Article Figures & Data
Figures
- Figure 1.
Overview of orofacial pain physiology.
- Figure 2.
Classification of orofacial pain.
- Figure 3.
The possible mechanisms of neuropathic pain.
Tables
Characteristics Acute orofacial pain Chronic orofacial pain Duration Onset Sustained, persistent >3 months in humans Cause Caused by inflammation or injury of tissue Caused by inflammation, nerve damage and excessive or uncontrolled inflammation Cause has gone away or healed No pain when normal healing occurs or is only temporary (pain disappears once stimulus is removed) Persistent pain and excessive, uncontrolled causes Signs and symptoms Sudden, sharp, intense, localized Aching, diffused Physiologic response Acute pain affects increased cardiovascular functions such as increased blood pressure and heart rate via sympathetic response Chronic pain affects physiological
responses with adaptation behaviors or psychological responses such as depression and anxietyExamples in the orofacial area (1) Dental pain: pulpitis
(2) Mucogingival pain(1) Neuropathic pain: trigeminal neuralgia, peripheral trigeminal nerve injury, postherpetic neuralgia
(2) Chronic inflammatory pain: chronic pulpitis and apical lesions, temporomandibular disorder pain
(3) Neurovascular pain: migraines, tension-type headachesCharacteristics Nociceptive orofacial pain Inflammatory orofacial pain Neuropathic pain Causes and mechanism of pain pathway Noxious stimulation at the peripheral nerve and transmitted by normal components of the sensory trigeminal nerve Strong noxious stimulus causes lesions in the tissue leading to local inflammation responses and increased inflammatory mediators Caused by nerve damage or injury and increased peripheral sensitization, structure change by increased sodium activation, calcium activity of nerves leading to ectopic discharges, and glia cell activation Nerve condition Normal nerve structure Normal nerve structure Abnormal nerve structure Stimulation Response to noxious stimulus for protective and withdrawal response Response to noxious stimulus and increase of activity of peripheral nociceptors -Response to non-noxious and noxious stimulation
-Spontaneous pain without stimulation because ectopic discharges occurred in damaged nervesExample Hot soup contacting the oral mucosa immediately caused pain perception (heat/hot), and then they threw away this hot soup -Pulp necrosis with apical abscess
-Temporomandibular joint capsulitis or synovitis is caused by joint inflammation. Joint pain and limitation of jaw movement develops afterwardPeripheral trigeminal nerve injury is caused by nerve damage such as facial trauma accident or trigeminal neuralgia contributing to abnormal nerve structure and expression of severe shooting pain, intermittent patterns, and feels like electric shocks
In this issue
Review of Literatures: Physiology of Orofacial Pain in Dentistry
Jump to section
- Article
- Abstract
- Introduction
- Physiology of the Orofacial Pain Pathway
- Primary Afferent Neurons and Pathologic Changes in Trigeminal Ganglion
- Brainstem Nociceptive Neurons
- Higher Brain Function Regulating Orofacial Nociception
- Classification of Orofacial Pain and Possible Mechanisms
- Conclusion
- Footnotes
- References
- Synthesis
- Author Response
- Figures & Data
- Info & Metrics
- eLetters