Determination of normative values for mechanical quantitative sensory tests in the orofacial regionDeterminação de valores normativos para testes quantitativos sensoriais mecânicos na região orofacial

• Autor(a) principal: Henrique Müller de Quevedo
• Data de Publicação: 2016
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Biblioteca Digital de Teses e Dissertações da USP
• Texto Completo: https://doi.org/10.11606/D.25.2016.tde-13092016-102731

Modern concepts for the treatment of pain patients are based on the hypothesis that different clinical signs and symptoms reflect different underlying pathophysiological mechanisms of pain generation. To analyze these mechanisms, in 2006, the DFNS (German Research Network on Neuropathic Pain) developed a standardized protocol of quantitative sensory testing (QST) for a quantitative evaluation of pain generating mechanisms, creating reference values for hand, foot and face (masseter muscle) sites. However, there is a lack of orofacial reference values for the temporalis muscle and maxillary gingiva. This study aimed to determine reference values for QST protocol in the orofacial region and evaluate the effectiveness of two test stimuli during conditioned pain modulation (CPM) test. Sixty participants (30 men/30 women) were examined through the tests of mechanical detection (MDT), mechanical pain (MPT), wind-up ratio (WUR), pressure pain threshold (PPT) and conditioned pain modulation (CPM), to determine reference values in healthy subjects. Individuals were examined in a single session by a trained examiner under the protocol developed by the DFNS (2006). The CPM statistical evaluation was done by a multi-way analysis of variance (ANOVA) within the factors site (2 levels), time (2 levels), and sex (2 levels); comparing the absolute values of MPT and PPT. QST reference values comparison was made by a multi-way withinsubjects ANOVA performed considering the factors site (3 levels), side (2 levels) and sex (2 levels) (&#x3B1;=5%). MDT and MPT showed main effects of site (p<0.001), where the maxillary gingiva presented the highest thresholds for MDT and lowest MPT thresholds. In addition, PPT values of the anterior temporalis were lower than the hand (p<0.001). PPT (p<0.001) showed main effects of sex, where men presented higher thresholds. WUR did not show any main effects of sex, site or side. Both CPM test-stimulus (PPT and MPT) were capable of producing significantly higher thresholds during conditioning stimulus when compared to baseline thresholds (p<0.001). Temporalis CPM respondents were significantly higher (p=0.002) than hand respondents for both QSTs. The study concluded that orofacial QST profile of healthy participants could be influenced by the test site and sex. The CPM does not differ considering PPT and MPT as test stimuli, but the test site can influence its effects.