Abstract
The aim of this study was to investigate if the 5-HT 3 antagonist granisetron reduces temporomandibular joint (TMJ) pain in patients with systemic inflammatory joint disorders. Sixteen patients with systemic inflammatory joint disease with pain localized over the TMJ region and tenderness to digital palpation of the TMJ were included. The current resting pain (VAS Rest) and the pain during maximum mouth opening (VAS MVM) of the TMJs were assessed with a 100 mm visual analogue scale. An electronic pressure algometer was used to estimate the pressure pain threshold (PPT) over the lateral aspect of the TMJ. Venous blood was collected for measurement of the plasma and serum levels of 5-HT, erythrocyte sedimentation rate, rheumatoid factor and C-reactive protein. The selective 5-HT 3 receptor antagonist granisetron or saline were injected into the posterior part of the upper TMJ compartment in a randomized double-blind manner. The patients in the granisetron group had lower VAS Rest than the patients in the saline group after 10 min. In the granisetron group, VAS Rest was decreased after 10 min, while VAS MVM was decreased and PPT increased after 20 min. In the saline group, VAS MVM was decreased after 20 min. In conclusion, granisetron has an immediate, short-lasting and specific pain reducing effect in TMJ inflammatory arthritis. The 5-HT 3 receptor may therefore be involved in the mediation of TMJ pain in systemic inflammatory joint disorders.
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