Serotonergic Mechanisms Influence the Response to Glucocorticoid Treatment in TMJ Arthritis

Abstract

The aims of this study were to investigate the influence of serotonin (5-HT) on the effects of intra-articular injections of glucocorticoid on pain of the temporomandibular joint (TMJ) in patients with inflammatory disorders of the TMJ. The pretreatment synovial fluid 5-HT was negatively, and plasma 5-HT positively, correlated to change in TMJ pain after treatment. The pretreatment plasma 5-HT was positively correlated to change in pressure-pain threshold after treatment. In conclusion, this study shows that local and systemic serotonergic mechanisms partly determine the effect of intra-articular glucocorticoid treatment on TMJ pain in patients with chronic TMJ arthritis of systemic nature, while change in pressure-pain threshold over the TMJ is influenced by systemic serotonergic mechanisms.

Tumor Necrosis Factor‐α in Temporomandibular Joint Synovial Fluid Predicts Treatment Effects on Pain by Intra‐Articular Glucocorticoid Treatment

“…TMJ resting pain and tenderness to digital palpation decreased after intra-articular glucocorticoid treatment, which is in accordance with several previous studies [18–20]. In this study, the tenderness to digital palpation of the posterior aspect of the TMJ was negatively correlated to the level of thrombocyte particle concentration which in turn was associated with the inflammatory markers, erythrocyte sedimentation rate, and C-reactive protein.…”

“…There are reasons to consider pain on maximum mouth opening as intra-articular allodynia, which corroborates earlier findings [17]. It has previously been hypothesized that pressure-pain threshold and resting pain of the TMJ are modulated by different pain mechanisms [20], which is supported by the results of this study since there was no relation between these variables which responded differently to local administration of glucocorticoid. Future studies should investigate whether tenderness to digital palpation represents intra-articular pain or periarticular pain or both.…”

Biomarkers in temporomandibular disorder and trigeminal neuralgia: A conceptual framework for understanding chronic pain

“…In TMD, elevated synovial 5-HT has been associated with increased pain, 81 and both local and systemic levels of 5-HT predict response to intra-articular glucocorticoid injection. 82 A small study found that the masseter muscles of women with myofascial TMD had more nerve fibers expressing 5-HT 3A receptors compared to healthy controls and that these fibers more frequently exhibited increased co-expression of 5-HT 3A receptors with Na v 1.8 channels, a marker of small, thinly myelinated nociceptive fibers. 83 A more recent study found no difference in plasma levels of 5-HT between patients with myofascial TMD and healthy controls but found that plasma dopamine levels were significantly increased in patients with TMD.…”

Application of corticosteroids in dentistry

“…Zavisno od uzroka, pored ostale farmako i fizikalne terapije, KS imaju važnu ulogu u lečenju ovakvih stanja, jer smanjuju bolove, hipomobilnost TMZ i inflamaciju. Intrakapsularna injekcija KS može u velikoj meri olakšati simptome bolesti 26 . 15.…”