Assessing the reliability of medical measurements is a crucial step towards the elaboration of an applicable clinical instrument. There are few studies that evaluate the reliability of somatosensory assessment and pain modulation of masticatory structures. This study estimated the test-retest reliability, that is over time, of the mechanical somatosensory assessment of anterior temporalis, masseter and temporomandibular joint (TMJ) and the conditioned pain modulation (CPM) using the anterior temporalis as the test site. Twenty healthy women were evaluated in two sessions (1 week apart) by the same examiner. Mechanical detection threshold (MDT), mechanical pain threshold (MPT), wind-up ratio (WUR) and pressure pain threshold (PPT) were assessed on the skin overlying the anterior temporalis, masseter and TMJ of the dominant side. CPM was tested by comparing PPT before and during the hand immersion in a hot water bath. anova and intra-class correlation coefficients (ICCs) were applied to the data (α = 5%). The overall ICCs showed acceptable values for the test-retest reliability of mechanical somatosensory assessment of masticatory structures. The ICC values of 75% of all quantitative sensory measurements were considered fair to excellent (fair = 8·4%, good = 33·3% and excellent = 33·3%). However, the CPM paradigm presented poor reliability (ICC = 0·25). The mechanical somatosensory assessment of the masticatory structures, but not the proposed CPM protocol, can be considered sufficiently reliable over time to evaluate the trigeminal sensory function.

Despite the nomenclature suggested to be a tumor, torus palatinus (TP) is an overgrowth of the bone in the palatal region and represents an anatomic variation. Its prevalence varies among the population studied and its etiology is still unclear; however, it seems to be a multifactorial disorder with genetics and environmental involvement. Surgical removal of the TP is indicated in the following circumstances: (1) deglutition and speech impairment, (2) cancer phobia, (3) traumatized mucosa over the torus, and (4) prosthetic reasons. The aim of this case report is describe cases that occurred in two sisters, emphasizing the genetic etiology of this anatomic variation. In addition, intra-oral exam and computed tomography scan (axial, coronal and sagittal view) provided a detailed assessment of the TP and elimination of other possible diagnoses, furthermore allowed a better analyzes of the anatomic relation with adjacentes structures. No surgical removal was indicated for both cases.

Summary Background Although inflammation can alter cytokines release and nerve function, it is not yet fully established if orthodontic‐induced inflammation can cause significant extraoral trigeminal somatosensory alterations and release of inflammatory chemical mediators. Objective The primary aim of this study was to investigate the impact of orthodontic separator and short‐term fixed orthodontic appliance on the extraoral trigeminal somatosensory function and concentrations of cytokines in the gingival crevicular fluid (GCF). Methods Twenty‐two female patients were evaluated as follow: baseline, 24 hour‐after elastomeric separator (‐aES), 24 hour‐ and 1 month‐after bonding brackets (‐aBB) at both arches. The outcome variables were as follows: self‐reported pain (Visual Analog Scale), QSTs (current perception threshold‐CPT, cold detection threshold‐CDT, warm detection threshold‐WDT, mechanical detection threshold‐MDT, mechanical suprathreshold‐MST and wind‐up ratio‐WUR. All QSTs were performed at infra‐orbital and mental nerve entry zone at patient`s dominant side. In addition, GCF samples in order to assess cytokines profile (IL‐1β,IL‐8,IL‐6 and TNF‐α) were collected. ANOVA and Tukey's post hoc analyses were performed (a = 5%). Results Patients reported higher pain intensity 24 hour‐aBB compared to baseline and 24 hour‐aES (P < 0.050). Patients were less sensitive to pin‐prick pain (MST) at 24 hour‐aBB and 1 month‐aBB compared to baseline (P < 0.006). Significant increases in IL‐6 levels were observed 24 hour‐aBB (P < 0.001). Multiple comparison analysis showed significant increase in IL‐1β levels (P < 0.001) and TNF‐α (P < 0.001) 1 month‐aBB compared to baseline. Conclusion Elastomeric separators only induced mild pain and were not able to significantly increase proinflammatory cytokines level in the GCF. In addition, orthodontic fixed appliance may induce only minor somatosensory changes at extraoral trigeminal locations.

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.

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