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Hovhannisyan AH, Lindquist KA, Belugin S, Mecklenburg J, Ibrahim T, Tram M, Corey TM, Salmon AB, Perez D, Ruparel S, Akopian AN. Sensory innervation of masseter, temporal and lateral pterygoid muscles in common marmosets. Sci Rep 2023; 13:23062. [PMID: 38155190 PMCID: PMC10754842 DOI: 10.1038/s41598-023-49882-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 12/13/2023] [Indexed: 12/30/2023] Open
Abstract
Myogenous temporomandibular disorders is associated with an increased responsiveness of nerves innervating the masseter (MM), temporal (TM), and lateral pterygoid muscles (LPM). This study aimed to examine sensory nerve types innervating MM, TM and LPM of adult non-human primate-common marmosets. Sensory nerves were localized in specific regions of these muscles. Pgp9.5, marker for all nerves, and NFH, a marker for A-fibers, showed that masticatory muscles were primarily innervated with A-fibers. The proportion of C- to A-fibers was highest in LPM, and lowest in MM. All C-fibers (pgp9.5+/NFH-) observed in masticatory muscles were peptidergic (CGRP+) and lacked mrgprD and CHRNA3, a silent nociceptive marker. TrpV1 was register in 17% of LPM nerves. All fibers in masticatory muscles were labeled with GFAP+, a myelin sheath marker. There were substantially more peptidergic A-fibers (CGRP+/NFH+) in TM and LPM compared to MM. MM, TM and LPM NFH+ fibers contained different percentages of trkC+ and parvalbumin+, but not trkB+ fibers. Tyrosine hydroxylase antibodies, which did not label TG, highlighted sympathetic fibers around blood vessels of the masticatory muscles. Overall, masticatory muscle types of marmosets have similarities and differences in innervation patterns.
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Affiliation(s)
- Anahit H Hovhannisyan
- Departments of Endodontics, The School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
| | - Karen A Lindquist
- Integrated Biomedical Sciences (IBMS) Program, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Sergei Belugin
- Departments of Endodontics, The School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
| | - Jennifer Mecklenburg
- Departments of Endodontics, The School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
| | - Tarek Ibrahim
- Departments of Endodontics, The School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
| | - Meilinn Tram
- Departments of Endodontics, The School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
- Integrated Biomedical Sciences (IBMS) Program, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Tatiana M Corey
- Departments of Laboratory Animal Resources, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Adam B Salmon
- Departments of Molecular Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
- Sam and Ann Barshop Institute for Longevity and Aging Studies, The University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
- South Texas Veterans Health Care System, Geriatric Research Education and Clinical Center San Antonio, San Antonio, TX, 78229, USA
| | - Daniel Perez
- Oral and Maxillofacial Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Shivani Ruparel
- Departments of Endodontics, The School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
- Integrated Biomedical Sciences (IBMS) Program, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
- Departments of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Armen N Akopian
- Departments of Endodontics, The School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA.
- Integrated Biomedical Sciences (IBMS) Program, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA.
- Departments of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA.
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Hovhannisyan AH, Lindquist K, Belugin S, Mecklenburg J, Ibrahim T, Tram M, Corey T, Salmon A, Ruparel S, Ruparel S, Akopian A. Sensory innervation of masseter, temporal and lateral pterygoid muscles in common marmosets. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.10.528062. [PMID: 36798270 PMCID: PMC9934658 DOI: 10.1101/2023.02.10.528062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Myogenous temporomandibular disorders (TMDM) is associated with an increased responsiveness of nerves innervating the masseter (MM), temporal (TM), medial pterygoid (MPM) and lateral pterygoid muscles (LPM). This study aimed to examine sensory nerve types innervating MM, TM and LPM of adult non-human primate - common marmosets. Sensory nerves are localized in specific regions of these muscles. Pgp9.5, marker for all nerves, and NFH, a marker for A-fibers, showed that masticatory muscles were predominantly innervated with A-fibers. The proportion of C- to A-fibers was highest in LPM, and minimal (6-8%) in MM. All C-fibers (pgp9.5+/NFH-) observed in masticatory muscles were peptidergic (CGRP+) and lacked mrgprD, trpV1 and CHRNA3, a silent nociceptive marker. All fibers in masticatory muscles were labeled with GFAP+, a myelin sheath marker. There were substantially more peptidergic A-fibers (CGRP+/NFH+) in TM and LPM compared to MM. Almost all A-fibers in MM expressed trkC, with some of them having trkB and parvalbumin. In contrast, a lesser number of TM and LPM nerves expressed trkC, and lacked trkB. Tyrosine hydroxylase antibodies, which did not label TG, highlighted sympathetic fibers around blood vessels of the masticatory muscles. Overall, masticatory muscle types of marmosets have distinct and different innervation patterns.
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3
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Temporomandibular joint anatomy, function and clinical relevance. Br Dent J 2022; 233:539-546. [PMID: 36241801 DOI: 10.1038/s41415-022-5082-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 04/14/2022] [Indexed: 11/08/2022]
Abstract
The articulatory system comprises the temporomandibular joints (TMJs), intra-articular discs, mandibular/jaw muscles and occlusion. In the simplest terms, the TMJ is the articulation between the upper and lower jaws. The teeth form the contacts between the upper and lower jaws and the muscles are the motors that move the mandible. This system is unique in that the TMJs are paired; any stimulus that affects one joint or any other single part of the articulatory system can have a 'knock-on effect' in the rest of the system.It is important to have a good understanding of anatomy, not only to be able to differentiate between what is physiological and what is pathological, but also to understand the objectives of some treatment options. Sound knowledge of anatomy is essential and an appreciation of the anatomical features associated with the TMJ can serve as a foundation for understanding the clinical management of temporomandibular disorders.This article reviews the functional anatomical features of the articulatory system with a look at the clinical significance of this anatomy.
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Temporomandibular joint innervation: Anatomical study and clinical implications. Ann Anat 2021; 240:151882. [PMID: 34906668 DOI: 10.1016/j.aanat.2021.151882] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 11/17/2021] [Accepted: 12/07/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Temporomandibular disorders and related pain are commonly seen in clinical practice. Due to its recurrent nature, they adversely affect a patient's social life. Current knowledge on the temporomandibular joint (TMJ) innervation is debatable and insufficient to ensure optimal treatment for the underlying pathology. This study aimed to elucidate the pathophysiology of temporomandibular pain by revealing the TMJ innervation topography, its variations, and its relationships with the surrounding anatomical structures. This will aid in creating a guide for temporomandibular, infratemporal, and preauricular interventions. METHODS A total of 20 cadaver half heads, 10 fresh frozen and 10 embalmed, were used. The TMJ nerves were dissected together with the surrounding anatomical structures. RESULTS We showed that the TMJ is mainly innervated by the auriculotemporal nerve posteriorly, the masseteric nerve anteriorly, the posterior deep temporal nerve anteromedially, and the TMJ branch originating directly from the mandibular nerve medially, and that there are variations in these innervation pathways. Additionally, we emphasized how these nerves might be affected in certain clinical conditions based on their anatomical relationships and pathophysiological mechanisms. To our knowledge, this is the first study showing the existence of a branch of the mandibular nerve directly innervating the TMJ. CONCLUSION In light of our findings, elucidating TMJ pain based on the anatomical characteristics of the region will allow precise treatment algorithms and better clinical outcomes in these patients. Based on this study, new clinical studies and interventions can be designed to reduce healthcare costs and alleviate the burden of temporomandibular disorders.
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Yi Y, Zhou X, Xiong X, Wang J. Neuroimmune interactions in painful TMD: Mechanisms and treatment implications. J Leukoc Biol 2021; 110:553-563. [PMID: 34322892 DOI: 10.1002/jlb.3mr0621-731rr] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 06/28/2021] [Accepted: 07/08/2021] [Indexed: 02/05/2023] Open
Abstract
The underlying mechanisms and treatment of painful temporomandibular disorders (TMDs) are important but understudied topics in craniofacial research. As a group of musculoskeletal diseases, the onset of painful TMD is proved to be a result of disturbance of multiple systems. Recently, emerging evidence has revealed the involvement of neuroimmune interactions in painful TMD. Inflammatory factors play an important role in peripheral sensitization of temporomandibular joint (TMJ), and neurogenic inflammation in turn enhances TMJs dysfunction in TMD. Furthermore, centralized neuroimmune communications contribute to neuron excitability amplification, leading to pain sensitization, and is also responsible for chronic TMD pain and other CNS symptoms. Therapeutics targeting neuroimmune interactions may shed light on new approaches for treating TMD. In this review, we will discuss the role of neuroimmune interactions in the onset of painful TMD from the peripheral and centralized perspectives, and how understanding this mechanism could provide new treatment options. Insights into the neuroimmune interactions within TMJs and painful TMD would broaden the knowledge of mechanisms and treatments of this multifactorial disease.
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Affiliation(s)
- Yating Yi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, 610041, China
| | - Xueman Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, 610041, China
| | - Xin Xiong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, 610041, China
| | - Jun Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, 610041, China
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Vadhanan P. Successful use of Gasserian ganglion block for maxillo-mandibular fixation in a patient with severe pulmonary dysfunction: a case report. J Dent Anesth Pain Med 2020; 20:331-335. [PMID: 33195811 PMCID: PMC7644356 DOI: 10.17245/jdapm.2020.20.5.331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/13/2020] [Accepted: 08/19/2020] [Indexed: 11/16/2022] Open
Abstract
Various anesthetic techniques have been utilized for maxillo-mandibular fixation. We report the case of a patient with bilateral condylar and zygomatic arch fractures who had severe pulmonary dysfunction. The patient was administered bilateral image-guided Gasserian ganglion block through the foramen ovale to achieve surgical anesthesia. The technical details, advantages, and disadvantages of this rather unusual technique are discussed. The procedure could be a feasible technique when performed meticulously in cases where other approaches are deemed difficult.
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Affiliation(s)
- Prasanna Vadhanan
- Department of Anaesthesiology, Vinayaka Missions Medical College, Vinayaka Missions Research foundation, Karaikal, Puducherry, India.,Vairam Multispeciality Hospitals, Mayiladuthurai, India
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7
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Cluster Headache with Temporomandibular Joint Pain. Can J Neurol Sci 2020; 47:719-720. [DOI: 10.1017/cjn.2020.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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8
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Xu L, Jiang H, Feng Y, Cao P, Ke J, Long X. Peripheral and central substance P expression in rat CFA-induced TMJ synovitis pain. Mol Pain 2020; 15:1744806919866340. [PMID: 31322474 PMCID: PMC6685108 DOI: 10.1177/1744806919866340] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Synovitis contributes to temporomandibular joint (TMJ) pain, nevertheless, the detailed nociceptive mechanism remains unclear. In this study, a rat model of TMJ synovitis was induced by intra-articular injection with complete Freund’s adjuvant (CFA). After CFA-induced synovitis, pain behaviors were observed. Then, TMJ, trigeminal ganglion, and trigeminal nucleus caudalis (TNC) tissues were collected, and immunohistochemistry was used to detect the expression of substance P (SP) and protein gene product 9.5 (PGP9.5) in the synovium tissue. Furthermore, the gene expression level of SP and PGP9.5 in synovium was detected by reverse transcription-polymerase chain reaction (RT-PCR). Afterwards, the expression of SP in the trigeminal ganglion and TNC and c-fos in the TNC was detected by immunohistochemistry. Compared with the control group, the expression of SP and PGP9.5 nerve fibers density and gene levels of them in the synovium tissue were significantly increased in CFA-induced TMJ synovitis rats. Similarly, SP expression in the trigeminal ganglion and TNC, and c-fos expression in the TNC were also obviously increased in CFA-induced TMJ synovitis rats. Collectively, CFA-induced rat TMJ synovitis resulted in obvious pain. This nociceptive reaction could be attributed to the augmented quantity of SP and PGP9.5 positive-stained nerve fibers distributed in the inflammatory synovium as well as enhanced SP expression in the trigeminal ganglion and TNC tissue. c-fos expression in the rat TNC illustrates CFA-induced TMJ synovitis can evoke the acute pain.
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Affiliation(s)
- Liqin Xu
- 1 State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Henghua Jiang
- 1 State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yaping Feng
- 1 State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Pinyin Cao
- 1 State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jin Ke
- 1 State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xing Long
- 2 Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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9
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Pais Clemente M, Pinto A, Milheiro F, Costa TF, Moreira A, Vardasca R, Pereira PA, Mendes J, Dulce Madeira M, Manuel Amarante J. Adhesive dentistry sensory stimulus technique as a neuromechanism for the treatment of orofacial pain associated to temporomandibular disorders: Case study. J Oral Biol Craniofac Res 2020; 10:6-12. [PMID: 32025480 DOI: 10.1016/j.jobcr.2020.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 01/14/2020] [Indexed: 11/15/2022] Open
Abstract
Purpose The authors intend, by presenting a case study, emphasize the neuromodulation process of orofacial pain induced by the stimulation of the sensory and motor stimulation of the trigeminal nerve, which can play an important role on pain modulation. Materials and methods A 25 year-old woman presenting orofacial pain was referred to the stomatology service at the Centro Hospitalar do Porto. After collecting the patient's anamnesis, the thermographic camera FLIR i7 was used to record the thermal status of the orofacial structures, before the adhesive dentistry sensory stimulus protocol, after 45 minutes, and after one week. Results This study suggests the relation of adhesive dentistry sensory stimulus technique in the neuromodulation of orofacial pain and its association with the temporomandibular disorders . As the tongue senses the stimulus of the resin composite placed on the palatal surface of the 1st premolar, 2nd premolar and 1st molar of the maxilla, this can promote and induce an effect regarding a peripheral nerve neuromodulation resulting in a blockage of the nociceptive trigeminal pathway from temporomandibular disorders. Conclusion Orofacial pain is a common complaint among the patients that come to a dentistry appointment, which may have different diagnosis and treatments. A positive effect on the patient's symptomatology was confirmed clinically on subsequent dental appointments and monitored by infrared thermography.
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Affiliation(s)
- Miguel Pais Clemente
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Portugal
| | - Asdrúbal Pinto
- Serviço de Estomatologia e Cirurgia Maxilo Facial, Centro Hospitalar do Porto, Portugal
| | - Fernando Milheiro
- Serviço de Estomatologia e Cirurgia Maxilo Facial, Centro Hospitalar do Porto, Portugal
| | - Teresa F Costa
- Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Andre Moreira
- Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Ricardo Vardasca
- Faculty of Engineering, University of Porto, Portugal.,Labiomep, University of Porto, Portugal
| | - Pedro A Pereira
- Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Portugal.,CINTESIS - Centro de Investigação em Tecnologias e Serviços de Saúde, Porto, Portugal
| | - Joaquim Mendes
- Faculty of Engineering, University of Porto, Portugal.,Labiomep, University of Porto, Portugal.,INEGI, Porto, Portugal
| | - M Dulce Madeira
- Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Portugal.,CINTESIS - Centro de Investigação em Tecnologias e Serviços de Saúde, Porto, Portugal
| | - José Manuel Amarante
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Portugal.,Labiomep, University of Porto, Portugal
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Edvall NK, Gunan E, Genitsaridi E, Lazar A, Mehraei G, Billing M, Tullberg M, Bulla J, Whitton J, Canlon B, Hall DA, Cederroth CR. Impact of Temporomandibular Joint Complaints on Tinnitus-Related Distress. Front Neurosci 2019; 13:879. [PMID: 31548840 PMCID: PMC6736614 DOI: 10.3389/fnins.2019.00879] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 08/05/2019] [Indexed: 12/26/2022] Open
Abstract
There is increasing evidence of associations between the presence of temporomandibular joint (TMJ) disorders and tinnitus. It has been recently proposed that tinnitus patients with TMJ complaints could constitute a subtype, meaning a subgroup of tinnitus patients responsive to specific treatments. Tinnitus patients with TMJ complaints are often young women with somatosensory features of their tinnitus. Here, we investigate the socio-economic factors, phenotypic characteristics and psychological variables of tinnitus subjects from the Swedish Tinnitus Outreach Project, with (n = 486) or without (n = 1,996) TMJ complaints. The prevalence of TMJ complaints was greater in tinnitus subjects with severe tinnitus (36%) when compared to those with any tinnitus (19%), strongly indicating the contribution of TMJ problems to the severity of tinnitus. Comparing subgroups with or without TMJ complaints in the whole sample, differences were found regarding a large number of socioeconomic, phenotypic, and psychological characteristics. Subjects with TMJ complaints were more often women, more often reported stress as the cause of tinnitus, were more severely affected by tinnitus, scored worse in measures of psychological well-being and life quality, and were more often affected by problems tolerating sounds, headache, vertigo/dizziness, and neck pain. In addition, they more often reported pulsating and tonal tinnitus, somatic modulation of tinnitus, and aggravation of tinnitus by loud sounds and stress. When focusing the analysis in subjects with tinnitus as a big problem using the Tinnitus Functional Index cut-off ≥ 48, or with severe tinnitus according to the Tinnitus Handicap Inventory cut-off ≥ 58, the impact of somatosensory modulations and stress on tinnitus were greater in subjects with TMJ complaints in comparison to those without. In light of these results, we hypothesize that stress could contribute to the co-occurrence of TMJ problems and tinnitus and also to the development of severe tinnitus. Our study supports the need of involving dental care and stress management in the holistic treatment of patients with severe tinnitus.
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Affiliation(s)
- Niklas K Edvall
- Laboratory of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Edis Gunan
- Laboratory of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Eleni Genitsaridi
- National Institute of Health Research, Nottingham Biomedical Research Centre, Ropewalk House, Nottingham, United Kingdom.,Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Andra Lazar
- Hörsel och Balansmottagningen, Karolinska Universitetssjukhuset, Stockholm, Sweden
| | | | | | | | - Jan Bulla
- Department of Mathematics, University of Bergen, Bergen, Norway.,Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | | | - Barbara Canlon
- Laboratory of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Deborah A Hall
- National Institute of Health Research, Nottingham Biomedical Research Centre, Ropewalk House, Nottingham, United Kingdom.,Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,University of Nottingham Malaysia, Semenyih, Malaysia
| | - Christopher R Cederroth
- Laboratory of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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Surgical Management of Mandibular Subcondylar Fractures Under Local Anesthesia: A Proposed Protocol. J Oral Maxillofac Surg 2019; 77:1040.e1-1040.e9. [DOI: 10.1016/j.joms.2019.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 12/15/2018] [Accepted: 01/01/2019] [Indexed: 11/29/2022]
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12
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Van der Cruyssen F, Politis C. Neurophysiological aspects of the trigeminal sensory system: an update. Rev Neurosci 2018; 29:115-123. [DOI: 10.1515/revneuro-2017-0044] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 07/20/2017] [Indexed: 02/04/2023]
Abstract
AbstractThe trigeminal system is one of the most complex cranial nerve systems of the human body. Research on it has vastly grown in recent years and concentrated more and more on molecular mechanisms and pathophysiology, but thorough reviews on this topic are lacking, certainly on the normal physiology of the trigeminal sensory system. Here we review the current literature on neurophysiology of the trigeminal nerve from peripheral receptors up to its central projections toward the somatosensory cortex. We focus on the most recent scientific discoveries and describe historical relevant research to substantiate further. One chapter on new insights of the pathophysiology of pain at the level of the trigeminal system is added. A database search of Medline, Embase and Cochrane was conducted with the search terms ‘animal study’, ‘neurophysiology’, ‘trigeminal’, ‘oral’ and ‘sensory’. Articles were manually selected after reading the abstract and where needed the article. Reference lists also served to include relevant research articles. Fifty-six articles were included after critical appraisal. Physiological aspects on mechanoreceptors, trigeminal afferents, trigeminal ganglion and central projections are reviewed in light of reference works. Embryologic and anatomic insights are cited where needed. A brief description of pathophysiology of pain pathways in the trigeminal area and recent advances in dental stem cell research are also discussed. Neurophysiology at the level of the central nervous system is not reviewed. The current body of knowledge is mainly based on animal and cadaveric studies, but recent advancements in functional imaging and molecular neuroscience are elucidating the pathways and functioning of this mixed nerve system. Extrapolation of animal studies or functioning of peripheral nerves should be warranted.
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13
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Capek S, Koutlas IG, Strasia RP, Amrami KK, Spinner RJ. An inferior alveolar intraneural cyst: a case example and an anatomical explanation to support the articular theory within cranial nerves. J Neurosurg 2015; 122:1433-7. [DOI: 10.3171/2014.12.jns14798] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors describe the case of an intraneural ganglion cyst involving a cranial nerve (V3), which was found to have a joint connection in support of an articular origin within the cranial nerves. An inferior alveolar intraneural cyst was incidentally discovered on a plain radiograph prior to edentulation. It was resected from within the mandibular canal with no joint connection perceived at surgery. Histologically, the cyst was confirmed to be an intraneural ganglion cyst. Reinterpretation of the preoperative CT scan showed the cyst arising from the temporomandibular joint. This case is consistent with the articular (synovial) theory of intraneural ganglion cysts. An anatomical explanation and potential joint connection are provided for this case as well as several other cases of intraneural cysts in the literature, and thus unifying cranial nerve involvement with accepted concepts of intraneural ganglion cyst formation and propagation.
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Affiliation(s)
- Stepan Capek
- Departments of 1Neurosurgery and
- 2International Clinical Research Center, St. Anne's University Hospital Brno, Czech Republic; and
| | - Ioannis G. Koutlas
- 3Division of Oral and Maxillofacial Pathology, School of Dentistry, University of Minnesota, Minneapolis, Minnesota
| | - Rhys P. Strasia
- 4Center for Oral & Maxillofacial Surgery, Madison, Wisconsin
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14
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Li W, Long X, Jiang S, Li Y, Fang W. Histamine and substance P in synovial fluid of patients with temporomandibular disorders. J Oral Rehabil 2014; 42:363-9. [PMID: 25545415 DOI: 10.1111/joor.12265] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2014] [Indexed: 11/27/2022]
Abstract
Although psychosocial factors and malocclusion are regarded as potential causes of temporomandibular disorders (TMD), the underlying pathogenesis is poorly understood. Recent studies suggest that substance P (SP), which has been associated with both psychosocial factors and malocclusion, and histamine, whose release can be induced by SP, may be implicated in the pathogenetic process. This study was designed to measure the concentration of histamine and SP in synovial fluid (SF) of both 38 patients with TMD and 11 healthy controls, and analyse the correlation between histamine and SP. Patients with TMD were divided into three subgroups: displaced disc with reduction (DDR), displaced disc without reduction (DDNR) and osteoarthritis (OA), with 10, 13, 15 subjects in every subgroup, respectively. After collecting SF samples, histamine and SP levels were measured by enzyme-linked immunosorbent assay analysis (ELISA) and calibrated by bicinchoninic acid (BCA)-quantified protein level in the samples. The results suggest that OA group presented a significantly higher level of both histamine and SP than DDNR, DDR and healthy control groups. Histamine or SP in DDR and DDNR groups tend to be higher than control group, but no significance was found. Painful TMJs show higher histamine and SP than painless TMJs. Correlation analysis reveals a significant correlation between histamine and SP concentrations. Collectively, this study showed the changes of histamine and SP in the SF from different stages of TMD and found a significant correlation between the two substances, suggesting their potential implication in the pathogenesis of TMD.
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Affiliation(s)
- W Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBM), School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
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15
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Gohritz A, Dellon AL, Kalbermatten D, Fulco I, Tremp M, Schaefer DJ. Joint denervation and neuroma surgery as joint-preserving therapy for ankle pain. Foot Ankle Clin 2013; 18:571-89. [PMID: 24008220 DOI: 10.1016/j.fcl.2013.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Partial joint denervation or surgical neuroma therapy are alternative concepts to treat pain around the ankle joint that preserve joint function and relieve pain by interrupting neural pathways that transmit pain impulses from the joint to the brain. This review article summarizes the indication, anatomic background, operative techniques, and clinical results of joint denervation or neuroma surgery, which, although rarely reported and used, may provide a valuable alternative treatment in selected patients with neurogenous problems around the ankle.
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Affiliation(s)
- Andreas Gohritz
- Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, University Hospital, Spitalstrasse 21, Basel CH-4031, Switzerland.
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Ansari H, Robertson CBE, Garza I. Synovial cyst of temporomandibular joint, a potential etiology for auriculotemporal neuralgia? J Headache Pain 2013. [PMCID: PMC3620341 DOI: 10.1186/1129-2377-14-s1-p170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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17
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Ansari H, Robertson CBE, Garza I. Synovial cyst of temporomandibular joint, a potential etiology for auriculotemporal neuralgia? J Headache Pain 2013. [DOI: 10.1186/1129-2377-1-s1-p170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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18
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Nascimento MM, Vasconcelos BC, Porto GG, Ferdinanda G, Nogueira CM, Raimundo RDC. Physical therapy and anesthetic blockage for treating temporomandibular disorders: a clinical trial. Med Oral Patol Oral Cir Bucal 2013; 18:e81-5. [PMID: 23229236 PMCID: PMC3548651 DOI: 10.4317/medoral.17491] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Accepted: 09/19/2011] [Indexed: 11/26/2022] Open
Abstract
Purpose: the aim of this study was to evaluate the use of physical therapy and anesthetic blockage of the auriculotemporal nerve as a treatment for temporomandibular joint disorders.
Methods: the sample comprised of twenty patients with a diagnosis of disc displacement with/ without reduction and arthralgia according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD Axis I Group IIa, IIb and IIIa). Ten patients (group 1) underwent a cycle of eight anesthetic blockages of the auriculotemporal nerve with injections (1 per week) of 1 ml of bupivacaine 0.5% without vasoconstrictor for 8 weeks. The other 10 patients (group 2) received anesthetic blockage and physical therapy (massage and muscular stretching exercises). After the end of treatment all patients were evaluated at baseline, 1st week, 4th week and 2 months. The t-Student and F (ANOVA) tests were used for statistical analysis, with a significance rate of 5%.
Results: there was a significant difference when both groups were compared according to VAS score (p=0.027). There was no significant difference for the other variables: MMO and jaw protrusion.
Conclusion: the anesthetic blockage and physical therapy, when used together, are effective in the reduction of pain in patients with TMD.
Key words:Temporomandibular joint disorders, physical therapy, physiotherapy and nerve block, local anesthetic, bupivacaine.
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19
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Williams CG, Dellon AL, Rosson GD. Management of chronic facial pain. Craniomaxillofac Trauma Reconstr 2011; 2:67-76. [PMID: 22110799 DOI: 10.1055/s-0029-1202593] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Pain persisting for at least 6 months is defined as chronic. Chronic facial pain conditions often take on lives of their own deleteriously changing the lives of the sufferer. Although much is known about facial pain, it is clear that those physicians who treat these conditions should continue elucidating the mechanisms and defining successful treatment strategies for these life-changing conditions. This article will review many of the classic causes of chronic facial pain due to the trigeminal nerve and its branches that are amenable to surgical therapies. Testing of facial sensibility is described and its utility introduced. We will also introduce some of the current hypotheses of atypical facial pain and headaches secondary to chronic nerve compressions and will suggest possible treatment strategies.
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Post-surgical neuromas in patients with total alloplastic temporomandibular joint reconstruction: a retrospective case series. Int J Oral Maxillofac Surg 2011; 40:366-71. [PMID: 21123031 DOI: 10.1016/j.ijom.2010.10.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2009] [Revised: 09/20/2010] [Accepted: 10/26/2010] [Indexed: 11/21/2022]
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21
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Cascone P, Fatone FMG, Paparo F, Arangio P, Iannetti G. Trigeminal impingement syndrome: the relationship between atypical trigeminal symptoms and anteromedial disk displacement. Cranio 2010; 28:177-80. [PMID: 20806735 DOI: 10.1179/crn.2010.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The purpose of this study was to determine if compression of the mandibular nerve and its branches could be caused by antero-medial disk displacement, resulting in atypical facial pain. Sixteen temporomandibular joints (TMJ) were dissected and injected with an autopolymerizing solution into the superior compartment, which produced an artificial capsular swelling that caused disk displacement. In all specimens, the TMJ capsule was close to the mandibular branch of the trigeminal nerve after the intracapsular injection. Thus, capsular distension or antero-medial disk displacement, as seen in various temporomandibular disorders (TMD), could result in nerve compression and facial pain symptoms.
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Affiliation(s)
- Piero Cascone
- European Society of Temporomandibular Joint Surgeons
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22
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Macroscopic and microscopic aspects of the temporomandibular joint related to its clinical implication. Micron 2008; 39:852-8. [DOI: 10.1016/j.micron.2007.12.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2007] [Revised: 12/09/2007] [Accepted: 12/14/2007] [Indexed: 11/17/2022]
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Decuadro-Sáenz G, Castro G, Sorrenti N, Doassans I, Deleon S, Salle F, Saibene A, Santamaría A, Soria-Vargas V, Pérez-Brignani A. El nervio auriculotemporal. Bases neuroanatómicas del Síndrome de Frey. Neurocirugia (Astur) 2008. [DOI: 10.1016/s1130-1473(08)70241-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ayesh EE, Ernberg M, Svensson P. Effects of local anesthetics on somatosensory function in the temporomandibular joint area. Exp Brain Res 2007; 180:715-25. [PMID: 17588187 DOI: 10.1007/s00221-007-0893-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2006] [Accepted: 01/24/2007] [Indexed: 10/23/2022]
Abstract
There is a need for systematic studies regarding the pathophysiology and pain mechanisms of somatosensory function in the temporomandibular joint (TMJ). So far, the effects on somatosensory functions of local anesthetics (LA) applied to the auriculotemporal (AT) nerve or intraarticularly (IA) into the TMJ have not been studied systemically. This study aimed to examine in a double-blinded, placebo-controlled manner the effects of LA on mechanical and thermal sensitivity in the TMJ area. Twenty-eight healthy subjects (27.4 +/- 6.2 years) without temporomandibular disorders (TMD) participated. The subjects received an AT nerve block (n = 14) or an IA injection (n = 14) with LA (Bupivacaine, 2.5 mg/ml) on one side, and a placebo injection (isotonic saline) on the contralateral side. Mechanical (tactile and pin-prick) and thermal sensitivity (40 and 5 degrees C) were assessed at 11 standardized points in the TMJ area before injections (baseline) as well as 30 min, 1 and 2 h after injections. All stimuli were rated by the subjects on a 0-100 numerical rating scale (NRS). TMJ pressure pain threshold (PPT) and pressure pain tolerance (PPTOL) were assessed laterally over both TMJs using an algometer. IA injections with LA were not associated with any changes in sensitivity of the TMJ or surrounding area. In contrast, AT nerve blocks with LA caused a decrease over time in the pin-prick sensitivity (P = 0.016), which however, did not differ significantly from saline, and an increase of the PPTs 30 min (P = 0.010) and PPTOLs 30 min, 1 h and 2 h (P < 0.05) after LA injections in comparison to saline. No other measures showed a significant change after the injections. Our results showed that IA bupivacaine injection in healthy subjects has no effect on the sensitivity of the TMJ or surrounding area, while AT nerve block has a more pronounced effect on deep mechanical, but not on superficial mechanical or thermal sensitivity. Further research to investigate the effect of LA on somatosensory functions in TMJ patients in comparison with this study results will give valuable information about the sensitivity in the TMJ area.
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Affiliation(s)
- Emad E Ayesh
- Department of Clinical Oral Physiology, School of Dentistry, Aarhus University, Vennelyst Boulevard 9, 8000 Aarhus C, Denmark.
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Abstract
The successful management of temporomandibular joint (TMJ) pain remains elusive. Often the initial relief of pain is complicated by recurrence of the symptoms. This time frame suggests that the pain may be related to neuromas of the nerves that innervate the TMJ. In 2003, an anatomic description of the innervation of the TMJ suggested that denervation of this joint might be the appropriate treatment for pain resistant to traditional forms of therapy. In January, 2005, this approach was used to treat recalcitrant left TMJ pain in a 21-year-old woman with congenital hearing loss who had recurrent dislocations of her TMJ articular disc. She previously had two arthroscopic surgeries and one open attempt to treat her TMJ pain. The last failed TMJ surgery created a painful neuroma that prevented her from wearing her hearing aid. A medial and lateral denervation of the TMJ joint was done. The successful results of this surgery are presented at one-year follow-up. The technical considerations of this approach and risk to the facial nerve are discussed.
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Affiliation(s)
- Lee Dellon
- Division of Plastic Surgery and Neurosurgery, Department of Anatomy, University of Arizona, Tucson, Arizona, USA.
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26
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Abstract
The head, face, mouth, and throat collectively is the most frequent site of pain in humans. Facial pain is a particularly distressing problem because identification and effective treatment of the underlying cause is often challenging and sometimes elusive. This article focuses on the more common causes of facial pain that originate in the oral cavity and associated structures and outlines a general approach to diagnosis and management of these problems.
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Affiliation(s)
- Donald J Annino
- Department of Otolaryngology, Tufts University School of Medicine, New England Medical Center, 750 Washington Street, Boston, MA 02111, USA.
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