Targeted Therapy for Orofacial Pain: A Novel Perspective for Precision Medicine.

Orofacial pain (OFP) is a dental specialty that includes the diagnosis, management and treatment of disorders of the jaw, mouth, face, head and neck. Evidence-based understanding is critical in effectively treating OFPs as the pathophysiology of these conditions is multifactorial. Since OFP impacts the quality of life of the affected individuals, treating patients successfully is of the utmost significance.

Dual orexin receptor antagonist drug suvorexant can help in amelioration of predictable chronic mild stress-induced hyperalgesia.

Aims: This study aimed to evaluate the involvement of the orexin system in predictable chronic mild stress (PCMS) and the effects of suvorexant, a dual orexin receptor antagonist, on nociceptive behavior in PCMS.

Materials And Methods: Male C57BL/6 J mice were separated into various PCMS groups: a control group with sawdust on the floor of the rearing cage (C), a group with mesh wire on the floor (M), and a group with water just below the mesh wire (W). Activation of lateral hypothalamic orexin neurons was assessed using immunofluorescence.

Analgesic Effect of Tranilast in an Animal Model of Neuropathic Pain and Its Role in the Regulation of Tetrahydrobiopterin Synthesis.

Trigeminal neuralgia is unilateral, lancinating, episodic pain that can be provoked by routine activities. Anticonvulsants, such as carbamazepine, are the drugs of choice; however, these possess side-effects. Microvascular decompression is the most effective surgical technique with a higher success rate, although occasionally causes adverse effects.

Managements of sleep bruxism in adult: A systematic review.

This systematic review aimed to update the management of sleep bruxism (SB) in adults, as diagnosed using polysomnography (PSG) and/or electromyography (EMG). Management methods covered were oral appliance therapy (OAT) with stabilization splints, cognitive-behavioral therapy (CBT), biofeedback therapy (BFT), and pharmacological therapy. A comprehensive search was conducted on MEDLINE, Cochrane Library, and Web of Science up to October 1st, 2021.

Peripherally Administered Botulinum Toxin Type A Localizes Bilaterally in Trigeminal Ganglia of Animal Model.

Peripheral nerve injury leads to sensory ganglion hyperexcitation, which increases neurotransmitter release and neuropathic pain. Botulinum toxin type A (BoNT/A) regulates pain transmission by reducing neurotransmitter release, thereby attenuating neuropathic pain. Despite multiple studies on the use of BoNT/A for managing neuropathic pain in the orofacial region, its exact mechanism of transport remains unclear.

Risk Factors for Tooth Loss in Patients with ≥25 Remaining Teeth Undergoing Mid-Long-Term Maintenance: A Retrospective Study.

Tooth loss represents a diffused pathologic condition affecting the worldwide population. Risk factors have been identified in both general features (smoking, diabetes, economic status) and local tooth-related factors (caries, periodontitis). In this retrospective study, we examined the data of 366 patients with a large number of remaining teeth (≥25) undergoing maintenance therapy in order to identify specific risk factors for tooth loss.

Pain sensitivity increases with sleep disturbance under predictable chronic mild stress in mice.

Even though it has been well documented that stress can lead to the development of sleep disorders and the intensification of pain, their relationships have not been fully understood. The present study was aimed at investigating the effects of predictable chronic mild stress (PCMS) on sleep-wake states and pain threshold, using the PCMS rearing conditions of mesh wire (MW) and water (W) for 21 days. Exposure to PCMS decreased the amount of non-rapid eye movement (NREM) sleep during the dark phase.

Effects of sitting posture and jaw clenching on neck and trunk muscle activities during typing.

Neck pain is one of the most common musculoskeletal complaints. Evidence suggests that increased activities of neck and trunk muscles are one of the mechanisms related to neck pain. Jaw clenching and sitting posture may modulate the muscle activity in neck and trunk muscles during typing.

Immediate Effect of Masticatory Muscle Activity with Transcutaneous Electrical Nerve Stimulation in Muscle Pain of Temporomandibular Disorders Patients.

Transcutaneous electrical nerve stimulation (TENS) is a non-invasive treatment modality for acute and chronic pain. However, little information for muscle activity is available on the immediate effects of TENS in masticatory muscle pain related to temporomandibular disorders (TMDs). The present study aimed to evaluate the immediate effects of TENS treatment on TMD-related muscle pain.

Risk Factors for Tooth Loss in Patients Undergoing Mid-Long-Term Maintenance: A Retrospective Study.

In this retrospective study, we identified risk factors for tooth loss in patients undergoing mid-long-term maintenance therapy. We surveyed 674 maintenance patients for ≥5 years after active treatment who visited a dental clinic between January 2015 and December 2016. Of these, 265 were men (mean age 54.

Comparative analysis of education, awareness, and knowledge of dentists and physical therapists in the treatment of temporomandibular disorders.

Objective: To compare the education, awareness, and knowledge of Filipino dentists and physical therapists (PTs) in terms of temporomandibular disorders (TMDs).

Methods: A 30-item structured online questionnaire was given to recruited PTs and dentists from January 2019 to December 2019. Welch's -test was used to compare the education, awareness, and knowledge of health professionals.

Changes in oxygen and carbon dioxide in the genesis of sleep bruxism: a mechanism study.

Purpose: Rhythmic masticatory muscle activity (RMMA), a biomarker of sleep bruxism (SB), has been associated with mild hypoxia and/or big breaths in some adults with non-sleep-disordered breathing. The purpose of this study was to investigate that concurrent oxygen and carbon dioxide fluctuations are among the physiological variables that contribute to RMMA onset.

Methods: Twelve subjects (5 female, 7 male, mean age: 43 ± 11) underwent polysomnography recording in a sleep laboratory.

Effects of exercise therapy on painful temporomandibular disorders.

Temporomandibular disorders (TMD) are common chronic musculoskeletal pain conditions among orofacial pain. Painful TMD condition such as myalgia and arthralgia can be managed by exercise therapy. However, as it is hard to access actual effect of each modality that is included in an exercise therapy programme due to multiple choice of the management modality, their efficacy remains controversial.

Validity of Peer Evaluation for Team-Based Learning in a Dental School in Japan.

The aim of this study was to determine the validity of peer evaluation for team-based learning (TBL) classes in dental education in comparison with the term-end examination records and TBL class scores. Examination and TBL class records of 256 third- and fourth-year dental students in six fixed prosthodontics courses from 2013 to 2015 in one dental school in Japan were investigated. Results of the term-end examination during those courses, individual readiness assurance test (IRAT), group readiness assurance test (GRAT), group assignment projects (GAP), and peer evaluation of group members in TBL classes were collected.

Mandibular movement during sleep bruxism associated with current tooth attrition.

Patient: Observation of attrition patterns suggests that mandibular movement in sleep bruxism (SB) may be associated with current tooth attrition. The aim of this study was to confirm this phenomenon by investigating mandibular movement and masseter muscle activity. The subject was a healthy 21-year-old Japanese male.

Comparison between flipped classroom and team-based learning in fixed prosthodontic education.

Purpose: We previously investigated the effects of team-based learning (TBL) on fixed prosthodontic education and reported that TBL could have higher efficiency with high student satisfaction than traditional lecture. In the current report, we introduced flipped classroom to the fixed prosthodontic education and compared their effectiveness based on the final examination score in addition to TBL.

Methods: Participants were 41 students from Tokushima University School of Dentistry who attended a fixed prosthodontics course.

A longitudinal retrospective study of the analysis of the risk factors of implant failure by the application of generalized estimating equations.

Purpose: Many studies have identified risk factors for dental implant failure, although few have investigated the correlation among implant fixtures within single patients. A better analytical method may include repeated measures analysis including generalized estimating equations (GEE). This retrospective cohort study aimed to (1) identify the risk factors for failure of dental implantation and (2) evaluate an analytical method using GEE analysis.

A preliminary investigation of reproducibility of EMG signals during daytime masticatory muscle activity using a portable EMG logging device.

Continuous parafunctional masseter muscle activities (MMA) that are associated with daytime bruxism have been suspected to be one of the main pathoetiology for orofacial pain. The purpose of this study was to examine the long-term stability and reliability of daytime EMG measurement of MMA using a portable device (Actiwave; CamNtech Ltd). Daytime masseter muscle EMG of five subjects were recorded for four days in their normal living environment.

Effects of team-based learning on fixed prosthodontic education in a Japanese School of Dentistry.

The aims of this study were to evaluate the quality of team-based learning (TBL) in prosthodontics education for fourth-year dental students at Tokushima University School of Dentistry and to compare this teaching method with traditional lecture-based delivery. Participants in the study were 36 students (22 males and 14 females) who attended the TBL-style fixed prosthodontics course. Ten 60-minute classes were held.

Effect of an exclusion range of jaw movement data from the intercuspal positionon the estimation of the kinematic axis point.

In patients who have lost natural occlusal contacts, the centric relation is usually estimated based on several anatomical factors such as the temporomandibular joint and masticatory muscles except dental arch. The clinical procedure to record the centric relation often depends on the clinician's expertise and technique; an objective method to determine proper occlusal position is desirable. The kinematic axis point (KAP) is kinematically estimated from sagittal movements and is an ideal posterior reference point that is used in dental articulators for reproducing jaw movement.

Sleep less and bite more: sleep disorders associated with occlusal loads during sleep.

Occlusal overload during sleep is a significant clinical issue that has negative impacts on the maintenance of teeth and the longevity of dental prostheses. Sleep is usually viewed as an 'out-of-functional' mode for masticatory muscles. However, orodental structures and prostheses are not free from occlusal loads during sleep since masticatory muscles can be activated at a low level within normal sleep continuity.

Gender specificity of the slow wave sleep lost in chronic widespread musculoskeletal pain.

Objectives: The majority of patients suffering from musculoskeletal chronic widespread pain (CWP) are females, and they tend to report poor sleep. We tested the hypothesis that the poor sleep of female patients reporting CWP is gender specific for changes in (1) electroencephalograph (EEG) features and (2) heart rate variability (HRV).

Methods: Twenty-four normal sleepers were compared to 24 patients with CWP who complained of poor sleep.

Comparison of sleep variables between chronic widespread musculoskeletal pain, insomnia, periodic leg movements syndrome and control subjects in a clinical sleep medicine practice.

Background: Between 50% and 89% of chronic pain patients report unrefreshing sleep. The aim of this retrospective analysis was to compare the sleep of normal subjects with the sleep of a clinical population presenting musculoskeletal chronic widespread pain (CWP), psychophysiological insomnia and restless legs syndrome/periodic limb movements during sleep (RLS/PLMS) in order to identify sleep variables that may explain the poor sleep complaints of CWP patients.

Methods: Sleep data from 10 normal subjects and 37 patients (mean age 55+/-3 yo), matched for age and sex, were retrieved from our sleep data bank.

Comparison of various treatments for sleep bruxism using determinants of number needed to treat and effect size.

Purpose: Sleep bruxism (SB) is associated with temporomandibular pain, headaches, tooth wear, and disruption of the bed partner's sleep. The aim of this report was to compare SB treatments from various experimental studies to guide the selection of a treatment for a large sample size study.

Materials And Methods: After a literature search, randomized controlled studies of 7 pharmacologic treatments and 3 oral devices were included.