Use of botulinal toxin in orofacial pain treatment: integrative review

The mechanisms underlying facial and oral pain are still incompletely understood, posing major therapeutic challenges. Cyclin-dependent kinase 5 (Cdk5) is a key neuronal kinase involved in pain signaling. However, the regulatory roles of Cdk5 in orofacial pain signaling and the possibility of therapeutic intervention at the level of mouse trigeminal ganglion primary neurons remain elusive. In this study, we used optimized intravital imaging to directly compare trigeminal neuronal activities after mechanical, thermal, and chemical stimulation. We then tested whether facial inflammatory pain in mice could be alleviated by the Cdk5 inhibitor peptide TFP5. We demonstrated regulation of total Ca2+ intensities by Cdk5 activity using transgenic and knockout mouse models. In mice with orofacial inflammation, application of TFP5 specifically decreased total Ca2+ intensities in response to noxious stimuli. It also alleviated inflammation-induced allodynia by inhibiting activation of trigeminal peripheral sensory neurons. Cdk5 inhibitors may provide promising non-opioid candidates for pain treatment.

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Top 60 Most Important Medications Used in an Orofacial Pain Treatment Center

Orofacial Pain ◽

10.1002/9781118704851.ch2 ◽

2013 ◽

pp. 29-46 ◽

Cited By ~ 1

Author(s):

Glenn T. Clark

Keyword(s):

Orofacial Pain ◽

Pain Treatment ◽

Treatment Center

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The Impact of Expectation for Pain Relief on Orofacial Pain Treatment Outcomes

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.734986 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yaron Haviv ◽

Sigal Mazor ◽

Margolis Shani ◽

Robert Yanko ◽

Doron J. Aframian ◽

...

Keyword(s):

Pain Relief ◽

Treatment Outcomes ◽

Orofacial Pain ◽

Pain Treatment ◽

Treatment Success ◽

Inverse Correlation ◽

Pain Clinic ◽

Complete Relief ◽

Subjective Outcome ◽

The Impact

Aims: To examine the effects of expectations for pain relief on the objective and subjective outcome of chronic orofacial pain (OFP) treatment.Materials and Methods: Sixty individuals referred to the Orofacial Pain Clinic at the Hebrew University-Hadassah School of Dental Medicine between 2015 and 2017 with OFP reported their expectation for pain relief upon initial consultation. They were also interviewed by telephone after treatment and asked to recall their expectations, referred to as “recalled expectations” (RE). Correlations between RE and treatment success were calculated from pain diaries, and from subjective pain improvement rates (PIR) reported by the patients.Results: 21 males (35.0%) and 39 females (65%), mean age of 46.90 ± 15.77 years and mean pain duration of 49.07 ± 51.95 months participated in the study. All participants rated their expectations as “10” on a 0 to 10 scale during their first visit. RE did not correlate with diary ratings, (P = 0.773) but inversely correlated (−0.3) with PIR (P = 0.020) treatment outcomes.Conclusions: Expectations for pain relief, reported as 10 on a 0–10 scale during the first appointment, may reflect the patient's desire for complete relief of their pain rather than their expectations. Clinicians should therefore be aware of the need for clear communication and wording when examining for expectations. Inverse correlation between recalled expectations and subjective outcome may be due to the nature of recalled expectations when patients already knew their treatment outcomes, and may be explained by the concept of cognitive dissonance.

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Orofacial Pain Management in Integrative Pain Treatment

PsycEXTRA Dataset ◽

10.1037/e611052010-001 ◽

2010 ◽

Author(s):

Richard F. Druckman

Keyword(s):

Pain Management ◽

Orofacial Pain ◽

Pain Treatment

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Pharmacological treatment of chronic non-malignant pain among elderly persons: an integrative review

Revista Brasileira de Geriatria e Gerontologia ◽

10.1590/1981-22562018021.170179 ◽

2018 ◽

Vol 21 (3) ◽

pp. 372-381

Author(s):

Salomão Antônio Olivência ◽

Luiza Gabriela Mendes Barbosa ◽

Marcela Rodrigues da Cunha ◽

Ledismar José da Silva

Keyword(s):

Chronic Pain ◽

Elderly Patients ◽

Elderly Population ◽

Pain Treatment ◽

Case Series ◽

The Elderly ◽

Integrative Review ◽

Elderly Persons ◽

Number Of Factors ◽

Individualized Approach

Abstract Objective: The objective of the present study was to perform an integrative review of proposed pharmacological treatments for chronic non-malignant pain in elderly patients. Method: An integrative review was carried out. The search of literature included papers about the treatment of chronic pain among the elderly, published from 2007 to 2017 and available in Portuguese or English. Searches were conducted on the LILACS and MEDLINE electronic databases using the key words “chronic pain”, “treatment” and “elderly” combined with the Boolean operator “AND”. To analyse methodological quality, the adapted Critical Appraisal Skill Program (CASP) was used. Results: Of a total of 303 studies found, 32 were included. The articles selected included 20 reviews, five observational studies, five clinical trials, one case series and one retrospective study. A total of 75% of the articles were published in the last five years, of which one was in Portuguese and 31 in English. Conclusion :The results demonstrate a variety of treatments for chronic pain among the elderly population, highlighting the role of opioids which, according to more recent evidence, can be carefully used in treatment. Several drugs, however, have not been specifically tested for the elderly population. A number of factors are relevant in pain management of elderly patients, including comorbidities, polypharmacy and patient functionality. An individualized approach should be applied to elderly patients to improve outcomes and reduce side effects.

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