Avaliação de alodínia e hiperalgesia cefálica e extracefálica associadas às disfunções temporomandibulares dolorosas

• Autor(a) principal: Campi, Leticia Bueno [UNESP]
• Data de Publicação: 2015
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNESP
• Texto Completo: http://hdl.handle.net/11449/145509; http://www.athena.biblioteca.unesp.br/exlibris/bd/cathedra/13-10-2016/000867893.pdf
• topic: Transtornos da articulação temporomandibular; Hiperalgesia; Articulação temporomandibular; Temporomandibular joint disorders

To test whether painful temporomandibular disorder (TMD) is associated with cephalic and extracephalic hyperalgesia and allodynia independent of the other painful conditions (OPC). Methods: Participants were classified according to the presence of painful TMD [Research Diagnostic Criteria for Temporomandibular Disorders (RDC) - Axis I], migraine (The International Classification of Headaches Disorders-II), depression and non-specific physical symptoms (NSPS)(RDC-Axis II). The allodynia and hyperalgesia in the cephalic and extracephalic area were detected after vibrotactile stimulation and algometry respectively. Fisher, Chi-Square and Mann-Whitney Tests were performed with a significant level of 5%. Results: The sample consisted of 250 individuals, 57 men (22.8%), 193 women (77.2%); aged between 19 and 65 years (mean = 35.8 years, SD = 12.8 years), free of fibromyalgia, other types of headaches (not migraine) or OPC. Presence of TMD pain was higher in females (p <0.001) and in the presence of migraine (p <0.001). Painful TMD was associated with higher pain sensitivity in the cephalic (p<0,001) and extracephalic region (p<0,001) independent of the presence of migraine, depression and NSPS; and lower pressure pain threshold (PPT) values in the trigeminal (p<0,001) and extratrigeminal area (p<0,001). Subjects with painful TMD had significantly lower PPT in the cephalic (p<0.001) and extracephalic region (p<0.001), suggesting the presence of secondary hyperalgesia. Conclusion: The highest incidence of hyperalgesia and allodynia among subjects with painful TMD pointed for central sensitization, an important aspect of the chronification processes. Changes involving the central nervous system should be considered in the evaluation and treatment of patients with painful TMD.