Journal of Oral & Facial Pain and Headache最新文献

{"title":"Benchmark evaluation of large language models for clinical decision support in headache management.","authors":"Shi Chen, Dong Liang, Xu Qiu, Chengqi Dong, Jiayi Deng, Li Xu, Xiaoxue Dong, Yonglei Zhao, Xuemei Fan, Xiaoyu Liu, Yali Wu, Jianliang Sun, Feifang He, Ke Ma, Liang Yu, Hanbin Wang","doi":"10.22514/jofph.2026.029","DOIUrl":"10.22514/jofph.2026.029","url":null,"abstract":"<p><strong>Background: </strong>Headache disorders are a major cause of disability worldwide. In routine practice, diagnosis and guideline-based management are difficult because symptoms can overlap between primary and secondary headaches, and clinicians must combine clinical, imaging, and pathological information. Large language models (LLMs) are being proposed to assist clinical reasoning, but their performance on headache cases and their sensitivity to prompting have not been systematically assessed.</p><p><strong>Methods: </strong>We evaluated seven leading LLMs using 13 headache cases from the New England Journal of Medicine (NEJM). We compared two prompting strategies: ask-in-sequence (AS) and ask-at-once (AO). Using a 5-point Likert rubric, three headache specialists independently scored six dimensions: rationality of diagnostic thinking, comprehensiveness of differential diagnosis, diagnostic accuracy, completeness of pathological diagnosis, clinical management, and supplementary value. Readability was measured with Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL). We analyzed differences across models, prompting strategies, and cases.</p><p><strong>Results: </strong>Diagnostic accuracy differed by model: in the AS strategy, ChatGPT-4o outperformed Grok-3. Supplementary value also varied: in AS, Grok-3 outperformed ChatGPT-5 and Hunyuan-T1; in AO, DeepSeek-R1 outperformed ChatGPT-5. Overall, supplementary value was generally higher with AS, while strategy-related differences in diagnostic accuracy were observed only for Grok-3. Performance also depended on the case; C8 and C11 consistently received very low scores, suggesting difficulty integrating psychiatric or warning signs with pathological findings. Readability differed significantly: Gemini 2.5 Pro had the highest FRE (best readability) across strategies, and AS outputs generally had higher FRE. Within AS, ChatGPT-4o had the highest FKGL (worst readability). No significant model differences were found for the other four clinical dimensions.</p><p><strong>Conclusions: </strong>This study provides a structured, reproducible evaluation of LLMs on headache case analysis. While some models improved supplementary value, diagnostic accuracy, or readability, overall clinical accuracy remains below expert performance and is not sufficient for unsupervised clinical use.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 2","pages":"140-150"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of articular disc displacement among Thai TMD patients: a retrospective study on the association with demographic and clinical characteristics.","authors":"Uthai Uma, Wacharasak Tumrasvin","doi":"10.22514/jofph.2026.028","DOIUrl":"10.22514/jofph.2026.028","url":null,"abstract":"<p><strong>Background: </strong>Disc displacement (DD) is among the most prevalent intra-articular temporomandibular disorders. Identifying associated factors can support early diagnosis and management. The objective of this study was to evaluate the relationship between disc conditions and patient demographics and clinical characteristics.</p><p><strong>Methods: </strong>This retrospective study analyzed 770 patient records collected from 2021 to 2025 using data extracted from the hospital's digital system. Variables included demographic information, behavioral habits, occlusal characteristics, clinical findings, and temporomandibular joint (TMJ) diagnoses. Statistical analyses were performed using descriptive statistics, chi-square tests, independent <i>t</i>-tests, one-way analysis of variance, and binary logistic regression, with significance set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>DD was diagnosed with 420 patients (54.5%). DD patients were significantly younger (mean 39.0 years, <i>p</i> < 0.001), predominantly in the 21-40 age group (<i>p</i> = 0.002), and more often female (72.0%, <i>p</i> < 0.001). Behavioral habits such as resting the chin on the hand (<i>p</i> < 0.001) and previous orthodontic treatment (<i>p</i> = 0.010) were more prevalent in the DD group. Occlusal characteristics, including overjet, overbite, midline deviation, and occlusal scheme, showed no significant association with DD. However, DD patients exhibited reduced posterior and total static articulation (<i>p</i> < 0.05), as well as decreased working contacts and increased non-working contacts during the right excursion. The distribution of TMJ clicking and disc diagnoses was comparable between the left and right sides. More advanced subtypes of DD were linked to younger age, female sex, reduced mouth opening capacity, and greater mandibular deviation.</p><p><strong>Conclusions: </strong>DD was associated with demographic and behavioral factors, particularly younger age, female sex, and certain oral habits. Functional occlusal contacts were also found to be associated with an increased likelihood of DD. Comprehensive assessment is essential for diagnosis and management.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 2","pages":"127-139"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translation, cultural adaptation, and pilot testing of the standardized tool for the assessment of bruxism and the bruxism screener in China.","authors":"XuTong Song, SiYi Mo, YaoJun Zhang, Yuan Li, JingWen Liu, Frank Lobbezoo, Daniele Manfredini, Jari Ahlberg, Alessandro Bracci, Jie Lei, KaiYuan Fu, Xiaoxiang Xu, Ye Cao","doi":"10.22514/jofph.2026.020","DOIUrl":"10.22514/jofph.2026.020","url":null,"abstract":"<p><strong>Background: </strong>The newly established Standardized Tool for the Assessment of Bruxism (STAB) and the bruxism screener (BruxScreen) offer thorough, methodical, and readily available instruments for the evaluation and screening of bruxism in clinical settings and research endeavors.</p><p><strong>Methods: </strong>The Chinese version provided is a translation of the original English text. The Chinese version of the STAB/BruxScreen was developed in accordance with the 12-step guideline for translation and cultural adaptation established by the expert group. The translation team consisted of 13 members: 4 study coordinators, 2 forward translators, 2 rear translators, and 5 expert panelists. Simultaneously, the Chinese iteration of the STAB and BruxScreen underwent pilot testing to assess its comprehensibility and practicality. Pilot testing comprised 60 participants for the STAB (20 patients, 20 dental students, 20 dentists) and 40 independent volunteers for the BruxScreen (20 patients, 10 students, 10 dentists).</p><p><strong>Results: </strong>The STAB completion time averaged 17.8 minutes for patients (self-report) and 11.4 minutes and 14.3 minutes for dentists and dental students (examination), respectively. The BruxScreen-Q (questionnaire) completion time averaged 1.6 minutes, and the BruxScreen-C (clinical examination) duration averaged 1.8 minutes per patient. High comprehensibility was achieved, with 95.5% of the STAB items and 100% of the BruxScreen items requiring no clarification. All 20 dentists (100%) endorsed both tools as clinically feasible. The test-retest and inter-examiner reliability of the BruxScreen showed excellent agreement (Kappa > 0.8, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>The Chinese versions demonstrate satisfactory preliminary comprehensibility and feasibility; the BruxScreen shows excellent reliability. Comprehensive validation in larger samples is required before these tools can be applied in clinical practice or large-scale screening.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 2","pages":"54-63"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unnecessary dental extractions in patients with Persistent Idiopathic Facial Pain: a qualitative and questionnaire-based study of patient perspectives.","authors":"Dror Shir, Iftah Biran, Rakefet Zalashik, Amnon Mosek","doi":"10.22514/jofph.2026.016","DOIUrl":"10.22514/jofph.2026.016","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to explore the perspectives of individuals with Persistent Idiopathic Facial Pain (PIFP) who sought dental extractions for pain relief and to identify common themes from their experiences. PIFP significantly impacts the quality of life, leading many patients to undergo unnecessary dental procedures on healthy teeth for pain relief. Recognizing unique characteristics in patients with a history of such interventions could help prevent unnecessary treatments and associated complications.</p><p><strong>Methods: </strong>We conducted qualitative research at the Headache Clinic, Tel Aviv Sourasky Medical Center, involving 12 consecutive patients with PIFP who had undergone dental extractions. Data were collected through medical records, interviews, and questionnaires. The recorded interviews were transcribed and analyzed using qualitative research guidelines, with a focus on descriptive, linguistic, and conceptual comments.</p><p><strong>Results: </strong>Twelve participants aged 28-83 were included in the study. Data analysis revealed three main themes: (1) physical metaphors (\"like an exposed nerve\"), (2) emotional and cognitive reactions to pain (\"life had stopped\"), and (3) encounters with the medical establishment (\"not just injustice, it's medical negligence\"). Physical metaphors included additional somatization, symbolic penetration, facial pain analogous to emotional pain or a traumatic event, and pain as a silencer. Emotional and cognitive reactions included catastrophic reactions, incomprehensibility, loss of agency, and disconnection from emotional pain. Finally, encounters with the medical establishment included complex interactions with medical figures, as well as confusion and perplexity with the medical system.</p><p><strong>Conclusions: </strong>This qualitative study offers insights into the subjective experiences of PIFP patients. The identified themes highlight shared challenges and the multifaceted nature of PIFP, underscoring the need for comprehensive, multidisciplinary approaches.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 2","pages":"31-42"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of simple snoring and myogenous temporomandibular disorders based on polysomnographic examination.","authors":"Helena Martynowicz, Marta Bort, Dorian Nowacki, Weronika Frosztega, Jakub Przegralek, Jaroslaw Nowak, Katarzyna Madziarska, Mieszko Wieckiewicz","doi":"10.22514/jofph.2026.017","DOIUrl":"10.22514/jofph.2026.017","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the association between objectively measured snoring characteristics and masticatory muscle pain in patients with myogenous temporomandibular disorders (TMD), while excluding patients with obstructive sleep apnea.</p><p><strong>Methods: </strong>This prospective study included 184 patients (mean age: 33.92 ± 10.05 years; 71.2% female) who underwent overnight polysomnography (PSG) and standardized TMD assessments. Snoring was quantified using acoustic recordings and parameters derived from PSG. Muscle pain intensity was assessed in the bilateral masseter and temporalis muscles. Correlation analyses and group comparisons were performed to examine the relationships between snoring characteristics (<i>e.g.</i>, snore index, train frequency, and audio volume) and pain outcomes.</p><p><strong>Results: </strong>No significant associations were found between primary snoring parameters and pain intensity. However, several snoring metrics,particularly those measured during specific body positions and sleep stages, especially during nonsupine rapid eye movement (REM) sleep-showed significant negative correlations with pain, mainly in the left masseter and temporalis muscles. Notably, higher snore intensity was associated with lower muscle pain, suggesting a potential modulatory effect. These relationships were lateralized and dependent on body position. Multivariate analysis did not identify independent predictors of pain. Although no direct link was observed between overall snoring and masticatory muscle pain, certain snoring patterns,particularly during nonsupine REM sleep-were inversely related to pain intensity.</p><p><strong>Conclusions: </strong>These findings suggest a possible protective or modulatory role of snoring in TMD-related muscle pain and highlight the complex influences of sleep stage, body position, and laterality.</p><p><strong>Clinical trial registration: </strong>Information on clinical trial registration can be found at ClinicalTrials.gov (identifiers: NCT03083405, NCT04214561).</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 2","pages":"1-13"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type-specific effects of orofacial pain on sleep quality: a cross-sectional clinical study.","authors":"Sümeyye Coşgun-Baybars, Merve Hacer Talu, Hacer Yalçin, Dicle Gökdemir","doi":"10.22514/jofph.2026.011","DOIUrl":"10.22514/jofph.2026.011","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess the impact of different types of orofacial pain on sleep quality and to examine the influence of age and gender on sleep-related parameters.</p><p><strong>Methods: </strong>In this cross-sectional study, 400 patients with orofacial pain presenting to the Faculty of Dentistry, Fırat University, were included. Participants were divided into eight pain categories: pulpal, periodontal, impacted tooth-related, dental implant-related, temporomandibular disorder-related, mucosal/cutaneous, neuropathic, and oncologic. Pain intensity was measured using the Numeric Rating Scale, and sleep quality was assessed via the Pittsburgh Sleep Quality Index (PSQI). Non-parametric tests and correlation analyses were used for statistical evaluation.</p><p><strong>Results: </strong>The mean age was 33.62 ± 13.06 years, and 66.8% were female. The mean global PSQI score was 5.56 ± 2.84. Neuropathic and mucosal/cutaneous pain groups demonstrated significantly higher PSQI scores, especially in sleep latency and disturbances (<i>p</i> < 0.05). Females had significantly higher scores in sleep latency, disturbances, and daytime dysfunction than males (<i>p</i> < 0.05). Age was weakly but significantly correlated with several PSQI components.</p><p><strong>Conclusions: </strong>Neuropathic and mucosal/cutaneous pain types were associated with the most detrimental effects on sleep quality. Gender and age were also found to influence specific sleep parameters.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 1","pages":"127-137"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12853164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The past, present, and future of temporomandibular disorders in predoctoral curriculum: historical perspectives and what comes next.","authors":"Elizabeth Hatfield, Shaiba Sandhu, Theodora Danciu, Daniel J Clauw, Alexandre DaSilva","doi":"10.22514/jofph.2026.003","DOIUrl":"10.22514/jofph.2026.003","url":null,"abstract":"<p><p>Approximately one-third of adults in the United States are estimated to suffer from temporomandibular disorders (TMD). Despite the widespread prevalence, effective diagnosis and management of TMD remains inadequate, contributing to patient frustration and a sense of stigmatization by healthcare providers. To address this gap, significant attention is being directed toward improving educational initiatives at all levels regarding TMD. This perspective aims to explore the historical development, current standards, and emerging trends in TMD-related education in the U.S. and Canada. From its early misconceptions as a disorder primarily caused by occlusal discrepancies, TMD education has evolved towards a biopsychosocial model that acknowledges the multifactorial nature of these disorders. Significant gaps persist in predoctoral dental curricula, hindering the development of effective clinical skills among students, despite advancements in diagnostic criteria, including the Research Diagnostic Criteria for TMD (RDC/TMD) and the more comprehensive Diagnostic Criteria for TMD (DC/TMD) and International Classification of Orofacial Pain (ICOP). Current standards for TMD education highlight the necessity for dentists to achieve competence in managing these disorders, yet the lack of standardization across schools remains a barrier. Integrating multidisciplinary and interprofessional education strategies into the curriculum offers a path forward, as these approaches foster collaborative practice and enhance patient management. Additionally, incorporating artificial intelligence (AI) and other innovative educational technologies holds the potential to revolutionize TMD education, enabling personalized learning and improved clinical decision-making. Addressing these educational gaps and embracing a standardized approach to TMD-related predoctoral education will equip future dental professionals with the knowledge and skills necessary to improve patient outcomes in TMD.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 1","pages":"32-41"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12853160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporomandibular disorders in a tertiary clinic: associations with pain, chronicity, sleep versus awake bruxism, and psychological factors-a retrospective study.","authors":"Thaviporn Limrachtamorn","doi":"10.22514/jofph.2026.010","DOIUrl":"10.22514/jofph.2026.010","url":null,"abstract":"<p><strong>Background: </strong>Temporomandibular disorders (TMD) are prevalent orofacial pain conditions; however, the interrelationships among clinical, psychological, and behavioral factors remain insufficiently explored, particularly within the Thai population. This single-center retrospective study aimed to examine the associations among clinical characteristics, pain, bruxism, and psychological factors in patients with TMD.</p><p><strong>Methods: </strong>The medical records of 222 adult patients diagnosed with TMD at the Orofacial Pain Clinic between January and December 2024 were reviewed. The primary outcomes were the associations of pain severity and symptom duration with psychological factors, and the secondary outcomes were the relationships of sleep and awake bruxism with psychological factors and related variables. Statistical analyses included nonparametric tests, chi-square tests, and logistic regression.</p><p><strong>Results: </strong>Among the 222 patients (75.7% female; mean age 35.83 ± 17.08 years), 56.8% presented with chronic symptoms, 36.0% reported sleep bruxism, and 37.8% reported awake bruxism. Higher pain severity was significantly associated with depression (<i>p</i> = 0.004), anxiety (<i>p</i> = 0.001), and stress (<i>p</i> = 0.045). Chronic symptoms (>3 months) were associated with depression, anxiety, and stress (<i>p</i> < 0.001). Awake bruxism demonstrated significant associations with all three psychological factors (<i>p</i> < 0.001), whereas sleep bruxism did not show such associations. In multivariable analyses, patients with acute symptoms (≤3 months) had lower odds of sleep bruxism compared with those with chronic symptoms (odds ratio (OR) = 0.37, <i>p</i> = 0.003), and higher stress levels were associated with awake bruxism (OR = 1.15, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>The findings highlight the burden of psychological factors among TMD patients, particularly those with higher pain intensity, chronic symptoms, and awake bruxism. Awake bruxism may serve as a clinical indicator of psychological factors, underscoring the importance of psychological screening and biopsychosocially oriented management. Nonetheless, the results should be interpreted with caution given the retrospective design and the single-center setting.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 1","pages":"106-118"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12853168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the salivary biomarker cortisol in patients with temporomandibular disorders.","authors":"Bruno Macedo de Sousa, Nansi Lopez-Valverde, Carla Cardoso, Antonio Lopez-Valverde, Maria J Rodrigues, Jose A Blanco Rueda","doi":"10.22514/jofph.2026.007","DOIUrl":"10.22514/jofph.2026.007","url":null,"abstract":"<p><strong>Background: </strong>Temporomandibular Disorders (TMD) are musculoskeletal and neuromuscular conditions involving the temporomandibular joint (TMJ), masticatory muscles, and related structures. Stress can trigger dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, leading to increased cortisol secretion. Salivary cortisol assessment provides a non-invasive method to investigate this relationship.</p><p><strong>Methods: </strong>A total of 98 participants were recruited-49 patients diagnosed with TMD and 49 healthy controls-at the Faculty of Medicine of the University of Coimbra. Participants were evaluated according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Saliva samples were collected between 9:00 and 11:00 AM, processed with Enzyme-Linked Immunosorbent Assay (ELISA), and analyzed statistically using Shapiro-Wilk and Mann-Whitney tests, with a 95% confidence level.</p><p><strong>Results: </strong>Salivary cortisol levels were significantly higher in TMD patients (mean = 17.55 nmol/L) compared with controls (mean = 11.09 nmol/L; <i>p</i> = 0.0032). No significant correlations were found between age and cortisol levels.</p><p><strong>Conclusions: </strong>Patients with TMD present higher salivary cortisol levels, suggesting dysregulation of the HPA axis associated with stress. These findings support the integration of psychosocial factors into the management of TMD.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov identifier NCT06874868.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 1","pages":"81-87"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12853154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HCN2 channels: a potential therapeutic target for orofacial neuropathic pain after trigeminal nerve injury.","authors":"Toru Yamamoto, Tomoaki Ujita, Yurie Sato-Yamada, Takako Ichiki, Naotaka Kishimoto, Miho Terunuma, Kenji Seo","doi":"10.22514/jofph.2026.013","DOIUrl":"10.22514/jofph.2026.013","url":null,"abstract":"<p><p>Hyperpolarization-activated cyclic nucleotide-gated (HCN) channels have recently emerged as promising targets for the treatment of neuropathic pain. This study investigated the potential involvement of HCN2 channels in the development of trigeminal neuropathic pain following peripheral nerve injury. Infraorbital nerve chronic constriction injury (ION-CCI) model was adopted to rats, and head withdrawal thresholds (HWT) to mechanical stimulation were assessed pre- and postoperatively, as well as after pharmacological intervention. In the trigeminal ganglion (TG), intracellular cyclic adenosine monophosphate (cAMP) and cytoplasmic protein kinase A (PKA) levels were quantified by Enzyme-Linked Immunosorbent Assay (ELISA), while <i>Hcn2</i> mRNA expression was evaluated by quantitative Polymerase Chain Reaction (qPCR). Immunohistochemical analysis was performed to assess phosphorylated cAMP response element-binding protein (pCREB) expression in the TG and HCN2 expression in infraorbital nerve (ION) axons. In the TG, cAMP and pCREB levels were elevated, whereas cytoplasmic PKA and <i>Hcn2</i> mRNA levels were reduced. Axonal HCN2 expression was increased in CCI rats. On day 14, HWT was significantly reduced following CCI but was ameliorated by local administration of the HCN channel blocker ivabradine at the site of axonal injury. Collectively, these findings suggest that CCI-induced alterations in cAMP-PKA-pCREB signaling promote HCN2 accumulation in injured axons, thereby contributing to the development of orofacial neuropathic pain following peripheral nerve injury.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 1","pages":"151-156"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12853158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}