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Quintessence Publishing: Journals: JOP
Journal of Orofacial Pain

Edited by Barry J. Sessle, BDS, MDS, BSc, PhD, FRSC

Official Journal of the American Academy of Orofacial Pain,
and the European, Australian, Asian, and Ibero-Latin Academies of Craniomandibular Disorders

ISSN 1064-6655

Publication:
Spring 2010
Volume 24 , Issue 2

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Glutamate-induced Temporomandibular Joint Pain in Healthy Individuals Is Partially Mediated by Peripheral NMDA Receptors

Per Alstergren, DDS, PhD/Malin Ernberg, DDS, PhD/Mikael Nilsson, DDS, MSc/Anna-Kari Hajati, DDS, MSc/Barry J. Sessle, MDS, PhD, DSc(hc)/Sigvard Kopp, DDS, PhD

Pages: 172–180
PMID: 20401355

Aim: To determine if glutamate injected into the healthy temporomandibular joint (TMJ) evokes pain through peripheral N-methyl-D-aspartate (NMDA) receptors and if such pain is influenced by sex or sex steroid hormones. Methods: Sixteen healthy men and 36 healthy women were included and subjected to two randomized and double-blind intra-articular injections of the TMJ. Experimental TMJ pain was induced by injection of glutamate (1.0 mol/L) and NMDA block was achieved by co-injection of the NMDA antagonist ketamine (10 mmol/L). The TMJ pain intensity in the joint before and during a 25-minute postinjection period was continuously recorded on an electronic visual analog scale (0 to 10). Estradiol, progesterone, and testosterone levels in serum were analyzed. Results: Glutamate-induced pain showed a median (25/75 percentile) duration of 8.3 (5.2/12.2) minutes. The peak pain intensity was 6.1 (4.2/8.2), the time to peak was 50 (30/95) seconds, and the area under the curve was 59 (29/115) arbitrary units. The women reported higher maximum pain intensity than the men and shorter time to peak. The sex hormone levels were not significantly related to the glutamate-induced TMJ pain. NMDA block significantly reduced the glutamate-induced TMJ pain, mainly in the women. There were no significant correlations between sex hormone levels and the effects of NMDA block for any pain variable. Conclusion: Glutamate evokes immediate pain in the healthy human TMJ that is partly mediated by peripheral NMDA receptors in the TMJ. J Orofac Pain 2010;24:172–180

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