Orofacial musculoskeletal pain: An evidence-based bio-psycho-social matrix model

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS

卷:128

Article

Ettlin, Dominik A.^1,2  Napimoga, Marcelo Henrique³  Meira e Cruz, Miguel^3,4  Clemente-Napimoga, Juliana Trindade³ 

[1] Univ Zurich, Ctr Dent Med, Orofacial Pain Unit, Clin Masticatory Disorders, Zurich, Switzerland

[2] Univ Bern, Sch Dent Med, Dept Reconstruct Dent & Gerodontol, Bern, Switzerland

[3] Inst & Ctr Pesquisas Sao Leopoldo Mandic, Fac Sao Leopoldo Mandic, Lab Neuroimmune Interface Pain Res, Campinas, SP, Brazil

[4] Univ Lisbon, Lisbon Sch Med, Sleep Unit, Cardiovasc Ctr, Lisbon, Portugal

关键词: Orofacial pain;    Pain;    Chronic pain;    Pain experience;    Cognition;    Emotional motor system;    Biopsychosocial;    Neuroimmunology;    Sleep disorders;    Circadian timing;   

DOI  :  10.1016/j.neubiorev.2021.06.008

来源: Elsevier

【 摘 要 】

Pain is a multidimensional experience comprising sensory-discriminative, affective-motivational, and cognitive-evaluative dimensions. Clinical and research findings have demonstrated a complex interplay between social burdens, individual coping strategies, mood states, psychological disorders, sleep disturbances, masticatory muscle tone, and orofacial musculoskeletal pain. Accordingly, current classification systems for orofacial pain require psychosocial assessments to be an integral part of the multidimensional diagnostic process. Here, we review evidence on how psychosocial and biological factors may generate and perpetuate musculoskeletal orofacial pain. Specifically, we discuss studies investigating a putative causal relationship between stress, bruxism, and pain in the masticatory system. We present findings that attribute brain structures various roles in modulating pain perception and pain-related behavior. We also examine studies investigating how the nervous and immune system on cellular and molecular levels may account for orofacial nociceptive signaling. Furthermore, we review evidence pointing towards associations between orofacial musculoskeletal pain and neuroendocrine imbalances, sleep disturbances, and alterations of the circadian timing system. We conclude with several proposals that may help to alleviate orofacial pain in the future.

【 授权许可】

Free