Head Pain Institute, 9481 E Ironwood Square Dr. Scottsdale, Scottsdale, AZ, 85258, USA.
Brotman Facial Pain Clinic, Department of Neural and Pain Sciences, University of Maryland, School of Dentistry, 650 W. Baltimore St. 8th Floor, Baltimore, MD, 21201, USA.
Curr Pain Headache Rep. 2022 Jul;26(7):517-523. doi: 10.1007/s11916-022-01054-6. Epub 2022 May 14.
Migraine and other primary headache disorders can be localized in the face resembling facial or dental pain, indicating the influence of the trigeminovascular system in the structures innervated by the maxillary (V2) and mandibulary (V3) branches of the trigeminal nerve. Disorders of oral and craniofacial structures may influence primary headache disorders. In the current article, we review the potential links of this interplay.
This interplay may be related to anatomy, with the trigeminal pathway and the involvement of both peripheral and central mechanisms, and the presence of calcitonin gene-related peptide (CGRP), a key mediator in migraine pathophysiology. CGRP is also involved in the pathophysiology of temporomandibular disorders (TMD) and their comorbidity with migraine and is also implicated in dental and periodontal pathology. Inflammatory and pathological processes of these structures and their trigeminal nociceptive pathways may influence the trigeminovascular system and consequently may exacerbate or even potentially trigger migraine.
偏头痛和其他原发性头痛疾病可发生在面部，类似于面部或牙痛，表明三叉神经系统的血管在由三叉神经上颌支（V2）和下颌支（V3）支配的结构中发挥作用。口腔和颅面结构的疾病可能会影响原发性头痛疾病。在目前的文章中，我们回顾了这种相互作用的潜在联系。
这种相互作用可能与解剖学有关，涉及三叉神经通路以及外周和中枢机制的参与，以及降钙素基因相关肽（CGRP）的存在，CGRP 是偏头痛病理生理学中的关键介质。CGRP 还参与颞下颌关节紊乱症（TMD）及其与偏头痛的共病，并且还与牙齿和牙周病理学有关。这些结构及其三叉神经伤害性通路的炎症和病理过程可能会影响三叉神经系统，并可能加重甚至潜在地引发偏头痛。
