Reproducibility of quantitative sensory testing applied to musculoskeletal orofacial region: Site and sex differences

Costa, Yuri Martins; Araújo-Júnior, Everardo N.S. de; Fiedler, Letícia Soares; Souza, Paulo Roberto J. de; Silva, L. L. C. P.; Ferreira, Dyna Mara Araújo Oliveira; Conti, Paulo César Rodrigues; Bonjardim, Leonardo Rigoldi

doi:10.1002/ejp.1287

Cited by 23 publications

(16 citation statements)

References 32 publications

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“…Finally, we also found significant baseline differences on the tactile sensitivity, that is, MDT, which could indicate differential somatosensory sensitivity within the trigeminal territory. Indeed, previous investigations have reported somatosensory differences within the trigeminal innervation when considering anatomical areas related to masticatory muscles and the temporomandibular joint (TMJ) . Further researches are encouraged to establish a systematic somatosensory mapping of the trigeminal region.…”

Section: Discussionmentioning

confidence: 99%

The effect of orthodontic separator and short‐term fixed orthodontic appliance on inflammatory mediators and somatosensory function

Sampaio

Sampaio²,

Cunha

et al. 2018

J of Oral Rehabilitation

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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.

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Section: Discussionmentioning

confidence: 99%

The effect of orthodontic separator and short‐term fixed orthodontic appliance on inflammatory mediators and somatosensory function

Sampaio

Sampaio²,

Cunha

et al. 2018

J of Oral Rehabilitation

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“…Mechanical detection threshold and MPT were assessed by means of a standardised set of Semmes‐Weinstein monofilaments (Touch‐TestTM Sensory Evaluators, North Coast Medical Inc, Gilroy, USA), which deliver forces between 0.008 g/mm 2 to 300 g/mm 2 . Participants were instructed to inform the first sensation of touch and sharpness/pinprick painful sensation for, respectively, the MDT and MPT assessment . The ‘method of limits’ was used to determine both thresholds where a series of ascending and descending stimuli intensities were applied yielding five ‘suprathreshold’ and five ‘subthreshold’ reports and the geometric mean were then calculated …”

Section: Methodsmentioning

confidence: 99%

Topical anaesthesia degree is reduced in temporomandibular disorders patients: A novel approach to assess underlying mechanisms of the somatosensory alterations

Costa

Ferreira

Conti

et al. 2019

J of Oral Rehabilitation

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Background: Changes in quantitative sensory testing (QST) parameters following topical anaesthesia could contribute to better elucidate underlying mechanisms of somatosensory alterations in temporomandibular disorder (TMD) pain patients. This placebo-controlled crossover investigation compared the somatosensory profile following topical anaesthesia between TMD patients (n = 20) and healthy participants (n = 20).Methods: Cold detection threshold, warm detection threshold, cold pain threshold, heat pain threshold, mechanical detection threshold, mechanical pain threshold, wind-up ratio and pressure pain threshold were assessed on the skin overlying the masseter at three consecutive days (baseline and immediately after lidocaine 4%/ placebo cream). Mixed ANOVA and a coding system that accounts for the diversity of types of peripheral axons associated with the somatosensory parameters were applied for data analysis. Results:The lidocaine application caused no changes in the somatosensory sensitivity in the masseter region in TMD patients (P > .050), but sensitivity to cold, cold pain, touch and pinprick stimuli were reduced after topical anaesthesia in healthy participants (P < .050). Also, the degree of topical anaesthesia was greater in healthy participants (P = .008). The coding system suggested that TMD patients presented only Aδ-fibre block, whereas a combination of either Aβ-and/or C-fibre block was observed in 35% of healthy participants in addition to Aδ-fibre block following lidocaine application. Conclusion:Quantitative sensory testing can be successfully applied to identify meaningful differences in the degree of hypoalgesia and hypoesthesia following short-time topical anaesthesia. K E Y W O R D Scentral sensitisation, local anaesthesia, musculoskeletal pain, pain thresholds, sensory thresholds, temporomandibular disorders

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“…The sample size calculation was based on the MDC for PPT at the trapezius muscle because at that time, and to our knowledge, the MDC for masseter muscle was still not published. We now have calculated it based on the data obtained by Costa et al [ 72 ] at the masseter muscle, and the sample size would have been of 20 participants (SD = 0.51 and MDC = 0.91). In addition, another limitation was that the treatment and assessment were performed only on the right side, which may have also contributed to the small effects obtained.…”

Section: Discussionmentioning

confidence: 99%

Hypoalgesic and Motor Effects of Neural Mobilisation versus Soft-Tissue Interventions in Experimental Craniofacial Hyperalgesia: A Single-Blinded Randomised Controlled Trial

Diaz-Saez

Sáenz-Jiménez

Villafañe

et al. 2021

JCM

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Objective: The present trial aimed to compare the effects of the mobilisation of the nervous system (NS) to those of a soft-tissue intervention in subjects exposed to an experimentally induced hyperalgesia of the masticatory muscles. Methods: The study was a single-blinded randomised controlled trial. A total of 49 participants (mean ± SD age: 41 ± 11 years; 61% female) with latent myofascial trigger points (LMTrPs) in the craniofacial region were randomly assigned to one of three groups: neural mobilisation (NM), soft-tissues techniques and stretching (STT-S), and control group (CG). An initial assessment (baseline) was performed before the provocation chewing masticatory test. The pre-treatment measurements were registered 24 hours later. Next, the randomised intervention was applied, and afterwards, post-treatment data were obtained. Outcome measures included pain-free maximum mouth opening (MMO), pressure pain thresholds (PPTs) in the trigeminal and cervical region, and trigeminal and cervical two-point discrimination (TPD). Results: ANOVA revealed significant differences for the time × group interaction for pain-free MMO and PPTs. The results showed an improvement in the MMO and the PPTs for NM and STT-S groups but not for the CG. There were no differences between the NM and STT-S groups. However, the effect sizes were large for the NM and medium for the STT-S. No differences were found for TDP between groups nor over time. Conclusion: The results show that with NM and STT-S techniques, we could influence motor and sensory variables in asymptomatic subjects with LMTrPs after a masticatory provocation test. Both techniques increased MMO and PPTs in the short term. These beneficial effects lead us to consider the importance of including these methods in clinical practice.

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Reproducibility of quantitative sensory testing applied to musculoskeletal orofacial region: Site and sex differences

Abstract: The test site and participant's sex can significantly influence the relative reliability and agreement of quantitative sensory testing applied to musculoskeletal orofacial region, which affect the capacity to discriminate participants and to evaluate changes over time.

Cited by 23 publications

References 32 publications

The effect of orthodontic separator and short‐term fixed orthodontic appliance on inflammatory mediators and somatosensory function

The effect of orthodontic separator and short‐term fixed orthodontic appliance on inflammatory mediators and somatosensory function

Topical anaesthesia degree is reduced in temporomandibular disorders patients: A novel approach to assess underlying mechanisms of the somatosensory alterations

Hypoalgesic and Motor Effects of Neural Mobilisation versus Soft-Tissue Interventions in Experimental Craniofacial Hyperalgesia: A Single-Blinded Randomised Controlled Trial

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