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Effects of local anesthetics on somatosensory function in the temporomandibular joint area

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Abstract

There is a need for systematic studies regarding the pathophysiology and pain mechanisms of somatosensory function in the temporomandibular joint (TMJ). So far, the effects on somatosensory functions of local anesthetics (LA) applied to the auriculotemporal (AT) nerve or intraarticularly (IA) into the TMJ have not been studied systemically. This study aimed to examine in a double-blinded, placebo-controlled manner the effects of LA on mechanical and thermal sensitivity in the TMJ area. Twenty-eight healthy subjects (27.4 ± 6.2 years) without temporomandibular disorders (TMD) participated. The subjects received an AT nerve block (n = 14) or an IA injection (n = 14) with LA (Bupivacaine, 2.5 mg/ml) on one side, and a placebo injection (isotonic saline) on the contralateral side. Mechanical (tactile and pin-prick) and thermal sensitivity (40 and 5°C) were assessed at 11 standardized points in the TMJ area before injections (baseline) as well as 30 min, 1 and 2 h after injections. All stimuli were rated by the subjects on a 0–100 numerical rating scale (NRS). TMJ pressure pain threshold (PPT) and pressure pain tolerance (PPTOL) were assessed laterally over both TMJs using an algometer. IA injections with LA were not associated with any changes in sensitivity of the TMJ or surrounding area. In contrast, AT nerve blocks with LA caused a decrease over time in the pin-prick sensitivity (P = 0.016), which however, did not differ significantly from saline, and an increase of the PPTs 30 min (P = 0.010) and PPTOLs 30 min, 1 h and 2 h (P < 0.05) after LA injections in comparison to saline. No other measures showed a significant change after the injections. Our results showed that IA bupivacaine injection in healthy subjects has no effect on the sensitivity of the TMJ or surrounding area, while AT nerve block has a more pronounced effect on deep mechanical, but not on superficial mechanical or thermal sensitivity. Further research to investigate the effect of LA on somatosensory functions in TMJ patients in comparison with this study results will give valuable information about the sensitivity in the TMJ area.

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Acknowledgments

The financial support from Aarhus University Foundation and the Danish Research Council is greatly appreciated. Special thanks to the clinical assistant Bente Haugsted for her appreciated help.

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Authors and Affiliations

  1. Department of Clinical Oral Physiology, School of Dentistry, Aarhus University, Vennelyst Boulevard 9, 8000, Aarhus C, Denmark

    Emad E. Ayesh, Malin Ernberg & Peter Svensson

  2. Department of Clinical Oral Physiology, Institute of Odontology, Karolinska Institutet, Huddinge, Sweden

    Malin Ernberg

  3. Department of Oral Maxillofacial Surgery, Aarhus University Hospital, Aarhus C, Denmark

    Peter Svensson

  4. Center for Sensory Motor Interaction, Aalborg University, Aalborg, Denmark

    Peter Svensson

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  1. Emad E. Ayesh
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Correspondence to Emad E. Ayesh.

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Ayesh, E.E., Ernberg, M. & Svensson, P. Effects of local anesthetics on somatosensory function in the temporomandibular joint area. Exp Brain Res 180, 715–725 (2007). https://doi.org/10.1007/s00221-007-0893-4

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