title: Painful temporomandibular disorders and central sensitization: implications for management-a pilot study.
abstract: The objective was to investigate the presence of cutaneous allodynia and hyperalgesia in the trigeminal and extra-trigeminal areas, as a surrogate for central sensitization (CS), in women with a painful temporomandibular disorder (TMD) and without other painful conditions. Painful TMDs, depression, and non-specific physical symptoms (NSPS) were classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The amount of pain in the trigeminal and extra-trigeminal areas was determined using a visual analogue scale (0-100mm) after the application of a vibrotactile stimulus and assessment of the pressure pain threshold (PPT). Statistical tests (Fisher's, χ2, and Mann-Whitney) were performed, with a significance level of 5%. The sample comprised 45 women (mean age 37.5 years; 16 with a painful TMD) who were free of any headache, fibromyalgia, or other painful condition. Painful TMD was associated with higher pain sensitivity and lower PPT values in the trigeminal (P<0.01) and extra-trigeminal regions (P<0.01). The presence of depression contributed significantly to increased pain sensitivity. The presence of hyperalgesia and allodynia in both the trigeminal and extra-trigeminal regions among women with a painful TMD indicated the presence of CS. Changes involving the central nervous system should be considered during the evaluation and management of patients with a painful TMD.
authors.affiliation: Araraquara School of Dentistry, Universidade Estadual Paulista - UNESP, Araraquara, Sao Paulo, Brazil. Electronic address: leticiabuenocampi@hotmail.com.
authors.forename: L B
authors.initials: LB
authors.lastname: Campi
authors.affiliation: Araraquara School of Dentistry, Universidade Estadual Paulista - UNESP, Araraquara, Sao Paulo, Brazil.
authors.forename: P C
authors.initials: PC
authors.lastname: Jordani
authors.affiliation: Araraquara School of Dentistry, Universidade Estadual Paulista - UNESP, Araraquara, Sao Paulo, Brazil.
authors.forename: H L
authors.initials: HL
authors.lastname: Tenan
authors.affiliation: Araraquara School of Dentistry, Universidade Estadual Paulista - UNESP, Araraquara, Sao Paulo, Brazil.
authors.forename: C M
authors.initials: CM
authors.lastname: Camparis
authors.affiliation: Araraquara School of Dentistry, Universidade Estadual Paulista - UNESP, Araraquara, Sao Paulo, Brazil.
authors.forename: D A G
authors.initials: DA
authors.lastname: Gonçalves
mesh_terms: D000328:Adult; D000368:Aged; D059333:Central Nervous System Sensitization; D003430:Cross-Sectional Studies; D005157:Facial Pain / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010865:Pilot Projects; D013705:Temporomandibular Joint Disorders / Q000150:complications*; D016896:Treatment Outcome
keywords: central nervous system sensitization; hyperalgesia; temporomandibular joint disorders