Arima T, Svensson P, Arendt-Nielsen L
Orofacial Pain Laboratory, Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark.
J Orofac Pain. 2000 Summer;14(3):213-23.
Strong jaw muscle exercises such as tooth grinding in sleep bruxism are frequently believed to be a predisposing factor in myogenous types of temporomandibular disorders. However, it is not known whether tooth grinding in sleep bruxism is associated with increased sensitivity to intramuscular stimuli. This study therefore compared the hyperalgesic effects of an intramuscular injection of capsaicin into the right masseter with and without a prior experimental tooth-grinding exercise.
Ten healthy men participated in 2 randomized sessions (exercise, non-exercise session) separated by 1 week. In the exercise session, 0.1 mL capsaicin (100 micrograms/mL) was injected into the right masseter immediately after 45 minutes of experimental tooth grinding. In the non-exercise session, the exact same paradigm was used, except that the experimental tooth grinding was omitted. The perceived intensity of pain evoked by intramuscular capsaicin was scored on a 100-mm visual analog scale (VAS). Pain detection thresholds (PDTs) to pressure stimuli and maximal voluntary occlusal force (MVOF) were measured before capsaicin injection; 5, 15, and 45 minutes after the injection; and once a day for the following 3 days.
Injections of capsaicin into an exercised or non-exercised masseter did not cause significant differences in peak pain intensity on the VAS (57 +/- 6 mm in exercised masseter vs. 53 +/- 6 mm in non-exercised masseter; P = 0.464). The PDTs in the exercised masseter were significantly decreased for up to 1 day after the capsaicin injection (P < or = 0.038), whereas PDTs in the non-exercised masseter were decreased for only 5 minutes (P = 0.017). The MVOF on the right side was decreased 5 minutes after the capsaicin injection in both sessions (P < 0.010). The MVOF on the left side was significantly reduced for up to 15 minutes after the capsaicin injection in the exercise session only (P < 0.019).
Increased sensitivity to percutaneous pressure stimuli probably reflects a post-exercise muscle soreness following tooth grinding, whereas intramuscular sensitivity to noxious chemical stimuli immediately following exercise seems to be unchanged.
诸如睡眠磨牙症中磨牙等强烈的咀嚼肌锻炼常被认为是肌源性颞下颌关节紊乱病的一个诱发因素。然而,尚不清楚睡眠磨牙症中的磨牙是否与肌肉内刺激的敏感性增加有关。因此,本研究比较了在有或没有预先进行实验性磨牙锻炼的情况下,向右侧咬肌内注射辣椒素的痛觉过敏效应。
10名健康男性参加了2次随机分组的实验(锻炼组、非锻炼组),两次实验间隔1周。在锻炼组中,在进行45分钟的实验性磨牙后,立即向右侧咬肌注射0.1毫升辣椒素(100微克/毫升)。在非锻炼组中,采用完全相同的模式,只是省略了实验性磨牙环节。通过100毫米视觉模拟量表(VAS)对肌肉内注射辣椒素诱发的疼痛感知强度进行评分。在注射辣椒素前、注射后5分钟、15分钟和45分钟以及随后3天每天测量对压力刺激的疼痛检测阈值(PDT)和最大自主咬合力(MVOF)。
向锻炼或未锻炼的咬肌内注射辣椒素,在VAS上的峰值疼痛强度没有显著差异(锻炼侧咬肌为57±6毫米,未锻炼侧咬肌为53±6毫米;P = 0.464)。锻炼侧咬肌的PDT在注射辣椒素后长达1天显著降低(P≤0.038),而未锻炼侧咬肌的PDT仅降低5分钟(P = 0.017)。在两个组中,注射辣椒素后5分钟右侧的MVOF均降低(P < 0.010)。仅在锻炼组中,注射辣椒素后左侧的MVOF在长达15分钟内显著降低(P < 0.019)。
对经皮压力刺激敏感性增加可能反映了磨牙后运动性肌肉酸痛,而运动后即刻对有害化学刺激的肌肉内敏感性似乎未改变。