Difference between revisions of "Trigeminal Nociceptive Evaluation in TMD Patients by studying CO2-Laser Evoked Potentials and Masseter Laser Silent Periods"

Trigeminal Nociceptive Evaluation in TMD Patients by studying CO2-Laser Evoked Potentials and Masseter Laser Silent Periods (view source)

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-The term temporomandibular dysfunction (TMD) refers to a group of painful syndromes affecting the masticatory muscles and the temporomandibular joint (TMJ). Nosographic classifications of TMD vary widely as they may involve different pathophysiological mechanisms, and the etiological factors are often unknown<ref name="Green2000">Green S. Case presentation: resolution of an oral lesion as a result of orofacial myofunctional therapy. Int J Orofacial Myology 2000; 26: 53-56.</ref>. Many of the hypotheses proposed to explain its pathophysiology and etiology remain largely unproven. Electromyographic (EMG) alterations of the voluntary or reflex activity of the masticatory muscles have often been found in association with TMD; however, EMG studies have neither provided reliable criteria nor clarified the pathogenesis of this controversial syndrome.
+The term temporomandibular dysfunction (TMD) refers to a group of painful syndromes affecting the masticatory muscles and the temporomandibular joint (TMJ). Nosographic classifications of TMD vary widely as they may involve different pathophysiological mechanisms, and the etiological factors are often unknown Many of the hypotheses proposed to explain its pathophysiology and etiology remain largely unproven. Electromyographic (EMG) alterations of the voluntary or reflex activity of the masticatory muscles have often been found in association with TMD; however, EMG studies have neither provided reliable criteria nor clarified the pathogenesis of this controversial syndrome.
 Recent studies have contradicted the hypothesis of muscle hyperactivity or a state of central nervous system hyperactivity in TMD patients. Studies aimed at evaluating the somatosensory system in TMD patients have yielded conflicting results regarding the extent and detection of somatic sensitivity alterations, reporting hypersensitivity, hyposensitivity, or no alterations at all. An experimental study conducted on healthy volunteers has recently shown that tonic experimental pain in the trigeminal territory reduces CO2 laser-evoked potentials (LEPs) and laser silent periods (LSPs). Since the laser stimulus selectively activates small-caliber afferents (A-delta and C fibers) and evaluates nociceptive afferents function, the authors concluded that tonic pain induces hypoexcitability of the trigeminal nociceptive system.