Estimation for pain origin in the temporomandibular joint

1998 Fiscal Year Final Research Report Summary

• Project/Area Number: 09672068
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Surgical dentistry
• Research Institution: Jikei University School of Medicine
• Principal Investigator: SUGISAKI Masashi Jikei University School of Medicine Associate Professor, 医学部, 助教授 (30085873)
• Co-Investigator(Kenkyū-buntansha): IKAI Akihiro Jikei University School of Medicine Lecture, 医学部, 講師 (70151248)
• Project Period (FY): 1998 – 1999
• Keywords: Temporomandibular disorders / Temporomandibular joint / pain evaluation / joint anesthesia

Research Abstract

Study purpose/schema : Pain is a reason for seeking a treatment for temporomandibular disorders (TMD) patients. The pain site in TMD is demonstrated by the patient during own jaw functioning or finger palpation via examiner. Although various clinical examination is used for evaluation of TMD pain, these examination is unidentified what pain of TMD is evaluated. So two kinds of experiments were done. In other words the TMJ superior articular cavity of painful side of the TMD patients who complained pain during his/her mouth opening were anesthetized with 2% lidocaine without epinephrine. In the first experiment, for the purpose to clarify the TMJ pain origin has any influence on the evaluations of various pain tests in patients with TMD, the pain reactions to 13 tests were studied on 35 patients about the following : (1) the optimum time for pain evaluation post-anesthesia, and (2) the rate of disappearance of pain with post-anesthesia time course after anesthesia. In the second experiment, purpose is to be clarify the relationship between various pain tests and TMJ pathological conditions including disc displacement with/without reduction, osteoarthrosis, joint cartilage degeneration and vascularity. It was calculated using logistic regression analysis that the pain origin of TMJ reflected what kind of pain tests.
New findings : TMJ pain during jaw function effected to the evaluation on various pain tests in TMD patient. And, it was cleared that patient self-reported pain site during jaw movement and palpation did not point out the pain origin. Furthermore it was difficulty to clear the specific pathologic condition in TMJ using almost clinical pain tests. However the patient who complained pain of the TMJ during mouth opening and pressure pain in the mid-portion of masseter showed the potency of the temporomandibular joint cartilage degeneration.