Journal
CLINICAL JOURNAL OF PAIN
Volume 31, Issue 8, Pages 740-749Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/AJP.0000000000000154
Keywords
temporomandibular disorders; serotonin; glutamate; masseter muscle; bruxism; microdialysis
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Funding
- Faculty of Odontology at Malmo University, Malmo, Sweden
- Swedish Dental Society
- Swedish Rheumatism Association
- Karolinska Institutet, Huddinge, Sweden
- Swedish Research Counsil
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Objectives: It has been suggested that tooth clenching may be associated with local metabolic changes, and is a risk factor for myofascial temporomandibular disorders (M-TMD). This study investigated the effects of experimental tooth clenching on the levels of 5-HT, glutamate, pyruvate, and lactate, as well as on blood flow and pain intensity, in the masseter muscles of M-TMD patients. Methods: Fifteen patients with M-TMD and 15 pain-free controls participated. Intramuscular microdialysis was performed to collect 5-HT, glutamate, pyruvate, and lactate and to assess blood flow. Two hours after the insertion of a microdialysis catheter, participants performed a 20-minute repetitive tooth clenching task (50% of maximal voluntary contraction). Pain intensity was measured throughout. Results: A significant effect of group (P < 0.01), but not of time, was observed on 5-HT levels and blood flow. No significant effects of time or group occurred on glutamate, pyruvate, or lactate levels. Time and group had significant main effects on pain intensity (P < 0.05 and < 0.001). No significant correlations were identified between: (1) 5-HT, glutamate, and pain intensity; or between (2) pyruvate, lactate, and blood flow. Discussion: This experimental tooth clenching model increased jaw muscle pain levels in M-TMD patients and evoked low levels of jaw muscle pain in controls. M-TMD patients had significantly higher levels of 5-HT than controls and significantly lower blood flow. These 2 factors may facilitate the release of other algesic substances that may cause pain.
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