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TMJD and Orofacial Pain Program

Contact: Dr. John Kusiak, (301) 594-7984, John.Kusiak@nih.gov

Orofacial pain involves numerous conditions, including  temporomandibular joint disorders (TMJD), dental pain, atypical odontalgia, burning mouth syndrome, and bruxism.  The most common cause of facial pain is TMJD. These disorders cause recurrent or chronic pain and dysfunction in the jaw joint and its associated muscles and supporting tissues. TMJDs are the second most commonly occurring musculoskeletal conditions resulting in pain and disability (after chronic low back pain), with an annual cost estimated at $4 billion. About half to two-thirds of those with TMJ disorders will seek treatment. Among these, approximately 15% will develop chronic TMJD. 

Program Goals

  • To maintain and expand NIDCR's commitment to orofacial pain and genetics research
  • To position the orofacial pain research field for post-genomic era translational research and clinical applications in molecular medicine

Health Goals

  • To better prevent, treat, and diagnose orofacial pain disorders

Research Agenda

  • To understand the mechanisms underlying the transition from acute to chronic pain states
  • To develop new pharmacological and behavioral interventions to prevent or reverse the transition

Implementation Plan

  • 2009: Workshop on genetics and pain
  • 2009-2011: Collaborative Research on the Transition From Acute to Chronic Pain: New Models and Measures in Clinical and Preclinical Pain Research (RFA DE-11-001)
  • 2010: Workshop on Pain Phenotypes (PC)
  • 2010: Workshop on Assessment of Feasibility & Requirements to Conduct GWAS on Pain (NIDCR)
  • 2010-2014: Training and career development awards
  • 2010-2012: GWAS on Chronic TMJD, Discovery Phase
  • 2012-2013: GWAS on Chronic Pain, Replication and Deep Sequencing Phase; follow-on basic research on orofacial pain mechanisms, structure/ function, and therapeutic targets
  • 2012-2014: translational research
  • 2013-2015: planning activities for clinical trials
  • 2014-2016: ÔÇťorofacial pain" clinical trials
  • Participation in NIH Pain Consortium activities

 

Research Capacity Building

New scientific expertise, tools and approaches in orofacial pain research. Pain researchers outside the orofacial pain area; non-pain researchers with complementary expertise: computational biologists, systems biologists, biobehavioral scientists; new investigators, junior faculty, trainees

 

Basic Biological and Behavioral Mechanisms

Discovery of the underlying etiology, pathology, and pathways to chronicity of TMJDs and other orofacial pain disorders; phenotypes / diagnosis

Current: focus on acute mechanisms of pain only or the chronic state, single gene or gene family studies, candidate gene approaches provide some novel insight into mechanisms of disease development

Need: identification of new genes and new pathways underlying chronic pain; development of appropriate phenotypes for characterizing heterogeneity of disease in patient pools leading to better diagnosis

 

Translational Research

Patient-oriented research leading to mechanistic understanding of
disease development, progression, and treatments; informing basic studies on mechanisms of disease, therapeutic target validation and animal model development

Current: inadequate animal models for analgesic testing; few patient oriented studies driving therapeutics development or animal mechanistic studies; lack of good targets; focus on chronic pain patients and/or acute pain in animal models

Need: new preclinical models appropriate for studying the transition from acute to chronic pain; patient studies to uncover mechanisms of transition that will also drive therapeutic target validation in animals

 

Clinical Research

Prevention and treatment of chronic painful orofacial disorders; focus on
preventing the transition to chronicity

Current: focus on the chronic condition, few novel targets

Need: testing of novel therapeutic approaches focused on preventing or reversing the transition from acute to chronic pain

 

 

 

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Five top priority areas:

  • Recruitment  and training
  • TMJD/Pain phenotypes, diagnosis, genetics
  • Follow-on research from genetics and genomics research: pain mechanisms, structure/function studies, and therapeutic targets
  • Translational research: Chair-side<->Laboratory
  • Clinical studies
This page last updated: January 06, 2014