Clinical evaluation and management of orofacial pain in the light of neurobiological evidence : A narrative review

Abstract

Pain conditions involving the trigeminal system-affecting the head, face, temporomandibular joint (TMJ), masticatory muscles, and related structures-are among the most common and disabling disorders encountered in clinical practice. Orofacial pain (OFP) can originate from diverse anatomical regions and etiology. Temporomandibular disorders (TMDs) represent the most frequent category of OFP for which patients seek treatment, encompassing dysfunctions of the masticatory muscles, TMJ, or both. Trigeminal neuropathic pain may result from trauma, dental interventions, infections, tumors, or disturbances within the peripheral or central nervous system. Additionally, neurovascular disorders, particularly primary headaches, may present as persistent OFP-for example, facial migraine affecting the maxillary and mandibular divisions of the trigeminal nerve. Collectively, these disorders significantly impair patients’ quality of life. Optimal management often requires a multidisciplinary approach that integrates both pharmacological and nonpharmacological strategies.