Orofacial pain management: current perspectives

Abstract

Some of the most prevalent and debilitating pain conditions arise from the structures innervated by the trigeminal system (head, face, masticatory musculature, temporomandibular joint and associated structures). Orofacial pain (OFP) can arise from different regions and etiologies. Temporomandibular disorders (TMD) are the most prevalent orofacial pain conditions for which patients seek treatment. Temporomandibular disorders include a number of clinical problems that involve the masticatory musculature, the temporomandibular joint (TMJ) or both. Trigeminal neuropathic pain conditions can arise from injury secondary to dental procedures, infection, neoplasias, or disease or dysfunction of the peripheral and/or central nervous system. Neurovascular disorders, such as primary headaches, can present as chronic orofacial pain, such as in the case of facial migraine, where the pain is localized in the second and third division of the trigeminal nerve. Together, these disorders of the trigeminal system impact the quality of life of the sufferer dramatically. A multidisciplinary pain management approach should be considered for the optimal treatment of orofacial pain disorders including both non-pharmacological and pharmacological modalities.

Efficacy of musculoskeletal manual approach in the treatment of temporomandibular joint disorder: A systematic review with meta-analysis

“…In the literature, treatments for TMD include patient education, home care programs, physical therapy, musculoskeletal manual approach, pharmacotherapy, nonsteroidal anti-inflammatory drugs (NSAIDs), local anesthetics, intracapsular injection of corticosteroids, muscle relaxants, antidepressants, occlusal appliance therapy, occlusal adjustment and surgical care (only indicated when non-surgical therapy has been ineffective) (Romero-Reyes and Uyanik, 2014). However, the multifactorial pathophysiology of TMJ related pain is far from being completely understood and effective management of pain has not been established yet (Lin, 2014).…”

Orofacial antinociceptive effect of the ethanolic extract of Annona vepretorum Mart. (Annonaceae)

“…Orofacial pain disorders are highly prevalent and debilitating conditions involving the hard and soft tissues of the head, face, neck, and all intra-oral structures; in addition, this condition represents a particular challenge, since the orofacial region is complex and therefore pain can arise from many sources [17].…”

Disfunção Temporomandibular E O Impacto Na Qualidade De Vida: Uma Revisão De Literatura

“…Tais disfunções incluem uma série de problemas clínicos que envolvem a musculatura mastigatória, a articulação temporomandibular (ATM) ou ambos, sendo que tais alterações interefrem na qualidade do indivíduo portador da mesma 8 . Tomaz-Morais et al 9 define a DTM como um termo clínico utilizado para definir um grupo de alterações na articulação temporomandibular (ATM), na musculatura da mastigação, e estruturas faciais associadas, onde essas alterações musculares e esqueléticas são consideradas os fatores desencadeantes de dor não dental na região orofacial.…”

“…A abordagem multidisciplinar para minimizar a dor deve ser considerada para o tratamento destas alterações incluindo modalidades não-farmacológicas e farmacológicas 8 . Bem como, pacientes com diagnóstico de desordem muscular apresetam risco para desenvolver a cronicidade do problema e apresentam um difícil controle dos sinais e sintomas 20 .…”