Acute and Chronic Pain from Facial Skin and Oral Mucosa: Unique Neurobiology and Challenging Treatment

Chung, Man‐Kyo; Wang, Sheng; Oh, Se Lim; Kim, Yu Shin

doi:10.3390/ijms22115810

Cited by 20 publications

(12 citation statements)

References 113 publications

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“…These studies have laid a solid foundation for our current understanding of orofacial pain mechanisms. While a detailed discussion of these mechanisms is beyond the scope of this review, there are other publications that have reviewed these topics ( 57 , 76 – 82 ). In brief, the identity of the subtypes of joint nociceptors and the peripheral sensitization of joint afferents leading to hypersensitivity has been defined ( 83 ), as has the dominant role TRPV1-expressing afferents play in TMJ pain ( 84 ).…”

Section: Preclinical Studies For Tmjoa and Pain From Tmjmentioning

confidence: 99%

The degeneration-pain relationship in the temporomandibular joint: Current understandings and rodent models

et al. 2023

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Temporomandibular disorders (TMD) represent a group of musculoskeletal conditions involving the temporomandibular joints (TMJ), the masticatory muscles and associated structures. Painful TMD are highly prevalent and conditions afflict 4% of US adults annually. TMD include heterogenous musculoskeletal pain conditions, such as myalgia, arthralgia, and myofascial pain. A subpopulations of TMD patients show structural changes in TMJ, including disc displacement or degenerative joint diseases (DJD). DJD is a slowly progressing, degenerative disease of the TMJ characterized by cartilage degradation and subchondral bone remodeling. Patients with DJD often develop pain (TMJ osteoarthritis; TMJ OA), but do not always have pain (TMJ osteoarthrosis). Therefore, pain symptoms are not always associated with altered TMJ structures, which suggests that a causal relationship between TMJ degeneration and pain is unclear. Multiple animal models have been developed for determining altered joint structure and pain phenotypes in response to various TMJ injuries. Rodent models of TMJOA and pain include injections to induce inflammation or cartilage destruction, sustained opening of the oral cavity, surgical resection of the articular disc, transgenic approaches to knockout or overexpress key genes, and an integrative approach with superimposed emotional stress or comorbidities. In rodents, TMJ pain and degeneration occur during partially overlapping time periods in these models, which suggests that common biological factors may mediate TMJ pain and degeneration over different time courses. While substances such as intra-articular pro-inflammatory cytokines commonly cause pain and joint degeneration, it remains unclear whether pain or nociceptive activities are causally associated with structural degeneration of TMJ and whether structural degeneration of TMJ is necessary for producing persistent pain. A thorough understanding of the determining factors of pain-structure relationships of TMJ during the onset, progression, and chronification by adopting novel approaches and models should improve the ability to simultaneously treat TMJ pain and TMJ degeneration.

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Section: Preclinical Studies For Tmjoa and Pain From Tmjmentioning

confidence: 99%

The degeneration-pain relationship in the temporomandibular joint: Current understandings and rodent models

et al. 2023

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“…Posttraumatic trigeminal neuropathic pain often occurs because of facial trauma or iatrogenic reasons such as a third molar extraction. 14 Because posttraumatic trigeminal neuropathic pain is more resistant to first-line therapy compared with other neuropathic pain conditions, 23 , 30 developing an effective strategy to treat these conditions with fewer adverse side effects is necessary.…”

Section: Introductionmentioning

confidence: 99%

Capsaicin-induced depolymerization of axonal microtubules mediates analgesia for trigeminal neuropathic pain

Arora¹,

Li²,

Kumari³

et al. 2021

Pain

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Capsaicin is a specific agonist of transient receptor potential vanilloid 1 (TRPV1), which is enriched in nociceptors. Capsaicin not only produces acute pain but also leads to long-lasting analgesia in patients with chronic pain. Although capsaicin-induced TRPV1 and Ca 21 /calpain-dependent ablation of axonal terminals is necessary for long-lasting analgesia, the mechanisms underlying capsaicininduced ablation of axonal terminals and its association with analgesia are not fully understood. Microtubules are composed of tubulin polymers and serve as a main axonal cytoskeleton maintaining axonal integrity. In this study, we hypothesized that capsaicin would increase the depolymerization of microtubules and lead to axonal ablation and analgesia for trigeminal neuropathic pain. Paclitaxel, a microtubule stabilizer, decreased capsaicin-induced ablation of axonal terminals in time-lapsed imaging in vitro. Capsaicin increases free tubulin in dissociated sensory neurons, which was inhibited by paclitaxel. Consistently, subcutaneous injection of paclitaxel prevented capsaicin-induced axonal ablation in the hind paw skin. Capsaicin administration to the facial skin produced analgesia for mechanical hyperalgesia in mice with chronic constriction injury of the infraorbital nerve, which was prevented by the coadministration of paclitaxel and capsaicin. Whole-mount staining of facial skin showed that paclitaxel reduced capsaicin-induced ablation of peptidergic afferent terminals. Despite the suggested involvement of TRPV1 Ser801 phosphorylation on microtubule integrity, capsaicin-induced analgesia was not affected in TRPV1 S801A knock-in mice. In conclusion, capsaicininduced depolymerization of axonal microtubules determined capsaicin-induced ablation of nociceptive terminals and the extent of analgesia. Further understanding of TRPV1/Ca 21 -dependent mechanisms of capsaicin-induced ablation and analgesia may help to improve the management of chronic pain.

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“…Less pain during the early postoperative period in TOETVA may be because oral vestibule incisions cause less pain than skin incisions on the neck. Compared to the skin, oral wounds contain fewer immune mediators and profibrotic mediators, and more bone marrow-derived cells, as well as a higher re-epithelialization rate, and faster proliferation of fibroblasts than dermal wounds, leading to faster healing of the oral mucosa after injury without scar tissue 38 . Having a more comprehensive insight into the nature of postoperative pain following the two approaches, which investigates postoperative pain scores at various locations, such as the anterior neck, lateral neck, lower lip, and chin, as well as swallowing pain, would be helpful.…”

Section: Discussionmentioning

confidence: 99%

Transoral endoscopic thyroidectomy vestibular approach as a safe and feasible alternative to open thyroidectomy: a systematic review and meta-analysis

Chai

et al. 2023

International Journal of Surgery

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Background: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a scarless alternative to open thyroidectomy (OT). This systematic review and meta-analysis aimed to synthesize evidence comparing the intraoperative and postoperative outcomes of TOETVA and OT. Methods: A systematic literature search of PubMed, Web of Science, the Cochrane Library, and Google Scholar was performed to identify studies comparing the outcomes of TOETVA and OT published before February 2023. The outcomes of interest were operative time, intraoperative blood loss, hospital stay, postoperative pain, number of central lymph nodes retrieved, number of metastatic central lymph nodes, and incidences of transient and permanent recurrent laryngeal nerve injury, transient and permanent hypocalcemia, hematoma, and infection. Results: Thirteen studies published between 2016 and 2022, involving a total of 2889 patients (TOETVA, n=1085; OT, n=1804) were included in this systematic review and meta-analysis. Meta-analysis showed that the TOETVA group had a significantly longer overall operative time (weighted mean difference [WMD] 55.19; 95% CI, 39.15, 71.23; P<0.001), longer hospital stay (WMD, 0.27; 95% CI, 0.14, 0.39; P<0.001), and lower pain scores on postoperative day 1 (WMD, −1.41; 95% CI, −2.79, −0.03; P=0.04) than the OT group. Other intraoperative and postoperative outcomes were not significantly different between the groups. Conclusion: TOETVA has a similar safety profile to OT with less postoperative pain, making it an appropriate and more cosmetically appealing alternative to OT for select patients.

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Acute and Chronic Pain from Facial Skin and Oral Mucosa: Unique Neurobiology and Challenging Treatment

Cited by 20 publications

References 113 publications

The degeneration-pain relationship in the temporomandibular joint: Current understandings and rodent models

The degeneration-pain relationship in the temporomandibular joint: Current understandings and rodent models

Capsaicin-induced depolymerization of axonal microtubules mediates analgesia for trigeminal neuropathic pain

Transoral endoscopic thyroidectomy vestibular approach as a safe and feasible alternative to open thyroidectomy: a systematic review and meta-analysis

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