Journal of Oral & Facial Pain and Headache最新文献

The aim of the study is to describe the severity, temporal characteristics, and types of autonomic features as they relate to the characteristics of pain of the neuralgias. Also, to describe, based on literature, how these autonomic features can affect the treatment outcomes of patients with craniofacial neuralgias. We carried out a literature search using five databases, PubMed, Embase, OVID, Scopus and Web of Science. The search was executed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The protocol for this systematic review and meta-analysis was registered on PROSPERO CRD42021235319. 40% of all patients with craniofacial neuralgias had at least one autonomic feature. Out of the craniofacial neuralgias, trigeminal neuralgia was the most reported, with lacrimation being the most prevalent concomitant autonomic feature. There was also differences in the occurrence of the autonomic features dependent on which branch of a nerve such as the trigeminal nerve, was afflicted. When trigeminal neuralgia is excluded, the rest of the craniofacial neuralgias had reported autonomic features 28% of the pain events. (95% Confidence Interval: 2-90%). Contrary to the conventional belief, we found certain autonomic features to be more predominant than others, in specific craniofacial neuralgias. The prevalence of the autonomic features for all craniofacial neuralgias in the descending order is as follows, lacrimation, conjunctival injection, nasal congestion, rhinorrhea, flushing, edema/swelling, salivation, ptosis and sweating. With trigeminal neuralgia, the most common autonomic feature was lacrimation, and the least common was nasal congestion.

The aim of this study was to compare the effectiveness of greater occipital nerve (GON) block and pulsed radiofrequency (PRF) treatment in chronic migraine patients. Seventy patients admitted to the Neurology and Algology outpatient clinic between September 2023 and December 2023 and diagnosed with chronic migraine according to The International Classification of Headache Disorders 3rd Edition (ICHD-3) criteria were included in the study. Patients were randomized into 2 groups to receive ultrasound-guided repeated GON block and PRF. Visual Analog Scale (VAS) scores for pain relief and Migraine Disability Assessment (MIDAS) scores for disability were recorded before the procedure and at 1st and 6th months after the procedure. In both groups, 35 patients with greater occipital nerve (GON) block, 32 patients with GON PRF, the pain scores at 1st and 6th months post-procedure were significantly lower compared to before the procedure (p < 0.001, p < 0.001, respectively). VAS scores were significantly lower in the PRF group than in the GON block group at 6th month (p = 0.009). In both groups, post-procedural MIDAS scores at 1st and 6th months were significantly lower compared to before the procedure (p < 0.001, p < 0.001, respectively). In the GON PRF group, MIDAS scores at 6th month were significantly lower than MIDAS scores at 1st month (p < 0.001). MIDAS scores were significantly lower in the PRF group compared to the GON block group at 6th months (p < 0.001).Interventional procedures such as GON block and PRF are safe and effective methods in chronic migraine. PRF is a better alternative to GON block in chronic migraine with longer effectiveness.

To synthesize scientific knowledge regarding the prevalence of neuropathies and nerve injuries caused by dental implant placement in mandible and the available management. Observational and interventional studies evaluating neuropathies occurrence in adults who underwent dental implant surgery were included. Any neuropathy diagnostic was accepted. The searches were conducted in six databases and grey literature. Methodological quality was screened using the Joanna Briggs Institute. The resulting synthesis was a narrative summary, and prevalence meta-analyses were performed in MetaXL 5.3. Among 98 full texts assessed, 38 studies were included. Neuropathies were diagnosed by questionnaires and/or clinical assessment. Eighteen studies presented high, sixteen moderate, and four low methodological quality. In implant surgeries without nerve lateralization, 12% and 5% of the patients may experience neuropathy during the first week and after three months, respectively. In implant surgeries with nerve lateralization, the prevalence was from 90% in the first week to 42% after three months. Proposed management included drugs, laser therapy and dental implant removal. In mandible, the prevalence of neuropathies in dental implant surgeries without lateralization is lower when compared with those with lateralization (eight times more in both follow-up times). The most frequent treatment was pharmacologic management.

Trigeminal neuralgia (TN) is a debilitating condition affecting the patients' life quality. New therapeutic approaches and novel drugs are required to treat TN. Trazodone being a serotonin antagonist and reuptake inhibitor (SARI) provides neuroprotection, however its role and underlying mechanism in TN in vitro or in vivo are not clear. This study was aimed to investigate the trazodone impact on glial BV-2 cells regarding TN. It was found that trazodone inhibited the BV-2 cells growth and suppressed the inflammation and oxidative stress in Lipopolysaccharide (LPS)-treated BV-2 cells. Trazodone treatment specifically decreased the levels of Tumor Necrosis Factor-alpha (TNF-α), Interleukin-6 (IL-6), Interleukin-1 beta (IL-1β) (p < 0.05), and Reactive Oxygen Species (ROS) (p < 0.01). Moreover, trazodone suppressed the Mitogen-Activated Protein Kinase (MAPK) pathway in LPS-treated BV-2 cells. These outcomes demonstrate that trazodone suppressed glial cell hyperproliferation, inflammation, and oxidative stress through MAPK pathway activation.

The simultaneous occurrence of primary headaches and temporomandibular disorders can pose a challenge in determining the best clinical management of patients. Therefore, we aimed to summarize evidence regarding the risk and prevalence of temporomandibular disorders (TMDs) in migraine and tension-type headaches (TTH) patients. Cross-sectional studies published in English comparing the presence of TMDs in adults with TTH or migraine to subjects without headaches were included, International Classification of Orofacial Pain, Diagnostic Criteria for Temporomandibular Disorders or Research Diagnostic Criteria for Temporomandibular Disorders, and large epidemiological studies (sensitive diagnostic criteria (SDC)). The methodological quality was assessed by Modified Newcastle-Ottawa Quality Assessment Scale. Odds ratio (OR) and random effects were calculated. 1405 articles were identified in PubMed, Embase and Central databases, and 13 cross-sectional studies were finally included. Overall Risk of TMDs was statistically significantly higher than control groups in both Migraine (SDC: 11 studies; OR: 3.79 (2.43, 5.90); I² = 99%), with higher values in chronic migraine (OR: 24.27; (95% Confidence interval (CI): 5.84, 100.82); I² = 0%) and TTH populations (SDC: 8 studies; OR: 4.45 (2.63, 7.53); I² = 86%). Headache subjects presented a higher risk of muscular TMDs (5 studies; OR: 2.01 (1.62, 2.50); I² = 0%), Combined TMDs (5 studies; OR: 2.74 (1.40, 5.36); I² = 63%), or Painful TMDs (8 studies; OR: 5.31 (2.96, 9.54); I² = 96%). Headache patients didn't show the risk of arthrogenous TMDs (4 studies; OR: 0.96 (0.54, 1.71); I² = 33%) or nonpainful TMDs (2 studies; OR: 1.10 (0.28, 4.26); I² = 84%). The high heterogeneity in the results was reduced following subgroup analysis. Migraine and TTH appear to increase the risk of painful, myogenous or combined arthrogenous and myogenous TMDs.

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive technique used to treat neuropathic orofacial pain (NOP). This study aimed to evaluate the efficacy and safety of rTMS in managing NOP and reducing health risks. A comprehensive literature search was conducted in various databases, including PubMed, Physiotherapy Evidence Database (PEDro), the Cochrane Library, Web of Science, Embase and Clinical Trials.gov. Thirteen relevant articles were identified and assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Risk of Bias assessment tool. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was utilized to evaluate the evidence rating for the studies. The analysis of the thirteen randomized controlled trials, involving 355 eligible patients, demonstrated moderate evidence supporting the significant effect of rTMS in reducing pain intensity (Mean Difference (MD): -1.01, 95% Confidence Interval (CI) -2.39 to -1.48, p < 0.001) and improving the quality of life (QOL) based on various instruments (MD: -9.23, 95% CI -11.91 to -6.54, p < 0.001; MD: -2.1, 95% CI -3.74 to -0.45, p < 0.05). Patients also reported favorable improvements in global impression (MD: -0.54, 95% CI -1.02 to -0.07, p < 0.05) and sensory status (Standardized Mean Difference (SMD): -1.30, 95% CI -1.74 to -0.87, p < 0.001). However, there were no significant improvements in sleep quality (MD: -1.72, 95% CI -4.13 to 0.68, p > 0.05) or psychological status (p > 0.05). Overall, the study demonstrated that rTMS is an effective and safe way to reduce pain, improve QOL, enhance sensory status, and create a positive clinical impression in patients with NOP. Further research is needed to investigate the effects of rTMS on sleep and psychological well-being in individuals with NOP.

Temporomandibular Disorders (TMDs) are pathologies based on multifactorial etiology and a biopsychosocial model, where anxiety becomes one of the most important psychological factors as it is the most frequent symptom presented in most of the population at some point in life. Taking into account the need for a multidisciplinary approach, we set out to evaluate the possible impact of orofacial pain on patients' quality of life. In this study, the sample population FROM the Medical School of the University of Coimbra (Portugal) was evaluated using two tools: Diagnostic Criteria for Temporomandibular Disorder (DC/TMD) and an adaptation of the West Haven-Yale Multidimensional Pain Inventory. Participants with Chronic Pain for more than three months and diagnosed with TMD were included in the research. The quality of life and pain intensity of participants with Chronic Orofacial Pain were assessed using questionnaires. Subsequently, statistical analysis were conducted. A total sample of 122 participants was selected. A statistically significant association was observed between an increase in pain intensity and a decrease in quality of life in three aspects we considered (daily activity, general mood and anxiety) and we demonstrated that pain intensity is significantly associated with a decrease in quality of life.

The coronavirus disease 2019 (COVID-19) and temporomandibular joint disorders (TMD) as the two major diseases are being focused by the public in modern societies. Previous epidemiological studies have shown increase in TMD prevalence during COVID-19 pandemic era. This study was aimed to verify the causal association between two sides using bidirectional mendelian randomization (MR) analysis. It explored whether COVID-19 could cause TMD or TMD influenced the COVID-19 susceptibility. Furthermore it was aimed to eliminate the reverse relationship and other confounders, and an attempt was made to provide etiologic evidence. Single-nucleotide polymorphisms (SNPs) related to three COVID-19 phenotypes (p < 5 × 10^-8) were selected from the genome-wide association study (GWAS) data collected through COVID-19 host genetics initiative (HGI). SNPs related to TMD (p < 5 × 10^-6) were collected from GWAS data in UK Biobank (UKB). Inverse variance weighted (IVW), weighted median (WM), and MR-Egger regression estimated the causal effect between two sides in this study. Furthermore, four sensitivity analyses (MR-PRESSO, Cochran's Q test, MR-Egger intercept test, and leave-one-out test) were used to confirm the robust results. TMD-related GWAS in FinnGen repeated the MR to validate the results. COVID-19 was not affected by TMD. The reversed MR suggested no significant causal effect of COVID-19 on TMD. Sensitivity analyses showed no gene pleiotropy and had robust results in this MR. Nonetheless, the MR statistical power was <80%, which suggested insufficient sample size of COVID-19 and TMD. This study based on current evidence depicted that COVID-19 had no impact on TMD, and TMD did not increase the susceptibility of severe acute respiratory syndrome coronavirus-2. During COVID-19 pandemic, excessive psychological stress caused by COVID-19 might act as a mediator between the two diseases. The relationship between the two sides needs verification by more external studies in the future.

The objective was to develop and evaluate a comprehensive search strategy (SS) and automated classifier (AC) for retrieving temporomandibular disorders (TMD) research articles. An initial version of SS and AC was created by compiling terms from various sources, including previous systematic reviews (SRs) and consulting with TMD specialists. Performance was assessed using the relative recall (RR) method against a sample of all the primary studies (PS) included in 100 TMD-related SRs, with RR calculated for both SS and AC based on their ability to capture/classify TMD PSs. Adjustments were made iteratively. A validation was performed against PSs included in all TMD-relevant SRs published from January to April 2023. The analysis included 1271 PSs from 100 SRs published between 2002-2022. The initial SS had a relative recall of 89.34%, while the AC detected 70.05% of the studies. After adjustments, the fifth version reached 99.5% and 89.5% relative recall, respectively. Validation with 28 SRs from 2023 showed a search strategy sensitivity of 99.67% and AC sensitivity of 88.04%. In conclusion, the proposed SS demonstrated excellent performance in retrieving TMD-related research articles, with only a small percentage not correctly classified by the AC. The SS can effectively support evidence synthesis related to TMD, while the AC can aid in creating an open-access, continuously updated digital repository for all relevant TMD evidence.

The objective of the study was to assess the utility and safety of Temporo-masseteric Nerve Block (TMNB), and to explore the mechanism for its apparent sustained pain relief. This manuscript describes, (1) a retrospective study evaluating pain reduction in patients who received the TMNB injection for the management of masticatory myogeneous pain (myalgia, per Diagnostic Criteria for Temporomandibular Disorders (DC/TMD criteria)), and (2) a motor nerve conduction study (NCS) of the temporalis and masseter, performed in the absence of signs or symptoms of TMD, before and after the TMNB injection. The results were as follows. (1) Retrospective study: (n = 186). 52 instances had available baseline and post-TMNB Numerical Pain Rating Scores (NRS) scores, the TMNB injection reduced baseline NRS scores by 70%; pain difference was qualitatively documented in 90 instances (pain relief or improvement in 86/90 instances). 4 instances yielded no pain relief. Mild adverse events recorded included a vasovagal episode (n = 1), transient weakening of blink (n = 2) or burning sensation (n = 1). (2) The Motor NCS demonstrated impairment of the compound-motor-action-potential (CMAP) as recorded from temporalis and masseter muscles following the TMNB injection. In conclusion, the TMNB injection is efficacious and safe. Further studies are warranted to warrant its effectiveness.