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Quantitative sensory testing in patients with the muscle pain subtype of temporomandibular disorder: a systemic review and meta-analysis

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Abstract

Objectives

This meta-analysis aimed to evaluate quantitative sensory testing (QST) evidence for pain processing in patients with the muscle pain subtype of temporomandibular disorders (mTMD).

Materials and methods

A comprehensive systematic electronic search strategy was performed in online literature databases. All full-text observational studies published up to July 2021 with the aim of investigating pain sensitization in humans with mTMD using QST measures were eligible for inclusion. Meta-analysis of QST data was performed using a random effects model, which included results comparing patients with mTMD to healthy controls, and standard mean difference (SMD) results were analyzed.

Results

Twelve studies with 732 participants (371 patients with mTMD and 361 healthy controls) were analyzed following screening and quality appraisal. Compared with healthy controls, patients with mTMD had significantly lower pressure pain threshold (SMD − 1.10, 95% confidence interval [CI] − 1.52 to − 0.68) with high heterogeneity (Tau2 = 0.61, I2 = 86%), and significantly lower mechanical pain threshold (SMD − 0.64, 95% CI − 0.95 to − 0.32) with no heterogeneity (Tau2 = 0.00, I2 = 0%). No difference was observed in the cold pain threshold (SMD 0.16, 95% CI − 0.13 to 0.45), heat pain threshold (SMD − 0.13, 95% CI − 0.40 to 0.15), and wind-up ratio (SMD 0.63, 95% CI − 0.11 to 1.38) between patients with mTMD and healthy controls. Other QST parameters were also discussed.

Conclusions

The study results suggest that the pain processing of deep tissues is likely sensitized in mTMD and calls for more QST studies with standard procedures to reduce inter-study heterogeneity.

Clinical relevance

The major findings of this meta-analysis support using PPT to examine the pain processing in patients with mTMD in clinical scenario.

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Data availability

All data generated or analyzed during this study are included in this published article and its supplementary information files.

Abbreviations

SMD:

Standard mean difference

CI:

Confidence interval

TMD:

Temporomandibular disorders

mTMD:

Muscle pain subtype of temporomandibular disorders

QST:

Quantitative sensory testing

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Acknowledgements

We would like to thank Editage (www.editage.cn) for English language editing.

Funding

YL was supported by the National Natural Science Foundation of China (Grant No. 82001103) and the Natural Science Foundation of Chongqing (Grant No. cstc2019jcyj-bshX0005). HM was supported by The Science Technology and Innovation Committee of Shenzhen Municipality (Grant No. 20200812112320001) and the Shenzhen Key Medical Discipline Construction Fund (SZXK0090).

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Authors and Affiliations

  1. Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, Chongqing, China

    Yuzhou Li

  2. Department of Stomatology, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen, Guangdong, China

    He Meng & Juan Dai

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  1. He Meng
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  2. Juan Dai
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Contributions

HM and YL designed the study and developed the meta-analysis procedure; YL, HM, and JD reviewed the literatures, collected the data, and evaluated the quality appraisal; YL and HM analyzed the data; YL and HM drafted the manuscript. All authors read and approved the final submitted paper.

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Correspondence to Yuzhou Li.

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Meng, H., Dai, J. & Li, Y. Quantitative sensory testing in patients with the muscle pain subtype of temporomandibular disorder: a systemic review and meta-analysis. Clin Oral Invest 25, 6547–6559 (2021). https://doi.org/10.1007/s00784-021-04171-5

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