Effect of nadolol on temporomandibular pain.

Abstract

Temporomandibular disorders (TMD) are pain conditions that affect the Temporomandibular joint (TMJ) and masticatory muscles. These conditions present higher prevalent, severity and duration in the female sex and are associated with inflammation. Although non-steroidal anti-inflammatory drugs have been frequently used in the control of inflammatory pains, many patients can be intolerant to the prolonged treatment and some of them can not answer to the effect of these medications.It is already known that the inflammatory pain has a sympathetic component that can be predominant in the cases showing less sensibility to the non-steroidal anti-inflammatory drugs. In this context, recently data of ours laboratory shows that sympathetic amines are released in the TMJ during the inflammatory process where they contribute with the development of hyperalgesia in the rat´s TMJ by activating ²-2 adrenoceptors.Clinically we don´t know if the use of ²-blockers can reduce the TMJ pain, but it is possible because TMJ has a rich sympathetic enervation, and because these drugs have been used in the treatment of migraine which has some common characteristics to the TMJ dysfunctions. Thus, the aim of this study is to test the hypotheses that the use of ²-blockers can reduce the pain and the allodynia associated with TMD in women in different phases of menstrual cycle and in men. In this double blind, cross-over and randomized study the volunteers presenting TMD will receive ²-blockers, anti-inflammatories or placebo, 6 days per month for men during 1 month, and 6 days per month for women during 2 months consecutively. The pain associated to TMJ dysfunctions will be tested by the visual analogical scale (VAS) and the allodynia by the quantification of mouth opening and bite force. Both will be tested with or without the use of medications in volunteers with or without TMJ pain.This study can contribute to the treatment of TMD since it has the potential to offer a new pharmacological option that considers patients' hormonal status to obtain higher indices of success.