Facial Pain Research Articles

28-year-old male patient with headaches on the left side and facial pain

A 28-year-old male suffers for two weeks from new-onset very severe headache located on his left temple radiating to his jaw. He also complains about left sided retroorbital pain and chewing aggravated symptoms. In addition, nausea and emesis in the mornings during the past six months were reported. Clinical examination revealed tender swelling over the left temple, but laboratory results showed no signs of inflammation, normal electrolytes, kidney and liver values. A CT-scan revealed a circumscriptive osteolytic lesion in the left os temporale.

Oral Findings and Salivary Alpha-Amylase in Major Depressive Disorder Patients

Background: The increasing global prevalence of major depressive disorder (MDD) has become an important challenge, leading to a heightened demand for oral medicine in developed nations. This demand arises from the recognition of the association between psychiatric disorders and other conditions, including various orofacial pain disorders. Objective: This study are to evaluate oral conditions such as recurrent aphthous ulcers, burning mouth syndrome, and altered taste and to assess salivary alpha-amylase in individuals diagnosed with major depressive disorder. Methods: This research uses a cross-sectional study design that includes a sample of 49 patients who have been diagnosed with major depressive disorder and who have undergone treatment for at least two weeks. The control group consists of 34 healthy subjects with no signs or symptoms of systemic disease. The study group received the diagnosis in Najaf City according to the criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). With respect to recurrent aphthous ulcers, the results of this study show the percentage of patients with oral ulcers is significantly higher than in the control group. Results: The results also show that the prevalence of burning mouth syndrome is significantly higher in patients with major depressive disorder than in healthy controls. A highly statistically significant difference was found between the study group and the control group regarding altered taste. There is also a significant difference in salivary alpha-amylase levels between the study and control groups (p = 0.009). Conclusion: Major depressive disorder patients have much higher incidences of reported recurrent aphthous ulcers, burning mouth syndrome, and altered taste than healthy subjects, indicating the importance of psychological factors in these conditions. Additionally, salivary alpha-amylase levels were higher in patients with major depressive disorder than in the control group.

Management of orofacial pain starts with careful differentiation of odontogenic and non-odontogenic pain

Management of orofacial pain starts with careful differentiation of odontogenic and non-odontogenic pain

Treatment of myofascial pain and dysfunction using botulinum toxin A: a prospective study

Abstract Purpose We prospectively assessed the effects of botulinum toxin type-A (BTX-A) on primary and secondary outcomes in a population of refractory myofascial pain and dysfunction patients when conservative management had proven ineffective. Methods In this study, 26 patients with masticatory myofascial pain, who were refractory to conservative management, were enrolled prospectively to evaluate responses following the injection of botulinum toxin-A (BTX-A). Masseter muscles were injected with 30 units BTX-A and 20 units into the temporalis muscles. Pain, tenderness to palpation, and oral function were evaluated subjectively using a visual analog scale (VAS). Objective outcomes of maximal mouth opening (MMO) and reduction in total facial width after injection with BTX-A were measured. Participants were reassessed at 1-week, 1, 3, and 6-month intervals. A linear mixed-effect model was employed to assess the level of correlation (dependence) among different outcomes. Results Administration of BTX-A had a significant strong positive correlation with the reduction of pain (Phi = 0.641, P < 0.0005); significant strong positive correlation with increase in oral function (Phi = 0.738, P < 0.0015); significant strong positive correlation with increase in maximal mouth opening (Phi = 0.645, P < 0.0085); significant strong positive correlation with tenderness to palpation (Phi = 0.510, P < 0.0011); and significant strong positive correlation with reduction in facial width (Phi = 0.565, P < 0.0001). Conclusion The results from this study demonstrate that BTX-A administration may provide a safe and effective means to treat myofascial pain from hyperfunctioning masticatory muscles. It is not recommended to replace first-line treatment but may provide relief from chronic facial pain if properly administered in patients where standard conservative management has been unsuccessful.

Effect of Short-term Deep Breathing Exercises on Perioperative Anxiety and Pain in Pediatric Orthopedic Patients: A Randomized Controlled Trial

PurposeThere are currently no pediatric studies examining the effects of deep breathing on perioperative pain and anxiety. This study sought to determine the effect of short-term deep breathing exercises on perioperative anxiety and pain in pediatric patients and their parents. DesignA randomized controlled trial was conducted in the Department of Orthopaedic Surgery where pediatric patients about to undergo surgery were allocated to a control group or a deep breathing group. In the intervention group, patients and their main guardian were guided to practice 10 minutes of deep breathing exercises twice a day for 3 to 4 days prior to surgery. Perioperative anxiety and pain were measured for both the children and parents as outcome indicators. MethodsPerioperative anxiety was measured using the modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF) and state anxiety was measured using the State-Trait Anxiety Inventory (STAI). Patients reported their pain levels daily using the Wong-Baker FACES Pain Rating Scale. The following cutoffs were determined as high levels of anxiety: STAI (adult) > 44, STAI (child) > 36, and mYPAS-SF ≥ 30. FindingsNo significant differences were found in the STAI, mYPAS-SF, and Wong-Baker FACES Pain Rating Scale scores of the patients between the intervention and control group. Overall statistics showed that parents had significantly higher postoperative state anxiety levels toward female children (44.93 ± 9.01) compared to male children (40.18 ± 9.89). Preoperative and postoperative parental state anxiety levels were correlated with the child’s postoperative anxiety. Furthermore, children’s postoperative state anxiety was slightly correlated with postoperative pain. ConclusionsShort-term use of our deep breathing exercises was ineffective in reducing incidences of perioperative pain and anxiety in pediatric orthopedic patients. A longer period of deep breathing administration may be required for the intervention to be effective. Parental anxiety may have an effect on anxiety levels in children, and postoperative parental anxiety may be affected by the gender of the child.

Lateral Medullary Syndrome from brainstem infarction: A case report

Background. Lateral medullary syndrome (LMS) is a rare posterior circulation stroke caused by thrombosis or dissection of the vertebral or posterior inferior cerebellar artery (PICA). It results in neurological deficits such as ipsilateral facial pain and temperature deficits, contralateral body pain and temperature deficits, ipsilateral ataxia, vertigo, nystagmus, slurred speech, dysphagia, and hiccups. Case reports. We report the case of a 50-year-old male with uncontrolled hypertension presented with sudden severe vertigo, ataxia, swallowing difficulties, slurred speech, and sensory deficits. He had right-sided facial pain and left-sided body pain. Conclusions. Neurological examination suggested LMS, confirmed by radiological imaging.

Peripheral NLR family pyrin domain-containing 3 protein pathway participates in the development of orofacial inflammatory pain in rats

Peripheral NLR family pyrin domain-containing 3 protein pathway participates in the development of orofacial inflammatory pain in rats

Comparison Between the Effects of Alvogyl Paste and 0.2% Chlorhexidine Gel on Postoperative Swelling Following Mandibular Third Molar Surgery

Facial swelling, pain, and trismus are typical side sequelae of mandibular third molar surgery. These symptoms are all caused by tissue inflammation followed by trauma from surgery and the quality of life of these patients has been significantly impacted by these symptoms in the immediate post-operative period. Both Alvogyl and chlorhexidine bio-adhesive gel are routinely used in dental practice to reduce post-operative sequelae due to their antimicrobial and anti-inflammatory properties. The study was set up as a randomized controlled clinical study and conducted from February 2022 to September 2022. The study involved patients 18-39 years old who sought extraction of an impacted lower third molar attending the Oral Surgery Clinic in the College of Dentistry in Baghdad. The sample was divided into three groups, the first group received Alvogyl paste following third molar surgery while the second group received periokin chlorhexidine bio-adhesive gel and the last control group didn’t receive any medication. Results of a study with 51 patients, equally assigned into two study groups and a control group, indicate that in the study groups, there was a reduction in post-operative facial swelling in comparison with the control group and the reduction was statistically significant (P =0.001), and the Alvogyl paste was superior to chlorhexidine in swelling reduction but statistically not significant.

MIGRADENT – MIGRAINE, DENTAL & LASER CLINIC

Abstract : Migradent represents a unique fusion of dental expertise and migraine management, providing comprehensive care for patients seeking relief from orofacial pain and migraines. This abstract delves into the innovative approach of Migradent, highlighting its interdisciplinary focus, patient centered care, and commitment to improving the quality of life for individuals suffering from migraines and related conditions. Through a combination of advanced dental treatments, specialized migraine therapies, and holistic patient support, Migradent aims to address the complex interplay between dental health and migraines, offering hope and relief to those in need. IndexTerm : HTML & CSS 3, JAVA SCRIPT ,PHP, LARAVEL’S FRAMEWORKS.

Comparative study of the effects of ibuprofen, acetaminophen, and codeine in a model of orofacial postoperative pain in male and female rats.

Pain management is a primary goal after oral surgeries, but little is known about sex differences in the sensitivity to analgesics. This study aimed to compare the efficacy of three drugs with analgesic potential on heat and mechanical hyperalgesia, spontaneous pain and locomotion on male and female rats subjected to a model of orofacial postoperative pain. Male and female Wistar rats were submitted to intraoral incision or sham surgery, and on postoperative day 3, the effect of the ibuprofen (30 and 100mg/kg), acetaminophen (100 and 300mg/kg) and codeine (3 and 10mg/kg) was assessed on responses to heat and mechanical facial stimulation, facial grooming, and locomotion. Ibuprofen reduced heat and mechanical hyperalgesia and grooming behavior in male and female rats in a non-sedative dose; acetaminophen dose-dependently reduced the mechanical hyperalgesia and abolished the heat hyperalgesia and the grooming behavior but caused sedation in both sexes; codeine dose-dependently reduced the mechanical hyperalgesia in male and female rats, and reduced the heat hyperalgesia, but females were less sensitive than males. It reduced spontaneous facial grooming in both sexes, but induced hyperlocomotion in females. Ibuprofen presented the most favorable profile, since it reduced over 50% heat and mechanical hyperalgesia in male and female rats, and significantly reduced spontaneous pain, without causing sedation or affecting locomotion. The identification of sex differences in the sensitivity and safety profile of frequently used analgesics can help guide the choice of more effective individualized therapies for pain control.

Prevalence of Trigeminal Neuralgia and Persistent Idiopathic Facial Pain in Afyonkarahisar, Türkiye

Background: Population-based studies examining the prevalence of trigeminal neuralgia (TN) and persistent idiopathic facial pain (PIFP) are rare, and data on TN prevalence in Türkiye are very limited, with the prevalence of PIFP being unknown. This study aimed to determine the prevalence of TN and PIFP in Türkiye. Materials and Methods: This population-based epidemiological study has a cross-sectional and descriptive design, and it was carried out in Afyonkarahisar, Türkiye. Participants aged 18 years and older were screened by using a self-assessment form to determine potential patients with TN or PIFP. Results: A total of 19,237 individuals were included in this study, of which 17,223 responded to the survey questions. TN was diagnosed in 17 individuals, and the prevalence of TN was calculated as 98.5 per 100,000. PIFP was diagnosed in 35 patients, and the prevalence of PIFP was calculated as 202 per 100,000. The mean age of the patients with TN was 54.29 ± 12.98 years, the mean age of patients with PIFP was 49.80 ± 16.10 years, and the female-to-male ratio was 1.13/1 for TN and 2.18/1 for PIFP. Conclusion: The prevalence of PIFP in Türkiye has been reported for the first time by this study. Additionally, a much higher prevalence of TN was found when compared to previous study.

Clinical characteristics of tension headache in occlusive disorders

Relevance. Common physiological human suffering is headache. The prevalence of headache ranks third after back pain and joint pain in the structure of muscle-fascial pain syndromes. However, headaches and facial pains associated with muscle-fascial trigger points are much more common than headaches and facial pains caused by other causes. An extremely irritated area of skeletal muscle associated with an oversensitive palpable node located in a compacted bundle is the muscle–fascial trigger points. In the pathogenesis of headaches, a major role belongs to dysfunction or disease of the temporomandibular joint, age-related changes in the masticatory muscles, jaws and teeth and all elements of the TMJ occuring during a person’s life. In some cases, minor changes in the occlusion of teeth and jaws, as well as a stressful situation, lead to a painful spasm of the masticatory muscles. Goal. To analyze the clinical characteristics of tension headache in patients with occlusive disorders (OD) and physiological occlusion (PO). Material and methods. The study covered 210 patients with occlusion disorders and 92 patients with the signs of physiological occlusion. 141 patients from the first group and 32 patients from the second group complained of a headache. Occlusal relationships of teeth were analyzed in the position of central and dynamic occlusion. The destruction of the hard tissues of the teeth and partial adentia, as well as anomalies and deformities of the dentition were determined as the disorder of occlusion. The study of the muscles of the maxillofacial region and neck was carried out using the techniques described in the book by Travell J.G., Simons D.G. (2005). A visual-analogue pain assessment scale and a Russified McGill’s questionnaire on the nature of pain were used to identify the nature of the pain syndrome, the severity of pain. The assessment was carried out at a consultative appointment, the localization, nature, duration and intensity of pain, as well as the specificities of the pain syndrome being taken into account. When examining muscles, to quantify the data obtained the muscle syndrome index (IMS) was evaluated. The analysis of the research results was carried out using nonparametric criteria. Results. According to the severity of the pain syndrome, the use of a visual analogue scale (VAS) of pain allowed us to divide all patients into 3 groups: with mild pain, with moderate and with severe pain. According to the international classification of headaches, episodic and chronic headaches were distinguished. In patients with OD, the headache becomes chronic more often and is felt more intense than in patients with PO. Among the patients complaining of a headache, in patients with OD the IMS is higher than the IMS of the muscles of the masticatory complex, and in patients with PO the IMS is higher than the IMS of the neck muscles. Conclusions. Female patients with OD and PO suffer from tension headache more often than male patients. In patients with OD, musculo-fascial headaches are twice as common, have a more pronounced character and become chronic more often than in patients with PO. The severity of the IMS of the masticatory muscles in patients with OD is 2.5 times higher than in patients with PO.

Facial pain after choking

Facial pain after choking

Back pain in adolescent idiopathic scoliosis: frequency and risk factors

PurposeAlthough back pain is commonly reported in patients with adolescent idiopathic scoliosis (AIS), factors that influence the presence and severity of back pain in AIS, including curve-specific variables, have not been well studied. This study aims to describe the prevalence and severity of back pain in AIS patients and determine the extent to which patient characteristics, including curve-specific factors, are associated with a higher risk of back pain in AIS.MethodsThe study was a retrospective medical records review of adolescents (aged 10–17 years) diagnosed with AIS between 01/01/2018 and 12/31/2021 at an academic tertiary children’s hospital. Patients with previous spine surgery were excluded. Variables collected included demographics (age, sex, race, insurance), Lenke classification, major coronal curve, back pain-related information, Risser stage, vitamin D levels, post-diagnosis brace utilization, physical therapy or chiropractic treatment, and surgery.ResultsA total of 891 AIS patients were included in the analysis. The sample was predominantly female (73.3%) and insured by Medicaid (57.8) with a mean age of 12.8 years. The mean major coronal curve was 26.3 degrees. Most patients had Lenke type 1 (47%) and type 5 (41%) curves. Nearly half of patients reported back pain (48.5%) with average pain severity in the low-to-moderate range (4.7) on FACES pain scale (0–10). Among those who reported back pain, 63.2% specified a location with the majority reporting pain in the lumbar region (56%) and, less commonly, in the thoracic (39%) and scapular (8%) regions. Lumbar pain was associated with significantly higher pain intensity (p = 0.033). Additionally, the location of pain reported was associated with location of major coronal curve (p < 0.0001). No association was observed between pain presence and vitamin D deficiency (p = 0.571, n = 175), major coronal curve magnitude (p = 0.999), Lenke curve type (p = 0.577), and sex (p = 0.069). Older patients, those insured by Medicaid, and those with higher Risser scores were more likely to report pain scores (p = 0.001 for all).ConclusionNearly half (48%) of newly diagnosed AIS patients experience back pain which is higher than the prevalence of 33% seen in the general adolescent population. Pain was more prevalent among patients over the age of 13, with heavier body weight, and those insured by Medicaid. Pain was most commonly reported in the lumbar region, especially among patients with lumbar curves. This information can be helpful in counseling AIS patients, though further investigations are needed, especially to determine the underlying causes of back pain in AIS and to elucidate the discrepancy in pain between patients with Medicaid and commercial insurance.Level of evidence.Prognostic Study Level II.

Adenoid Cystic Carcinoma of the Nasopharynx: A Retrospective Study of 12 Cases.

Objective: This study aimed to describe the experience of a single institution in China in treating adenoid cystic carcinoma of the nasopharynx. Methods: We reviewed the previous literature and conducted a retrospective analysis of 12 patients who diagnosed with nasopharyngeal adenoid cystic carcinoma (NACC) in clinical data, treatment, and follow-up data during 2019 to 2021. Results: Patients ranged in age from 32 to 68 years (mean 40.7 years, median 48.5 years), with a male to female ratio of 5:7. Most of our patients have T4a and T4b diseases (50% and 25%, respectively). A quarter of patients develop distant metastases. Among the 12 patients, 7 of them have positive margins under the microscope (7/12, 58.3%). The chief clinical manifestations were epistaxis, facial swelling, facial pain, headache ear stuffy, and hearing loss. If the tumors involved with cavernous sinus, brain stem infiltrated, and internal carotid artery circumvented, patients will undertake routine enhanced magnetic resonance imaging with Magnetic Resonance Angiography/Magnetic Resonance Venogram (MRA/MRV) to clearly show the lesion region. All patients underwent endoscopic endonasal approach. Fifty percent of patients received radiotherapy and 25% of patients received chemotherapy. None of the patients was lost and the follow-up time ranged from 16 to 45 months. The mean and median follow-up were 2.08 and 1.58 years. Two patients were dead of distant metastasis within 18 and 20 months after the surgery, and another patient with recurrent NACC died of hemorrhage. Conclusion: NACC is a rare malignant tumor that occurs in the nasopharynx, which can grow along the nerve, destroy the bone of the skull base, and metastasize to other organs. Up to now, there is no standard treatment. Our results show that endoscopic sinus surgery is a better choice for advanced or recurrent NACC.

Association of night-time sleep and daytime napping with painful temporomandibular disorder.

Painful temporomandibular disorder (TMD) is the common cause of chronic oro-facial pain, which may interfere with sleep. Previous studies have documented an association between sleep and TMD. This study aimed to further explore the association of night-time sleep and daytime napping with painful TMD. A total of 419 patients (aged 31.88 ± 11.54 years with women forming 85.4%) from a TMD/Orofacial Pain center were enrolled. Patients' sleep conditions were evaluated with the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and information on night-time sleep duration, napping duration and napping frequency was interviewed. TMD was diagnosed according to the Diagnostic Criteria for TMD protocol and stratified into myalgia (muscle pain), arthralgia (joint pain) and combined (muscle and joint pain) subgroups. The severity of TMD was measured with the Fonseca Anamnestic Index (FAI) questionnaire. Restricted cubic spline (RCS) regression models were established to explore relationships between sleep and painful TMD subgroups. Patients with poor sleep quality (PSQI≥6) had higher FAI scores (median 60, p < .001) and higher proportions of painful TMDs. The myalgia subgroup had higher PSQI scores (median 8, p < .001) than the arthralgia subgroup. The RCS models indicated a non-linear relationship between night-time sleep duration and myalgia (p < .001), which was not observed in arthralgia. However, there were no significant findings concerning napping and painful TMD subgroups. This study found that the association between sleep and TMD is mainly related to painful TMD conditions, which are associated with night-time sleep duration.

(048) PERI-ORGASMIC PHENOMENON IN WOMEN: VARIABILITY AND CIRCUMSTANCES

Abstract Introduction Introduction: Peri-orgasmic phenomena are rare physical or psychological responses experienced by some individuals in association with orgasm. By definition, a peri-orgasmic response to orgasm is not related to the physiology of orgasm and does not include psychological, whole body, or genito-pelvic sensations commonly experienced during sexual activity. While many women may experience coital incontinence, uterine contractions, female ejaculation from peri-urethral glands or pelvic pain simultaneous with orgasm, these are not considered to be peri-orgasmic phenomena. The literature on peri-orgasmic phenomena is sparse and comprised almost exclusively of case reports and reviews. Examples of reported physical symptoms include cataplexy, facial pain, ear pain, foot pain, and sneezing. Emotional symptoms include crying, dysphoria, laughter, hallucinations, and panic attacks. While a number of mechanisms to explain physical phenomena have been proposed, the etiology of these symptoms is not understood. Objective Objective: To survey a population of women that experience peri-orgasmic phenomena to determine 1) the relative frequency of various symptoms, 2) the consistency in which symptoms occur, and 3) if the symptoms are more likely to occur in partnered sexual activity as opposed to masturbation. Methods Methods: A short video explaining peri-orgasmic phenomena was posted on social media for the purposes of recruiting women who experienced physical or psychological peri-orgasmic phenomena. They were then directed to a six-question anonymous survey. Results Results: 3800 women viewed the video. 72 women, ages 18 to over 65 who self-identified as experiencing peri-orgasmic phenomena responded to the online survey. 62% of women reported physical symptoms: Headache- 33%, Muscle weakness 24%, foot pain or tingling 20.56%, facial pain or itching 3.25 %, sneezing 2.22%, yawning 1%. 87.5% of women reported psychological symptoms: 60.32% crying, 42.86% sadness or urge to cry (with a positive sexual experience), 38% laughing, 4.76% hallucinations. 14% of women experienced symptomatology consistently with orgasm. 74.65% only experienced symptoms “sometimes”. The majority of respondents (50.7%) experienced symptoms exclusively with partnered sexual activity, 9.86% during masturbation, and 14.08% with the use of a vibrator. Many respondents experienced more than one symptom. Over 30% experienced both physical and psychological symptoms. Conclusions Conclusions: Peri-orgasmic phenomena, while rarely reported, appear to occur more frequently than generally appreciated. Most women who report peri-orgasmic phenomena experience psychological symptoms such as crying or laughing. Physical symptoms occurred less often, and in most cases were headache, muscle weakness, or foot pain. While some symptoms are more common, there is a wide range of both physical and psychological symptoms reported in this survey. These phenomena do not occur consistently with orgasm and are more likely to occur with a partner than during masturbation, suggesting that there may be an emotional component to both physical and psychological symptoms. Vibrator use was not preferentially associated with peri-orgasmic phenomena indicating that it is unlikely that the intensity of the orgasm determines the likelihood of symptomatology. More research is needed to determine the etiology of these psychological and physical responses to orgasm. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Sermonix.

Beta Oscillations in the Sensory Thalamus During Severe Facial Neuropathic Pain Using Novel Sensing Deep Brain Stimulation

ObjectiveAdvancements in deep brain stimulation (DBS) devices provide a unique opportunity to record local field potentials longitudinally to improve the efficacy of treatment for intractable facial pain. We aimed to identify potential electrophysiological biomarkers of pain in the ventral posteromedial nucleus (VPM) of the thalamus and periaqueductal gray (PAG) using a long-term sensing DBS system. Materials and MethodsWe analyzed power spectra of ambulatory pain-related events from one patient implanted with a long-term sensing generator, representing different pain intensities (pain >7, pain >9) and pain qualities (no pain, burning, stabbing, and shocking pain). Power spectra were parametrized to separate oscillatory and aperiodic features and compared across the different pain states. ResultsOverall, 96 events were marked during a 16-month follow-up. Parameterization of spectra revealed a total of 62 oscillatory peaks with most in the VPM (77.4%). The pain-free condition did not show any oscillations. In contrast, β peaks were observed in the VPM during all episodes (100%) associated with pain >9, 56% of episodes with pain >7, and 50% of burning pain events (center frequencies: 28.4 Hz, 17.8 Hz, and 20.7 Hz, respectively). Episodes of pain >9 indicated the highest relative β band power in the VPM and decreased aperiodic exponents (denoting the slope of the power spectra) in both the VPM and PAG. ConclusionsFor this patient, an increase in β band activity in the sensory thalamus was associated with severe facial pain, opening the possibility for closed-loop DBS in facial pain.

Development of a novel three-dimensional injection guide for trigeminal ganglia

BackgroundTrigeminal ganglion (TG) plays an important role in the process of orthodontic pain. It’s necessary to design an accurate, precise and minimally invasive trigeminal ganglion injection guide plate to study TG. MethodsMicro-CT was used to obtain the Dicom format data, and three-dimensional (3D) software (mimics and magics23.03) was used to reconstruct 3D head models. Design and modifications of the TG injection guide plate were performed in Magic 23.03 software, and the guide plate was produced by a 3D stereolithography printer. X-ray, micro-CT, Evans blue, and virus transduction were used to demonstrate the accuracy of the guide-assisted injection. Pain levels were evaluated after using the injection guide by a bite force test and Von Frey test. ResultsX-ray and micro-CT tests confirmed that the injection needle reached the bilateral trigeminal ganglia fossa. The Evans blue test and virus transduction proved that the injected drug could be accurately injected into the bilateral trigeminal ganglion and the lentivirus could be successfully transfected. The percentage of accurate injection was 10/10 (bilateral trigeminal ganglia). Orofacial pain induced by the trigeminal ganglion injection was mild and returned to baseline within seven days. ConclusionThe injection guide described in this study is viable and reliable for the delivery of drugs and virus transduction into the trigeminal ganglia.

Comparative effects of post isometric relaxation technique and Bowen’s therapy on pain, range of motion and function in patients with temporomandibular joint disorder

BackgroundThe most common cause of mouth and facial pain is a temporomandibular joint disorder, which affects the patient’s quality of life and interferes with their ability to perform daily tasks.ObjectiveThe purpose was to compare the effects of the Post-Isometric Relaxation Technique and Bowen’s Therapy on pain, range of motion and functional activity in patients with temporomandibular joint disorders.MethodsThis study was a randomized clinical trial. A total of 24 participants were randomly allocated into two groups using the lottery method. Baseline treatment was the same (ultrasound and tapping) in both groups. Group 1 (12 participants) was treated with a post-isometric relaxation technique, and Group 2 (12 participants) with Bowen’s therapy for two sessions per week (total duration of 4 weeks). Outcome measures were the Numeric Pain Rating Scale, Maximal mouth opening inter-incisal rural and jaw functional limitation scale-20. SPSS version 25 was used for statistical analysis.ResultsA significant improvement in pain, range of motions and functional activities in the post-isometric group showed significant results (p < 0.05) as compared to Bowen’s group (independent t-test). However, within-group comparison (paired t-test), both groups showed significant results (p < 0.05).ConclusionThis study concluded that post-isometric relaxation was more effective in terms of pain, range of motions for mouth opening, lateral deviations and functional activity of temporomandibular joint disorder patients. However, both groups showed clinical results according to minimal clinical difference values.Trial registry numberThe trial is registered under ClinicalTrials.govt with reference no. ID: NCT05392049 registered on 26/05/2022.