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To determine whether there is an association between gene polymorphisms and patients with painful temporomandibular joint (TMJ) clicking when compared to patients with painless TMJ clicking and a healthy control group.In this pilot study, the genotypic and allelic frequencies of candidate single-nucleotide polymorphisms (SNP) were compared among 60 individuals divided equally into three groups: patients with painful TMJ clicking (n = 20); patients with painless TMJ clicking (n = 20); and healthy controls (n = 20). Participants were genotyped for the following SNPs using real-time polymerase chain reaction: MMP1 -16071G/2G, COMT Val158Met, TNFα -308, IL1β +3954, IL6 -174, and IL10 -1082. The pressure pain threshold (PPT) of the TMJ was also assessed. All variables were compared among groups.Patients with painful TMJ clicking had a significant association and a higher frequency of MMP1 -16071G/2G (P = .042), COMT Val158Met (P = .030), and TNFα -308 (P = .016) when compared to the other groups, as well as a lower frequency of IL10 -1082. Considering PPT values, a progressively lower mean was found in individuals with painful TMJ clicking, followed sequentially by the painless TMJ clicking and the control groups.This pilot study showed that patients with painful TMJ clicking had a significant association with mutant genotypes related to degradation of extracellular matrix components, pain, proinflammation, and anti-inflammation. Furthermore, these patients also had significantly lower TMJ PPT values in all comparisons.

Objectives To evaluate the effect of a mechanical polishing protocol (MPP) performed continuously on the surface roughness and color stability of a denture base acrylic resin and artificial teeth exposed to different pigmenting substances. Materials and Methods Seventy specimens of each material (n=10) were exposed to: distilled water (DW, negative control); cigarette smoke (CS); immersion in coffee (CF); association CS+CF; and association of each pigmenting condition to the MPP (CS+MPP, CF+MPP and CS+CF+MPP). The MPP used aluminum oxide paste and felt wheel coupled to an electric motor. Color stability and surface roughness were evaluated by standard procedures at baseline and after 12 and 24 days. Two-way mixed ANOVA was used for statistical analysis. Results In most experimental conditions, the polishing controlled the roughness changes, making roughness values significantly lower (ppConclusions The proposed MPP, when carried out at biweekly intervals, was able to control the increase in surface roughness and reduce the color change on the tested acrylic resin-based prosthetic materials. Clinical Relevance Continuous polishing of removable dental prostheses can bring more durability, reducing the deleterious effect of agents such as cigarette and coffee. As it is a simple procedure to perform, the development of a portable device would allow the polishing to be done at home by the users of these prostheses.

Aim The present study aimed to report a case of orofacial pain secondary to acoustic neuroma (AN). Methods and results A 66-year-old female presented with unilateral facial pain and odontalgia. The pain was described as throbbing, dull, and constant. Tinnitus, hearing loss, dizziness, and others symptoms were also present. Due to the characteristics of the pain and clinical or radiographic findings, other possible diagnoses, such as temporomadibular disorder, tooth-related pain, sinusitis, and primary headaches, were excluded. Somatosensory tests for allodynia and hyperalgesia showed extraoral and intraoral hypersensitivity. Magnetic resonance imaging revealed a lesion located on the right cerebellopontine angle extending into and obliterating the internal auditory canal and compressing the middle cerebral peduncle, the pons, and the cisternal segment of cranial nerve V. The patient was diagnosed with a brainstem tumor compatible with AN and trigeminal neuralgia secondary to cranial nerve V compression. Conclusion Although uncommon, intracranial tumors should be considered during orofacial pain evaluation to avoid iatrogenic treatment and delayed diagnosis.

This study aims to validate the Brazilian version of World Health Organization Disability Assessment Schedule (WHODAS 2.0) for individuals with temporomandibular disorders (TMD), assessing its psychometric properties, including internal consistency, construct validity, and discriminant validity. In total, 100 female and male patients with TMD were included. Participants were assessed based on the Research Diagnostic Criteria for TMD (RDC/TMD). For statistical analyses, McDonald’s omega coefficient was used to assess internal consistency; Spearman correlation, for construct validity; Kruskal-Wallis test and multiple comparisons (Dunn method), for discriminant validity. The results of internal consistency for the WHODAS 2.0 domains ranged from 0.70 to 0.94. The WHODAS 2.0 showed a moderate and significant correlation with the disability points of the RDC/TMD and with the WHOQOL-BREF domains. In the discriminant validity, significant differences were found in all domains of WHODAS 2.0 between grade 0 and grade III, between grade I and grade III, and between grade II and grade III from the chronic pain grading of the RDC/TMD. The results demonstrate that the instrument is reliable and valid for measuring the functioning of individuals with TMD, presenting acceptable psychometric properties for internal consistency, as well as for construct validity and discriminant validity. RESUMO Este estudo metodológico teve como objetivo validar a versão brasileira do World Health Organization Disability Assessment Schedule (WHODAS 2.0) para indivíduos com desordem temporomandibular (DTM), avaliando suas propriedades psicométricas, incluindo consistência interna, validade de construto e validade discriminante. Um total de 100 pacientes do sexo feminino e masculino com DTM participaram do estudo e foram avaliados com base no Research Diagnostic Criteria for TMD (RDC/TMD). Para as análises estatísticas, o coeficiente ômega de McDonald foi usado para avaliar a consistência interna, a correlação de Spearman para a validade de construto, o teste de Kruskal-Wallis e comparações múltiplas (método de Dunn) para a validade discriminante. Os resultados de consistência interna para os domínios do WHODAS 2.0 variaram de 0,70 a 0,94. O WHODAS 2.0 apresentou correlação moderada e significativa com os pontos de incapacidade do RDC/TMD e com os domínios do WHOQOL-bref. Na validade discriminante, foram encontradas diferenças significativas em todos os domínios do WHODAS 2.0 entre os graus 0 e III, entre os graus I e III, e entre os graus II e III dos graus de dor crônica do RDC/TMD. Os resultados obtidos demonstram que o WHODAS 2.0 é um instrumento confiável e válido para mensurar a funcionalidade em indivíduos com DTM, apresentando propriedades psicométricas aceitáveis para consistência interna, bem como para validade de construto e validade discriminante. RESUMEN Este estudio metodológico tuvo como objetivo validar la versión brasileña del Cuestionario para la Evaluación de la Discapacidad de la Organización Mundial de la Salud (WHODAS 2.0) para personas con trastorno temporomandibular (TTM), así como evaluar sus propiedades psicométricas, incluidas la consistencia interna, la validez de constructo y la validez discriminante. Participaron en el estudio un total de 100 pacientes de ambos sexos con TTM, quienes fueron evaluados con base en Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). En los análisis estadísticos, se utilizó el coeficiente omega de McDonald para evaluar la consistencia interna; la correlación de Spearman para la validez de constructo; y la prueba de Kruskal-Wallis y comparaciones múltiples (método de Dunn) para la validez discriminante. Los resultados de consistencia interna para los dominios de WHODAS 2.0 variaron de 0,70 a 0,94. El WHODAS 2.0 tuvo una correlación moderada y significativa con los puntos de incapacidad del RDC/TMD y con los dominios del WHOQOL-bref. En la validez discriminante, se encontraron diferencias significativas en todos los dominios de WHODAS 2.0 entre los grados 0 y 3, entre los grados 1 y 3 y entre los grados 2 y 3 de los grados de dolor crónico del RDC/TMD. Los resultados apuntan que el WHODAS 2.0 es fiable y válido para medir la funcionalidad de personas con TTM, presentando propiedades psicométricas aceptables para la consistencia interna, así como para la validez de constructo y la validez discriminante.

As disfunções temporomandibulares (DTMs) podem ser classificadas como alterações que acometem a articulação temporomandibular, os músculos mastigatórios e as estruturas associadas, dividindo-se em dois grandes grupos: as DTMs de origem muscular e de origem articular, sendo a dor miofascial, de origem muscular, mais frequente. Apesar dos estudos existentes, a etiologia e o tratamento dessas alterações ainda não foram totalmente esclarecidos, e, dentre as modalidades de tratamento, tem sido discutido o uso de toxina botulínica tipo A (TXA) para manejo da dor miofascial. Assim, o objetivo desse estudo é fazer uma revisão da literatura sobre a efetividade da utilização da TXA para o tratamento de dor miofascial. Realizou-se um levantamento nas bases de dados PubMed e SciELO utilizando os descritores “Botulinum Toxin”, “Temporomandibular” e “Myofascial Pain”, no período de 2012 a 2022. Foram encontrados 167 artigos, mas apenas 11 obedeceram aos critérios de inclusão estabelecidos. Observou-se que a utilização de TXA para o tratamento de dor miofascial mostrou-se, na maioria dos estudos, igualmente efetivo quando comparada com outros métodos de tratamentos menos invasivos e com menos efeitos adversos conhecidos. Ademais, a alta diversidade metodológica entre os estudos dificultou comparação entre os resultados. Portanto, são necessários mais ensaios clínicos randomizados controlados de alto rigor metodológico e com acompanhamento a longo prazo para suportar a indicação de TXA no tratamento de dor miofascial relacionada a DTM.

Disfunções temporomandibulares (DTMs) são doenças que envolvem a articulação temporomandibular, músculos mastigatórios e estruturas associadas, tendo como um de seus principais sintomas a dor e podendo estar associadas a comorbidades. Todavia, a associação entre as DTMs e distúrbios gastrointestinais (DGIs) ainda é pouco estudada. DGIs podem ser classificados em orgânicos quando associados a uma causa anatômica ou dano tecidual, e funiconal quando não são evidentes achados patológicos, na ausência de uma causa anatômica, ou dano tecidual. Diante disso, esse estudo busca investigar, através de uma revisão de literatura, a possível associação entre DTM e DGIs de ordem estrutural ou funcional. Trata-se de uma busca bibliográfica nas bases de dados PubMed e SciELO em agosto de 2022, sem limitantes na busca no que se refere ao idioma e à data da publicação. Os descritores utilizados para a busca foram: “irritable bowel syndrome”; “gastroesophageal reflux disease”; “gastritis”; “Crohn's disease”; “constipation” e “temporomandibular disorders”. Um total de 53 artigos foram encontrados, e 18 desses incluídos. Com base na presente revisão, pode-se afirmar que existe uma potencial associação entre DTM e DGIs específicos a se dizer: síndrome do intestino irritável, doença do refluxo gastroesofágico e gastrite/úlcera péptica. Essa associação pode-se justificar por possíveis fatores mediadores comórbidos, a se destacar: somatização, ansiedade, depressão, catastrofização da dor e distúrbios do sono. Temporomandibular disorders (TMDs) are diseases that involve the temporomandibular joint, masticatory muscles and associated structures, with pain as one of its main symptoms and which may be associated with comorbidities. However, the association between TMDs and gastrointestinal disorders (GIDs) is still poorly studied. DGIs can be classified as organic when associated with an anatomic cause or tissue damage, and functional when no pathological findings are evident, in the absence of an anatomical cause or tissue damage. Therefore, this study seeks to investigate, through a literature review, the possible association between TMDs and DGIs of a structural or functional nature. This is a bibliographic search in the PubMed and SciELO databases in August 2022, without limitations in the search in terms of language and publication date. The descriptors used for the search were: “irritable bowel syndrome”; “gastroesophageal reflux disease”; “gastritis”; “Crohn's disease”; “constipation” and “temporomandibular disorders”. A total of 53 articles were found and 18 of these were included. Based on the present review, it can be stated that there is a potential association between TMDs and specific DGIs, namely: irritable bowel syndrome, gastroesophageal reflux disease and gastritis/peptic ulcer. This association can be justified by possible comorbid mediating factors, namely: somatization, anxiety, depression, pain catastrophizing and sleep disorders. Los trastornos temporomandibulares (TTM) son enfermedades que involucran la articulación temporomandibular, los músculos masticatorios y estructuras asociadas, teniendo el dolor como uno de sus principales síntomas y pueden estar asociados a comorbilidades. Sin embargo, la asociación entre los TTM y los trastornos gastrointestinales (TGI) aún está poco estudiada. Los TGI pueden clasificarse en orgánicos cuando se asocian con una causa anatómica o daño tisular, y funiconales cuando no se evidencian hallazgos patológicos, en ausencia de una causa anatómica o daño tisular. Por lo tanto, este estudio busca investigar, a través de una revisión de la literatura, la posible asociación entre TTM y TGI de carácter estructural o funcional. Se trata de una búsqueda bibliográfica en las bases de datos PubMed y SciELO en agosto de 2022, sin limitaciones en la búsqueda en cuanto a idioma y fecha de publicación. Los descriptores utilizados para la búsqueda fueron: “síndrome del intestino irritable”; “La enfermedad por reflujo gastroesofágico”; “gastritis”; “Enfermedad de Crohn”; “estreñimiento” y “trastornos temporomandibulares”. Se encontraron un total de 53 artículos y 18 de estos fueron incluidos en la presente revisión. Con base en la presente revisión, se puede afirmar que existe una posible asociación entre los TTM y los TGI específicos, a saber: síndrome del intestino irritable, enfermedad por reflujo gastroesofágico y gastritis/úlcera péptica. Esta asociación puede ser justificada por posibles factores mediadores comórbidos, a saber: somatización, ansiedad, depresión, catastrofización del dolor y trastornos del sueño.

AIMS To evaluate the efficacy of a gluten-free diet (GFD) as a treatment modality for pain management in women with chronic myofascial pain in masticatory muscles. METHODS In this randomized controlled trial, 39 female subjects were evaluated according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and divided into three groups: a healthy group (n = 14; mean ± SD age = 34.57 ± 9.14 years); a control group (n = 12; age = 31.50 ± 7.38 years); and an experimental group (n = 13; age 30.00 ± 7.64 years). The outcome variables were: pain intensity, mechanical pain threshold (MPT), and pressure pain threshold (PPT). MPT was performed on the masseter muscle, and PPT was performed on both the masseter and anterior temporalis muscles. A nutritionist prescribed a 4-week individualized GFD for the experimental group. The healthy group was analyzed only initially, whereas the control and experimental groups were analyzed again after 4 weeks. Data were subjected to statistical analysis with a significance level of 5% (one-way analysis of variance followed by Bonferroni post hoc, paired t, Wilcoxon signed rank, Kruskal-Wallis/Dunn, and Pearson chi-square tests). RESULTS Participants who underwent a GFD showed reduction in pain intensity (P = .006) and an increase in PPT of the masseter (P = .017) and anterior temporalis (P = .033) muscles. The intervention did not influence the MPT of the masseter muscle (P = .26). In contrast, the control group showed no improvement in any parameter evaluated. CONCLUSION GFD seemed to reduce pain sensitivity in women with TMD and may be beneficial as an adjunctive therapy for chronic myofascial pain in masticatory muscles; however, further studies in the fields of orofacial pain and nutrition are required.

Aims This case report aimed to discuss the multifactorial etiology and also the management of temporomandibular disorders (TMD) by addressing important associated psychosocial and biological factors, emphasizing the interaction between these factors and a probable genetic predisposition. Methods and results A 21-year-old female patient was evaluated according to Research Diagnostic Criteria for TMD and diagnosed with arthralgia, myofascial pain, disc displacement without reduction, and temporomandibular joint (TMJ) degenerative disease. TMJ alterations were confirmed through magnetic resonance imaging and cone-beam computed tomography. Pressure pain threshold of masticatory structures was evaluated using a pressure algometer. Sleep bruxism, poor sleep quality, migraine with aura, mild anxiety, and history of facial trauma were also identified through anamnesis and clinical examination. Following this, genetic analysis was performed to evaluate the presence of single nucleotide polymorphisms (SNPs) already associated with TMD: SNP COMT Val158 Met (rs4680), MMP1-1607 (rs1799750), and tumor necrosis factor alpha-308 (rs1800629), which were all present. A personalized treatment for TMD management was performed, and it included self-management programs, occlusal appliance therapy, pharmacotherapy, anxiety management, and stress control. An 8-year follow-up demonstrated long-term stabilization of TMJ degenerative disease. Conclusion Genetic evaluation, added to anamnesis and clinical examination, could be useful for TMD prognosis and management.

A desinfecção de amostras de resina acrílica pode ser alcançada através de irradiação de micro-ondas. No entanto, configurações inadequadas podem levar a distorções físicas ou prejudicar o processo de descontaminação. Este estudo tem como objetivo propor um regime de desinfecção por micro-ondas rápido e confiável para amostras de resina acrílica, em conformidade com as normas de esterilidade certificadas, para aplicações experimentais em laboratório. Os espécimes foram submetidos à formação de biofilme monoespecífico de Staphylococcus aureus, Escherichia coli e Candida albicans. O meio fluido tioglicolato foi utilizado para o teste qualitativo de desinfecção durante 14 dias de incubação a 35°C. A rugosidade da superfície, microdureza Knoop, resistência à flexão e estabilidade dimensional também foram avaliadas. Os protocolos de irradiação foram de 3 ou 5 min a 450 W ou 650 W em 250 mL de água destilada. As análises estatísticas foram realizadas considerando α=0,05. Todos os regimes de irradiação foram capazes de desinfetar os espécimes expostos a C. albicans. Apenas o regime de 450 W por 3 min não atingiu a desinfecção das amostras expostas a S. aureus e E. coli. A rugosidade da superfície, estabilidade dimensional e resistência à flexão não foram alteradas por nenhum regime (p>0,05). A microdureza diminuiu em todos os regimes, exceto 450 W por 3 min. A irradiação com 450 W por 5 min em 250 mL de água é um procedimento de desinfecção ideal para amostras de resina acrílica, pois combina potência e tempo de exposição ideais.

The events related to the COVID-19 pandemic are having a strong impact on public mental health. However, there are few studies focusing on these aspects in patients with temporomandibular disorders (TMD). The aim of this study was to evaluate the painful intensity, distress and symptoms of post-traumatic stress disorder (PTSD) in a population with and without TMD during the COVID-19 pandemic. This case-control study evaluated electronic questionnaires from 197 participants (105 with TMD and 92 controls), that were carried out during and after the first lockdown due to COVID-19 pandemic. To assess the presence of possible TMD, painful intensity, distress, and PTSD symptoms the respective questionnaires were used: TMD Pain Screener, Numeric Rating Scale, Patient Health Questionnaire – 4 and PTSD Checklist - Civilian Version. TMD participants showed higher levels of distress during (p = 0.027) and after (p < 0.001) the lockdown compared to the control group. The TMD group also reported increased levels of distress in the post-lockdown period in relation to the period during the lockdown (p = 0.002), although the same intensity of pain was observed at both evaluated periods. Furthermore, participants with TMD were 3.91 × more likely to be female (CI 95% = 1.88-8.13) and 3.82 × more likely to show PTSD symptoms (CI95% = 1.61-9.08) after the lockdown. These data suggest that a pre-existing painful condition can lead to increased distress and symptoms of PTSD as a result of stressful situations, such as the COVID-19 pandemic lockdown.

Oral rehabilitations in esthetic regions may be challenging when different prosthodontic modalities must be combined with interventions on gingival tissues to create a harmonious smile for the patient. This case report describes the treatment of a 36-year-old man with an esthetically compromised maxillary anterior region by means of periodontal microsurgery, an implant-supported dental prosthesis, and tooth-supported crowns. Combined esthetic-functional planning based on clinical and radiographic examinations, photographs, and a diagnostic wax-up led to correction of the gingival contour and thickness by means of periodontal microsurgery; customization of an implant-supported zirconia abutment with the application of feldspathic porcelain; fabrication of a lithium disilicate ceramic infrastructure to mask darkened substrate; and fabrication of lithium disilicate ceramic definitive restorations. Five years after cementation of the restorations, the results remained stable. Careful treatment planning allowed the achievement of a satisfactory, predictable, and long-lasting esthetic result.

The aim of this study was to assess the correlation of inflammatory and pain genes polymorphisms with the presence of temporomandibular disorder (TMD) patients and with pressure pain sensitivity.Data was collected from 268 consecutive subjects at Bauru School of Dentistry. Subjects aged younger than 20 years, with dental and neuropathic pain, sinusitis, cognitive and neurologic disorder were excluded. Included subjects were evaluated using the Research Diagnostic Criteria for Temporomandibular disorders and divided into two groups: TMD cases and healthy controls. Groups were submitted to pressure pain threshold (PPT) test for the temporomandibular joint, anterior temporalis and masseter muscles and genotyped for Val158Met, IL6-174, IL-1β-3954 and TNFA-308. Student's t-test and Pearson chi-square test were used to comparisons between groups. A linear multiple regression was used to evaluate the influence of genetics variables on the PPT and a bivariate analysis was used to assesses the influence of genetics variables on pain sensitivity below the PPT cut off of the structures in TMD group.TMD group showed significantly lower PPT values for all structures when compared with control group (p0.001). SNP IL6-174 predicted higher pain sensitivity in the temporomandibular joint (p0.005) and in anterior temporalis muscle (p0.044) and SNP Val158Met in the masseter muscle (p0.038); when TMD group was divided according to PPT cut-off values the SNP Val158Met influenced increase pain sensibility in the masseter muscle.TNFA-308 was associated with TMD and SNP IL6-174 and SNP Val158Met influenced pain sensitivity of patients with TMD.

Temporomandibular joint (TMJ) disorders are divided by the American Academy of Orofacial Pain into five categories. The most common ones are joint pain, as arthralgia and joint disorders, as disc displacements. An important clinical presentation of arthralgia is the painful tenderness to manual palpation or decreased pressure pain threshold (PPT). The authors conducted a study to determine the appropriate PPT value to discriminate asymptomatic TMJ individuals from those with moderate to severe arthralgia. Forty-nine individuals was evaluated and divided into groups: TMJ arthralgia, asymptomatic disc displacement and control group. Magnetic resonance images were obtained for all the groups, and algometry was performed on the TMJ lateral pole. Patients with arthralgia filled out a visual analogue scale (VAS). anova test with 1% of significance analysed the data. Specificity, sensitivity and ROC curve were also determined. Arthralgia group had significant lower PPT (mean of 1.07 kgf cm(-2) ) than the others. Asymptomatic disc displacement group (mean of 1.64 kgf cm(-2) ) has shown significant lower PPT than the control (mean of 2.35 kgf cm(-2) ). 89.66% of specificity and 70% of sensitivity were obtained when 1.36 kgf cm(-2) was applied to the TMJ (ROC area = 0.90). This value was considered to be the most appropriate to detected moderate to severe TMJ arthralgia. Indeed, the presence of disc displacement seems to significantly decrease PPT levels in asymptomatic subjects. The PPT value of 1.36 kgf cm(-2) can be used in the calibration procedures of the professionals involved with temporomandibular disorders and orofacial pain.

BACKGROUND AND OBJECTIVES: Several studies have shown the importance of biopsychosocial strategies, including pharmacological and non-pharmacological therapies, to decrease pain in orofacial pain patients. The involvement of pain modulation during aerobic exercise contributes to the use of such modality as part of rehabilitation programs for chronic pain patients. Studies have shown that aerobic exercise may increase the level of several neurotransmitters, such as serotonin, dopamine, acetylcholine and norepinephrine. The reality is that it activates endocannabinoid and endogenous opioid systems, involved in pain modulation. The effect of physical activity on pain perception is often called exercise-induced hypoalgesia. This study aimed at discussing the use of exercise-induced hypoalgesia as part of chronic pain management, including orofacial pain. CONTENTS: Comprehensive search on Pubmed, Medline, Web of Science and Scopus databases was carried out using the keywords: physical exercise, aerobic exercise, exercise-induced hypoalgesia, exercise-induced analgesia and orofacial pain/chronic orofacial pain. CONCLUSION: Exercise does not need to be of high-intensity to have an effect on pain management. Although there is evidence that some chronic pain patients may have the capacity to exercise at intensities and durations that appear to be required to elicit exercise-induced hypoalgesia in healthy subjects, the exercise tolerance of other unhealthy populations requires study. Additional research is needed to clarify and expand the understanding of the mechanisms responsible for exercise-induced hypoalgesia and how it can be used in chronic pain conditions such as chronic orofacial pain. RESUMO JUSTIFICATIVA E OBJETIVOS: Vários estudos têm demonstrado a importância de utilização de estratégias biopsicossociais, incluindo terapias farmacológicas e não farmacológicas, para reduzir a dor em pacientes com dor orofacial. O envolvimento da modulação da dor durante o exercício aeróbico contribui para o uso dessa modalidade como parte de programas de reabilitação para pacientes com dor crônica. Estudos demonstram que o exercício aeróbico pode aumentar o nível de vários neurotransmissores tais como serotonina, dopamina, acetilcolina e norepinefrina. A realidade é que ele ativa os sistemas endocanabinóide e opioide endógeno, envolvidos no sistema de modulação de dor. O efeito da atividade física na percepção da dor é comumente denominado hipoalgesia induzida por exercício. O objetivo deste estudo foi discutir o uso do fenômeno da hipoalgesia induzida por exercício como parte do tratamento da dor crônica, incluindo a dor orofacial. CONTEÚDO: Pesquisas abrangentes na base de dados Pubmed, Medline, Web of Science e Scopus foram realizadas utilizando as palavras-chave: exercício físico, exercício aeróbico, hipoalgesia induzida por exercício, analgesia induzida por exercício e dor orofacial/dor orofacial crônica. CONCLUSÃO: O exercício não precisa ser de alta intensidade para se obter efeito sobre o controle da dor. Embora alguns estudos comprovem que alguns pacientes com dor crônica tem a capacidade de se exercitarem em intensidades e durações de exercício que induzem a hipoalgesia induzida por exercício, a tolerância ao exercício e seus efeitos em populações de pacientes crônicos ainda exigem mais estudos e investigações para esclarecer e ampliar a compreensão do mecanismo da hipoalgesia induzida por exercício.

A irradiação por microondas vem sendo estudada como método alternativo de desinfecção e esterilização de prótese dentária. A literatura tem demonstrado ser um método eficaz, mas ainda não foram publicados estudos associando ação antimicrobiana com total ausência de prejuízos nas propriedades da resina acrílica. O objetivo deste estudo foi revisar a literatura, verificando os protocolos de potência e tempo utilizados, com análises microbiológicas e de propriedades, como rugosidade superficial, microdureza, resistência flexural e estabilidade dimensional. Foi realizada uma pesquisa na base de dados Pubmed, utilizando os descritores “microwaves”, “disinfection” e “acrylic resins”, encontrando 47 títulos, destes foram incluídos artigos em inglês, sem limitação de tempo e que estivessem de acordo com o objetivo do trabalho e excluídos estudos de revisão de literatura, sendo, então, 25 artigos selecionados. Foi constatado que a potência 650W por 3 minutos inviabilizou totalmente o crescimento de diversos micro-organismos. Contudo, os estudos que avaliaram as propriedades físico-mecânicas apresentaram resultados bastante conflitantes, não revelando concordância com relação ao protocolo de potência e tempo. No entanto, a maioria demonstrou que as alterações encontradas eram clinicamente insignificantes. Diante desses achados, observa-se que ainda não existe um protocolo padrão estabelecido para utilização da energia de microondas na resina acrílica, garantindo a eficácia antimicrobiana, sem danos a peça protética.Palavras-chave: Micro-ondas. Desinfecção. Resinas Acrílicas.

Many conditions may cause painful symptoms in orofacial structures. Among the chronic conditions that affect this area, temporomandibular disorders are the most common. Temporomandibular Disorder is a collective term that includes a number of clinical complaints involving the masticatory muscles, the Temporomandibular Joint and associated structures. In some cases, these complaints can be associated with depression, catastrophizing behavior and impact on quality of life. The present study aims to explain the relationship between Temporomandibular Disorders and pain chronification and their relation to a variety of psychosocial and behavioral comorbid conditions. The mechanisms of pain conduction and suggestions for management are also addressed.

Aims: To assess the influence of myofascial temporomandibular disorder (TMD) pain on the pressure pain threshold (PPT) of masticatory muscles in women during a migraine attack. Methods: The sample comprised 34 women, 18 to 60 years of age, with a diagnosis of episodic migraine previously confirmed by a neurologist. All subjects were evaluated using the Research Diagnostic Criteria for TMD (RDC/TMD) to determine the presence of myofascial pain. They were divided into two groups: group 1 (n = 18) included women with migraine; group 2 (n = 16) included women with migraine and myofascial TMD pain. Participants were evaluated by measuring PPT values of the masseter and anterior temporalis muscles and Achilles tendon with a pressure algometer at two moments: pain free and during a migraine attack. A three-way analysis of variance with a 5% significance level was used for statistical purposes. Results: Significantly lower PPT values were found during the migraine attack, especially for women with concomitant myofascial pain, regardless of the side of the reported pain. Conclusion: Migraine attack is associated with a significant reduction in PPT values of masticatory muscles, which appears to be influenced by the presence of myofascial TMD pain. J Orofac Pain 2013;27:343–349. doi: 10.11607/jop:1059