Journal of Oral & Facial Pain and Headache最新文献

{"title":"The prevalence of comorbid migraine in multiple sclerosis: do multiple sclerosis and migraine really coexist?","authors":"Katarzyna Kępczyńska, Patryk Sochań, Natalia Bednarczyk, Patrycja J Sochań, Wojciech Domitrz, Jan Kochanowski, Izabela Domitrz","doi":"10.22514/jofph.2026.030","DOIUrl":"10.22514/jofph.2026.030","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) is a chronic inflammatory disease causing multifocal demyelination and axonal damage in the central nervous system. Recent studies indicate that MS patients have a higher prevalence of migraine than the general population. This cross-sectional, single-centre study assessed migraine prevalence in MS patients receiving disease-modifying therapies (DMTs).</p><p><strong>Methods: </strong>A total of 205 MS patients were included. All participants were assessed for migraine diagnosis according to the International Classification of Headache Disorders, 3rd edition (ICHD-3), by a qualified physician. Migraine subtypes (episodic or chronic, with or without aura) were determined per ICHD-3 criteria. Each participant provided data on age, gender, current DMT type and duration, previous DMT history, MS-related symptoms, and MS relapses in the past 12 months.</p><p><strong>Results: </strong>Episodic migraine was identified in 36 patients, corresponding to a prevalence of 17.56% (95% CI (confidence interval): 12.4%-22.8%). Age-stratified analysis revealed higher prevalence in younger participants: 21.4% in those under 40 years (n = 98) compared to 14.0% in those aged 40 years or older (n = 107). The majority of cases (n = 28) presented without aura, with aura occurring in 8 patients. No chronic migraine was detected in the cohort. A total of 193 patients were diagnosed with relapsing-remitting multiple sclerosis (RRMS), 2 with secondary progressive MS (SPMS), and 10 with primary progressive MS (PPMS). No cases of progressive-relapsing MS (PRMS) were reported. Among the participants, 193 were receiving DMT, while 12 patients were not undergoing chronic immunotherapy. No significant correlations were found between migraine occurrence and MS type, type of DMT, disease duration, or Expanded Disability Status Scale (EDSS) score.</p><p><strong>Conclusions: </strong>Migraine does not seem to be less common in MS patients compared to the general population but further, age-stratified and controlled studies are needed to investigate if it is more/as common.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 3","pages":"149-155"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139449","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":"Psychological and somatosensory correlates of temporomandibular disorder: anxiety, somatosensory amplification, and coping strategies-a biopsychosocial perspective.","authors":"Zekeriya Temircan","doi":"10.22514/jofph.2026.014","DOIUrl":"10.22514/jofph.2026.014","url":null,"abstract":"<p><strong>Background: </strong>Temporomandibular disorders (TMDs) are multifactorial conditions influenced by physical, psychological, and behavioral factors. Emotional distress, altered pain perception, and maladaptive coping strategies contribute to TMD pathology. This study examined psychological and somatosensory correlates of TMDs, focusing on anxiety, somatosensory amplification, and coping styles.</p><p><strong>Methods: </strong>This cross-sectional study included 108 patients with TMDs (76 females, 32 males; mean age 33.98 ± 7.20 years) and 112 healthy controls (58 females, 54 males; mean age 34.25 ± 6.85 years). Anxiety was assessed using the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A), somatosensory amplification with the Somatosensory Amplification Scale (SSAS), and coping strategies with the Coping Orientation to Problems Experienced (COPE) Inventory. Pain intensity and symptom duration were measured using the Visual Analog Scale (VAS). Group differences were analyzed using independent-samples <i>t</i>-tests and chi-square tests. Pearson correlation and multivariate regression analyses were conducted within the TMD group to identify predictors of somatosensory amplification. Ethical approval was obtained from Cappadocia University.</p><p><strong>Results: </strong>Patients with TMDs showed significantly higher anxiety (HADS-A: 11.42 ± 3.85 <i>vs.</i> 6.18 ± 2.90, <i>p</i> < 0.001) and somatosensory amplification (SSAS: 31.75 ± 7.92 <i>vs.</i> 20.84 ± 8.33, <i>p</i> < 0.001) compared with controls. The TMD group reported greater use of emotion-focused and maladaptive coping strategies (<i>p</i> ≤ 0.01), while problem-focused coping did not differ. Pain intensity (VAS: 6.48 ± 1.72) and symptom duration (4.62 ± 2.74 years) were positively correlated with anxiety, somatosensory amplification, and maladaptive coping (all <i>p</i> < 0.001). Regression analyses identified pain intensity and anxiety as significant predictors of somatosensory amplification, with female gender and older age also contributing.</p><p><strong>Conclusions: </strong>These findings support a biopsychosocial model of TMDs, highlighting interactions among pain, emotional distress, somatosensory amplification, and coping strategies. Integrative treatments addressing both physical and psychological factors may improve outcomes.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 3","pages":"139-148"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139515","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":"Research progress on cellular senescence in the pathogenesis and treatment of osteoarthritis and temporomandibular joint osteoarthritis.","authors":"Yuan Wang, Xiaohui Jing, Yu Li","doi":"10.22514/jofph.2026.033","DOIUrl":"10.22514/jofph.2026.033","url":null,"abstract":"<p><p>Osteoarthritis (OA) is a common joint disorder characterized primarily by cartilage degeneration and osteophyte formation, leading to a substantial decline in patients' quality of life. Temporomandibular joint OA (TMJOA) is a degenerative lesion within temporomandibular joint disorders, accounting for approximately 8%-16% of diagnosed cases. Its clinical manifestations include joint pain, limited mouth opening, joint noises, and related symptoms. Cellular senescence plays a pivotal role in OA pathogenesis. Senescent processes contribute to functional impairment of chondrocytes, synovial cells, and osteocytes through multiple signaling pathways. DNA damage, telomere attrition, oxidative stress, and the release of inflammatory mediators are major drivers of cellular senescence. However, current literature lacks a systematic integration of senescence-related mechanisms in OA and TMJOA. Furthermore, anti-aging therapeutic strategies for these conditions lack targeted approaches that account for interactions among distinct senescence mechanisms. This review elucidates the various characteristic types of cellular senescence, their interactions, and the senescence-induced pathogenesis of OA and TMJOA. A comprehensive investigation into the mechanisms of cellular senescence may yield novel insights and inform the development of therapeutic strategies for managing OA.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 3","pages":"14-25"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138916","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":"Reciprocal association between neurovascular conflict and trigeminal neuralgia: a systematic review and meta-analysis.","authors":"Raimundas Golubevas, Augustinas Buškus, Gintaras Janužis, Dainius Razukevičius, Jan Pavel Rokicki","doi":"10.22514/jofph.2026.035","DOIUrl":"10.22514/jofph.2026.035","url":null,"abstract":"<p><strong>Background: </strong>Classical trigeminal neuralgia is thought to be primarily caused by neurovascular contact of the trigeminal nerve root. However, neurovascular contact is also seen in individuals without trigeminal neuralgia on magnetic resonance imaging (MRI). Understanding this reciprocal association is important for clinical decision-making, as microvascular decompression is usually considered in medication-refractory cases.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of MRI studies evaluating neurovascular contact in patients with trigeminal neuralgia and in individuals without trigeminal neuralgia. PubMed, ScienceDirect, and the Cochrane Library were searched for studies published between 2015 and 2025. Seven studies involving 699 patients and 1092 trigeminal nerves (357 symptomatic and 735 asymptomatic) met the inclusion criteria and were analyzed.</p><p><strong>Results: </strong>Neurovascular contact was present in 66.7% of nerves in individuals without trigeminal neuralgia (95% confidence interval: 58.9-73.8%) and in 87.5% of nerves in patients with trigeminal neuralgia (95% CI: 81.3-91.8%). The symptomatic side showed neurovascular contact at significantly higher rates than asymptomatic nerves. Severe contact was rarely observed in non-trigeminal neuralgia patients, but was strongly associated with symptomatic nerves. Neurovascular contact at the root entry zone was not significantly linked to the symptomatic side. Interpretation across studies was limited by heterogeneous and non-standardized reporting of neurovascular contact location and severity.</p><p><strong>Conclusions: </strong>Simple neurovascular contact is common in individuals without trigeminal neuralgia, whereas severe contact is more specific to symptomatic nerves, supporting a reciprocal association between neurovascular conflict and trigeminal neuralgia. Neurovascular contact should not be regarded as a binary MRI finding; severity, location, and vessel type appear to be important for symptom development. Standardized MRI reporting protocols and larger, well-designed studies are needed to refine diagnostic criteria and imaging-based assessment of trigeminal neuralgia.</p><p><strong>The prospero registration: </strong>CRD420250611313.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 3","pages":"52-64"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139549","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":"Slow-inactivated sodium channels as a therapeutic target in trigeminal neuralgia: evidence from a systematic review and meta-analysis of lacosamide.","authors":"Tonporn Meechumnarn, Somkiat Phutinart, Prakit Anukoolwittaya, Waritnun Kleechaya, Patcharanan Deprasertwong, Patavee Pajareya, Abhishet Varama, Noppachai Siranart, Sekh Thanprasertsuk","doi":"10.22514/jofph.2026.037","DOIUrl":"10.22514/jofph.2026.037","url":null,"abstract":"<p><strong>Background: </strong>Lacosamide (LCM), a selective enhancer of the slow inactivation of voltage-gated sodium channels, has been proposed as a treatment for trigeminal neuralgia (TN), although its clinical efficacy and safety remain incompletely defined.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of cohort studies involving adults with TN. PubMed, EMBASE, and CENTRAL were searched from inception to 16 October 2025. The primary outcomes were efficacy, measured as pain relief, and safety, assessed by adverse events (AEs) associated with LCM.</p><p><strong>Results: </strong>Four studies were included in the quantitative synthesis. The pooled proportion of patients achieving pain relief with oral LCM was 66.7% (95% confidence interval (CI): 57.3%-74.9%; <i>I</i>² = 0.0%). The pooled overall incidence of adverse events with oral LCM was 35.2% (95% CI: 26.8%-44.6%; <i>I</i>² = 20.7%). The most frequently reported adverse event of oral LCM was sleepiness/somnolence (24.6%), followed by dizziness (21.7%), instability (2.5%), first-degree atrioventricular block (1.7%), and inattention (1.7%). All adverse events were infrequent and generally non-persistent. Additionally, intravenous LCM in acute exacerbation of TN reported that 77.8% of patients achieved patient-reported pain absence within 10 hours, with only 1.6% experiencing sleepiness.</p><p><strong>Conclusion: </strong>Lacosamide (LCM) has shown favorable outcomes in some patients with trigeminal neuralgia (TN) and may serve as an alternative therapy, particularly those refractory to or intolerant of first-line agents, and intravenous LCM may be useful for acute exacerbations. However, the current evidence is preliminary, observational, and insufficient to support comparative treatment decisions. Randomized controlled trials are needed to establish its efficacy and safety.</p><p><strong>The prospero registration: </strong>CRD420261295578.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 3","pages":"76-82"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139423","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":"Clinical features and diagnostic pathways of trigeminal neuralgia: a retrospective study in a tertiary orofacial pain clinic.","authors":"Thaviporn Limrachtamorn","doi":"10.22514/jofph.2026.043","DOIUrl":"10.22514/jofph.2026.043","url":null,"abstract":"<p><strong>Background: </strong>Trigeminal neuralgia (TN) is a neuropathic facial pain disorder that frequently mimics odontogenic and other orofacial pain conditions, leading many patients to initially seek dental care. This study aimed to characterize the clinical features and diagnostic pathways of patients with TN presenting to a tertiary orofacial pain clinic.</p><p><strong>Methods: </strong>This single-center retrospective study included newly diagnosed patients with TN who attended a tertiary orofacial pain clinic between 2024 and 2025. Data regarding their demographic characteristics, pain features, pain intensity, trigger factors, and trigeminal nerve distribution were collected, and their psychological characteristics were assessed using the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), and the 10-item Perceived Stress Scale (PSS-10). Diagnostic pathways before referral, including dental procedures performed before diagnosis, were also evaluated.</p><p><strong>Results: </strong>A total of 36 patients were assessed (mean age 66.8 ± 10.7 years; 66.7% female), and most presented with severe paroxysmal electric shock-like pain, predominantly involving the maxillary and mandibular divisions of the trigeminal nerve. Pain episodes were found to be triggered by light facial touch, with additional common triggers including washing the face, tooth brushing, speaking, and chewing. Pain intensity at presentation was graded as severe, with a mean Numerical Rating Scale (NRS) score of 8.17 ± 1.08. Moderate to moderately severe depressive symptoms, moderate to severe anxiety, and moderate perceived stress were frequently observed. Notably, before referral, 22.2% of patients had undergone tooth extraction, and 2.8% had received root canal treatment without achieving pain relief.</p><p><strong>Conclusions: </strong>Patients with TN presenting to a tertiary orofacial pain clinic exhibit characteristic neuropathic pain features, although their diagnostic pathways are variable, and a notable proportion undergo dental procedures before a confirmed diagnosis. Better recognition of these characteristic neuropathic pain features may facilitate earlier suspicion of TN, promote timely referral, and reduce unnecessary dental procedures.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 3","pages":"167-175"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139519","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":"Diagnostic re-evaluation of non-odontogenic orofacial pain after treatment failure: a retrospective case series.","authors":"Hao Chih Chuang, Hisashi Sato, Kosei Kubota, Wataru Kobayashi","doi":"10.22514/jofph.2026.039","DOIUrl":"10.22514/jofph.2026.039","url":null,"abstract":"<p><strong>Background: </strong>Orofacial pain often arises from overlapping odontogenic and non-odontogenic causes, which can lead to misdiagnosis and unnecessary irreversible procedures. Practical guidance on diagnostic re-evaluation in treatment-refractory cases with negative dental findings remain limited.</p><p><strong>Methods: </strong>This retrospective case series describes six illustrative patients (one man and five women; median age, 74.5 years) selected from referrals for suspected non-odontogenic orofacial pain, based on diagnostic difficulty, treatment refractoriness, and objective negative dental findings. Two oral and maxillofacial surgeons independently re-evaluated each case using the International Classification of Orofacial Pain, the 3rd edition of the International Classification of Headache Disorders, and the Diagnostic Criteria for Temporomandibular Disorders.</p><p><strong>Results: </strong>The final or most strongly suspected diagnoses included persistent idiopathic dentoalveolar pain, lingual nerve injury, trigeminal neuralgia, trigeminal autonomic cephalalgia, and myofascial pain. The median diagnostic delay was 17 months (interquartile range, 7-96). Initial empiric dental management (<i>e.g.</i>, antibiotics and/or nonsteroidal anti-inflammatory drugs (NSAIDs)) was insufficient in all cases. Pain intensity improved from a median numerical rating scale score of 8 at baseline to 0-2 at final observation. Across cases, common diagnostic pitfalls included premature attribution to a single cause, overreliance on imaging or prior medication history, and insufficient musculoskeletal or neurological examination. One or more clinical features prompting diagnostic re-evaluation were observed in each case, including persistent pain with objective negative dental findings, autonomic signs, or incongruent treatment response.</p><p><strong>Conclusions: </strong>In cases of treatment-refractory orofacial pain with objective negative dental findings, suspending further irreversible interventions and conducting systematic diagnostic re-evaluation may help reduce diagnostic delays and avoid unnecessary procedures.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 3","pages":"93-104"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139597","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":"Chronic pain after orthognathic surgery: a retrospective single-center study.","authors":"Sakari Kettunen, Olli-Pekka Lappalainen, Laura Nykänen, Aleksi Haapanen, Antti Asikainen, Jussi Furuholm, Johanna Snäll","doi":"10.22514/jofph.2026.042","DOIUrl":"10.22514/jofph.2026.042","url":null,"abstract":"<p><strong>Background: </strong>We aimed to clarify the occurrence and variables associated with postoperative chronic postsurgical pain in orthognathic surgery patients (OS).</p><p><strong>Methods: </strong>This retrospective single-center study included patients ≥18 years old undergoing bilateral sagittal split osteotomy (BSSO) with or without Le Fort I osteotomy between January 2016 and December 2022. The outcome variable was the occurrence of chronic postsurgical pain three months after OS. SPSS software (IBM Corporation, 28.0.0.0) was used to analyze the associations between predictor variables and outcome.</p><p><strong>Results: </strong>Chronic postsurgical pain was observed in 7.9% of the 317 patients included in this study. In univariate analysis, the outcome was predicted by older age (odds ratio (OR) = 1.044; 95% confidence interval (CI): 1.003-1.087; <i>p</i> = 0.033) and use of early gabapentinoid medication at hospital discharge (OR = 3.526; 95% CI: 1.286-9.666; <i>p</i> = 0.014). In multivariate analysis, only early gabapentinoid medication predicted outcome independently (adjusted odds ratio (aOR) = 2.975; 95% CI: 1.055-8.388; <i>p</i> = 0.039).</p><p><strong>Conclusions: </strong>Chronic postsurgical pain represents a significant postoperative disadvantage in OS, yet surgical factors appear to have limited influence on its development. More detailed information on other variables, such as psychosocial factors and resilience, is needed to predict postoperative pain in this specific patient group.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 3","pages":"130-138"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139588","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":"Effectiveness of extracorporeal shock wave therapy for temporomandibular disorders: a systematic review and meta-analysis.","authors":"Shunyuan Liu, Yuli Shuai, Liu Ye, Shiqi Tan, Yizhan Wang, Dandong Wu","doi":"10.22514/jofph.2026.036","DOIUrl":"10.22514/jofph.2026.036","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal shock wave therapy (ESWT) is commonly employed for treating various musculoskeletal disorders; however, its effectiveness in managing temporomandibular disorders (TMD) remains inconclusive. This study aimed to assess the effectiveness of ESWT for TMD by reviewing randomized clinical trials.</p><p><strong>Methods: </strong>Systematic searches were conducted across seven databases from inception to April 2025 to identify randomized clinical trials (RCTs) evaluating ESWT in patients with TMD. Eligible studies were required to report at least one of the following outcomes: visual analog scale (VAS) for pain or maximum mouth opening (MMO). A meta-analysis was performed, categorizing results by treatment type (ESWT alone <i>vs.</i> ESWT combined with other treatments). The risk of bias and study quality were assessed using Review Manager version 5.4.1, and all analyses were conducted using R v.4.4.3 (R Project for Statistical Computing).</p><p><strong>Results: </strong>Fourteen RCTs (n = 1107 participants) were included. Compared to active controls, ESWT did not result in significant improvements (VAS: mean difference (MD) = -0.81; 95% confidence interval (CI) = -1.77 to 0.16; <i>p</i> = 0.06, <i>I</i>² = 0.0%; MMO: Standardized Mean Difference (SMD) = -1.84; 95% CI = -18.43 to 14.74; <i>p</i> = 0.39, <i>I</i>² = 97.5%). However, when used as an adjunctive therapy, ESWT significantly improved pain intensity and mouth opening (VAS: MD = 0.94; 95% CI = 0.61 to 1.26; <i>p</i> < 0.0001, <i>I</i>² = 19.5%; MMO: SMD = 0.69; 95% CI = 0.48 to 0.90; <i>p</i> < 0.0001, <i>I</i>² = 45.5%).</p><p><strong>Conclusions: </strong>ESWT, when used as an adjunctive therapy for TMD, significantly alleviates pain and improves mouth opening. However, these results should be interpreted with caution due to the generally low quality of the included studies and the absence of long-term follow-up data. This meta-analysis synthesizes the available evidence, highlights critical research gaps, and provides cautious recommendations for clinical practice.</p><p><strong>The prospero registration: </strong>CRD42025631405.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 3","pages":"65-75"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139591","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 relationship between triglyceride levels and medication overuse headache in patients with chronic migraine.","authors":"Hailin Liu, Hefei Tang, Zhihui Duan","doi":"10.22514/jofph.2026.027","DOIUrl":"10.22514/jofph.2026.027","url":null,"abstract":"<p><strong>Background: </strong>Emerging evidence suggests that disturbances in lipid metabolism play a significant role in the etiology of migraines. However, the relationship between lipid metabolism disturbances and medication overuse headache (MOH) remains uncertain. This study aims to evaluate the association between elevated triglyceride (TG) levels and the occurrence of MOH among patients with chronic migraine (CM).</p><p><strong>Methods: </strong>A total of 267 hospitalized individuals diagnosed with CM were enrolled into the study. The participants were divided into two distinct groups based on the presence or absence of MOH. Questionnaires were employed for gathering demographic data, and a systematic inquiry was conducted to ascertain the overall prevalence of headaches. The laboratory examination, anxiety and depression scale, Pittsburgh sleep quality index, and other components were used to evaluate improvement. Initially, the study data underwent univariate analysis, whereby indicators demonstrating statistical significance (<i>p</i> < 0.05) were chosen as independent variables. Subsequently, a binary logistic regression analysis was conducted.</p><p><strong>Results: </strong>The cohort included a total of 87 patients without MOH and 180 patients with MOH. The following five risk variables emerged via single-factor analysis (<i>p</i> < 0.05): headache duration (years), headache frequency (days/months), headache intensity measured by a visual analogue scale (0-10), diabetes history, and TG levels. Elevated TG was associated with greater odds (OR = 1.498 (1.018, 2.259), <i>p</i> = 0.037) of MOH after accounting for demographics, headache features, and cardiometabolic comorbidities (including diabetes and hypertension).</p><p><strong>Conclusions: </strong>Elevated TG levels may be associated with MOH in patients with CM, underscoring their importance in the diagnostic evaluation and therapeutic management of patients with CM.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":"40 2","pages":"120-126"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582705","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}