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To systematically review the literature to assess whether genetic polymorphisms affect orofacial pain sensitivity in healthy individuals and in patients with chronic orofacial pain disorders. Methods: Electronic searches were conducted to identify observational studies and clinical trials investigating the association between genetic polymorphisms and orofacial pain sensitivity in healthy individuals and/or patients with chronic orofacial pain disorders. Searches were carried out in PubMed, Embase, and Scopus databases using Medical Subject Headings and free terms. Results: Seven studies fulfilled the eligibility criteria: four analyzed healthy subjects, two included chronic orofacial pain patients, and one included samples of healthy subjects and patients with neuropathic pain. The results showed that genes associated with mechanical and thermal pain sensitivity were mostly related to opioid, catecholaminergic, inflammatory, and dopaminergic pathways. Conclusion: Genetic polymorphisms related to opioid, catecholaminergic, inflammatory, and dopaminergic pathways were associated with sensitivity to thermal and pressure stimuli in the orofacial region. Therefore, genetic factors should be taken into account for an accurate interpretation of orofacial pain sensitivity. These results will allow for a better understanding of the etiopathogenesis of chronic pain affecting the orofacial region, and consequently for finding new therapeutic targets.

Background: Previous evidence indicates significant association between genetic polymorphisms and phenotypes related to pain sensitivity in patients with temporomandibular disorders (TMD). Despite the important advances in cataloguing diverse factors such as sleep disorders, anxiety and depression, the interrelated mechanisms of painful TMD aetiopathogenesis still need investigation.Objectives: This case-control study aimed to evaluate the influence of genetic polymorphisms (rs6296, rs6295, rs1799971, rs4680, rs4633, rs4818) and psychosocial factors on the mechanical pain sensitivity and endogenous pain modulation in women with painful TMD and asymptomatic controls. Methods:We evaluated six independent variables: anxiety levels, depression, stress, sleep quality, pain catastrophising and genetic polymorphisms, and four dependent variables: mechanical pain threshold (MPT), pressure pain threshold (PPT), wind-up ratio (WUR) and conditioned pain modulation (CPM) collected at masseter (trigeminal) and hand (spinal) areas in a sample of 95 painful TMD patients and 85 controls. A regression model was used to test the possible effect of the independent variables on dependent variables. Results:The regression model was significant for MPT (F 11,168 = 9.772; R 2 = .390).Painful TMD diagnoses and sleep quality were associated with trigeminal MPT (B coefficient = −.499; and B coefficient = −.211, respectively). WUR was associated with rs6295 and rs6746030, respectively, for the spinal and the trigeminal area. Conclusion:Genetic polymorphisms had a slight contribution to endogenous pain modulation as indicated by the significant association with WUR but did not contribute to mechanical pain sensitivity. On the other hand, the presence of painful TMD and the sleep quality contributed significantly to mechanical pain sensitivity.

The surgical treatment of some odontogenic tumors often leads to tooth and maxillary bone loss as well as facial deformity. Therefore, the identification of genes involved in their pathogenesis may result in alternative molecular therapies. The PRKAR1A gene shows loss of protein expression, as well as somatic mutations in odontogenic myxomas, an odontogenic ectomesenchymal neoplasm. We used a combination of qRT-PCR, immunohistochemistry, LOH analysis and direct sequencing of all PRKAR1A exons to assess if this gene is altered in mixed odontogenic tumors. Thirteen tumors were included, being six ameloblastic fibromas, four ameloblastic fibro-odontomas, one ameloblastic fibrodentinoma and two ameloblastic fibrosarcomas. The epithelial component of the tumors was separated from the mesenchymal by laser microdissection in most of the cases. We also searched for odontogenic pathology in Prkar1a+/− mice. PRKAR1A mRNA/protein expression was decreased in the benign mixed odontogenic tumors in association with LOH at markers around PRKAR1A gene. We also detected a missense and two synonymous mutations, besides two 5’-UTR and four intronic mutations in the mixed odontogenic tumors. Prkar1a+/− mice did not show evidence of odontogenic tumor formation, suggesting that additional genes may be involved in their pathogenesis, at least in rodents. We conclude that the PRKAR1A gene and its locus are altered in mixed odontogenic tumors. PRKAR1A's expression is decreased in a subset of tumors but not in all, and Prkar1a+/− mice do not show abnormalities, suggesting that additional genes play a role in this tumor's pathogenesis.