Neuropathic Pain in Temporomandibular Joint Disorders: Case-Control Analysis by MR Imaging

Pedullà, Eugenio; Meli, G.A.; Garufi, Antonio; Mandalà, Marco; Blandino, Alfredo; Cascone, Piero

doi:10.3174/ajnr.a1575

Cited by 15 publications

(10 citation statements)

References 15 publications

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“…These differences may be due to the different methodologies used in the studies where the diagnostic method and causes of OFP considered were different, which makes comparisons difficult. Pedullà et al 22 think that TMD and NP can be related. Using imaging methods, they found that in patients with TMD and NP, the distance between the articular disc and the mandibular nerve was lower than in patients with TMD without NP.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of neuropathic symptoms in patients referred for temporomandibular disorder in a Chilean hospital, 2014-2015.

Miranda¹,

Gayoso²,

Ruiz³

et al. 2015

Joralres

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Aim: To determine the prevalence of neuropathic symptoms in the orofacial region in patients referred for painful temporomandibular disorder at Hospital Base Valdivia in 2014 and 2015. Materials and method: An observational study was conducted on patients referred for painful temporomandibular disorder by general dentists working in primary dental health care at Hospital Base Valdivia, during October 2014 and March and April 2015. Patients were asked to complete the LANSS pain scale by one of the examiners. The variables age, sex and location of pain were measured and registered. Results: Of the 84 patients surveyed, 88.1% were women, with a mean age of 38.2 years. The median score obtained with the LANSS scale was 3.0 [0-8.75]. A 20.2% had neuropathic pain symptoms. They were all women with an average age of 36.7. The most recurrent painful area was the right mandibular dermatome of the trigeminal nerve in patients with neuropathic pain symptoms. Conclusion: The prevalence of symptoms of neuropathic pain was 20% in patients referred for painful temporomandibular disorders. Dentists should evaluate neuropathic symptoms to provide a proper management of the condition.

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Section: Discussionmentioning

confidence: 99%

Prevalence of neuropathic symptoms in patients referred for temporomandibular disorder in a Chilean hospital, 2014-2015.

Miranda¹,

Gayoso²,

Ruiz³

et al. 2015

Joralres

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“…In the orofacial, TMJ, and masticatory muscle regions, pain symptoms originate from various factors including musculoskeletal, vascular, neurovascular, neuropathic, psychogenic, and infectious diseases [35,36].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the relationships between contrast-enhanced magnetic resonance characteristics and joint pain in patients with temporomandibular disorders

et al. 2015

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Objectives To evaluate the correlations between temporomandibular joint (TMJ) pain and both conventional and gadolinium-enhanced magnetic resonance (MR) imaging characteristics in patients with temporomandibular disorders (TMDs). Methods T1-weighted, T2-weighted, and fat-suppressed contrast-enhanced T1-weighted MR imaging were performed in 80 TMD patients with the main complaint of TMJ pain. A kappa statistical analysis was performed to calculate the interobserver agreement between two of three radiologists. The relationships between TMJ pain and various MR findings were analyzed by multiple comparison test, Spearman's rank correlation test, Chi-square test, Student's t test, and multivariate logistic regression analysis. Results Significant correlations were observed between anterior disk displacement without reduction, joint effusion, and TMJ pain (p \ 0.01). The degree of contrast enhancement of the posterior disk attachment was correlated with the severity of TMJ pain, especially spontaneous pain (r = 0.725, p \ 0.01), while no correlation was observed in the masticatory muscle pain group. The correlation tended to be higher in the latero-central portions than in the medial portion of the mandibular condyle, although no significant difference was seen. Conclusions It has been suggested that fat-suppressed contrast-enhanced MR imaging techniques facilitate better understanding of the sources of TMJ pain, but not masticatory muscle pain, and could reflect TMJ synovial inflammation. The severity of TMJ pain was closely correlated with the degree of contrast enhancement. The above-mentioned correlation had a tendency to be higher in the latero-central portions of the mandibular condyle.

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“…TMDs may be associated with the onset of neuropathic pain [158] . Although TMJ pain seems to correlate with the presence of internal derangement, joint effusion, OA, and bone marrow edema within the TMJ, the possible causes of neuropathic pain in patients with TMDs are less clear [3] , [28] , [53] .…”

Section: Tumor Involvement Inflammatory Process and Autoimmune Diseamentioning

confidence: 99%

The usefulness of diagnostic imaging for the assessment of pain symptoms in temporomandibular disorders

Suenaga

Nagayama

Nagasawa

et al. 2016

Japanese Dental Science Review

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SummaryThe causes of pain symptoms in the temporomandibular joint (TMJ) and masticatory muscle (MM) regions may not be determined by clinical examination alone. In this review, we document that pain symptoms of the TMJ and MM regions in patients with temporomandibular disorders (TMDs) are associated with computed tomography and magnetic resonance (MR) findings of internal derangement, joint effusion, osteoarthritis, and bone marrow edema. However, it is emphasized that these imaging findings must not be regarded as the unique and dominant factors in defining TMJ pain. High signal intensity and prominent enhancement of the posterior disk attachment on fat saturation T2-weighted imaging and dynamic MR imaging with contrast material are closely correlated with the severity of TMJ pain. Magnetic transfer contrast, MR spectroscopy, diffusion tensor imaging, and ultrasonography findings have helped identify intramuscular edema and contracture as one of the causes of MM pain and fatigue. Recently, changes in brain as detected by functional MR neuroimaging have been associated with changes in the TMJ and MM regions. The thalamus, the primary somatosensory cortex, the insula, and the anterior and mid-cinglate cortices are most frequently associated with TMD pain.

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Neuropathic Pain in Temporomandibular Joint Disorders: Case-Control Analysis by MR Imaging

Cited by 15 publications

References 15 publications

Prevalence of neuropathic symptoms in patients referred for temporomandibular disorder in a Chilean hospital, 2014-2015.

Prevalence of neuropathic symptoms in patients referred for temporomandibular disorder in a Chilean hospital, 2014-2015.

Evaluation of the relationships between contrast-enhanced magnetic resonance characteristics and joint pain in patients with temporomandibular disorders

The usefulness of diagnostic imaging for the assessment of pain symptoms in temporomandibular disorders

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