de vida foram menores na capacidade funcional (p<0,002) e estado de saúde geral (p<0,014). Os escores relacionados à saúde mental do grupo com baixo nível de atividade física foram menores apenas em comparação ao grupo com moderado nível de atividade física (p=0,034). Embora o domínio vitalidade tenha apresentado um efeito principal do grupo significativo, as comparações múltiplas entre pares não revelaram diferenças entre os grupos (p<0,050). Não houve efeito principal significante do grupo para nenhuma das variáveis somatossensoriais (F<0,34 e p>0,416). Entretanto, houve um efeito principal do sítio para o PPT, em que os limiares da região tenar foram maiores que os do temporal anterior (Tukey: p <0.001). Por fim, embora a interação entre sítio, sexo e qualidade de vida tenha sido significativa para os valores de WUR (F=6,08 e p=0,015), as análises de comparações múltiplas não foram significantes nos principais pontos de comparação (p<0.050). O estudo concluiu que o autorrelato do nível de prática de atividades físicas não influencia de maneira significativa os limiares somatossensoriais mecânicos e a somação temporal na região orofacial, embora piores índices de qualidade de vida estejam presentes em participantes que reportam autorrelato de baixo nível de atividade física.The actual role of regular practice of physical activity at different levels of intensity on the somatosensory mechanical pain profile in the orofacial region in healthy individuals is still unclear. Psychosocial and behavioral aspects have also been described as capable of interfering with pain perception. This study aimed to evaluate the influence of the self-reported level of physical activity on painful mechanical somatosensory profile and quality of life. 90 adult participants, aged 18-40 years, of both sexes were classified into three groups that differed in the frequency, duration and intensity of physical activity that they performed in the last three months. The classification was made according to a modified criteria of the summary version of the International Physical Activity Questionnaire (IPAQ). In order to evaluate the presence of alterations in the somatosensory mechanical pain profile, quantitative sensory tests of mechanical pain threshold (MPT), pressure pain threshold (PPT) and temporal summation test (WUR) were performed in the anterior temporalis muscle region and the non-dominant hands thenar eminence. An analysis of variance (ANOVA) with intra-subject factors for site (2 levels) and inter-subject factor for sex (2 levels), level of physical activity (3 levels) and lifestyle (2 levels) was applied for comparison of somatosensory variables. To compare the psychosocial variables between the groups, an ANOVA was applied with the inter-subject factors level of physical activity for catastrophic evaluation and the Kruskal-Wallis H test to compare levels of anxiety, lifestyle and quality of life. Psychosocial aspects differed significantly among the groups, and the low level of physical activity had the lowest scores in the lifestyle questionnaire (p <0.009). The following domains of quality of life assessment were lower in functional capacity (p <0.002) and general health status (p <0.014). The scores related to the mental health of the group with low level of physical activity were smaller only in comparison to the group with moderate level of physical activity (p = 0.034). Although the vitality domain had a significant effect within each group, multiple paired comparisons did not reveal differences between groups (p <0.050). There was no significant effect of the group on any of the somatosensory variables (F <0.34 and p>0.416). However, there was a major effect of site for PPT, where the thresholds of the thenar region were higher than those of the anterior temporalis (Tukey: p <0.001). Finally, although the interaction between site, sex and quality of life was significant for WUR values (F = 6.08 and p = 0.015), the multiple comparison analysis were not significant in the main comparison points (p <0.050 ). The study concluded that self-reported level of physical activity does not significantly influence mechanical somatosensory thresholds and temporal summation in the orofacial region, although worse quality of life values are present in participants reporting low level of physical activity.
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Zheng, Jun, and 郑军. "Orofacial pain and its functional and psychosocial impact: a community-based study in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B41290987.
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Zheng, Jun. "Orofacial pain and its functional and psychosocial impact a community-based study in Hong Kong /." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B41290987.
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Alvarez, Fabio Kurogi. "Neuralgia pós-herpética trigeminal: avaliações clínica e de sensibilidade orofacial." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/5/5138/tde-05082008-095023/.
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A neuralgia pós-herpética é uma complicação da infecção pelo vírus da varicela zoster (VVZ). O nervo trigêmeo é acometido em cerca de 20-25% dos casos. Este estudo transversal teve como objetivo avaliar a sensibilidade orofacial de doentes com NPH trigeminal e identificar as características odontológicas da amostra. Foram utilizados os seguintes instrumentos de avaliação: exame sensitivo padronizado da face (algiometria, testes de sensibilidade térmica e táctil), questionário RDC/TMD, eixo I e II, (critérios de diagnóstico em pesquisa) para o diagnóstico de disfunção mandibular (DTM), protocolo para avaliação de dor orofacial (EDOF-HC), questionário McGill para avaliação de dor, exame periodontal (índice de placa - IP, índice de sangramento - IS, índice de profundidade clínica de sondagem - PCS e índice de profundidade clínica de inserção - PCI), e o índice CPO-D (somatória do número de dentes cariados, perdidos em razão de cárie dentária e restaurados). Houve diferença significativa entre o lado ipsolateral e o contralateral aos testes de sensibilidade no V1 com frio (p=0,038), vonFrey (p=0,008), alfinete (p=0,022) e algiometria (p=0,001); no V2 com frio (p=0,034), calor (p=0,019) e alfinete (p=0,037) e no V3 com frio (p= 0,042) e calor (p= 0,036); e na região intra-oral com alfinete (p=0,021). Dos 19 pacientes avaliados, 63,2% eram desdentados totais, a média do CPO-D foi de 28,3, a média do índice de placa foi de 48,0 e a média do índice de sangramento foi de 31,6. Neste estudo, 21% dos doentes relataram lesão na cavidade oral como sinal inicial do Herpes zoster. Com relação à condição músculo-esquelética da face (RDC/TMD), 78,9% tinha dor miofascial à palpação. Como conclusão destaca-se alteração de sensibilidade ipsolateral, mesmo nos ramos onde não houve erupção do VVZ, hipoalgesia em V1 e na mucosa oral ipsolateral; saúde oral comprometida, dor miofascial mastigatória e anormalidade da ATM na maioria dos doentes.Postherpetic neuralgia is a complication after a varicella-zoster virus infection (VZV), affecting the trigeminal nerve in about 15-25% of the cases. This transversal study had the objective to evaluate the orofacial sensitivity and odontological characteristics of patients with trigeminal postherpetic neuralgia. The instruments used were: mechanical, thermal and pain sensory test, RDC/TMD questionnaire axis I and II (research diagnostic criteria for temporomandibular disorders), EDOF-HC protocol (for orofacial pain), McGill´s questionnaire, periodontal form (plaque index, blending index, clinical insertion and clinical deep level measures, to evaluate the periodontal disease as well the activity of disease) and DMFT index (Add of the number of teeth decayed, lost because caries and restored). There was significant difference compared the affected and the opposite side for tests of sensitivity at V1 with cold (p=0.038), vonFrey (p=0.008), pinpricks (p=0.022) and algiometric (p=0.001); at V2 with cold (p=0.034), heat (p=0.019) and pinpricks (p=0.037) and at V3 with cold (p = 0.042) and heat (p = 0.036) and in the intra-oral region with pinpricks (p=0.021). 63.2 % was edentulous, the average of the DMFT was 28.3, the average of the plaque\'s index was 48 and the average of the blending index was 31.6. In this study, 21 % of the patients reported lesion in the oral cavity like initial sign of the Herpes zoster. 78.9 % had myofascial pain with palpation (RDC/TMD). The main conclusions were alteration of sensitivity in the ipsolateral, even in the branches wherethere were no eruptions of the VVZ, hypoalgesia at V1 and oral mucosa ipsolateral; poor oral heath, masticatory myofascial pain and abnormality of the TMJ in the majority of the patients.
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Gomes, KÃtia do Nascimento. "Modelo experimental de disfunÃÃo temporomandibular em ratos." Universidade Federal do CearÃ, 2005. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=287.
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Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgicoEstudos de comportamentos espontÃneos, atividade farmacolÃgica sobre os comportamentos alterados, avaliaÃÃo histopatolÃgica e alteraÃÃo de peso corporal foram realizados em ratos (180-300g), atravÃs da administraÃÃo de Adjuvante completo de Freund (CFA) na regiÃo da articulaÃÃo temporomandibular de ratos, a fim de investigar se um estÃmulo inflamatÃrio crÃnico promove alteraÃÃo de comportamento espontÃneo comparado a estÃmulo agudo ou subagudo como a formalina 2,5%. Os animais apÃs a injeÃÃo de CFA, formalina 2,5% e soluÃÃo salina fisiolÃgica 0,9% foram observados diariamente durante 30 minutos por 7 dias onde foram sacrificados para a remoÃÃo da regiÃo articular e periarticular para avaliaÃÃo de alteraÃÃo de parÃmetros inflamatÃrios frente a um estÃmulo pelo CFA e pela formalina 2,5% comparando com o grupo controle. As principais alteraÃÃes promovidas pelo CFA ocorreram no tempo de execuÃÃo de alguns comportamentos como movimento de rotaÃÃo da mandÃbula ou mastigaÃÃo (chewing like), tempo de descanso e sono (rest/sleeping), aparente congelamento (freezing) e auto cuidado como coÃar a face se pata anterior (grooming ou rubbing), enquanto que no grupo de animais da formalina 2,5%, os comportamentos alterados formam grooming e scratching. Os estudos comportamentais demonstram que o CFA possui uma atividade tempo dependente sobre comportamentos, pois essas alteraÃÃes ocorreram a partir do 2Âdia e persistiu atà o 7Âdia apÃs a administraÃÃo do CFA, ao passo que a formalina apresentou uma atividade principal no 1 dia de injeÃÃo. A administraÃÃo de drogas analgÃsicas (Morfina 4mg/Kg; Indometacina, 5mg/Kg e LidocaÃna com fenilefrina) demonstrou que o comportamento chewing like foi sensÃvel à aÃÃo da morfina e indometacina, o sleeping foi aumentado por administraÃÃo de lidocaÃna e indometacina, o tempo de execuÃÃo do comportamento grooming foi reduzido por atividade da morfina e lidocaÃna e o comportamento freezing nÃo foi alterado por aÃÃo de nenhuma das drogas administradas. Comparativamente, os comportamentos alterados pela atividade nociceptiva da formalina 2,5% na regiÃo orofacial dos animais foram grooming e scratching. A morfina e a lidocaÃna foram efetivas em reduzir o grooming e o scratching desenvolvidos pela formalina. A atividade de drogas classicamente analgÃsicas testadas sobre esses comportamentos pode caracterizÃ-los como nociceptivos. Foi observado tambÃm que o peso corporal dos animais nÃo foi alterado pela induÃÃo inflamatÃria do CFA. Comparando sessÃes histolÃgicas da regiÃo articular e periarticular da ATM dos ratos, observamos que no grupo do CFA hà presenÃa de infiltrado inflamatÃrio linfocitÃrio intenso comparado ao grupo da formalina, alÃm de alteraÃÃes degenerativas e pequeno infiltrado inflamatÃrio periarticular. NÃs sugerimos que o fenÃmeno da neuroplasticidade està relacionado Ãs alteraÃÃes comportamentais desenvolvidas pelo CFA e a identificaÃÃo de comportamentos relacionados a sua atividade inflamatÃria pode fornecer subsÃdios para a avaliaÃÃo de novos e melhores agentes terapÃuticos para o tratamento da dor orofacial como tambÃm avaliaÃÃo dos benefÃcios dos tratamentos jà existentes, em consonÃncia com os avanÃos no estudo de dor experimental.
Studies on rats spontaneous behaviors and pharmacological effects of drugs on them, as well as their body weight and histopathological analysis of their joints were carried out to investigate the effect of chronic inflammation of the temporomandibular articulation induced by the administration of Complete Freund Adjuvant (CFA) compared with the acute and subacute stimulus of 2.5% formalin. After CFA, 2.5% formalin and 0.9% saline injection, the animals were daily observed during 30 minutes for 7 days; thereafter, they were killed for removal of the articular and periarticular region for evaluation of inflammatory changes induced by CFA and formalin compared with control rats. The main behavioral changes induced by CFA concerned chewing-like, rest/sleeping, freezing, grooming or rubbing whereas those induced by formalin were grooming and scratching. The CFA-induced behavioral changes were time-dependent from the 2nd up to the 7th day, while the formalin-induced changes occurred in the 1st day only. For pharmacological testing, morphine (4 mg/kg), indomethacin (5 mg/kg) and lidocaine with phenilephrine were used. In the CFA rats, morphine reduced significantly chewing-like and grooming, indomethacin decreased grooming and increased sleeping. Freezing was not changed by any drugs. In the formalin rats, grooming and scratching towards the orofacial region were increased and those behaviors were significantly decreased by morphine and formalin. The effects of the drugs on the different behaviors shown above show their nociceptive meaning. Moreover, the body weight of the animals was not changed. In both CFA and formalin groups, the histological analysis evidenced degenerative and small periarticular inflammatory infiltration. Neuroplasticity changes may be related to the CFA induction and the nociceptive meaning of the behaviors may be useful for experimental therapeutic studies.
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Fiedler, Letícia Soares. "Influência do nível de atividade física na modulação condicionada da dor na região orofacial." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/25/25146/tde-30082018-213352/.
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O objetivo desse trabalho foi avaliar a influência do nível de atividade física e da qualidade do sono, de maneira isolada ou combinada, na capacidade de modulação inibitória endógena da dor na região orofacial. Noventa participantes saudáveis com idade entre 18 e 50 anos foram agrupados de acordo com o nível de atividade física em baixo nível (G1), moderado nível (G2) e alto nível (G3), com 15 homens e 15 mulheres em cada grupo. A classificação do nível de atividade física seguiu critérios modificados do Questionário Internacional de Atividade Física (IPAQ, sigla em inglês), preconizando-se a duração e a frequência da atividade física. A qualidade do sono foi avaliada pelo Índice de Qualidade do sono de Pittsburgh (PSQI, sigla em inglês). O paradigma da modulação condicionada da dor (CPM, sigla em inglês) utilizado foi o limiar de dor à pressão (PPT, sigla em inglês) como estímulo teste e imersão da mão em água quente como estímulo condicionante. A análise de variância (ANOVA) foi utilizada para comparação do PPT e do CPM entre os grupos e a interação com a qualidade do sono. O pós-teste de Tukey foi aplicado quando os efeitos principais ou interações se mostraram significantes (p=0,050). De maneira isolada não houve efeito principal significante do nível de atividade física nem da qualidade do sono na capacidade de modulação da dor (p>0,050). Entretanto, foi encontrada uma influência significativa da interação entre qualidade do sono e nível de atividade física na modulação de dor. O grupo com alto nível de atividade física e boa qualidade do sono apresentou maior modulação de dor quando comparado aos que tinham sono ruim, dentro do mesmo grupo (p=0,049), com uma média (DP) do CPM absoluto de, respectivamente, -0,60 (0,34) e -0,17 (0,41). O mesmo aconteceu nos grupos moderado e baixo nível de atividade física e boa qualidade do sono, com uma média (DP) do CPM absoluto de, respectivamente, -0,10 (0,25) e -0,10 (0,52), (Tukey: p<0,028). Pode-se concluir que, isoladamente, a modulação de dor não é significativamente impactada nem pelo nível de atividade física e nem pela qualidade do sono. Entretanto, essa modulação inibitória da dor é influenciada de maneira significativa quando a qualidade do sono e atividade física são consideradas em conjunto, sendo que a modulação inibitória de dor parece ser mais eficiente em indivíduos que apresentam boa qualidade de sono e um alto nível de atividade física.The aim of this study was to evaluate the separate or combined influence of selfreported physical activity and sleep quality on conditioned pain modulation. Ninety healthy participants aged 18-50 years old were equally divided according to the level of physical activity into low level (G1), moderate level (G2) and high level (G3). The classification of physical activity followed the modified criteria of the International Physical Activity Questionnaire (IPAQ), taking into account the duration and frequency of physical activity. The Pittsburgh Sleep Quality Index (PSQI) assessed sleep quality. The paradigm of conditioned pain modulation (CPM) was the pressure pain threshold (PPT) as test stimulus and hand immersion in hot water as conditioning stimulus. Analysis of variance (ANOVA) was used to compare PPT and CPM between groups and interaction with sleep quality. Tukey\'s post-test was applied when the main effects or interactions were significant (p = 0.050). There was no significant main effect of either physical activity or sleep quality on pain modulation (p> 0.050). However, a significant interaction between sleep quality and level of physical activity on pain modulation was found. The group who reported high level of physical activity and good quality of sleep had a greater pain modulation when compared to: a) those who reported poor sleep, within the same group (p = 0.049), with an absolute CPM mean (SD) of, respectively, - 0.60 (0.34) and -0.17 (0.41); b) the moderate and low level of physical activity and good sleep quality, with an absolute CPM mean (SD) of, respectively, -0.10 (0.25) and -0.10 (0.52) (Tukey: p <0.028). We can conclude that neither the level of physical activity nor the sleep quality significantly affects pain modulation. However, pain inhibitory modulation is influenced significantly when sleep quality and physical activity are combined, and pain inhibitory modulation seems to be more efficient in individuals who have good sleep quality and a high level of physical activity.
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Fernandes, Carmen das Graças. "Efeito da escuta terapêutica fonoaudiológica no atendimento em pacientes que apresentam dor orofacial crônica." Pontifícia Universidade Católica de São Paulo, 2007. https://tede2.pucsp.br/handle/handle/12128.
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Previous issue date: 2007-10-10Clinical experience with patients which present chronic orofacial pain associated to muscular disturbances delimited the problem of this research once it provokes uncertainties generated by limitations that phenomenon of pain promotes in the evolution of the therapeutic phonoaudiologic processes. The objective of this study is to analyze the effects of the phonoaudiologic therapeutic listening of the psychic contents associated to chronic orofacial pain, presupposing the indissociability among body, language and psychism. This research has a clinical-qualitative and exploratory nature. It was developed by study of clinical cases of two female patients, being one 23 years old and other 32 years old; both refering to the beginning of the pain around the age 7. Clinical material was analysed based on phonoaudiologic and psychoanalytical theoretical references on the perspective of the articulation among body, psychism and language in order to understand the existing correlation between corporal structure and its vulnerabilities face to psychic factors. Concepts of pain, suffering, latent and manifest contents, clinical listening and transference have been considered. Clinical experience with these two patients revealed that pain affects the functions of stomatognathic system, especially mastication, and mobilizes conscious and unconscious psychic contents. The therapeutic phonoaudiologic process was favoured by simultaneous intervention as to both aspects, reducing the pain in both cases. Due to the complexity of symptoms associated to the chronic pain, it is necessary phonoaudiologic assistance, including in an interdisciplinary team work. The phonoaudiologic therapeutic listening, supported by Psychoanalysis theoretical references, contributes to effectiveness of phonoaudiologic treatment in both cases
A experiência clínica com pacientes que apresentam dor orofacial crônica associada a distúrbios musculares delimitou o problema dessa pesquisa ao provocar inquietações geradas pelas limitações que o fenômeno da dor promovem na evolução dos processos terapêuticos fonoaudiológicos. De acordo com o relato dos pacientes, há o envolvimento de conteúdos subjetivos, particularmente os psíquicos, provocando ansiedade e depressão. O objetivo desse estudo é analisar os efeitos da escuta terapêutica fonoaudiológica dos conteúdos psíquicos associados à dor orofacial crônica, pressupondo-se a indissociabilidade entre corpo, linguagem e psiquismo. Esta pesquisa é de natureza clínico-qualitativa, exploratória, desenvolvida por meio de estudo de caso clínico de duas pacientes do sexo feminino, uma com 23 anos e a outra com 32 anos de idade. Ambas referem o início da dor aos sete anos. O material clínico foi analisado a partir dos referenciais teóricos psicanalítico e fonoaudiológico na perspectiva da articulação entre corpo, psiquismo e linguagem para tentar compreender a correlação existente entre a estrutura corporal e suas vulnerabilidades aos fatores psíquicos. Foram considerados os conceitos sobre dor, sofrimento, conteúdo manifesto e latente, escuta e transferência. O resultado da análise dos casos revela que o processo terapêutico fonoaudiológico foi favorecido pela intervenção simultânea quanto a ambos os aspectos, resultando na redução da dor em ambos os casos. Considera-se que devido à complexidade de sintomas associados à dor crônica, é necessário o trabalho fonoaudiológico em equipe interdisciplinar. Observa-se que a escuta terapêutica fonoaudiológica, sustentada pelo referencial teórico da psicanálise, contribuiu para a efetividade do tratamento fonoaudiológico nos dois casos clínicos estudados
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Uekama, Ira Cristina. "Estudo de alterações locais e sistêmicas em indivíduos portadores de disfunção temporomandibular." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/58/58133/tde-22052012-164136/.
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Disfunção temporomandibular (DTM) é um termo coletivo que engloba um largo espectro de alterações articulares e musculares no sistema estomatognático. Estas disfunções são caracterizadas por dor, ruídos articulares e funções irregulares da mandíbula, e representam a principal causa de dor não dentária da região orofacial. A prevalência de indivíduos com necessidade de tratamento está entre 5 e 12%, calcula-se que no Brasil 8,5 milhões de brasileiros precisariam ter algum tipo de intervenção. Estudos epidemiológicos sobre DTM têm se apresentado deficientes quanto à padronização de índices e classificações. Conscientes disso realizou-se um levantamento de prontuários dos pacientes atendidos no Serviço de Oclusão, Disfunção Temporomandibular e Dor Orofacial, do projeto DAPE da Faculdade de Odontologia de Ribeirão Preto USP, que realiza atendimento na área de DTM para população encaminhada pelo Sistema Único de Saúde (SUS), entre os anos de 2010 e 2011. Avaliou-se 117 prontuários de indivíduos, que foram submetidos à classificação do Índice Anamétido de Helkimo, divididos de acordo com a severidade de sinais e sintomas, em dois grupos : AiI (leves a moderados) e AiII (severos). Posteriormente os grupos foram subdivididos com relação ao gênero e faixa etária. Os dados foram coletados por meio de entrevista, onde os indivíduos foram questionados quanto à presença de hábitos parafuncionais, alterações otológicas, oftalmológicas, sistêmicas e comportamentais. Os dados foram tabulados em planilha de Excel, e submetidos à Análise Estatística, utilizando o Teste de Kruskal-Wallis e Teste de Miller, ambos com significância de 0,05. A prevalência de cada alteração também foi avaliada. Os resultados evidenciaram que indivíduos com DTM apresentaram altas prevalências nas alterações locais e sistêmicas pesquisadas.Temporomandibular (DTM) is a collective term that encompasses a broad spectrum of clinical problems and deformations in orofacial area. These disorders are characterized by pain, joint noises and irregular functions of the jaw, and represent the leading cause of orofacial pain not dental. The prevalence of individuals in need of treatment is between 5% and 12%, it is estimated that in Brazil 8.5 million Brazilians would have some kind of intervention. Epidemiological studies on TMD have presented handicapped on the standardization of indexes and ratings. Aware of this was done a survey of medical records of patients seen in Orofacial Pain service of special Patients clinic FORP-USP, who performs service in the area of TMD for population forwarded by the Central regulating (SUS), the city of Ribeirão Preto, between the years 2010 and 2011. Assessed-if medical records of individuals, these 117 were subjected to the classification of the Anamétido Index of Helkimo, and divided according to the severity of symptoms and signs, in two groups AiI (mild to moderate) and AiII (severe). Later groups were sub-divided in relation to gender and age group. The data were collected through interview, where individuals were questioned as to the presence of parafunctional habits, changes otologicals, ophthalmologicals, systemic and behavioral. The data were tabulated into Excel spreadsheet, and subjected to statistical analysis, using the Kruskal-Wallis test, and Miller\'s Test, both with significance of 0.05. The prevalence of each change was also evaluated. The results showed that TMD patients showed a high prevalence in the surveyed local and systemic changes.
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Gantasala, Mahesh V. "Retrospective study of temporomandibular disorders in the Orofacial Pain Clinic of Westmead Centre for Oral Health." Master's thesis, Faculty of Dentistry, 2003. http://hdl.handle.net/2123/4670.
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This work was digitised and made available on open access by the University of Sydney, Faculty of Dentistry and Sydney eScholarship . It may only be used for the purposes of research and study. Where possible, the Faculty will try to notify the author of this work. If you have any inquiries or issues regarding this work being made available please contact the Sydney eScholarship Repository Coordinator - ses@library.usyd.edu.au
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Silva, Adailton Martins. "Avaliação do efeito antinociceptivo orofacial da Sida cordifolia L. (Malvaceae) em roedores." Universidade Federal de Sergipe, 2011. https://ri.ufs.br/handle/riufs/3703.
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Sida cordifolia from Malvaceae family (Sida L.) with about 250 species around the world, has been used in folk medicine as anti-inflammatory, antirheumatic and antipyretic, laxative, diuretic, analgesic and hypoglycemic, antiviral, bactericide and antifungal. In this study, we attempted to identify the possible antinociceptive action of the ethanol extract (EE), chloroform (CF) and methanol (MF) fractions obtained of Sida cordifolia, known in Brazil as malva branca or malva branca sedosa . Leaves of S. cordifolia were used to produce the crude ethanol extract and after CF and MF. Experiments were conducted on Swiss mice using the glutamate and formalin-induced orofacial nociception. In the formalin test, all doses of EE, CF and MF significantly reduced the orofacial nociception in the first (p < 0.001) and second phase (p < 0.001), which was also naloxone-sensitive. The percentage reduction average for the first phase of the formalin test was 79,6% (EE), 78,4% (CF) e 65,6% (MF) and for the second phase 77,9% (EE), 69,7% (CF) e 81,1% (MF). In the glutamate-induced nociception test, only CF and MF significantly reduced the orofacial nociceptive behavior with inhibition percentage values of 48.1% (100 mg/kg, CF), 56.1% (200 mg/kg, CF), 66.4% (400 mg/kg, CF), 48.2 (200 mg/kg, MF) and 60.1 (400 mg/kg, MF). Furthermore, treatment of the animals with EE, CF and MF was not able to promote motor activity changes. These data demonstrate that S. cordifolia has a pronounced antinociceptive activity against orofacial nociception. However, pharmacological and chemical studies are continuing in order to characterize the mechanism(s) responsible for this antinociceptive action and also to identify other active substances present in S. cordifolia.A Sida cordifolia pertencente a família Malvaceae e gênero Sida L. com cerca de 250 espécies em todo mundo, tem sido utilizada na medicina popular como anti-inflamatória, antireumático e antipirético, laxante, diurético, analgésico e hipoglicemiante, antiviral, bactericida e antifúngica. O objetivo do presente estudo foi identificar a possível ação antinociceptiva do extrato etanólico (EE) e das frações clorofórmica (FC) e metanólica (FM) obtidas das folhas de Sida cordifolia, conhecida no Brasil como malva branca . As folhas de Sida cordifolia foram usadas para a preparação do extrato bruto e depois foi obtida frações a partir desse extrato. Os experimentos foram realizados com camundongos Swiss usando o glutamato e formalina como agentes de indução da nocicepção orofacial. No teste da formalina, todas as doses do EE, FC e FM significativamente reduziram o comportamento nociceptivo orofacial em ambas as fases do teste (p<0,001), as quais foram sensíveis a naloxona. A média percentual de redução para a primeira fase do teste da formalina foi 79,6% (EE), 78,4% (FC) e 65,6% (FM) e para a segunda fase 77,9% (EE), 69,7% (FC) e 81,1% (FM). No teste de nocicepção induzida por glutamanto, somente as FC e FM reduziram significativamente o comportamento nociceptivo orofacial com um percentual de inibição de 48,1% (100 mg/kg, FC), 56,1% (200 mg/kg, FC), 66,4% (400 mg/kg, FC), 48,2% (200 mg/kg, FM) e 60,1% (400 mg/kg, FM). O tratamento dos animais com EE, FC e FM não foi capaz de promover alterações na atividade motora. Esses resultados demonstraram que a S. cordifolia possui um pronunciado efeito sobre a nocicepção orofacial. No entanto, estudos químicos e farmacológicos são necessários a fim de caracterizar os mecanismos responsáveis por essa ação antinociceptiva, bem como identificar substâncias presentes dentro da S. cordifolia
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Borin, Graciele da Silva. "EFEITO DA ACUPUNTURA EM INDIVÍDUOS COM DESORDEM TEMPOROMANDIBULAR: AVALIAÇÃO ELETROMIOGRÁFICA, NÍVEL DE DOR E ASPECTOS PSICOLÓGICOS." Universidade Federal de Santa Maria, 2011. http://repositorio.ufsm.br/handle/1/6497.
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Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorTemporomandibular disorders (TMD) can be described as a set of joint and muscle disorders in the region orofacial. Its etiology has multifactorial causes, and may be caused by associations among postural, psychological and structural factors. The acupuncture, because of the whole body approach, is presented as a treatment option indicated for the treatment of TMD patients, since this involves physical and psychosocial aspects. Thus, this study proposes to evaluate the use of acupuncture as a therapeutic intervention in the TMD, verifying its effect on the electrical activity of masticatory muscles, on the psychological aspects of pain level in individuals with this disorder. The study included 40 women aged between 20 and 40 years, with reports of pain in the temporomandibular joint and masticatory muscles. The first 20 volunteers were undergone to acupuncture twice a week for five weeks without interruption and after, they were reassessed. The results of these participants constituted the study group. The other volunteers received the treatment after the first group and their data, collected in the beginning and after 5 weeks without treatment, were utilized as control. The diagnosis of TMD was performed by applying the Diagnostic Criteria for Research of temporomandibular disorders (TMD-RD. Evaluations of the level of pain using a visual analog scale (VAS), severity index of Fonseca and the Craniomandibular Index and Electromyographic (EMG) assessment of masticatory muscles (masseter and anterior temporal bilaterally) were carried out. The evaluations were performed before (Av), soon after (R1) and after 10 session (R10) in the study group. The control group was evaluated at baseline (Av) and after 5 weeks (R10).The results of this study showed after acupuncture therapy 20% of the study group (SG) showed complete extinction of the diagnosis of TMD, while the control group (CG) retained 100% of individuals diagnosed with TMD. The results from the Axis I of RDC / TMD showed that SG has statistically significant increase in all mandibular movements, while in the CG there was a statistically significant reduction of these movements. Regarding the psychological aspects, evaluated by the Axis II of the RDC / TMD, it was verified a reduction in the intensity of chronic orofacial pain and improvements in physical symptoms including pain items in the SG, and the normal classification presented by 35% of participants at baseline rose to 60% at the reassessment. In the CG classification of mild symptoms increased from 10% to 30% and severe classification maintained their initial values. In the physical symptoms excluding pain items, the normal classification observed in 40% of participants increased to 75% after treatment. The severity of the disorder assessed by the Fonseca and craniomandibular indexes showed a significant reduction in SG (p = 0.00 and p = 0.004, respectively). The CG showed no significant differences in these indexes assessments. The EMG results observed in the rest mandibular position demonstrated statistically significant reduction in the electrical activity values in the left temporal muscle (p = 0.0062) immediately after an acupuncture session (R1) and higher electrical activity in the temporal muscles in relation to the masseter, with statistical significance for the left temporal muscle. After treatment (R10) there was a decrease in the EMG at rest, with statistical significance in the temporal muscles, however, these muscles maintained their electrical activity above the masseter. The CG had a higher electrical activity in the temporalis muscles both in the assessment and the reassessment; with statistically increase in the left temporal muscle and left masseter with the prevalence of left temporal muscle. No difference was observed in CG and SG (R1 and R10) during the maximum intercuspal position of the masticatory muscles. In SG, during chewing, there was a statistically significant decrease of activity in the right masseter after treatment. There was no statistical difference during chewing and during left unilateral chewing between CG and SG in the R1. In the SG (R10) there was a statistically significant decrease in electrical activity of the left temporal muscle in left unilateral chewing. From this study, it can be concluded that acupuncture is an effective technique in reducing pain level, the severity index and the electrical activity at mandibular rest in individualswithTMD.
A desordem temporomandibular (DTM) pode ser descrita como um conjunto de distúrbios articulares e musculares na região orofacial. Sua etiologia possui causas multifatoriais, podendo ser originada por associações entre fatores posturais, estruturais e psicológicos. A Acupuntura, pela abordagem da globalidade corporal, apresenta-se como uma opção terapêutica indicada para o tratamento de indivíduos com DTM, uma vez que esta envolve aspectos físicos e psicossociais. Assim, este estudo propõe-se a avaliar o uso da Acupuntura como intervenção terapêutica na DTM, verificando o seu efeito sobre a atividade elétrica dos músculos mastigatórios, sobre aspectos psicológicos e no nível de dor de indivíduos portadores desta desordem. Participaram deste estudo 40 mulheres com idade entre 20 e 40 anos, com relato de dor na região da articulação temporomandibular e músculos mastigatórios. As 20 primeiras participantes foram submetidas à acupuntura duas vezes na semana por cinco semanas ininterruptas e, após foram reavaliadas. Os dados destas participantes constituíram os resultados para grupo de estudo. As demais voluntárias receberam o tratamento após o primeiro grupo e seus dados, coletados no início e após 5 semanas sem tratamento, foram utilizados para controle. O diagnóstico de DTM foi realizado pela aplicação do Critério de Diagnóstico para Pesquisa de Desordens Temporomandibulares (RDC-TMD). Foram realizadas avaliações do nível de dor pela escala visual analógica (EVA), grau de severidade pelo Índice de Fonseca e Índice Craniomandibular, aspectos psicológicos pelo Eixo II do RDC/TMD e a avaliação eletromiográfica dos músculos mastigatórios (masseter e temporal anterior, bilateralmente). As avaliações foram realizadas antes (Av), imediatamente após (R1) e ao final de 10 sessões (R10) no grupo de estudo. No grupo controle, avaliou-se no início (Av) e após 5 semanas (R10). Os resultados deste estudo demonstraram que após a terapia de acupuntura 20% do grupo de estudo (GE) apresentou extinção completa da sintomatologia da DTM, enquanto o grupo controle (GC) manteve 100% dos indivíduos com a sintomatologia inicial de DTM. Conforme os resultados do eixo I do RDC/TMD, o GE apresentou aumento estatisticamente significante em todos os movimentos mandibulares, enquanto no GC houve uma redução estatisticamente significante destes movimentos. Quanto aos aspectos psicológicos avaliados pelo Eixo II do RDC/TMD, verificou-se redução da intensidade da dor orofacial crônica e melhora dos sintomas físicos incluindo itens de dor no GE, sendo que a classificação normal apresentada por 35% dos participantes na avaliação inicial passou para 60% na reavaliação. No GC a classificação de sintomas moderada aumentou de 10 % para 30% e a classificação severa manteve seus valores iniciais. Nos sintomas físicos excluindo itens de dor, a classificação normal observada em 40% dos participantes passou para 75% após o tratamento. O grau de severidade avaliado pelo Índice de Fonseca e o Índice Craniomandibular apresentaram redução significativa no GE (p=0,00 e p=0,004 , respectivamente). O GC não apresentou diferença significante na avaliação destes índices. Os resultados eletromiográficos observados na situação de repouso mandibular demonstraram diferença estatisticamente significante para o músculo temporal esquerdo (p=0,0062) com diminuição do valor da atividade elétrica imediatamente após uma sessão(R1) de acupuntura. Também foi verificada uma atividade elétrica de repouso mandibular maior nos músculos temporais em relação aos masseteres, com significância estatística, principalmente para o músculo temporal esquerdo no GE. Após o tratamento (R10) houve diminuição dos valores eletromiográficos em repouso, com significância estatística nos músculos temporais, no entanto, estes músculos mantiveram a sua atividade elétrica superior aos masseteres. O GC apresentou maior atividade elétrica nos músculos temporais na avaliação e, na reavaliação, os músculos temporal esquerdo e masseter esquerdo apresentaram aumento estatisticamente significante da atividade elétrica com prevalência do músculo temporal esquerdo. Não foi observada diferença no GC e GE (R1 e R10) durante a máxima intercuspidação dos músculos mastigatórios. No GE na mastigação habitual, verificou-se redução estatisticamente significante no valor de atividade elétrica no músculo masseter direito. Não houve diferença na mastigação habitual e na mastigação unilateral esquerda entre o GC e o GE na R1. No GE (R10) observou-se uma diminuição estatisticamente significante da atividade elétrica do músculo temporal esquerdo na mastigação unilateral esquerda. Concluí-se com este estudo que a Acupuntura é uma técnica eficaz na redução da dor, na redução grau de severidade e na redução da atividade elétrica em repouso de indivíduos com DTM.
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Iyomasa, Daniela Mizusaki. "Avaliação morfofisiológica do músculo pterigóideo lateral e da sensibilidade nociceptiva orofacial em ratos com hipofunção mastigatória." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/58/58137/tde-12052014-141658/.
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Evidências clínicas sugerem que o estresse emocional pode ser um fator de risco para as desordens temporomandibulares (DTM), bem como para outras funções desempenhadas pelo sistema estomatognático. Ainda é controversa a participação da alteração oclusal na etiopatogenia das dores miofasciais. O músculo pterigoideo lateral foi escolhido pela íntima relação com a articulação temporomandibular (ATM). Assim, o objetivo deste projeto foi avaliar a hipótese de que os diferentes tipos de estresse agudo e crônico (repetido e variado) induzem alterações morfofisiológicas no músculo pterigóideo lateral esquerdo em animais submetidos ou não à exodontia unilateral. Em uma segunda etapa, foi avaliada se o procedimento de exodontia unilateral promove alteração da sensibilidade nociceptiva orofacial. Foram utilizados 60 ratos machos Wistar (250 g), divididos aleatoriamente em 2 grandes protocolos: Exodontia (GE): expostos a exodontia unilateral (n = 30); e Sem Exodontia (GSE): sem exodontia unilateral (n = 30). Cada protocolo foi composto por 6 subgrupos (n = 5 ratos cada): Ag: Estresse agudo; Rep: Estresse crônico repetido; Var: Estresse crônico variado; Form: Avaliação nociceptiva orofacial; Sal: Avaliação nociceptiva orofacial (controle formalina); e C: sem estresse (Controle estresses). O GE foi submetido à exodontia unilateral dos molares superiores esquerdo, sob anestesia com associação de xilazina 4% (10mg/kg) e cetamina 10% (80mg/kg), i.p. Em ambos os grupos: GE e GSE, os ratos dos subgrupos Rep e Var foram submetidos aos protocolos de estresse (por 10 dias) a partir do 14º dia após a exodontia; e no 23º, os animais do subgrupo Ag, foram submetidos ao estresse agudo, e dos subgrupos Form e Sal foram submetidos ao protocolo de Formalina orofacial. Com o término dos experimentos, os animais foram submetidos à eutanásia para obtenção dos músculos para análise. Os estresses crônicos, isolados ou associados à exodontia, afetaram a morfologia, a capacidade oxidativa, o estresse oxidativo e a densidade capilar do músculo pterigoideo lateral esquerdo. Estes sinais demonstram a adaptação deste músculo, no período estudado, e sugerem que a persistência destes estímulos podem levar à respostas mais severas como, por exemplo, desencadear a dor miofacial ligada à DTM.Clinical evidences have suggested that emotional stress could be a risk factor for temporomandibular joint disorder (TMD), as well as other functions performed by stomatognatic system. Remains controversial the participation of occlusal alteration on the miofascial pain etiopathogenesis. The lateral pterygoid muscle was chosen because of the closely relationship with temporomandibular joint (TMJ). Therefore, the aim of this project was evaluate the hypothesis that different types of acute and chronic (repeted and unpredictable) stress induce morphophysiological alteration on the left lateral pterygoid muscle in animals submitted or not to unilateral exodontia. In a second phase, it was evaluated whether the unilateral exodontia procedure promotes orofacial nociceptive sensibility alteration. Sixty male Wistar rats (250 g) were randomly divided into 2 protocols: Exodontia (GE): exposed to unilateral exodontia (n = 30); and Without Exodontia (GSE): without unilateral exodontia (n = 30). Each protocol was composed by 6 subgroups (n = 5): Ag: Acute Stress; Rep: Repeted Chronic Stress; Var: Unpredictable Chronic Stress; Form: Orofacial Nociception Evaluation; Sal: Orofacial Nociception Evaluation (Formalin Control); and C: No Stress (Stress Control). The GE was submitted to unilateral exodontia of superior left molar under anesthesia with the association of xylazine 4% (10 mg/kg) and ketamine 10% (80 mg/kg), i.p. In both groups: GE and GSE, the rats in subgroups Rep and Var were submitted to the stress protocols (during 10 days) from the 14th day after exodontia, and on day 23rd , the animais from subgroup Ag, were submitted to acute stress, and the subgroups Form and Sal were submitted to the Orofacial Formalin protocol. With the end of the experiments, the animals were submitted to euthanasia to obtaining muscle for analysis. The chronic stress, isolated or associated to exodontia, affected the morphology, oxidative capacity, oxidative stress and capillary density of left lateral pterygoid muscle. These signs show the adaptation of this muscle, during the studied period, suggesting that the persistence of these stimuli can lead to a more severe response, such as, myofascial pain trigger linked to the DTM.
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Athanassiadis, Tuija. "Neural circuits engaged in mastication and orofacial nociception." Doctoral thesis, Umeå : Department of Integrative Medical Biology, Umeå university, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-26342.
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Senise, Érika Sbeghen. "Terapia miofuncional orofacial modular em pessoas com disfunção temporomandibular: um estudo eletromiográfico." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5160/tde-04112010-152510/.
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O objetivo foi verificar a eficácia da terapia fonoaudiológica modular (intervenção breve) em pacientes portadores de disfunção temporomandibular de origem muscular, por meio de questionário e eletromiografia de superfície. Foram avaliados 15 pacientes, encaminhados pela Disciplina de Traumatologia da Faculdade de Odontologia da USP, com diagnóstico de disfunção temporomandibular do tipo muscular. Foram realizadas avaliações na primeira, sétima e décima terceira sessão fonoaudiológica por meio de questionário e eletromiografia dos músculos orbicular dos lábios, região das bochechas, temporais e masseteres direito e esquerdo, em repouso e nos movimentos de apertamento labial, sorriso fechado e fechamento da mandíbula em máxima contração voluntária. O tratamento foi realizado com um programa de exercícios previamente elaborado. Houve diferença significativa nos seguintes valores: diminuição da dor (p<0,0001); diminuição da dor na músculatura da face (p=0,0078); diminuição da fadiga muscular (p=0,0169); na eletromiografia de repouso foram encontrados a diminuição da atividade muscular do músculo masseter esquerdo nas sessões 1 a 6 (p=0,0172). Nos seguintes movimentos, os valores de RMS foram superiores durante o apertamento labial região da bochecha esquerda (p<0,01) da primeira à sexta sessão; fechamento da mandíbula em máxima contração voluntária região da bochecha direita (p=0,0131) nas sessões 1 a 6 e nas sessões 1 e 12 (p=0,0133); na atividade de apertamento labial com relação ao temporal esquerdo (p=0,0245), direito (p=0,0437) e na região da bochecha esquerda (p=0,0246) verificamos que quanto maior o sinal eletromiográfico, menor o nível relatado de dor. O mesmo ocorreu com a região das bochechas esquerda (p=0,0458) e direita (p=0,0398) no movimento de sorriso fechado. Desta forma, conclui-se que a terapia fonoaudiológica modular mostrou ser eficiente em pacientes com disfunção temporomandibular de origem muscular na melhora da sintomatologia dolorosa e na estabilidade do sistema estomatognáticoThe aim of this study was to verify the efficiency of speech therapy (short intervetion) in patients with temporomandibular disorders of muscular origin, using a questionnaire and surface electromyography. It was evaluated a total of 15 patients, provided by Discipline of Traumatologia da Faculdade de Odontologia da USP, diagnosed with temporomandibular disorder of muscular type. The evaluations were conducted in the first, seventh, and thirteenth speech therapy session with a questionaire and surface electromyography of the obicularis oris, cheek region, temporal and masseter, at rest and movement of lip pressure, closed smile and jaw closing with maxima volunteer contraction. The treatment was done with exercises previous elaborated. There was significant difference at the following values: decrease of pain (p<0.0001); decrease of pain in face muscles (p=0.0078); decrease of muscle fatigue (p=0.0169); in the rest electromyographic was found the reduction of left masseter muscle values from the first to sixth session (p=0.0172). On the fallowing movements, the values of RMS were inferior during the lip pressure left cheek region (p<0.01) from the first to sixth session; jaw closing with maxima volunteer contraction right cheek region (p=0.0131) on the first to sixth session and on the first to thirteenth session (p=0.0133); on the lip pressure in relation to the left temporal muscle (p=0.0245), right (p=0.0437) and on the left cheek region (p=0.0246) was verified that the higher was the electromygraphic signal, less was the level of pain. The same occurred with the left cheek region (p=0.0458) and right (p=0.0398) on the closed smile. Therefore, the speech therapy (short intervetion) showed efficiency in patients with temporomandibular disorders of muscular origin, on the decrease of pain sintomatology and stability of the stomatognatic system
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Oliveira, Cinthya Iamille Frithz BrandÃo de. "Estudo da atividade antinoceptiva de β-amirina, um triterpeno pentaciclÃco isolado de Protium heptaphyllum March. em modelos experimentais de dor." Universidade Federal do CearÃ, 2010. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=5158.
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FundaÃÃo de Amparo à Pesquisa do Estado do AmazonasOs efeitos dos triterpenos pentaciclicos -amirina e -amirina, isolados a partir da resina de Protium heptaphyllum March. (Burseraceae), foram testados preliminarmente em modelos de nocicepÃÃo oral, sendo que -amirina apresentou significantes efeitos antinociceptivos, norteando a pesquisa com este isolado na investigaÃÃo de seus efeitos em modelos de dor orofacial induzida por capsaicina ou formalina e na dor induzida por capsaicina na cÃrnea de camundongos; na dor tÃrmica (testes de imersÃo de cauda em Ãgua quente e placa quente); e na nocicepÃÃo visceral induzida por Ãcido acÃtico 0,6%. Camundongos Swiss machos (n = 8 / grupo) foram prÃ-tratados com β-amirina (10, 30 e 100 mg / kg, v.o.), morfina (5 mg / kg, s.c.) ou controle (Ãgua destilada + 0,05% de Tween 80, v.o.), uma hora antes de capsaicina (20 L, 1,5 g) ou formalina (20L/animal) serem administradas na vibrissa direita. β-amirina tambÃm foi avaliada em teste comportamental relacionado à dor, desta vez por aplicaÃÃo tÃpica de capsaicina na conjuntiva do camundongo (âeye wiping testâ). Neste teste foi medido o tempo, em segundos, que o animal passou âlimpandoâ o olho durante um perÃodo de 10 minutos. O triterpenÃide demonstrou principalmente um efeito antinociceptivo dose-independente em todos os modelos de nocicepÃÃo testados. Na dor orofacial induzida por capsaicina, -amirina (30 e 100 mg/kg) e morfina foram mais eficazes na reduÃÃo da resposta nociceptiva. Nestas doses, as reduÃÃes foram de 81 e 90% para -amirina e 97% para morfina, respectivamente. No modelo de dor orofacial, a nocicepÃÃo produzida pela capsaicina à acompanhada por um aumento na resposta tÃrmica localizada (que foi mensurada por termometria), e reduzida significantemente pelo prÃ-tratamento dos animais com -amirina ou L-NAME, um inibidor da NOS. Em animais diabÃticos, a capsaicina injetada na vibrissa promoveu um menor grau de nocicepÃÃo orofacial comparada com os nÃo-diabÃticos. No teste da formalina, morfina e β-amirina apresentaram antinocicepÃÃo significativa reversÃvel nas duas fases por naloxona. No entanto, β-amirina (30 mg/kg) inibiu a segunda fase com maior eficiÃncia. Os valores de DE50 para β-amirina e morfina foram 16,44 mg/kg (LC 10,0-38,41) e 3 mg/kg (LC 2,5-5,0) na primeira fase e 43,37 mg/kg (LC 30,52-39,30) e 3 mg/kg (LC 2,5-5,0) na segunda fase, respectivamente. A co-administraÃÃo de β-amirina e morfina, em seus respectivos nÃveis de dose de DE50, nÃo apresentou qualquer efeito aditivo ou potencializador antinociceptivo. No entanto, as combinaÃÃes das doses DE25 e DE12,5 apresentaram uma antinocicepÃÃo comparÃvel ao efeito combinado da DE50, sugerindo que atravÃs da utilizaÃÃo de β-amirina, a dose analgÃsica de morfina poderia ser minimizada para evitar a sua alta dose e os efeitos colaterais associados. β-amirina tambÃm foi eficaz em aumentar o limiar de dor tÃrmica no teste da imersÃo da cauda (mais nÃo no teste placa quente) e, na reduÃÃo das contorÃÃes induzidas por Ãcido acÃtico. A antinocicepÃÃo produzida por β-amirina, foi significativamente bloqueada em animais prÃ-tratados com os respectivos antagonistas vermelho de rutÃnio (2 mg/kg, s.c.) e naloxona (1 mg/kg, i.p.), indicando o envolvimento de receptores da capsaicina (TRPV1) e opiÃides em seu mecanismo. No teste da formalina, de forma similar à morfina, β-amirina bloqueou significativamente a inibiÃÃo da ingestÃo alimentar associada a dor. Assim como morfina, β-amirina apresentou aÃÃo inibitÃria sobre o trÃnsito intestinal, efeito esse revertido pelo prÃ-tratamento com antagonista opiÃide nÃo seletivo, naloxona. Estes dados sugerem que β-amirina apresenta um potencial antinociceptivo comparÃvel à analgesia perifÃrica produzida pela morfina, evidencia a exploraÃÃo desta para o desenvolvimento de um analgÃsico nÃo-opiÃide Ãtil na farmacoterapia de patologias do trigÃmeo e visceral.
The effects of pentacyclic triterpene β-amiryn and β-amyrin, isolated from resin of Protium heptaphyllum March. (Burseraceae), were preliminarily showed significant tested in models of nociception oral, and antinociceptives effects, guiding the search with this isolate in the investigation of their effects in models of orofacial pain induced by capsaicin or formalin and against capsaicin-induced corneal pain; thermal pain (tail immersion test in hot water and hot-plate) and in acetic acid 0,6%-induced visceral nociception in mice. Male Swiss mice (n = 8 per group) were pre-treated with β-Amyrin (10, 30, and 100 mg/kg, p.o.), morphine (5 mg/kg, s.c.) or vehicle (distlled water + 0,05% Tween 80), one hour before the capsaicin (20 μl, 1.5 μg) or formalin (20 μl, 1.5%) injection into the right vibrissa. β-Amyrin was also assessed on pain-related behavioral test (Eye-wiping) by topical application of capsaicin (20 μl, 1.5 μg) on to the mouse conjuctiva and the time (sec) that the animal spent in eye wiping was determined during a 10 min period. The triterpenoid demonstrated mostly a dose-unrelated antinociception in all the test models of nociception. Against the orofacial pain induced by capsaicin, β-Amyrin (30 e 100 mg/kg, p.o.) and morphine showed greater potency in reducing the nociceptive response. At the doses employed, the reductions were 81 and 90% to β-Amyrin and 97% for the morphine, respectively. Capsaicin nociception in orofacial test is accompanied by a localized thermal flare (measured by thermometry), which was significantly diminished by pretreatment of animals with β-Amyrin or L-NAME, an NOS inhibitor. In four weeks diabetic mice, capsaicin injected into vibrissa pad demonstrated a lesser degree of orofacial nociception compared to non-diabetics. In formalin test, both morphine and β-Amyrin showed significant naloxone reversible antinociception in both phases. However, β-Amyrin inhibited the second phase response, more prominently, at 30 mg/kg. The caliculated ED50 values for β-Amyrin and morphine were 16,44 mg/kg (CL 10,0 - 38,41) and 3 mg/kg (CL 2,5 - 5,0) in the first phase and 43,37 mg/kg (CL 30,52 - 39,30) and 3 mg/kg (CL 2,5 - 5,0) in the second phase, respectively. Co-administration of β-Amyrin and morphine at their respective ED50 dose levels failed to demonstrate any additive or potentiating effect on anti-nociception. However, at ED25 and ED12.5 dose-combinations exhibited an antinociception that equalled their ED50 combination effect, suggesting that by the use of β-Amyrin, the analgesic dose of morphine could be minimised to avoid its high-dose-associated side-effects. Similar to morphine, β-Amyrin significantly blocked the pain-related suppression of food intake in formalin test. β-Amyrin (30 and 100 mg/kg was also effective in increasing the thermal pain threshold in hot-water tail immersion test (but not in hot-plate test), and in reducing the acetic acid-induced writhes. The antinociception produced by 30 mg/kg β-Amyrin was significantly blocked in animals pre-treated with the respective antagonists capsazepine (5 mg/kg, s.c.), and naloxone (1 mg kg/kg, i.p.), indicating the involvement of capsaicin (TRPV1) and opioid receptors in its mechanism. Like morphine, β-Amyrin showed an inhibitory effect on intestinal transit, an effect reversed by pretreatment with nonseletive opiÃide antagonist, naloxona. These data indicate that β-Amyrin has the antinociceptive potential comparable to peripheral analgesia produced by morphine that could be explored further on its suitability in developing a non-opioid analgesic useful in pharmacotherapy of trigeminal and visceral pathologies.