Prof. Rafael Benoliel (IASP SIG on OFP)

Prof. Koichi Wajima (Asian Academy of Craniomandibular Disorders)

Prof. Koichi Iwata (Japanese Society of Orofacial Pain)

2016. 9.24 256-68 Sumiyoshimachi, Naka-ku, Yokohama, 231-003 Japan

Sat

Kanagawa Dental Association HallVenue

Presidents

International Association for the Study of Pain Special Interest Groupon Orofacial pain （IASP SIG on OFP) 201616th Scientific Meeting of Asian Academy of Craniomandibular Disorders21st Scientific Meeting of Japanese Society of Orofacial Pain

Joint meeting of the three organizations

International Congress on Orofacial Pain (ICOP)

Sun

http://www.assiste-j.net/icop2016/english.html

The Abstract Book抄録集

CONTENTS

Greetings

67

Organizations

70

Congress Schedule 72

General Information

Congress Facility 74

Registration and Check in 78

Business & Social Events 78

Services 79

Requested Considerations 79

Presentation 80

Commercial Exhibition 83

Abstracts

AACMD / Joint Sessions 84

SIG Sessions 103

Poster Abstracts 116

- 67 -

GREETINGS

IASP Special Interest Group President

Rafael Benoliel

Welcome to ICOP 2016!

Dear friends, it is such a pleasure to welcome you all to the joint meeting of the Asian Academy of

Craniomandibular Disorders (AACMD), The Japanese Society for Orofacial Pain (JSOP) and the IASP’s

OFP Special Interest Group (SIG). As you know the joint meeting is an officially approved satellite of the

IASP’s meeting.

The focus of the OFP-SIG meeting will be on designing an improved classification for acute and chronic

orofacial pain. We are lucky to have attracted some of the best international speakers on the subject matter.

I am confident we will enjoy interesting and important discussions following these presentations. As we move

forwards we will set up work groups who will continue to collaborate over the next year and hopefully we will

meet in the USA during September 2017 for a follow up meeting.

The AACMD and the JSOP have been excellent partners and generous hosts and I thank them for their

efforts. Specifically Dr. Wajima (AACMD President), Dr. Iwata (JSOP President), and Dr. Imamura who have

worked to produce an exciting and rich scientific meeting. I would also like to recognize my partners who

worked with me in conceptualizing and organizing the OFP-SIG session. Dr Lene Baad-Hansen, the elected

Secretary for the SIG, has been invaluable in her input and practical assistance. I also asked Dr. Peter

Svensson to act as a consultant for the meeting. Peter has been very active and has contributed his vast

experience to creating an interesting content.

I am looking forward to speaking and interacting with you all.

Best Regards

Rafael Benoliel (OFP SIG President)

- 68 -

Message from the President, 21st Scientific Meeting of

Japanese Society of Orofacial Pain

President of the 21st Scientific Meeting of the Japanese Society of Orofacial Pain

Koichi Iwata

Dear Orofacial pain Clinicians and Researchers,

I am happy to welcome you to International Congress of Orofacial Pain (ICOP) in Yokohama. ICOP is

organized by 3 societies, the Asian Academy of Craniomandibular Disorders (AACMD), The Japanese

Society for Orofacial Pain (JSOP) and the IASP Special Interest Group (SIG) on Orofacial Pain (OFP). This

is the first joint meeting organized by these 3 societies.

Two years ago, orofacial pain was selected as the global year in the IASP. This indicates that the OFP SIG

is recognized as an important group in the IASP society. As you may know, the OFP mechanisms are more

specific and complex in comparison with the spinal cord system. Dysfunction of the orofacial region due to

the orofacial chronic pain directly affects the quality of life. It is important to understand the mechanisms

underlying chronic orofacial pain associated with trigeminal nerve injury or inflammation to treat OFP patients

appropriately. We OFP Clinicians and Researchers need to know OFP mechanisms as well as clinical

treatments.

In this meeting many famous clinicians and basic researchers are invited from the whole world and many

important clinical and basic research lectures will be presented. Professor B. Sessle is invited as the plenary

lecturer; Professors E. Eliav, G. Heir and R. Benoliel are also invited as the guest speakers. From Japan,

Professor R. Kakigi will give a lecture on functional brain imaging of Pain. This is a good opportunity to get

new insights regarding OFP mechanisms and techniques to treat patients, and also a good chance to talk

with famous pain clinicians and researchers. Thank you for joining us. Let’s discuss OFP.

- 69 -

Welcome message from the President of AACMD

Asian Academy of Craniomandibular Disorders, President

Koichi Wajima

Dear Colleagues and Friends,

On behalf of AACMD, it is a great honor to co-host the International Congress of Orofacial Pain2016 in

Yokohama, Japan, September 24-25, 2016.

We are pleased to invite you to this very special meetingwhich is an official satellite meeting of the 16th

World Congress on Pain IASP (IASP).

The Asian Academy of Craniomandibular Disorders (AACMD) made some significant progress in the past

several years. A change in generation of council members occurred and the communication between

members became close. The program of the scientific meeting was substantial and discussion became

active.

The theme of this AACMD meeting is “Cooperation for Improving the Education and Treatment of TMD/OFP”.

There are concerns of TMD and OFP in each Asian country. The level of each country’s future activity in

special features, advancement, and the present condition of TMD and OFP will be presented and shared

with all countries. As a future goal, the present condition of TMD medical treatment and the OFP resident

training course in USA are explained by Dr. Gary Heir, who has been invited as keynote speaker by AACMD.

I would like to express my hearty thanks to Prof. Yoshika Imamura, the chairman of the organizing committee,

for his enthusiastic effort to make this meeting successful. I also thank Prof. Rafael Benoliel, the president

of IASP SIG on OFP, and Prof. Koichi Iwata, the president of JSOP, and their corporations for organizing

this joint meeting.

Let’s start discussion and enjoy in Yokohama.

- 70 -

ORGANIZATIONS

1. International Association for the Study of Pain Special Interest Group on

Orofacial Pain (IASP SIG on OFP)

Position Name

President Rafael Benoliel

Treasurer Lene Baad-Hansen

Immediate Past President William Maixner

2. Japanese Society of Orofacial Pain (JSOP)

Position Name

President Keiichi Sasaki

Vice President Koichi Iwata, Hirofumi Yatani

Secretary Yasushi Sakuma

Treasurer Osamu Komiyama

Trustee Yoshiki Imamura, Eiji Konfo, Yoshizo Matsuka, Masahiko Shimada, Kenji Seo, Wataru Muraoka

Auditor Ryusuke Kakigi, Osamu Nakanishi

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3. Asian Academy of Craniomandibular Disorders (AACMD)

Position Name

President Koichi Wajima

Immediate Past President Jae-Kap Choi

President-Elect Yunn-Jy Chen

Vice President Youn-Joong Kim

Secretary Masakazu Okubo

Treasurer Wataru Muraoka

Country Representatives

Korea: Jin-Woo Chung

Japan: Hirofumi Yatani

Taiwan: Tai-Kum Mao

Indonesia Laura S. Himawan

Philippines Ricardo B. Boncan

Committee for Academic Affairs

Korea: Mee-Eun Kim

Yang-Hyun Chun

Japan: Yoshiki Imamura

Masakazu Okubo

Taiwan: Huey-Yuan Wang

Indonesia Ira Tanti

Philippines Jonathan Fandialan

Committee for International Liaison

Korea: Jong-Mo Ahn

Hyung-Joon Ahn

Japan: Yoshihiro Tsukiyama

Osamu Komiyama

Taiwan: Chien-Chih Chen

Indonesia Carolina Marpaung

Philippines Mario Esquillo

Committee for Membership Promotion

Korea: Yun-Heon Song

Hyun-Dae Lim

Japan: Yoshizou Matsuka

Kiyoshi Koyano

Taiwan: Hsien-Shu Lin

Indonesia Ade Amahorseya

Philippines David Davila

- 72 -

9/23 Friday 9/24 Saturday

13:00

Board & Council Meetings

(6F Conference Room) 9:00

AACMD Session

(B1F Auditorium +

7F Meeting Room)

JSOP Session

(6F AV Room)

Poster Session

（5F Rooms 501 & 502)

14:00

JSOP

Board Meeting 9:15

Opening Remarks

Koichi Wajima

(9:00-9:15)

Opening Remarks

Koichi Iwata

(9:00-9:15)

15:00

JSOP

Councili Meeting

10:15

AACMD Symposium

Intercommunicating

the Advancements in

the Training Program

of TMD/OFP in Each

Asian Country

(9:15-12:15)

Nociceptive Pain

Junichi Kitagawa,

Masamichi Shinoda

(9:15-10:15)

Poster Exhibition

(in English/Japanese)

16:00

Neuropathic Pain

Akiko Okada-Ogawa,

Ayano Katagiri, Kenichi

Fukuda

(10:15-12:15)

AACMD

Councill Meeting

(5F Conference Room)

12:15

12:25 Break

18:30 13:15

Luncheon Lecture

Understanding of Pain from Brain Activity

Ryusuke Kakigi

(12:25-13:15)

19:00 13:25 Break

AACMD & JSOP

Banquet

14:15

Plenary Lecture

What has been learnt about the mechanistic basis of

chronic orofacial pain states: A 50-year journey

Barry J Sessle

(13:25-14:15)

15:30

AACMD Workshop

Demonstration Lesson

of Clinical Reasoning

for the Diagnosis

of OFP

(14:15-15:30)

Temporomandibular

Disorders

Akimasa Tashiro, Yoshizo

Matsuka

(14:15-15:15)

Poster Exhibition

(in English/Japanese)

Conducted in English

16:00

Poster Free Communication / Break

AACMD & JSOP

(in Englush/Japanese)

Conducted in English and

Japanese AACMD, JSOP, SIG OFP Joint Plenary Symposium

Brain as a Therapeutic Target in Orofacial Pain

Rafael Benoliel, Eli Eliav and Gary Heir

(16:00-18:00)

Conducted in Japanese

17:00

Simultaneous Translation

between English and

Japanese is provided 18:00

18:30

20:30 Reception

Legends

CONGRESS SCHEDULE

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9/25 Sunday

8:30

SIG OFP Sessions

(B1F Auditorium +

7F Meeting Room)

JSOP Sessions

(6F AV Room)

Poster Sessions

（5F Rooms 501 & 502)

9:00

JSOP General Assembly (8:30-9:30)

9:15

Welcome

Rafael Benoliel

Poster Exhibition

(in English/Japanese)

10:00

Dental Pain

Maria Pigg

(9:15-10:00) Neural Mechanism of Photophobia

Keiichiro Okamoto

(9:45-10:30)

11:00

Orofacial Neuropathic Pain

Ralf D Treede,

Eli Eliav

(10:00-11:00)

Pain Management

Akira Toyofuku,

Noboru Noma,

Isao Kitahara

(10:30-12:00)

12:00

Neurovascular Headache and

Facial Pain

Arne May,

Rafael Benoliel

(11:00-12:00)

13:00

Musle and TMJ

Peter Svensson,

Boudewijn Stegenga

(12:00-13:00)

Poster Free Communication

AACMD & JSOP

(12:00-13:00)

14:00

Business Meeting & Lunch

(13:00-14:00)

AACMD & JSOP

Poster Award Session with Lunch

(13:00-14:00)

15:00

Idiopathic Pain

Charly Gaul,

Lene Baad-Hansen

(14:00-15:00) KDA Seminar

Overview of OFP

Diagnosis and Treatment of Non-

odontogenic Toothache

Yasushi Sakuma,

Masako Ikawa,

Wataru Muraoka, Osamu Komiyama

(14:00-16:30)

Poster Exhibition

(in English/Japanese)

16:00

OFP, TMDs. Headache and

Commorbidities

Bill Maixner,

Inna Tchivileva

(15:00-16:00)

16:30 Q&A, Discussion

(16:00-17:00)

17:00 Poster Removal

17:30 Closing Ceremony

- 74 -

GENERAL INFORMATION

1. CONGRESS FACILITY

All official congress functions for general delegates are located at the Kanagawa Dental

Association Hall.

Venue: Kanagawa Dental Association Hall

6-68 Sumiyoshi-machi Naka-ku

Yokohama 231-0013

Japan

Directions from JR Yokohama Station & YCAT (Yokohama City Air Terminal) to the Venue

1. Taking JR lines

Take Keihin Tohoku-Negishi line at the Track 3 to Sakuragi-cho Station. First stop.

2. Taking Minatomirai line

Take Minatomirai line at the Track 1 to Bashamichi Station, Third stop.

Kanagawa Dental Association Hall

Bashamichi Station

Exit #3

Sakuragi-cho Station

- 75 -

Auditorium

Lobby

W.C. (Male)

W.C. (Female)

Registration

1F

B1F

PC Check in

(AACMD &

SIG sessions)

Lunch Box Delivery

- 76 -

Cloak

5F

Conference

Room

Cloak (Board & Council

Meetings)

Room

602

Room

601

6F

(JSOP sessions)

Room 501 Room 502

(Poster Sessions)

Drink Corner

AV Room

Organization Committee Office

Lunch Box Delivery

Commercial

Exhibition Books

- 77 -

Basic location of programs

English Sessions (AACMD Sessions, SIG Sessions & Joint Sessions)

Main venue: B1F Auditorium

Satellite: 7F Meeting Room (Whole day 9/24 & 9/25)

6F AV Room (Luncheon & Plenary Lectures and Joint Symposium)

Japanese Sessions (JSOP Sessions)

Main venue: 6F AV Room

Poster Sessions (AACMD + JSOP)

Main venue: 5F Rooms 501 & 502

Meeting

Room

(Satellite)

7F

Lunch Box

Delivery

- 78 -

2. CONGRESS REGISTRATION AND CHECK-IN

Location

The registration desk is located on the 1st (ground) floor of Kanagawa Dental

Association Hall.

Registration and Check in Hour

September 23, Friday: 13:00-17:00

September 24, Saturday: 8:00-17:00

September 25, Sunday: 8:00-16:00

Registration Bag

Those who have registered in advance should bring a copy of the printed pre-

registration invoice with you and present it at the registration desk to receive an

envelope that contains an abstract book, your name card printed with the congress

receipt and tickets for a lunch box. The invoice was sent by e-mail in August.

Payment of Registration Fee

Registration fee will be collected at the registration desk. Please provide cash in

Japanese yen. We do not accept foreign currencies, bank checks, traveler’s

checks or credit cards. Currency exchange and ATM machines are located on

the 1st Floor of the JR Sakuragi-cho Station. They are on your way to the venue.

3. BUSINESS & SOCIAL EVENTS

1) AACMD COUNCIL MEETING

Time: September 23, Friday 16:00 – 18:00

Place: Conference room on the 5th floor

2) IASP SIG ON OFP BUSINESS MEETING

Time: September 25, Sunday 13:00 - 14:00

Place: Auditorium on the B1 floor.

AII IASP SIG on OFP members and other interested persons are invited to attend.

3) Welcome Reception

ICOP2016 invites delegates and registered accompanying guests who have

registered for the Welcome Reception in advance to the Welcome Reception. A

congress name badge with a mark on it is required for admission to the Welcome

Reception.

- 79 -

Time: September 24 (Sat), 18:30 - 20:30

Place: Beer Station “Umaya” in the next building to the Kanagawa Dental

Association Hall

4. SERVICES

CLOAKROOM / LUGGAGE STORAGE

Time: September 24 (Sat), 8:00 – 18:00

September 25 (Sun), 8:00 – 17:30

Place: Conference Room on the 5th floor of Kanagawa Dental Association Hall.

You must pick up your bags before moving to the welcome reception on Sep 24.

SIMULTANEOUS TRANSLATION

Simultaneous translation between English and Japanese will be provided for SIG

sessions on Sunday, September 25. A translation receiver will be handed at the

entrance of the auditorium. Please show your registration number on your name

card and receive it. The receiver will be collected at the exit of the auditorium. Don’t

forget to return it when you get out of the hall.

Lunch Box

ICOP2016 will offer a free lunch box each day to pre-registered participants.

Those who have pre-registered may receive free tickets for the lunch box at the

registration desk (They are inside the congress envelope). Please exchange the

ticket with a lunch box at lunch-time each day. The lunch box will be delivered on

the B1, 6 and 7th Floors. Please do not leave your garbage inside the hall. The

garbage will be collected at the exit of each lecture room.

There are many restaurants and coffee shops around the venue. If you have time,

there is an excellent Chinese town in a two-stop distance by train from Bashamichi

Station. You can enjoy wonderful Chinese cuisine there. This Chinese town is quite

clean and safe.

MESSAGE BOARDS

Message boards are located at the poster exhibition hall for delegates to post or

retrieve messages.

5. REQUESTED CONSIDERATION

RECORDING MOVIES, AUDIO or TAKING PHOTOGRAPHS

Recording lectures and presentations by devices including video cameras, audio

recorders, cameras and smartphones are prohibited throughout the congress.

MOBILE PHONE

Mobile phones should be turned off or put to silent mode during lectures.

SMOKING

The Kanagawa Dental Association Hall is smoke-free in all areas. Those who want

to smoke may ask at restaurants and coffee shops. Some of them have a smoking

zone and smoking time.

6. PRESENTATION

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1) ORAL PRESENTATIONS (INVITED SPEAKERS)

DATA PREPARATION

Recommended operating system is Windows 7 and Power Point 2010 / 2013

(PPT).

Recommended fonts are Times, Times New Roman and Arial (MS Standard)

Please state any conflict of interest on the second slide.

If you have movies or any other reference files, put all of them in a same folder

with your PPT file. Movies should be saved in a WMV file format with bitrate in

10Mbps or less. We recommend you bring the movie files.

Backup all files and bring them in a USB memory or a CD-R disk.

Be sure you can open and correctly operate the saved files. We recommend

that you check it using another PC especially for movies and animations.

We promise to delete all the duplicated files on our PC after the congress.

PC CHECK-IN DESK

The PC Check-in for Plenary and Symposium speakers is located next to the

registration desk on the 1st Floor. It opens on Saturday September 24 and

Sunday September 25, from 08:30 to 16:00. All speakers are required to visit

this desk at least 1 hour before their scheduled sessions. Check your digital

presentation file and provide a backup on the designated PC. The AV manager

is not responsible for errors or technical issues with presentation files provided

less than 1 hour before a scheduled lecture or symposium. Computers will be

available for speakers to preview their presentations.

TRANSLATOR’S INTERVIEW

Speakers in the SIG sessions are requested to participate in an interview by

the translators. This is necessary for them to interpret your presentation

correctly. Please visit Room 602 with your computer or an USB memory that

contains your presentation file 45 minutes before your presentation.

PRESENTATION

A monitor, a keyboard, a mouse and a laser pointer will be provided on the

podium. Please operate them by yourself.

FOR SPEAKERS WHO USE OWN PC

In case you use electric devices in your presentation, the standard voltage in

Japan is 100V, 50 Hz. Appliances designed for other voltages require a voltage

converter and plug adaptor. All sockets in Japan are Type A.

You may use D-sub 15pins for video output.

Please bring your port replicator if needed (MacBook, Sony VAIO, etc.)

Turn off the screensaver and the power saving function.

Use an AC adapter to prevent the battery from running down.

Bring a backup presentation on a USB stick or a CD-R just in case.

Please refrain from using “Speaker Notes Function” of Power Point during the

presentation.

- 81 -

2) POSTER PRESENTATIONS

POSTER PREPARATION

Posters should be no larger than 90cm wide by 150cm long (35 inches wide

x 60 inches long).

Please note that format is not compatible to WCP2016’s format.

Max 90cm

Max150cm

Each poster must have a top label indicating the title of the paper, the names

of the authors and their affiliations. The size of the characters for the title should

be at least one inch (2.5cm) high.

Your presentation Graphics should be explicit and brief. Elaboration is best

done verbally, just as if it were an oral presentation using slides. The poster

display should focus on:

Objective, Methods, Results or Outcomes and Conclusions

Conflicts of interest should be stated at the bottom of the poster.

You may hand out information sheets to those viewing your poster. Electric

devices (PC or projectors, etc) are not allowed.

POSTER SESSIONS

Poster sessions are located in the Room 501 and 502 on the 5th floor. Each

poster is on display for two entire days from 08:30 to 18:00 on September 24

and from 08:30 to 16:30 on September 25. Poster presenters must have their

posters in place by 08:30 on September 24. Presenters will be allowed to enter

the poster exhibition hall at 08:00 on September 24. Please do not remove

posters before the end of the second day's poster session. Presenters may pick

up pins to hang posters on the poster boards at the Poster Services desk in the

poster area. Please note that Velcro tapes are not allowed to use for this

purpose.

Note: Presenting authors are required to be present at their posters during the

daily discussion periods.

• Even-numbered poster boards: 15:30-15:45 on September 24 and

12:00-12:30 on September 25, both.

• Odd-numbered poster boards: 15:45-16:00 on September 24 and

12:30-13:00 on September 25, both.

POSTER AWARDS COMPETITION

Referees will select and mark up some candidate posters for the poster awards

20cm

20cm

Title Affiliation Authors Name

No. 👦 Portrait of the presenter

- 82 -

around 18:00 on September 24. Presenting authors of the candidate posters

are requested to stand next to own poster and make an oral presentation of

their studies to the audience during 13:00-14:00 on September 25. Assigned

time for presentation is 6 minutes and for Q&A 4 minutes. Six posters (3 Basic

and 3 Clinical) each will be awarded by AACMD and JSOP, respectively. Poster

award winners are requested to attend the closing ceremony.

- 83 -

COMMERCIAL EXHIBITION

In conjunction with the congress, a vendor exhibition will be held. Please visit Room 501

with your colleagues to view the latest products and services offered by exhibitors. New

product information, product demonstrations and equipment demonstrations will be

provided in Room 501 on September 24 and 25 from 09:00 to 18:00.

List of exhibitors (alphabetical order) 1. Intercross

5-5-21-2801 Nishiikebukuro Toshima-ku

Tokyo 171-0021 Japan

2. Ishiyaku Pub Inc.

1-7-10 Komagome, Bunkyo-ku

Tokyo 113-8612 Japan

3. Nipro

3‐9‐3 Honjo-nishi Kita-ku

Osaka 531-8510 Japan

4. Sunstar Suisse SA Route de Pallatex 11

1163 Etoy Switzerland

- 84 -

AACMD Sessions / Joint Sessions Date: Sep 24

Place: B1F Auditorium + 7F Meeting Room

- 85 -

Time Abstract

No Subject Speaker Moderator

9:00-9:15 Opening

Change from TMD to OFP Koichi Wajima,

President AACMD

AACMD Symposium Intercommunicating the Advancements of TMD/OFP in Each Asian Country

9:15-9:45

AS-1

Overview of

temporomandibular

Disorders/Orofacial Pain in

Indonesia

Indonesia Ira Tanti

J Kap Choi (Korea)

Koichi Wajima (Japan) AS-2

Update on the Training

Program of TMD and OFP in

the Philippines

Philippines Jonathan Fandialan

9:45-10:40

AS-3 Current Topics of TMD/OFP in

Taiwan

Taiwan Tai-Kum Mao Laura S.

Himawan (Indonesia)

Mario

Esquillo (Philippines)

AS-4 Advances in Orofacial Pain

and TMD Education in Korea

Korea Jin-Woo Chung

AS-5

Conceptual changes in the

therapeutic approach for

temporomandibular disorders

in Japan

Japan Hirofumi Yatani

10:40-10:50 Questions and Answers

10:50-11:15 Coffee break and Poster viewing

11:15-12:05 PL-1 Plenary Lecture

Current trend of TMD and OFP in USA

Gary Heir

Yuh-yuan Shiau

(Taiwan) Youn-Joong

Kim (Korea)

12:05-12:15 Questions and Answers

12:15-12:30 Break

Joint Sessions

12:30-13:20 LS-1 Luncheon Seminar Understanding

of Pain from Brain Activity Ryusuke Kakigi

Yoshiki Imamura

13:20-13:25 Break

13:25-14:15 PL-2

Plenary Lecture

What has been learnt about the

mechanistic basis of chronic orofacial

pain states: A 50-year journey

Barry J

Sessle Koichi Iwata

Sep 24 (Sat)

- 86 -

* Clinical diagnosticians A：Dr. Sato (Japan), Dr. Jung-Hwan Jo (Korea), Dr. Wilfredo De Ocampo Jr (Philippines), Dr. Yenny Pragustine (Indonesia) B：Dr. Saisu (Japan), Dr. Hye-Kyoung Kim (Korea), Dr. Huey-Yuan Wang (Taiwan), Dr. Inge Paramitha (Indonesia) C：Dr. Munakata (Japan), Dr. Chien-Chih Chen (Taiwan), Dr. Leslie Odelia Latif (Indonesia)

Time Abstrac

t No Subject Speaker Moderator

AACMD Workshop Demonstration Lesson of Clinical Reasoning for the Diagnosis of OFP

14:15-14:25 Introduction of Clinical diagnostic reasoning Koichi

Wajima

&

Gary Heir

14:25-15:40

Exercise of clinical

diagnostic reasoning

through the actual OFP

patients.

* Clinical diagnosticians

Case presenter Okubo, Muraoka, Wajima

15:40-15:45 Questions and answers

15:45-16:00 Coffee break and Poster viewing

Joint Session / Plenary Symposium

Brain as a Therapeutic Target in Orofacial Pain

16:00-18:00

JS-1 Overview of Pain Pathways

and their Modulation Rafael Benoliel

Rafael Benoliel

JS-2

The Role of Endogenous Pain Modulation in Chronic

Orofacial Pain Diagnosis and Treatment

Eli Eliav

JS-3 The Experience of Pain:

Cognitive, Emotional and Motivational Considerations

Gary Heir

Sep 24 (Sat)

- 87 -

AS 1-1 AACMD Sessions (9/24) AACMD Symposium Intercommunicating the Advanancements in the Training Program of TMD/OFP in Each Asian Country

Overview of Temporomandibular Disorders/Orofacial Pain in Indonesia

Faculty of Dentistry, Universitas Indonesia, Prosthodontic1)

Ira Tanti1) The incidence of temporomandibular disorders/orofacial pain (TMD/OFP) has been increasing recent years. To overcome this problem, almost every dental education center in Indonesia has a gnathology or TMD department which is a part of the Prosthodontic curriculum. Many studies have been done by undergraduate as well as postgraduate students, ranging from epidemiological to, clinical and laboratory study. The Indonesian Dental Association also confirms that Indonesian Academy of Craniomandibular Disorders (IACMD) is responsible for developing and promoting scientific knowledge in diagnosis and treatment of TMD/OFP in Indonesia. All dentists who are interested in TMD/OFP could join us. Diagnostic criteria used in Indonesia are based on the DC/TMD since 2014, besides other indices, which have been created in Indonesia, i.e. “Diagnostic Index for TMD” and “TMD Etiology Index”. The highest concern of the pathological conditions of TMD based on DC/TMD are myalgia and disc displacement; Occlusal abnormality could be an etiology of TMD, but not as the main cause; The most commonly found diagnoses and treatment are the non odontogenic toothache and myofascial pain of the masticatory muscles; Patients with neuropathic pain of the trigeminal nerve are normally referred to neurologist and team. COI and Funding = None Keywords: Orofacial pain, temporomandibular disorders, Indonesia

AS 1-2 AACMD Sessions (9/24) AACMD Symposium Intercommunicating the Advanancements in the Training Program of TMD/OFP in Each Asian Country

Update on the Training Program of TMD and OFP in the Philippines

University of the Philippines College of Dentistry1) Jonathan Fandialan1)

Objective: The objective of this presentation is to describe how management of Temporomandibular Disorders and Orofacial Pains are conducted in the Philippines. At present there are no formal research data available but the ground work has already been laid down. The more popular concept of etiology and treatment is still based on a dental and mechanistic view of the disorder. A five month continuing education program in partnership with the University of the Philippines and spearheaded by the Orofacial Pain Association has commenced in the hope to correct this notion and implement evidenced-based practice. The program promotes the use of the DC for TMD in the hope of standardizing the diagnostic procedure as well as collating data which will be used to assess the focus of TMD education in the country. Keywords: TMD, Philippines

Sep 24 (Sat)

- 88 -

AS 1-3 AACMD Sessions (9/24) AACMD Symposium Intercommunicating the Advanancements in the Training Program of TMD/OFP in Each Asian Country Current Topics of TMD/OFP in Taiwan

Tai-Kum Mao

National health insurance is one of the most successful policies with good international reputation

applied in Taiwan for more than three decades. However the payment policy for TMD patients is

relatively low and only for occlusal splint. One of the side effects is hindered the young dentists from

interested in treatment of TMD patients.

From the past experience we are convinced that dental society should be engaged or consulted for policy

of decisions making even we are not interested.

For dental education of TMD patients treatment was mixed with the class of occlusion and been taught

in second or third year of dental students which were complained lower efficiency and not concept

clearly! Even dental school graduate students complained

The knowledge of Neurophysiology to treat TMD patients is relatively not solid enough! Nevertheless

the divergent for treatment concept to TMD/OFP patients need to reestablish the Gold-Standard both

in diagnosis and treatment.

“Dry needle technique” for treatment “trigger zone” of OFP was described and tested with great success

in clinical and literature review.

AS 1-4 AACMD Sessions (9/24) AACMD Symposium Intercommunicating the Advanancements in the Training Program of TMD/OFP in Each Asian Country

Advances in Orofacial Pain and TMD Education in Korea

Seoul National University, School of Dentistry,

Department of Oral Medicine and Oral Diagnosis1), Jin Woo Chung1) The education of orofacial pain and temporomandibular disorder (TMD) have been developed successfully in Korea. Advanced programs in orofacial pain and TMD have been managed by the Department of Oral Medicine of Korean dental schools since the 1980s producing experts in this field. Pioneers have worked to establish the dental specialty (certificated board by government) since the 1960s, and results have started to appear since 2000. We have planned to bestow specialty boards on the dentists who have started the program in 2004. Thus, the first government certified specialists of Oral Medicine (including orofacial pain and TMD specialty) produced in 2008 and now we have 102 orofacial pain and TMD specialists in 2016. This lecture will present an overview of orofacial pain and TMD education and training programs and its implementation in clinical practice in Korea, and describe how this field has been integrated in dentistry and future aspects. Keywords: Education, Orofacial pain, Temporomandibular disorder

Sep 24 (Sat)

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AS 1-5 AACMD Sessions (9/24) AACMD Symposium Intercommunicating the Advanancements in the Training Program of TMD/OFP in Each Asian Country

Conceptual changes in the therapeutic approach for temporomandibular disorders in Japan

Osaka University Graduate School of Dentistry Department of Fixed Prosthodontics1) Hirofumi Yatani1)

Owing to the tremendous amount of clinical researches on temporomandibular disorders (TMD), we could finally reach the following universal understandings : 1) TMD is a collective term that consists of several pathological conditions with similar clinical signs and symptoms; 2) TMD is a multifactorial clinical condition whose etiology is based on the biopsychological model; 3) TMD should be treated and managed within the flame of biopsychological model; and 4) Since TMD is a condition that natural remission can be expected, reversible therapies should come first. These understandings have changed the therapeutic concept for TMD from mechanical (occlusal) one to more functional one based on biopsychosocial model. This conceptual change was attained relatively quickly in Japan and TMD is currently considered one of the orofacial pain conditions. My presentation will fully trace the history of the development of the therapeutic approach to the management of TMD in Japan, with emphasis on the conservative approaches.

Sep 24 (Sat)

- 90 -

PL 1 AACMD Sessions (9/24) : Plenary Lecture, Review

Current trend of TMD and OFP in USA

Center for Temporomandibular Disorders and Orofacial Pain, Rutgers University 1)

Gary Heir1)

The treatment of temporomandibular disorders in the United States has evolved into the broad concept

of orofacial pain. Orofacial, as defined by the Orofacial Pain Special Interest Group of the IASP as pain

perceived in the face and/or oral cavity. It is caused by diseases or disorders of regional structures, by

dysfunction of the nervous system, or through referral from distant sources. Treatment of orofacial pain

is a specialty in dentistry in many parts of the world and an emerging area of specialization in others.

Orofacial Pain includes etiologies of musculoskeletal, neuropathic, neurovascular and non-organic

causes. Therefore, a training program in orofacial pain must include a broad background on pain

physiology, biomechanics of the temporomandibular joints, pathology of muscle pain, neurovascular and

headache disorders and how to assess for non-organic pain.

Currently, the American Dental Association, through the Commission on Dental Accreditation has

approved 10 postgraduate programs in the United States as having met its standards for an Advanced

Educational Program in Orofacial Pain. These standards will be disused. The minimum competencies of

an orofacial pain clinician will be listed, and methods of external validations through the American Board

of Orofacial Pain examination will be explained.

Sep 24 (Sat)

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LS 1 Joint Sessions (9/24) : Luncheon Seminar, Review

Pain and itch perception in humans National Institute for Physiological Science, Department of Integrative Physiology, Laboratory of Sensori -Motor Integration 1) Ryusuke Kakigi1) I will review pain and itch perception in humans using neuroimaging methods. To record activities following A-delta and C fiber stimulation related to first and second pain, respectively, I will introduce our new method, intra-epidermal stimulation (IES). Findings showed small but significant differences between A-delta and C fiber stimulation. We developed a new itch stimulus (electrical itch stimulus). Findings using the electrical itch stimulus were similar to those following pain stimulation, but activation of the precuneus occurred only on itch stimulation. Key words： pain, itch, brain

Sep 24 (Sat)

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PL 2 Joint Sessions (9/24) : Plenary Lecture, Review

What has been learnt about the mechanistic basis of

chronic orofacial pain states: A 50-year journey

Faculties of Dentistry and Medicine, University of Toronto1) Barry J Sessle1) A wide range of chronic orofacial pain states exists, although there is disagreement or inconsistencies in the several classification schemes that have been developed to assist in their diagnosis and management. While the aetiology and pathogenesis of many of these pain states are also still unclear, many advances have been made over the past 50 years in animal and human experimental pain models that bear on possible mechanisms underlying orofacial pain and its modulation. The initial and continuing focus on acute pain processes has been extended in recent decades to encompass also models of chronic orofacial inflammatory and neuropathic pain states and their underlying mechanisms. This presentation will review this 50-year history, concentrating on recent advances that have revealed and characterised the chronic orofacial pain mechanisms. It will outline these mechanisms which include ectopic impulses generated in afferent nerve fibres following trigeminal nerve injury, peripheral sensitization of nociceptive afferent fibres that is especially evident in association with orofacial tissue trauma and inflammation, neuroplastic and phenotypic alterations in trigeminal afferent fibres and nociceptive neurons in the CNS that are expressed as central sensitisation, changes in segmental and descending modulatory influences on trigeminal nociceptive neurons in the CNS, and the involvement of non-neural (eg, glial) as well as neural cells in these processes. The presentation will also address how these mechanisms relate (or not) to the sensory-discriminative, affective and cognitive dimensions of pain and to specific orofacial pain states, and also identify important gaps in knowledge that still need to be addressed.

Sep 24 (Sat)

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AACMD workshop Demonstration Lesson of Clinical Reasoning for Diagnosis of OFP

Step by step chart for clinical diagnostic reasoning

Step1-3

Step1 Step2 Step3

Chief complaint

Medical interview Key sign and symptoms Structured medical interview form

Semantic qualifier

Differential diagnosis

Examinations for confirmation interview or tests

Tentative result

Yes or No

Must be ruled out

Common or Most

likely

Others

Step4-5

Step2 Step3 Step4 Step5

Chief complaint

Differential diagnosis

Examinations for

confirmation interview or

tests

Tentative result

Yes or No

total verification

For providing consistent and

reasonable diagnosis

Final diagnosis

Must be ruled out

Common or

Most likely

Others

Step1 Step2 Step3 Step4 Step5

Medical interview Key sign and symptoms Structured medical interview form

Semantic

qualifier

Differential

diagnosis

Examinations

for

confirmation

interview or

tests

Tentative

result

Yes

or

No

total verification For providing consistent and reasonable diagnosis

Final

diagnosis

Sep 24 (Sat)

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AACMD workshop

Demonstration Lesson of Clinical Reasoning for Diagnosis of OFP

Case 1: A 67-year-old male with severe toothache and headache

Case presenter: Masakazu Okubo

Chief Complaints: Severe left maxillary toothache and temple headache

History

A 67-year-old male presented with complaints of severe, episodic, toothache-like pain on his left

upper quadrant and continuous headache on left temple area. The toothache-like pain was

spontaneous and triggered by light touch with a finger of painful region, and movement of jaw

and chewing food made his headache worse.

The patient reported that the toothache first began 1 year ago and it was dull aching pain located

in tooth #13. He consulted family dentist and was given a diagnosed as periodontitis. Antibiotics

and NSAIDs has been prescribed was ineffective against the pain, then tooth #13 following #12

were extracted. Also, the patient reported that the pain quality was changed to episodic paroxysms

after the extraction which spread to lips, nose and lower eyelid, and since this time any jaw

movements aggravated his “toothache” and temple headache. The headache was getting worse in

severity and frequency which lasted almost all day during last 3months caused weight loss. Since

the complaints persisted, he was referred to the orofacial and head pain clinic of NUSDM-hospital

for evaluation.

Examination

Intraoral: The mouth is partially edentulous. No dental or oral source for complaints is found

clinically and radiologically. The severe toothache-like pain is triggered by light touch, and lip

and mandibular movement. Episodes are accompanied by tearing and rhinorrhea. Opening mouth

is restricted to 25 mm without deflection. Passive stretching of elevator muscles can achieve an

opening of 55mm and accompanied by pain in the left temporal area replicated familiar headache.

Lateral and protrusive movements are normal.

TMJs: Both joints are normal clinically and radiologically. The restricted condylar movement

appears to be the result of an extracapsular restriction associated with pain in the left temporalis

and masseter muscles.

Muscles: Palpable tenderness in the left temporalis and masseter muscles.

Cervical: Within normal limits

Cranial nerves: Although light touch seems to initiate the pain, there is no hyperesthesia,

hyperalgesia, or paresthesia.

Sep 24 (Sat)

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Structured medical interview form for pain patient

Please let me know the aspect of your pain according to question items.

question item the aspect of your pain

1. Location

2. Event of onset

3. Course

4. Quality

5. Intensity

6. Frequency

7. Duration

8. Temporal property

9. Precipitating or

Aggravating factor

10. Improving factor

11. Associated symptoms

12. Pain behavior

Step by step chart for clinical diagnostic reasoning

Step 1 Step 2 Step 3

Key sign and

symptoms

Semantic

qualifier

Differential

diagnosis

Test or interview

for confirmation Result

Must be

ruled

out

Common

or Most

likely

Others

Sep 24 (Sat)

- 96 -

AACMD workshop

Demonstration Lesson of Clinical Reasoning for Diagnosis of OFP

Case 2: A 51-year-old male in the right mandibular toothache.

Case presenter: Wataru Muraoka

Chief Complaint: Dull pain in the right mandibular teeth

History

A 51-year-old male presented with moderate, variable but continuous, dull pain diffusely located

in the right mandibular teeth. The patient reported that the toothache first began 6 months ago and

it was provoked by the cold wind on a railroad station platform on the way to work. When he

drunk a cup of hot tea in the company, the attack of pain improved within 20 minutes. He

consulted family dentist and was given a diagnosed as periodontitis. Some treatments were

ineffective against the pain, finally tooth #48 were extracted. After extracted tooth, the area of

pain was spread to right neck, throat and shoulder. He consulted his otolaryngologist and was

given a diagnosed as within normal limits. Since a few days ago the pain was getting worse

associated with cold sweats, he visited to the orofacial pain clinic in our municipal hospital.

There is no history of illness. He drinks 6-12 beers each week for over 30 years. He had smoked

2 packs-per-day of cigarettes for over 31 years.

Examination

Intraoral: The implant fixture embedded in the area of tooth #43 by X-ray. No dental or oral

source for complaints is found clinically and radiologically.

TMJs: Both joints are normal clinically and radiologically.

Muscles: Palpable tenderness in the right masseter muscle.

Cervical: Within normal limits

Cranial nerves: Within normal limits

Sep 24 (Sat)

- 97 -

Structured medical interview form for pain patient

Please let me know the aspect of your pain according to question items.

question item the aspect of your pain

1. Location

2. Event of onset

3. Course

4. Quality

5. Intensity

6. Frequency

7. Duration

8. Temporal property

9. Precipitating or

Aggravating factor

10. Improving factor

11. Associated symptoms

12. Pain behavior

Step by step chart for clinical diagnostic reasoning

Step 1 Step 2 Step 3

Key sign and

symptoms

Semantic

qualifier

Differential

diagnosis

Test or interview

for confirmation Result

Must be

ruled

out

Common

or Most

likely

Others

Sep 24 (Sat)

- 98 -

AACMD workshop

Demonstration Lesson of Clinical Reasoning for Diagnosis of OFP

Case 3: A33-year old woman with continuous, and paroxysmal pain

Case presenter: Koichi Wajima

Chief complaint: Triggered paroxysmal shock-like pain

History

A33-year old woman presented with mild, continuous, protracted, steady, dull, burning

pain diffusely located in the right side of the jaw and face and accompanying by sensitive

to touch.

The complaint began about 3 months ago. 2 weeks later, the mandibular left second

molar was treated restoratively with no relief, because of pain felt on the mandibular

left first and second molars. In three weeks, another paroxysmal shock-like pain was

triggered by peripheral stimulation of the right mental area on where continuous

burning pain was not felt. Soon it was felt as earache. The patient's ENT physician found

the ear to be normal. When the complaint persisted, the patient was referred to our

hospital for a TMD evaluation.

The patient reported that she had continuous, sharp, burning pain in the right side

intraoral buccal mucosa and lower jaw gum 6 months ago. It lasted 5 to 6 days and finally

disappeared without therapy.

Examination

Intraoral: The teeth and mouth are clinically and radiographically negative for cause of

pain. The right mandibular gum is hypersensitive to touch. There is subjective increase

in discomfort with all mandibular movements, but there is no identifiable masticatory

dysfunction of any kind.

Face: The auricular and buccal areas all seem to be hyperesthetic to touch.

TMJs: Both joints are clinically and radiographically normal.

Muscles: There is minor tenderness in the right masseter muscle area, which is

interpreted to be a secondary response to the chronic pain condition.

Cervical: With in normal limits.

Cranial nerves: Tissues innervated by the mandibular branch of the right trigeminal

nerve are very hyperesthetic. All other sensory and motor functions are within normal

limits.

Sep 24 (Sat)

- 99 -

Structured medical interview form for pain patient

Please let me know the aspect of your pain according to question items.

question item the aspect of your pain

1. Location

2. Event of onset

3. Course

4. Quality

5. Intensity

6. Frequency

7. Duration

8. Temporal property

9. Precipitating or

Aggravating factor

10. Improving factor

11. Associated symptoms

12. Pain behavior

Step by step chart for clinical diagnostic reasoning

Step 1 Step 2 Step 3

Key sign and

symptoms

Semantic

qualifier

Differential

diagnosis

Test or interview

for confirmation Result

Must be

ruled

out

Common

or Most

likely

Others

Sep 24 (Sat)

- 100 -

JS 1 Joint Sessions (9/24) : Plenary Symposium Brain As Therapeutic Target In Orofacial Pain, Review

Overview of Pain Pathways and their Modulation Rutgers School of Dental Medicine1) Rafael Benoliel1) In this presentation I will overview, in a simplified manner, the nociceptive pathways from the periphery to higher centers in the nervous system. We will examine the role of individual sensory afferents in persistent pain and how these signals may be modulated, inhibited or facilitated, by spinal and other mechanisms. Key words： nociception, pain, pain modulation

Sep 24 (Sat)

- 101 -

JS 2 Joint Lectures (9/24) : Plenary Symposium Brain As Therapeutic Target In Orofacial Pain, Review

The Role of Endogenous Pain Modulation in Chronic Orofacial Pain Diagnosis and Treatment

University of Rochester, Eastman Institute for Oral health1) Eli Eliav1) Pain perception is the result of peripherally generated data transmitted centrally, and modulated in the Central Nervous System (CNS) before its arrival in the cortex, and consciousness. Similar external stimuli may evoke different perceptions among different people, pending on their CNS modulation processes. Inhibitory pain modulation can be activated by a painful stimuli, isometric muscle contraction or exercise. Faulty pain modulation has been linked to various chronic pain conditions as fibromyalgia, irritable bowel syndrome, and headaches. Patients with less efficient inhibitory modulation develop more significant post surgical pain and respond better to certain groups of pain medications, suggesting that pain modulation profile can support personalized or more targeted treatment for patients suffering from chronic pain condition. In the orofacial region, impaired inhibitory pain modulation has been demonstrated in patients with posttraumatic trigeminal neuropathy. TMD patients’ data is more conflicting; some studies demonstrated impaired inhibitory pain modulation while other demonstrated limited or no alteration at all.

Further research should study the role of pain modulation in chronic orofacial pain diagnosis, treatment prognosis, as well as a potential treatment modality.

Sep 24 (Sat)

- 102 -

JS 3 Joint Sessions (9/24) : Plenary Symposium Brain As Therapeutic Target In Orofacial Pain, Review

The Experience of Pain: Cognitive, Emotional and Motivational Considerations

Rutgers University School of Dental Medicine, Center for Temporomandibular Disorders and Orofacial Pain1) Gary Heir1)

The afferent peripheral nervous system is primarily protective. Through the action of sensors, referred to as nociceptors, the body’s alarm system constantly monitors the external and internal environment for chemical, thermal or mechanical changes. Noxious input warns of a threat. The brain may interpret that threat as a danger of actual or potential tissue damage, or choose to suppress it as innocuous or non-threatening. Signals of changes arrive at the brain by the millions per second and may set off the alarm of danger in the form of actual or potential tissue damage resulting in pain, or may suppress those signals to below the level of consciousness.

Signals of a threat begin with a change that may exceed the level of comfort; allodynia and hyperalgesia. These signals activate nociceptors in the periphery resulting in action potentials. However, not all potentially noxious signals achieve recognition as a sign of impending tissue damage. The brain, through memory of past experiences, biophysical, psychological and sociocultural risk factors may make an individual pronociceptive, while others are pain resistant. Furthermore, the positive or negative context in which the signals of actual or potential tissue damage occur actives areas of the brain responsible for inhibition or facilitation of pain. The fact that noxious input is not always perceived as pain is illustrated by circumstances where the CNS can ignore extensive trauma such as sports or battlefield injuries, and conversely, amplifies the most innocuous injuries.

Pain is more than a sensory phenomenon it is also perceptual.

It’s not pain until the brain says it hurts!

This session will include a brief discussion on how the brain reacts to noxious input, how it responds by activation of areas of the brain that can influence cognition and modulation.

A discussion regarding treatment strategies will be included.

Sep 24 (Sat)

- 103 -

SIG Sessions Date: Sep 25

Place: B1F Auditorium + 7F Meeting Room

- 104 -

Orofacial Pain Special Interest Group Meeting

“Towards an Integrated Classification of OFP”

Organizing Committee:

Dr. Lene Baad Hansen, Dr. Peter Svensson, Dr. Rafael Benoliel

Time Subject Speaker Moderator 9:00-

9:15am Welcome Rafael Benoliel

9:15-

10:00am SIG1 Dental pain Maria Pigg

Koichi

Wajima

&

Koichi

Iwata

10:00-

11:00am

Orofacial Neuropathic Pain

SIG2-1 Principles of Classification Rolf-Detlef

Treede

SIG2-2 Critical Review of Trigeminal Neuropathies Eli Eliav

11:00-

12:00am

Neurovascular Headache and Facial Pain

Tai-Kum

Mao

&

Jin-Woo

Chung

SIG3-1 Neurovascular Headache Arne May

SIG3-3 Neurovascular Facial Pains? Rafael Benoliel

12:00am

-1:00pm

Muscle and TMJ

SIG4-1 Myalgia- A critical appraisal Peter Svensson

SIG4-2 Arthralgia- A critical appraisal Boudewijn

Stegenga

1:00-

2:00pm SIG Meeting Working Lunch

2:00-

3:00pm

Idiopathic Pain

Yoshiki

Imamura

&

Masakazu

Okubo

SIG5-1 Persistent Idopathic Facial Pain Charly Gaul

SIG5-2 Idiopathic oral pain Lene Baad-

Hansen

3:00-

4:00pm

OFP, TMDs, Headache and Comorbidities

SIG6-1 Facial Pain and Comorbidities William

Maixner

SIG6-2 Headache and the risk of first-onset TMD Inna Tchivileva

4:00-

5:00pm Q&A and Discussion Speakers

Rafael

Benoliel

5:00pm Closing Ceremony Rafael Benoliel

Sep 25 (Sun)

- 105 -

SIG 1 SIG Lectures (9/25) Towards an Integrated Classification of OFP Dental Pain, Review

Dental Pain Malmö University, Endodontics1), Malmö University, Orofacial Pain and Jaw Function2) Maria Pigg1,2) Perhaps the most frequent orofacial pain is dental pain, with a reported prevalence of at least 12% but possibly as high as 40% in community-dwelling adults. The lecture aims to give an overview of acute pain originating from dental or surrounding tissues and caused by dental pathology. The main focus is on endodontically related pain. Pain mechanisms, relevant terminology, and diagnostic as well as treatment considerations will be discussed from the perspective of pain in general, in particular orofacial pain, and from the perspective of optimizing dental health. Keywords:dental pain, diagnosis, endodontic pain

Sep 25 (Sun)

- 106 -

SIG 2-1 SIG Lectures (9/25) Towards an Integrated Classification of OFP

Orofacial Neuropathic Pain, Review

Orofacial Neuropathic Pain: Principles of Classification IASP President1)

Chair of Neurophysiology, Medical Faculty Mannheim, Heidelberg University, Germany2)

Rolf-Detlef Treede1,2)

In ICD10, orofacial pain syndromes are classified in the headache section of neurology, while

neuropathic pain syndromes are not grouped at all. WHO is currently finalizing ICD11 for which a

distinction between primary and secondary chronic pain syndromes including a section on neuropathic

pain have been proposed (Treede et al. 2015, Pain 156: 1003-7). Trigeminal neuralgia is an interesting

entity, since it is considered both a classical neuropathic pain syndrome and a classical headache

syndrome. A recent paper has made proposals how to better integrate trigeminal neuralgia into the

nosology of pain and headache syndromes by defining patient-reported provoked attacks as sensory

signs and reviewing the evidence for detecting neuro-vascular contacts with MRI techniques prior to

neurosurgery (Cruccu et al. 2016, Neurology 87: 220-8). In parallel, the grading system for neuropathic

pain diagnostics has been streamlined for better clinical utility (Finnerup et al. 2016, Pain 157: 1599-

606). This presentation will outline, how thee recent developments are supposed to fit together for

better classification of orofacial neuropathic pain syndromes.

Sep 25 (Sun)

- 107 -

SIG 2-2 SIG Lectures (9/25) Towards an Integrated Classification of OFP Orofacial Neuropathic Pain, Review

Painful Trigeminal Neuropathies, Diagnostic Issues

University of Rochester, Eastman Institute for Oral health1) Eli Eliav1) Painful trigeminal neuropathies (or Neuropathic Orofacial Pain) share mechanisms and features with other neuropathic pains, yet it demonstrates inimitable characteristics. The exact prevalence of trigeminal neuropathies is unknown; partially since there is no classification system that satisfies the needs of researchers and clinicians dealing with this condition. The various classification systems will be discussed with emphasis on 2 of the most challenging diagnoses: Burning Mouth Syndrome and persistent continuous neuropathic pain in the dentoalveolar region. Post Traumatic Trigeminal Neuropathy, Persistent Dento Alveolar Pain, Idiopathic Trigeminal neuropathic Pain and Atypical Odontalgia are some of the terminologies used by various classification systems (IHS, AAOP, RDC) to describe persistent continuous neuropathic orofacial pain. These terms probably describe overlapping conditions with common mechanisms. Similarly, chronic burning oral sensation is described as Burning Mouth Syndrome, Burning Mouth Disease/Disorder, Glossodynia and is often confused by symptoms induced by other conditions. A common system relying on existing classifications for neuropathic pain with emphasis on the special requirements of the trigeminal system is essential for the development of new treatment strategies and related research. Acknowledgments / Funding sources and COI: I have no conflicts of interests. I am the Editor-in-Chief of Quintessence International since 2008. Over the years I had research support from: Celgene Cellular Therapeutics, Johnson & Johnson, Ethicon, Pharmos, Neurogene and the National Institute for Oral Health (NIH). The data that will be presented in my lectures is not related to the industry research support. Some of the data may be related to NIH grant support. Keywords: Neuropathic Pain, Diagnosis

Sep 25 (Sun)

- 108 -

SIG 3-1 SIG Lectures (9/25) Towards an Integrated Classification of OFP Neurovascular Headache and Facial Pain, Review

Trigemino-Autonomic Cephalgias

University of Hamburg, Dept. of Systems Neuroscience1) Arne May1) The updated IHS classification published in 2013 summarises different headache syndromes as TACs 1. Headaches classified as TAC have two characteristics in common: short-lasting pain attacks and associated autonomic symptoms. Autonomic symptoms such as lacrimation, conjunctival injection, rhinorrhoea, nasal congestion, hyperhidrosis and eyelid oedema occur only on the ipsilateral side to the pain 2 and are only absent in 3% of the cases. According to the IHS the following syndromes are currently classified as TACs: • Episodic and chronic cluster headaches (CH) • Episodic and chronic paroxysmal hemicrania (PH) • Hemicrania continua (HC) • SUNA-syndrome (short-lasting unilateral neuralgiform headache with autonomic symptoms) • SUNCT-syndrome (short-lasting unilateral neuralgiform headache with conjunctival injection and tearing) The talk will cover classification issues and will discuss TACs as an examle. Key words： classification, TAC, Cluster headache

Sep 25 (Sun)

- 109 -

SIG 3-2 SIG Lectures (9/25) Towards an Integrated Classification of OFP

Neurovascular Headache and Facial Pain, Review

Neurovascular Facial Pain Rutgers School of Dental Medicine1) Rafael Benoliel1) The term NVOP encompasses a number of pain syndromes that present exclusively around the lower two-thirds of the face and diplay typical symptoms associated with migraine and/or trigeminal autonomic cephalgias (TACs). Based on the clinical phenotype many of these patients may indeed be diagnosed as atypically located migraines. These have been referred to in the literature as ‘lower half migraine’, ‘facial migraine’ or ‘isolated facial migraine’. Alternatively the phenotype may resemble one of the TACs. Often these have been recognized as ‘lower cluster headache’ and others as anatomical variations of the shortlasting unilateral neuralgiform headache attacks (SUNHA). Others may not be neatly classified into either of these groups and may be a new entity. These presentations have caused widespread misdiagnosis as ‘sinusitis’. ‘dental pain’, and ‘jaw problem’ depending on the exact pain location and professional consulted. Therefore a distinct classification of these seems to be essential for clinicians. Key words： migraine, cluster headache, facial pain

Sep 25 (Sun)

- 110 -

SIG 4-1 SIG Lectures (9/25) Towards an Integrated Classification of OFP

Muscle and TMJ, Review

Myalgia

Section of Orofacial Pain and Jaw Function, Aarhus University1), Dental Medicine, Karolinska Institutet2), Scandinavian Center for Orofacial Neurosciences3) Peter Svensson1,2,3) The current classification of myalgia according to Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) details myalgia, local myalgia, myofascial pain with spreading and myofascial pain with referral. The diagnoses are simply based on combinations of patient reports of pain in the masticatory structures (muscles), pain modified by function, movements or parafunction in addition to examiner-based confirmation of the pain reports, familiar pain on palpation or maximum jaw opening and specific criteria for spreading or referred pain on palpation. The sensitivity and specificity for myalgia is 0.84 / 0.95 and for myofascial pain with referral 0.85 /0.98 which is excellent. Thus DC/TMD provides clinicians and researchers with a well-tested and well-described tool to diagnose pain in the jaw-muscles. From a broader perspective these common types of pain can be viewed as primary chronic orofacial pain, i.e., without a known cause. But what do we know about the pathophysiology of jaw muscle pains? And what is so special about referred pain from jaw muscles? The talk will provide a brief review on muscle pain mechanisms and discuss implications for the diagnostic criteria. Keywords: Orofacial pain, TMD, Trigeminal

Sep 25 (Sun)

- 111 -

SIG 4-2 SIG Lectures (9/25) Towards an Integrated Classification of OFP

Muscle and TMJ, Review

Classification of orofacial pain: arthralgia

University Medical Center Groningen, Department of Oral & Maxillofacial Surgery1)

Boudewijn Stegenga1)

Classifying orofacial pains should focus on identifying the structures and systems from which pain

originate, the mechanisms that play a role in the processing of pain, and on factors that address

patient variability and the impact of the pain.

To be a useful aid in the diagnostic process in order to provide for a solid basis for subsequent

treatment, articular pain classification depends on the innervation of the structures that make up the

joints, the pain mechanisms involved and the contributing risk factors. Free nerve endings are the

major receptors that detect noxious stimulation and are mainly present in the fibrous capsule,

ligaments and periosteum. Joint pain usually indicates an inflammatory process or may indicate

neuropathic process. Besides loading, factors that contribute to the development of chronic pain

should be taken into account.

The currently used classifications for temporomandibular disorders, with the focus on articular pain,

are appraised based on these requirements.

Key words: classification, arthralgia

Sep 25 (Sun)

- 112 -

SIG 5-1 SIG Lectures (9/25) Towards an Integrated Classification of OFP

Idiopathic Pain, Review

Persistent idiopathic facial pain

Migraine and Headache Clinic Königstein, Headache and Pain1)

Charly Gaul1)

Persistent idiopathic facial pain and its subtype atypical odontalgia (persistent dento-alveolar pain

disorder) are very disabling. Often patients report delayed diagnosed and therefore missing of adequate

therapy. As both disorders are clinically insufficiently characterized diagnosis is made by exclusion. As

a consequence, a lot of patients undergo unnecessary diagnostic and therapeutic procedures which may

worsen the symptoms. Pathophysiological mechanisms resulting in the facial pain syndrome are still

enigmatic. In contrast to trigeminal neuralgia a microvascular contact is not relevant in persistent

idiopathic facial pain. Based on more recent neurophysiological findings neuropathic alteration is

suspected as an essential aspect of pathogenesis. Therapeutic strategies are mainly based on clinical

experiences and expert statements. Randomized clinical trials regarding treatment of persistent

idiopathic facial pain are missing. Based on case reports antidepressants such as amitriptyline might

be effective. Psychotherapeutic intervention seems to be effective regarding the high frequency of

psychiatric comorbidities (especially depression) in these patients and should be implemented early in

the course of disease. Invasive procedures and repeated dental treatments should be avoided.

Keywords: Persistent idiopathic facial pain, persistent dento-alveolar pain disorder, neuropathic pain

Sep 25 (Sun)

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SIG 5-2 SIG Lectures (9/25) Towards an Integrated Classification of OFP Idiopathic Pain, Review

Idiopathic oral pain

Aarhus University, Section of Orofacial Pain and Jaw Function, Department of Dentistry1), Scandinavian Center for Orofacial Neurosciences2) Lene Baad-Hansen1) This talk will focus on issues related to taxonomy and classification of those intraoral pain conditions, which often have been referred to as idiopathic or primary. Conditions presently or earlier termed atypical odontalgia (AO) or persistent dentoalveolar pain (PDAP) by different groups of researchers and burning mouth syndrome will be reviewed and discussed in terms of taxonomy, classification, putative pain mechanisms and possible overlap with other conditions such as for example painful post-traumatic trigeminal neuropathy (PTTN).

Sep 25 (Sun)

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SIG 6-1 SIG Lectures (9/25) Towards an Integrated Classification of OFP

OFP, TMDs, Headache and Comorbidities, Review

Facial Pain and Comorbidities

School of Dentistry, University of North Carolina at Chapel Hill, Center for Pain Research and Innovation1) William Maixner1)

Sep 25 (Sun)

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SIG 6-2 SIG Lectures (9/25) Towards an Integrated Classification of OFP

OFP, TMDs, Headache and Comorbidities, Review

Headache and the risk of first-onset TMD in the OPPERA study School of Dentistry, University of North Carolina at Chapel Hill, Department of Endodontics1), School of Dentistry, University of North Carolina at Chapel Hill, Center for Pain Research and

Innovation2), University at Buffalo, Department of Oral Diagnostic Sciences3), University of Florida, Department of Community Dentistry & Behavioral Science4), School of Dentistry, University of Maryland, Department of Neural and Pain Sciences5), School of Dentistry, University of Maryland, Brotman Facial Pain Center6), Duke University, Center for Translational Pain Medicine7), Duke University, Durham, Department of Anesthesiology8), School of Dentistry, University of North Carolina at Chapel Hill, Department of Dental

Ecology9) Inna Tchivileva1,2), Richard Ohrbach3), Roger Fillingim4), Joel Greenspan5,6), William Maixner7,8), Gary Slade2,9) While cross-sectional studies have demonstrated an association between headache and temporomandibular disorder (TMD), whether headache can predict the onset of TMD is unknown. We evaluated contribution of headache to the risk of developing TMD and described patterns of change in headache types over time. An initially TMD-free cohort of 2,410 persons completed quarterly questionnaires assessing TMD and headache symptoms over a median 3.0-year follow-up period. First-onset TMD was confirmed by clinical examination in 199 participants. Baseline reports of migraine (HR=1.67, 95% CI: 1.06-2.62), mixed headache (HR=4.11, 95% CI: 1.47-11.46), or headache frequency (HR=2.13, 95% CI: 1.31-3.48) predicted increased risk of developing TMD. Additionally, headache dynamics prior to the TMD onset were evaluated in a nested case-control study where 248 incident TMD cases were matched to 191 TMD-free controls. Both headache prevalence and frequency increased across the observation period among those who developed TMD but not among controls. TMD cases were more likely to experience worsening in headache type compared to controls. The clinical implication of these findings is that adequate treatment of migraine may reduce the risk for developing TMD. Acknowledgment: Finding for this study was provided by the National Institutes of Health (NIH)/National Institute of Dental and Cranial Research (NIDCR) U01-DE017018 and K12-DE022793 grants. COI Statement: Drs. Slade, Fillingim, and Maixner have equity ownership in Algynomics Inc., a company providing research services in personalized pain treatment and diagnostics. Dr. Maixner is President of the company and has equity holdings in Proove Biosciences Inc. and Orthogen. All other authors declare no financial relations that might represent a possible conflict of interest.

Keywords: orofacial pain, migraine, tension-type headache.

Sep 25 (Sun)

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Communication Time

Each presenter is required standing by the poster

• Even-numbered poster boards: 15:30-15:45 on September 24 and 12:00-12:30 on September 25, both.

• Odd-numbered poster boards: 15:45-16:00 on September 24 and 12:30-13:00 on September 25, both.

Poster Presentations

Date: Sep 24 ＆ 25

Place: 5F Room 501 + 502

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ID Poster Title and Presenters

Central Pain Mechanism EB1 An ultrastructural evidence for the expression of P2X3 receptor

in astrocytes in the rat trigeminal caudal nucleus School of Dentistry, Kyungpook National University, Department of Anatomy and

Neurobiology1) Won Mah1), Sang Man Lee1), Yi Sul Cho1), Jin Young Bae1)

EB2 Changes of insular cortical local circuits in the model rats that receive ablation of unmyelinated primary sensory fibers by capsaicin injection

School of Dentistry, Nihon University, Department of Endodontics1)

School of Dentistry, Nihon University, Department of pharmacology2),

Division of Oral and Craniomaxillofacial Research, Nihon University3)

Division of Advanced Dental Treatment, Dental Research Center, Nihon

University 4)

Shota Murayama1), Masayuki Kobayashi2,3), Bunnai Ogiso1,4)

EB3 Changes of neural activity responding to dental pulp stimulation in an inferior alveolar nerve transection model Nihon University School of Dentistry, Department of Pharmacology1)

Nihon University School of Dentistry, Department of Pediatric Dentistry2),

Nihon University School of Dentistry, Department of Orthodontics3)

Satoshi Fujita1), Risako Kato1), Hiroko Nakamura2), Mari Kaneko3),

Masayuki Kobayashi1)

EB4 Spatiotemporal profiles of cortical excitation induced by mechanical stimulation of the periodontal ligament during experimental tooth movement Nihon University School of Dentistry, Orthodontics1)

Nihon University School of Dentistry, Pharmachology2)

Mari Kaneko1,2), Eri Horinuki1,2), Noriyoshi Shimizu1), Masayuki Kobayashi2)

EB5 Peripheral interactions between cannabinoid and opioid receptor agonists in a model of inflammatory mechanical hyperalgesia University of Maryland School of Dentistry, Neural and Pain Sciences1)

Kyung Hee University, School of Dentistry, Oral Medicine2)

Q-Schick Auh2), Yang Hyun Chun2), Ohannes K Melemedjian1), Jin Y Ro1,2)

EB6 Unknown transcripts regulated by capsaicin application in rat trigeminal ganglion Matsumoto Dental Univsity Hospital1),

Matsumoto Dental University, Oral Anatomy & Neuroscience2)

Emi Ohki1), Masayo Okumura2), Osamu Tadokoro2), Eiji Kondo2)

Sep 24 & 25

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Peripheral Pain Mechanism EC1 First statistical analysis of 1,005 patients diagnosed at an

Orofacial Pain-Liaison Clinic Shizuoka City Shimizu Hospital, Department of Oral Sugery1),

Tokyo Women's Medical University Medical Center East 2)

Hiroko Ikeda1), Masako Ikawa1), Kazuo Yamada2), Aya Michibara1), Kouji Takamori1), Shinobu Ikeuchi1)

EC2 Prevalence and associated factors of orofacial pain in children and adolescents: a questionnaire study Faculty of Dentistry, Trisakti University, Prosthodontics1), Academic Center of Dentistry Amsterdam, Oral Kinesiology2) Carolina Marpaung1,2), Maurits van Selms2), Frank Lobbezoo2)

Statistics EC3 The use of pre-treatment analgesia by patients receiving root-canal-

treatment in the National Dental Practice-Based Research Network University of Minnesota, School of Dentistry, Div of TMD and Orofacial Pain1), University of Minnesota, School of Medicine, Neurology2), HealthPartners Institute for Education and Research3), University of Minnesota, School of Dentistry, Division of Endodontics4), The Dental Specialists, Private Practice5), University of Minnesota, School of Public Health, Division of Epidemiology and Community Health6) Flavia P Kapos1), Donald R Nixdorf1,2,3), Alan S Law4,5), Ruby H Nguyen6)

Case Report EC4 Orofacial pain and headache attributed to acute glaucoma

Nihon University School of Dentistry, Department of Oral Diagnostic Sciences1), Nihon University Dental Hospital, Division of Orofacial Pain Clinic2)

Mariko Ikeda1,2), Noboru Noma1,2), Yoshiki Imamura1,2), Naohiko Sekine1,2),

Ryutaro Kohashi1,2)

EC5 Facial pain induced by narrowing of the parotid duct: Two case report Nihon University School of Dentistry, Department of Oral Diagnostic Sciences1),

Tomomi Yamadera1), Akiko Okada1), Haruna Kono1), Ryutarou Kohashi1), Yoshiki Imamura1)

EC6 A study on recurrent orofacial pain after neurovascular decompression surgery for trigeminal neuralgia Nihon University School of Dentistry, Department of Oral Diagnostic Sciences1)

Haruna Kono1), Akiko Okada1), Tomomi Yamadera1), Yuka Sato1), Yoshiki Imamura1)

EC7 Orofacial pain due to Eagle’s syndrome and temporomandibular disorders: A case report Kyung Hee University School of Dentistry, Orofacial Pain and Oral Medicine1) Mi-Jin Hwang1), Yeon-Hee Lee1), Q-Schick Auh1), Jung-Pyo Hong1), Yang-Hyun Chun1), Soo-Kyung Kang1)

EC8 A case of giant-cell (temporal) arteritis that presented difficulty in diagnosis

Keio University, School of Medicine, Department of Dentistry and Maxillofacial

Surgery1),

Showa University, School of Dentistry, Department of Oral and Maxillofacial

Surgery2),

Kawasaki Municipal Ida Hospital, Department of Dentistry & Oral surgery3)

Hitoshi Sato1,2), Mariko Inoue1), Hironori Saisu1), Wataru Muraoka3), Tastuo Shirota2), Taneaki Nakagawa1), Koichi Wajima1)

Sleep

Sep 24 & 25

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EC9 Evaluation of the compliance and sleep quality of oral appliances fabricated by different materials for patients with OSAS: A pilot study Kyushu Dental University, Division of Occlusion & Maxillofacial Reconstruction1)

Eri Makihara1), Ryuichiro Miyajima1), Toshihiro Kawano1), Shogo Tsuda1),

Yoshito Shima1), Takafumi Watanabe1), Shin-ichi Masumi1)

EC10 Sleep related breathing disorders treatment of temporo-mandibular disorders patient with anterior repositioning splint: A case report Kyung Hee University School of Dentistry, Orofacial Pain and Oral Medicine1),

Tok Talk Dental Clinic2)

Jin-Suk Kim1,2), Mi-Jin Hwang1), Chi-Hyuk Ahn1), Yeon-Hee Lee1),

Q-Schick Auh1), Yang-Hyun Chun1), Jung-Pyo Hong1), Soo-Kyung Kang1)

BMS EC11 Evaluation of sleep quality using self-reported questionnaires

in patients with burning mouth syndrome School of Dentistry, Chonbuk National University, Department of Oral Medicine1),

School of Dentistry, Chonbuk National University, Institute of Oral Bioscience2)

Jung-Yong Jin1), Bong-Jik Suh1,2), Kyung-Eun Lee1,2)

EC12 Trigger point injection of the anterior belly of digastric muscle for burning mouth syndrome: A case report Kyung Hee University, School of Dentistry, Oral Medicine1)

Chi-Hyuk Ahn1), Mi-Jin Hwang1), Yeon-Hee Lee1), Soo-Kyung Kang1),

Q-Schick Auh1), Yang-Hyun Chun1), Jung-Pyo Hong1)

EC13 Spatial and temporal brain responses to noxious heat thermal stimuli in burning mouth syndrome Nihon University School of Dentistry, Department of Oral Diagnostic Sciences1)

Takahiro Shinozaki1), Ryutaro Kohashi1), Akiko Okada1), Noboru Noma1), Yoshiki Imamura1)

EC14 Heat, capsaicin sensation and TRPV1 genome SNPs in human Matsumoto Dental University, Oral Anatomy & Neuroscience1),

Matsumoto Dental Univsity Hospital2)

Nozomu Okamoto1), Masayo Okumura1), Emi Ohki2), Osamu Tadokoro1),

Eiji Kondo1)

Saliva EC15 Metabolomic profiling in saliva of healthy Malaysian adults

University of Technology MARA, Oral Medicine1),

Hospital Sultan Haji Ahmad Shah Dentistry2),

Bundaberg Base Hospital, General Medicine3),

International Medical University, School of Pharmacy4),

Bruker (Malaysia) Sdn Bhd5)

Yoshinobu Shoji1), Han Hing Lee2), Lee Chee Yen3), Chee Onn Leong4), Iven Yap4),

Chin Hoe Teh5)

EC16 Factors influencing on the xerostomia symptom in the patients with temporomandibular disorder

Kyungpook National University, Dental Hospital, Department of Oral Medicine1)

Ki-Mi Kim1), Jin-Seok Byun1), Jae-Kwang Jung1)

EC17 MRI diagnosis of 1526 TMJs: disc displacements and osteoarthrosis Osaka University Graduate School of Dentistry, Fixed Prosthodontics1)

Ryota Takaoka1), Daisuke Moriguchi1), Yukiko Koishi1), Yuki Senzaki1),

Koichiro Uno1), Shoichi Ishigaki1), Hirofumi Yatani1)

EC18 TMJ degenerative changes as an occult finding in Cone-beam CT

Sep 24 & 25

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scans for routine dental assessment Facial Pain and Sleep Center (Private Practice)1),

Columbia University2),

Aristotle University3),

University of Geneva4)

Ghabi Kaspo1), Christos Angelopoulos2)3), Stavros Kiliaridis4)

EC19 The long-term effect of anterior reposition splint for temporomandibular joint disc displacement with reduction Mackay Memorial Hospital , Department of Prosthodontics1),

Mackay Memorial Hospital , Department of Radiology2)

Huey-Yuan Wang1), Sho-Jen Cheng2)

EC20 Therapeutic mouth rehabilation training improves maximal nterincisor opening and alleviates pain in temporomandibular joint disorder patients College of Medicine, Korea University, Dept of Oral and Maxillofacial Surgery1)

Aaron Besana1), Hak-Gi Lee1), Ho Kyeong Lim1), Choi Hyok1), Eui Seok Lee1)

Tests EC21 Repeatability of measurements of surface EMG variables during

maximum voluntary contraction of the temporalis and masseter muscles in normal adults

Chonnam National University Dental Hospital, Gwangju, Korea, Department of Oral

Medicine1),

GnS International, Daejeon, Korea2),

Gwangju Health College, Gwangju, Korea, Department of Dental Hygiene3),

School of Dentistry, Chonnam National University, Gwangju, Department of Dental

Education4),

School of Dentistry, Chonnam National University, Gwangju, Korea, Department of

Oral Medicine5)

Yeong-Gwan Im1), Sang-Ho Han2), Ji-Il Park3), Hoi-Soon Lim4), Byung-Gook Kim5),

Jae-Hyung Kim5)

EC22 A novel test for assessing oral stereognosis ability - methods and preliminary results School of Dentistry, National Yang-Ming University, Department of Dentistry1),

School of Dentistry, National Yang-Ming University, Department of Dentistry2)

Kai-Hsiang Chuang1), Chia-shu Lin2)

EC23 Analyzing relationship between jaw stiffness and heart rate variability

Keio University, Department of Dentistry and Oral Surgery1)

Kawasaki Municipal Ida Hosital Department of Dentistry and Oral Surgery 2)

Showa University Department of dentistry and oral surgery 3)

Kanako Munakata1) Wataru Muraoka1,2) Hitoshi Sato3) Hironori Saisu1)

Sho Usuda1) Mariko Inoue1) Taneaki Nakagawa1) Koichi Wajima1)

EC24 Validation of the Indonesian version of the oral health impact profile for TMDs (OHIP-TMDs-ID) Prosthodontic Universitas Indonesia1),

Vivi Wira1), Laura S Himawan1), Ira Tanti1), Nina Ariani1)

Sep 24 & 25

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EB1 Poster Presentations (9/24 &25) Central Pain Mechanism

An ultrastructural evidence for the expression of P2X3 receptor in astrocytes in the rat trigeminal caudal nucleus

School of Dentistry, Kyungpook National University, Department of Anatomy and Neurobiology1) Won Mah1), Sang Man Lee1), Yi Sul Cho1), Jin Young Bae1) P2X3 is a nonselective cation channel that is implicated in chronic pain. Its expression has been presumed to be confined to nociceptive primary afferent terminals. However, little is known about the expression pattern of P2X3 in trigeminal sensory nucleus. To address this, we investigated the expression of P2X3 in the trigeminal caudal nucleus (Vc) by light- and electron-microscopic immunohistochemistry. Immunoreactivity of P2X3 was consistently observed in somata and processes of astrocytes as well as dendrites and central axon terminals in Vc. Astrocytic P2X3 was functional as the application of α,β-meATP increased Cl- current of the astrocytes in the Vc, which was reversed by A-317491. In the Vc of CCI-ION rats, the P2X3 expression was increased in the astrocytic small processes, suggesting the involvement of astrocytic P2X3 receptor in CCI-ION induced central sensitization. The increased expression of astrocytic P2X3 in CCI-ION rats was reduced by MPEP which ameliorated CCI-ION induced mechanical allodynia. These results suggest that nerve injury increases the expression of astrocytic P2X3 by mGluR5 activation, the process of which might be associated with the neuropathic chronic pain. Keywords: Trigeminal, P2X3, Astrocyte

EB2 Poster Presentations (9/24 &25) Central Pain Mechanism Changes of insular cortical local circuits in the model rats that receive ablation

of unmyelinated primary sensory fibers by capsaicin injection School of Dentistry, Nihon University, Department of Endodontics1)

School of Dentistry, Nihon University, Department of pharmacology2),

Division of Oral and Craniomaxillofacial Research, Nihon University3)

Division of Advanced Dental Treatment, Dental Research Center, Nihon University 4)

Shota Murayama1), Masayuki Kobayashi2,3), Bunnai Ogiso1,4) Objective: Nociceptive signals in the orofacial region are conveyed to the secondary sensory neurons in the spinal trigeminal nucleus via myelinated Aδ and unmyelinated C fibers. Materials & Methods: The model rat whose unmyelinated C fibers are partially ablated by capsaicin (CAP, 100 mg/kg) injection 1-2 days after birth is quite useful to discriminate Aδ and C fiber-mediated nociceptive information in the central nervous system. Whole-cell patch-clamp recording from layers II/III pyramidal (Pyr) and fast-spiking neurons (FS) in the insular cortical slice preparation were obtained 20-25 days after CAP treatment. Miniature IPSCs (mIPSCs) were recorded under application of CNQX (20 μM) and tetrodotoxin (1 μM). Results: Both Pyr and FS of the CAP-treated rats showed a suppression of the amplitude of mIPSCs without changing their frequency. Our V-M analysis suggests that quantal size of GABA release is smaller in the CAP model in comparison to that of control. [Conclusion] These results suggest ablation of unmyelinated primary sensory fibers suppresses GABAergic inputs to Pyr and FS in the insular cortex. Grant: JSPS KAKENHI Grant Numbers 16K15783 and 16H05507. COI: None declared. Keywords: ablation of unmyelinated C fiber, Insular cortex, Whole-cell patch-clamp recording

Sep 24 & 25

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EB3 Poster Presentations (9/24 &25) Central Pain Mechanism

Changes of neural activity responding to dental pulp stimulation in an inferior alveolar nerve transection model

Nihon University School of Dentistry, Department of Pharmacology1)

Nihon University School of Dentistry, Department of Pediatric Dentistry2),

Nihon University School of Dentistry, Department of Orthodontics3)

Satoshi Fujita1), Risako Kato1), Hiroko Nakamura2), Mari Kaneko3),

Masayuki Kobayashi1) Objective: It is not fully understood how the neural activity in the cortex is changed in neuropathic pain model animals. To explore the neural activity in inferior alveolar nerve transection (IAN) rats, we performed calcium imaging by a two-photon microscopy. Materials & Methods: Five-week old vesicular GABA transporter Venus transgenic rats received an IAN. One week later, the rats received a small craniotomy on the dorsal part of insular cortex under urethane anesthesia. After injections of a calcium indicator, Oregon Green 488 BAPTA-1, responses to electrical stimulation of the maxillary molar pulp were recorded and compared to responses in naive rats. Results: The number of responding neurons in IAN rats increased in both excitatory and inhibitory neurons. In IAN rats, the duration of calcium responses increased in excitatory neurons, although the amplitude of calcium responses increased in inhibitory neuron. Conclusion: These results suggest that inhibition by inhibitory neurons decreased in IAN rats. Funding Source: KAKENHI (16K11491, 16K15783, and 16H05507); MEXT-Supported Program for the Strategic Research Foundation at Private Universities, 2013-2017 COI: None declared.

Keywords: Insular cortex, calcium imaging, toothache

EB4 Poster Presentations (9/24 &25) Central Pain Mechanism

Spatiotemporal profiles of cortical excitation induced by mechanical stimulation of the periodontal ligament

during experimental tooth movement Nihon University School of Dentistry, Orthodontics1)

Nihon University School of Dentistry, Pharmachology2)

Mari Kaneko1,2), Eri Horinuki1,2), Noriyoshi Shimizu1), Masayuki Kobayashi2) Objective: We performed optical imaging to identify the cortical regions responding to mechanical stimulation of the maxillary first molar periodontal ligament (PDL), and examined whether experimental tooth movement (ETM) changes the cortical responses to mechanical stimulation. Materials & Methods: Orthodontic force was applied using a closed-coil spring ligated between the maxillary first molar and incisors. Optical imaging was performed 1 day, 3 days, and 7 days after ETM. Results: Mechanical stimulation of PDL evoked excitation in the primary, secondary somatosensory cortex, and in the insular oral region. One day after ETM, the cortical responses were significantly increased. The facilitation of responses gradually recovered to the control level 3 to 7 days after ETM. Conclusion: Although the initially activated regions by mechanical stimulation were different from those responding to electrical stimulation, the temporal profile of ETM-induced facilitative response to mechanical stimulation was similar to those of electrical stimulation. These findings support our hypothesis that ETM does not induce long-lasting plastic changes in the cortex. Funding Source and COI: KAKENHI Grant Number 16K15873 and 16H05507. Keywords: Mechanical Stimulation, Neuro physiology, cortex

Sep 24 & 25

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EB5 Poster Presentations (9/24 &25) Peripheral Pain Mechanism

Peripheral interactions between cannabinoid and opioid receptor agonists in a model of inflammatory mechanical hyperalgesia

University of Maryland School of Dentistry, Neural and Pain Sciences1)

Kyung Hee University, School of Dentistry, Oral Medicine2)

Q-Schick Auh2), Yang Hyun Chun2), Ohannes K Melemedjian1), Jin Y Ro1,2) Objective: We examined whether combinations of opioid and cannabinoid receptor agonists directed at the injured site would enhance therapeutic effectiveness. Materaials & Methods: DAMGO (1g ~ 1mg) or ACPA (1g ~ 2mg) were administered into the inflamed paw when mechanical hyperalgesia was fully developed. When administered individually, DAMGO and ACPA dose-dependently reversed the mechanical hyperalgesia. Results: DAMGO displayed a lower ED50 value (57.4 ± 2.49 g) than ACPA (111.6 ± 2.18 g), but ACPA produced longer lasting antihyperalgesic effects. Combinations of DAMGO and ACPA also dose-dependently attenuated mechanical hyperalgesia, but the antihyperalgesic effects were partial and transient even at high doses. Using isobolographic analysis, we determined that combined treatment with DAMGO and ACPA produced sub-additive effects with the observed ED50 of 191.8 ± 2.53 g. Conclusion: Our findings showed that MOR and CB1 agonists directed at the inflamed site effectively attenuate mechanical hyperalgesia when administered individually, but exert opposing effects when administered together. The sub-additive interactions between the two classes of drugs at the inflamed site suggest distinct mechanisms unique to peripheral nociceptors or inflamed tissue. Keywords: DAMGO, ACPA, mu opioid receptor

EB6 Poster Presentations (9/24 &25) Peripheral Pain Mechanism

Unknown transcripts regulated by capsaicin application

in rat trigeminal ganglion Matsumoto Dental Univsity Hospital1),

Matsumoto Dental University, Oral Anatomy & Neuroscience2)

Emi Ohki1), Masayo Okumura2), Osamu Tadokoro2), Eiji Kondo2) Objective: Capsaicin application is a nociceptive stimulus for sensory neurons, and the activation of neurons can alter gene expression. The aim of this investigation is to examine the relationship between capsaicin stimulus and transcripts. Methods: Microarray analysis has shown many genes to be up-regulated or down-regulated after capsaicin application including both well-defined genes and unidentified sequences, and we focused on the unidentified sequences. Capsaicin was applied to the whisker pads of rats and total RNAs were extracted from the trigeminal ganglia. The expressions of the target transcripts were confirmed by PCR, and up-regulation after capsaicin application was examined by real-time PCR. Results: Microarray analysis showed 48 up-regulated transcripts (24 transcripts from the intron region of identified genes, and the other 24 transcripts from the long inter-gene region ), and only 1 transcript was down-regulated, after capsaicin application. 6 transcripts from intron regions were confirmed to be up-regulated, which were transcripts from the intron regions of rat Tra2a, Cadm1, LOC685917, Gnas, RBm39, Ccln1. Conclusions: Gene expression alterations induced by capsaicin application included many transcripts from the intron region or inter-gene region. Keywords: capsaicin, trigeminal ganglion, gene expression

Sep 24 & 25

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EC1 Poster Presentations (9/24 &25) Peripheral Pain Mechanism

First statistical analysis of 1,005 patients diagnosed at an Orofacial Pain-Liaison Clinic

Shizuoka City Shimizu Hospital, Department of Oral Sugery1),

Tokyo Women's Medical University Medical Center East 2)

Hiroko Ikeda1), Masako Ikawa1), Kazuo Yamada2), Aya Michibara1), Kouji Takamori1), Shinobu Ikeuchi1)

Purpose: To determine the clinical characteristics of patients who attended the Orofacial Pain-Liaison Clinic at Shizuoka City Shimizu Hospital for the first time. Methods: We analyzed the age distribution, male-to-female ratio, and diagnoses of 1,005 patients who initially attended the clinic between January 2009 and March 2016. Results: The patients comprised 204 males and 801 females who ranged in age from 10 to 92 years (average, 56.7 years; mode, 61.0 years). Among them, 73.5% did not have structural disorders and 47.6% had idiopathic oro-facial pain such as persistent idiopathic facial pain (PIFP; 28.0%) and burning mouth syndrome (BMS; 19.6%). A total of 83.0% of patients with PIFP had a chief complaint of odontalgia, and 57.0% of patients with BMS had glossodynia. The 25.9% of patients had somatization of a mental disorder manifesting as orofacial pain. The remaining 24.2% of patients had physical disorders. Conclusion: Most patients attending the clinic had diseases beyond the scope of standard dental knowledge and PIFP, BMS, and the somatization of mental disorders are quite prevalent. Keywords: capsaicin, trigeminal ganglion, gene expression

EC2 Poster Presentations (9/24 &25) Statistics

Prevalence and associated factors of orofacial pain in children and adolescents: a questionnaire study

Faculty of Dentistry, Trisakti University, Prosthodontics1), Academic Center of Dentistry Amsterdam, Oral Kinesiology2) Carolina Marpaung1,2), Maurits van Selms2), Frank Lobbezoo2) Introduction: A high prevalence of orofacial pain found among children and adolescents has raised concerns to the community, and knowledge was scarce. Biopsychosocial model approach was used in this study to gain information on its prevalence and risk factors among Indonesian children and adolescents. Materials and Methods: The presence of orofacial pain was assessed from parental and self-reported questionnaire. Demographical, bio-behavioral, and psychological aspects were evaluated for their roles as predictors. Logistic regression analysis was used to identify associations between predictor variables and TMD pain. Results: Among 1200 participants, 22.8% of children, and 36.9% of adolescents had orofacial pain complaints. Logistic regression model identified that oral habit (OR:1.87), Multiple pain (OR:2.27), and psychological problems (OR:2.31) were associated in children, while multiple pain (OR:1.51), sleep problem (OR:1.69), Alcohol consumption (OR:1.87), sleep bruxism (OR:1.95), and 3-4 psychological problems (OR:3.42) were associated with orofacial pain complaint in adolescents Conclusions: Orofacial pain complaints were common among Indonesian children and adolescent. Bio-behavioral and psychological aspects played an important role in pain existence among children and adolescents, and need further explorations. Acknowledgements and/or Funding Source: None Keywords: Orofacial pain, children, adolescents

Sep 24 & 25

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EC3 Poster Presentations (9/24 &25) Statistics The use of pre-treatment analgesia by patients receiving root-canal-treatment

in the National Dental Practice-Based Research Network University of Minnesota, School of Dentistry, Division of TMD and Orofacial Pain1), University of Minnesota, School of Medicine, Neurology2), HealthPartners Institute for Education and Research3), University of Minnesota, School of Dentistry, Division of Endodontics4), The Dental Specialists, Private Practice5), University of Minnesota, School of Public Health, Division of Epidemiology and Community Health6) Flavia P Kapos1), Donald R Nixdorf1,2,3), Alan S Law4,5), Ruby H Nguyen6) Objective: The majority of patients (65%) report moderate-to-severe pain within 1 week after initial orthograde root-canal treatment (RCT). Pre-treatment analgesia (PA) has been suggested to reduce post-operative pain. This observational study described the types of PA, proportion of use, and its determinants in patients receiving RCT. Methods: 62 dentists enrolled 708 RCT patients in the U.S. and Scandinavia; both dentists and patients completed questionnaires. PA was defined as analgesics or anxiolytics used by patients within 8 hours before and during RCT visits. Adjusted odds ratios identified determinants of PA use. Results: 17% of patients received some form of PA. The most common types were non-opioids (6%) and nitrous oxide (6%). Patients who were significantly more likely to use PA had higher education (adj. OR=1.4 every category increase, 95% CI: 1.4-1.8) and reported pain on biting (adj. OR=2.0, 95% CI: 1.3-3.2). Conclusion: While most RCT patients experienced moderate-to-severe post-operative pain, only a minority (17%) received some form of PA; suggesting PA may be underused. Research on pre-operative risk factors and post-operative pain treatments in RCT patients is needed. Acknowledgments/Funding Source: UMN GPS Alliance International Travel Grant, NIH grants K12-RR023247, U01-DE016746, U01-DE016747, and U19-DE022516. one Keywords: Analgesia, Pain, Postoperative, Root Canal Therapy

EC4 Poster Presentations (9/24 &25) Case Report

Orofacial pain and headache attributed to acute glaucoma Nihon University School of Dentistry, Department of Oral Diagnostic Sciences1), Nihon University Dental Hospital, Division of Orofacial Pain Clinic2) Mariko Ikeda1,2), Noboru Noma1,2), Yoshiki Imamura1,2), Naohiko Sekine1,2),Ryutaro Kohashi1,2) Objective: we experienced a rare case of acute glaucoma with orofacial pain Case: A 77-year-old female patient presented to the Orofacial Pain Clinic for the treatment of a left side facial pain and headache. Extraoral examination revealed conjunctival injection, lacrimation and eyelid edema in the left eye. Magnetic resonance imaging (MRI) and computed tomography (CT) were performed, and results were negative for any intra or extra-cranial pathologies. A diagnosis consistent with possible trigeminal autonomic cephalagias was considered, and indomethacin was prescribed. However, indomethacin did not reduce headache. She was referred to an ophthalmologist because of complaining visual disturbances (bleariness). Intraocular pressure was 13 mm Hg in the right eye and 67 mm Hg (normal value: 10-21mm Hg) in the left. Acute glaucoma was diagnosed. Although she has been treated with eye drops, glaucoma and cataract surgery procedures were performed since intraocular pressure elevated gradually. Results: She became completely free of symptoms with 13mm Hg of intraocular pressure in the left eye. Conclusion: Dentists need to consult appropriate medical specialists or refer such patients for specialized care. Acknowledgements/ Funding Source and COI: None Keywords: orofacial pain, headache, glaucoma

Sep 24 & 25

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EC5 Poster Presentations (9/24 &25) Case Report

Facial pain induced by narrowing of the parotid duct: Two case report

Nihon University School of Dentistry, Department of Oral Diagnostic Sciences1),

Tomomi Yamadera1), Akiko Okada1), Haruna Kono1), Ryutarou Kohashi1), Yoshiki Imamura1) Objective: Both parotid gland stenosis and trigeminal neuralgia cause a transient pain at the beginning of eating. These similar symptoms of diseases sometimes lead to misdiagnosis. We aim to report two cases of parotid gland stenosis confused with some diseases such as trigeminal neuralgia. Case: A 45-year-old and a 41-year-old men visited our department with pain from front of the ear to lower jaw at the beginning of eating. They could not find any specific findings in the clinical examination Results: Carbamazepine did not have any effect on these patients. It was difficult to inject the contrast agents to parotid ducts Conclusion: The results suggest that the parotid duct was expanded by insertion of the catheters for ptyalography Acknowledgements/ Funding Source and COI: None Key Words: Trigeminal neuralgia, Parotid duct stenosis, Orofacial pain

EC6 Poster Presentations (9/24 &25) Case Report

A study on recurrent orofacial pain after neurovascular decompression surgery for trigeminal neuralgia

Nihon University School of Dentistry, Department of Oral Diagnostic Sciences1)

Haruna Kono1), Akiko Okada1), Tomomi Yamadera1), Yuka Sato1), Yoshiki Imamura1) Objective: More than 90 % of trigeminal neuralgia is curable by neurovascular decompression for a long term. However, trigeminal neuralgia-like pain may occur after surgery, and is generally difficult to manage. The purpose of this study is to characterize the cases of recurrent orofacial pain after surgery. Materials & Methods: A total of 6 patients who visited our department had a recurrent orofacial pain after receiving a microvascular decompression surgery (MVD).We investigated their age, type of pain, reasons of having the surgery, recurrence time and subsequent pain management. Results: The reasons patients had surgery were mostly drug resistance. Natures of pain were transient haphalgesia, occlusal pain, and burning pain. Management method of the pain after MVD included medication such as carbamazepine and pregabalin and trigeminal nerve blocks. Conclusion: Recurrent orofacial pain after MVD is atypical and requires a pain management that is specific to the case. Acknowledgements/ Funding Source and COI: None Keyword: trigeminal neuralgia, MVD, Postoperative pain

Sep 24 & 25

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EC7 Poster Presentations (9/24 &25) Case Report Orofacial pain due to Eagle’s syndrome and temporomandibular disorders:

A case report Kyung Hee University School of Dentistry, Orofacial Pain and Oral Medicine1) Mi-Jin Hwang1), Yeon-Hee Lee1), Q-Schick Auh1), Jung-Pyo Hong1), Yang-Hyun Chun1), Soo-Kyung Kang1) Objective: Since the orofacial pain due to eagle’s syndrome (ES) is non-specific and overlaps with the pain due to temporomandibular disorders (TMD), it is difficult to separate the patient’s symptoms to each diagnosis. This case report aims to describe the treatment of the patient with orofacial pain due to ES and TMD concurrently. Case results: A 54-year-old female patient who presented with a neck pain and stiffness of right temporomandibular joint (TMJ) when opening the jaw, tinnitus, and headache visited our clinic. On the clinical and radiological examination, the patient was diagnosed with myofascial pain in the masticatory muscles and arthritis in both TMJs according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). On cone-beam computerized tomography (CBCT), elongated styloid processes were identified. The physical therapy, medication, and stabilizing splint treatment were performed. Subsequently, the calcified stylohyoid ligament on right side was surgically removed and excisional biopsy was performed. The result diagnosis was heterotopic bone formation. Conclusion: Multifactorial approach is crucial for the patient with TMD and ES concurrently. Under the conservative treatment, additional surgical approach can be considered for quick pain release. . Acknowledgements & Funding Source and COI : none Keywordss: Eagle’s syndrome, orofacial pain, TMD

EC8 Poster Presentations (9/24 &25) Case Report

A case of giant-cell (temporal) arteritis that presented difficulty in diagnosis

Keio University, School of Medicine, Department of Dentistry and Maxillofacial Surgery1),

Showa University, School of Dentistry, Department of Oral and Maxillofacial Surgery2),

Kawasaki Municipal Ida Hospital, Department of Dentistry & Oral surgery3)

Hitoshi Sato1,2), Mariko Inoue1), Hironori Saisu1), Wataru Muraoka3), Tastuo Shirota2), Taneaki Nakagawa1), Koichi Wajima1)

Objective: Giant-cell arteritis (GCA) which is commonly known as temporal arteritis is a chronic granulomatous vasculitis, and it affects predominantly extracranial branches of the carotid artery. We describe a case of GCA which had no abnormality of the superficial temporal artery but the patient had jaw claudication. Case: A 78-year-old man was referred to our department with facial pain associated with mastication. He had been hospitalized to investigate an unidentified fever in department of rheumatology. A blood test revealed an increased C-reactive protein level and a high erythrocyte sedimentation rate (70 mm/h). Although ultrasonography and CT angiography of the temporal region showed no findings specific for GCA, based on the pain characteristics we determined that it arose from jaw claudication. Results: Histopathological examination by temporal artery biopsy showed intima thickening with disruption of elastic lamina, and were consequently diagnosed GCA. Conclusion: We describe a case of GCA that presented difficulty in diagnosis. Acknowledgments: We wish to thank Dr. Hiroya Tamai for his efforts in the correct differential diagnosis. Conflict of interest: None of us have any conflict of interests to declare. Keywords: Giant cell arteritis, jaw claudication, temporomandibular disorder

Sep 24 & 25

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EC9 Poster Presentations (9/24 &25) Sleep

Evaluation of the compliance and sleep quality of oral appliances fabricated by different materials

for patients with OSAS: A pilot study Kyushu Dental University, Division of Occlusion & Maxillofacial Reconstruction1)

Eri Makihara1), Ryuichiro Miyajima1), Toshihiro Kawano1), Shogo Tsuda1), Yoshito Shima1), Takafumi Watanabe1), Shin-ichi Masumi1) Objective: The purpose of this study was to improve oral appliances (OA) to achieve high-level compliance in patients with OSAS. Materials & Methods: Two types of OAs were fabricated based on the same therapeutic jaw position for four patients. Patient responses regarding sensation and sleeping conditions when each appliance was fitted were compared. Results: Discomfort was greater for the soft-type appliance than for the hard-type appliance in the following patient-assessed variables: Ill-fitting; Difficulty closing lips; and Difficulty sleeping. Conversely, discomfort was greater for the hard-type appliance in the following variables: Difficulty wearing; and Teeth pain. Only one patient exhibited a complete match between results of sleep data and the type of OA that the patient wanted to continue using. Conclusions: This study was conducted on a small population of four patients, so future research needs to target more patients and to collect sleep data prior to fitting the OA in order to clarify the properties of each of these two types of experimental OAs. Acknowledgments: None Funding Source and COI: None of the authors have any conflicts of interest to declare. Keywords: obstructive sleep apnea syndrome, oral appliance, sleep conditions

EC10 Poster Presentations (9/24 &25) Sleep

Sleep related breathing disorders treatment of temporomandibular disorders patient

with anterior repositioning splint: A case report Kyung Hee University School of Dentistry, Orofacial Pain and Oral Medicine1),

Tok Talk Dental Clinic2)

Jin-Suk Kim1,2), Mi-Jin Hwang1), Chi-Hyuk Ahn1), Yeon-Hee Lee1), Q-Schick Auh1), Yang-Hyun Chun1), Jung-Pyo Hong1), Soo-Kyung Kang1) Objective: Sleep related breathing disorders (SRBD) patients with temporomandibular disorders (TMD) may have difficulties using mandibular advancement devices (MAD). In this case, anterior repositioning splint (ARS) could be an alternative to MAD, so we would like to report a case of snoring patient who had chronic TMD. Case Results: A 64-year-old male patient who had been treated for chronic TMD was complained of snoring and arousal during sleep. He told that in spite of received uvulopalatopharyngoplasty about 10 years ago, he has still snoring. He was diagnosed as Axis I: Group IIIb Osteoarthritis on left temporomandibular joint (TMJ) and Group IIIc Osteoarthrosis on right TMJ by Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), and had lost right mandibular second molar. He was evaluated about sleep quality by sleep questionnaires (STOP-BANG, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index) and provisionally diagnosed to SRBD. Due to his TMJs condition, he could not use the MAD, so we applied an ARS (maxillar) to him. He improved the quality of sleep and TMJ pain after using ARS. Conclusion: It could be considered to use of ARS to SRBD patients with TMD, instead of MAD. Acknowledgments /Funding Source and COI: None Keywords: Temporomandibular disorders, Anterior repositioning splint, Sleep related breathing disorders

Sep 24 & 25

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EC11 Poster Presentations (9/24 &25) BMS

Evaluation of sleep quality using self-reported questionnaires in patients with burning mouth syndrome

School of Dentistry, Chonbuk National University, Department of Oral Medicine1), School of Dentistry, Chonbuk National University, Institute of Oral Bioscience2) Jung-Yong Jin1), Bong-Jik Suh1,2), Kyung-Eun Lee1,2) Purpose: Burning mouth syndrome (BMS) is ambiguous and enigmatic oral condition. Sleep disturbance is one of the most prevalent complaints of patients with chronic pain. Aim of this study was to evaluate sleep quality in BMS patients. Methods: A total of thirty BMS patients and thirty healthy control subjects were investigated from August 2015 to July 2016. Self-reported measures of sleep quality were conducted using Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). Results: BMS patients and control subjects were classified into good sleeper and poor sleeper according to cutoff score recommended in ESS and PSQI. Poor sleepers in BMS patients were more than those in control subjects in both ESS and PSQI. BMS patients also showed statistically significant poor sleep quality compared with control subjects in both ESS (p=0.012) and PSQI (p=0.038). Conclusions: The results support that BMS patients exhibited significantly more sleep disturbance compared with the control group. Therefore, we suggest that evaluation of sleep disturbance should be encouraged in management of BMS.patients. Keywords: BMS, sleep quality

EC12 Poster Presentations (9/24 &25) BMS

Trigger point injection of the anterior belly of digastric muscle for burning mouth syndrome: A case report

Kyung Hee University, School of Dentistry, Oral Medicine1)

Chi-Hyuk Ahn1), Mi-Jin Hwang1), Yeon-Hee Lee1), Soo-Kyung Kang1), Q-Schick Auh1), Yang-Hyun Chun1), Jung-Pyo Hong1) Objective: Burning mouth syndrome (BMS) is a symptom of burning sensations in oral cavity and alterations of taste perception. We present a case report of trigger point injection of anterior belly of digastric muscle as a treatment for BMS. Case results: A 66-year-old healthy female complained of 6 month of burning sensation in the anterior tongue and lower lip mucosa. Her visual analog scale (VAS) was 9.0. Despite the severity of pain, All medical trials to alleviate pain were failed. After that, Physical examination revealed myofascial pain of anterior belly of digastric muscle according to the Research Diagnostic Criteria for TMD (RDC/TMD). Trigger point injection with local anesthetic (1% lidocaine, 0.2 mL) was bilaterally performed in the standard manner using a 23 gauge needle. Injection was repeated weekly for two times. After the first and second injections, VAS was 4.8, 2.9 respectively. Conclusion: Trigger point injection of anterior belly of digastric muscle may have a role in treating BMS. Further studies are needed to elucidate the understanding mechanical bases for interactions between referred pain and BMS. Keywords: burning mouth syndrome, trigger point injection, myofascial pain

Sep 24 & 25

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EC13 Poster Presentations (9/24 &25) BMS

Spatial and temporal brain responses to noxious heat thermal stimuli in burning mouth syndrome

Nihon University School of Dentistry, Department of Oral Diagnostic Sciences1)

Takahiro Shinozaki1), Ryutaro Kohashi1), Akiko Okada1), Noboru Noma1), Yoshiki Imamura1) Objective: The pathophysiology of burning mouth syndrome (BMS) is not clearly understood, central and peripheral neuropathic mechanisms are thought to be involved. We compared brain response to noxious heat stimuli to investigate primary BMS condition. Methods: 16 right-handed women younger than 65 years old with a diagnosis of BMS and 15 right-handed sex and age-matched healthy controls participated. Thermal stimulation was applied with a computer controlled thermal generator. A session included a complete thermal cycle that comprised four of these sequences of baseline, warm, baseline, and noxious heat.The thermal cycle was repeated four times. Conclusions: An fMRI study with a psychophysical test of BMS patients and pain-free controls revealed pathophysiological changes in brain activity in BMS patients. Specific brain responses in BMS patients to repetition (1st to 4th) of thermal sequence probably reflect BMS pathophysiology. Repetitive tonic heat stimulus revealed involvement of both the central and peripheral nervous systems. The cingulate cortex (ACC, MCC, and PCC) appeared to be specifically involved in trigeminal pain processing/modulation in BMS patients.

Funding Source: Grants-in-Aid for Scientific Research (24593065, 15K11326)

COI: None

Keywords: BMS, fMRI, pain

EC14 Poster Presentations (9/24 &25) BMS

Heat, capsaicin sensation and TRPV1 genome SNPs in human Matsumoto Dental University, Oral Anatomy & Neuroscience1),

Matsumoto Dental Univsity Hospital2)

Nozomu Okamoto1), Masayo Okumura1), Emi Ohki2), Osamu Tadokoro1), Eiji Kondo1) Objective: TRPV1 is a receptor for both heat sensation and hot taste sensation. However, awareness of these sensations obviously differs from person to person. The aim of this investigation is to elucidate the personal differences of heat and capsaicin sensations, and their relationships with TRPV1 genome sequences. Methods: Thirty healthy adults participated in this investigation including questionnaire, hot plate test for heat sensation, capsaicin test for oral capsaicin sensation, and genome sequence analysis of TRPV1 gene. Results: Few subjects showed an especially high threshold for the heat sensation, for the capsaicin sensation, or for both. Genome analysis revealed many 63 SNPs in their TRPV1 gene, and 6 SNPs were significantly related to the heat sensation. In particular, M315I showed a significant difference. Isoleucine type subjects were more sensitive to heat than Methionine type subjects. Conclusions: Human heat sensation and capsaicin sensation did not show a clear correlation. Many SNPs were detected in the human TRPV1 gene, and some of them were significantly related to heat sensation but not to capsaicin sensation. Keywords: Capsaicin, TRPV1, SNP

Sep 24 & 25

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EC15 Poster Presentations (9/24 &25) Saliva

Metabolomic profiling in saliva of healthy Malaysian adults University of Technology MARA, Oral Medicine1), Hospital Sultan Haji Ahmad Shah Dentistry2), Bundaberg Base Hospital, General Medicine3), International Medical University, School of Pharmacy4), Bruker (Malaysia) Sdn Bhd5) Yoshinobu Shoji1), Han Hing Lee2), Lee Chee Yen3), Chee Onn Leong4), Iven Yap4), Chin Hoe Teh5) Objectives: Metabolomics provide an analysis of changing metabolite levels in biological samples. Salivary metabolomics have been applied to a number of important diseases such as Crohn’s disease, cancer and genetic inborn errors of metabolism. The aim of this study is to assess the metabolomic profile of saliva in healthy Malaysian adults. Materials & Methods: Saliva samples were collected from 50 healthy individuals (30 female and 20 male), aged 12 to 64 (median age of 38 years). We measured the salivary metabolite by using nuclear magnetic resonance (NMR) spectrometer, Bruker Avance III operating at 500 MHz. Multivariate data analysis was used for NMR data analysis. Results: We have identified a number of key metabolites such as Proprionate, Acetate, Alanine, Lactic acid, Tyrosine, Phenylalanine and Formate. There was no significant inter-individual and inter-sex variations of the key metabolites observed among the samples. Conclusion: The metabolomic profile of saliva in healthy Malaysian adults could be used to identify new biomarker for early diagnosis of some specific diseases. Acknowledgements: A part of this study was supported by the grant IMU #917/2012. Keywords: Metabolomics, Saliva, Biomarker

EC16 Poster Presentations (9/24 &25) Saliva

Factors influencing on the xerostomia symptom in the patients with temporomandibular disorder

Kyungpook National University, Dental Hospital, Department of Oral Medicine1)

Ki-Mi Kim1), Jin-Seok Byun1), Jae-Kwang Jung1) Objective: To investigate factors influencing the xerostomia symptom in the patients with

temporomandibular disorder

Material & Methods: Eighty-six participants over the age of twenty were randomly enrolled from patients

with tempromandibualar disorder (TMD)-related symptoms. Revised Symptom Checklist (SCL-90R),

subjective dry mouth symptom questionnaire were filled out and unstimulated salivary flow rate (USFR),

and oral moisture were measured.

Results: The patients who had above the mean of the TMD pain VAS had significantly higher scores on the

stress VAS (p=0.003), the sum of the VAS of six questions to evaluate the degree of dry mouth (Sub-sum6)

(p=0.000) and somatization (SOM) in SCL-90R (p=0.023) than the opposite group. The patients who had

pain for more than three months(chronic group) had significantly higher scores on TMD pain VAS (p=0.002),

Sub-sum6 (p=0.010) and SOM (p=0.013) than the acute group. The patients who had above the mean of the

stress VAS had significantly higher scores on the TMD pain VAS (p=0.013), Sub-sum6 (p=0.009), all SCL-

90R items except Phobia.

Conclusion: The severity, the duration of TMD pain and stress significantly affected the subjective dry

mouth symptoms, but did not significantly affect the unstimulated salivary flow rate and oral moisture.

Acknowledgments: None

Funding Source and COI (Basic and Clinical researches): This research was supported by Basic Science

Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of

Science, ICT & Future Planning (NRF-2014R1A1A1003214). There is no COI.

Keywords: Temporomandibular disorders, Xerostomia, Stress

Sep 24 & 25

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EC17 Poster Presentations (9/24 &25) TMD

MRI diagnosis of 1526 TMJs: disc displacements and osteoarthrosis Osaka University Graduate School of Dentistry, Fixed Prosthodontics1)

Ryota Takaoka1), Daisuke Moriguchi1), Yukiko Koishi1), Yuki Senzaki1), Koichiro Uno1), Shoichi Ishigaki1), Hirofumi Yatani1) Objective: To consecutively investigate the intra-articular joint disorders in patients with temporomandibular

disorders (TMD) based on the diagnosis of magnetic resonance imaging (MRI).

Materials & Methods: Study samples were consecutively obtained from 763 TMD patients who visited Osaka

University Dental Hospital from 2009 to 2015. A total of 1526 joints were assessed and classified into four groups

based on their MRI diagnosis: disc replacement with reduction (DDwR), disc displacement without reduction

(DDw/oR), osteoarthrosis (OA) and no abnormality (N/A).

Results: Of these MR images, 392, 362, 107 and 665 TMJ showed DDwR (25.7 %), DDw/oR (23.7 %), OA (7.0 %) and

N/A (43.6 %), respectively. In 107 OA joints, 103 were diagnosed as having DDw/oR. In particular, all the joints with

erosion and osteophyte were diagnosed as having DDw/oR.

Conclusion: This MRI investigation shows that there is a great occurrence of disc displacement in TMD patients,

although not a few joints with disc displacement are asymptomatic and that the occurrence of osteoarthrosis is

strongly related to disc displacement without reduction.

Acknowledgements: The authors thank the Department of Diagnostic Imaging and Radiotherapy for its collaboration. Funding Source and COI: The authors declare that they have no conflict of interest. Keywords: intra-articular joint disorders, Magnetic resonance imaging, osteoarthrosis

EC18 Poster Presentations (9/24 &25) TMD

TMJ degenerative changes as an occult finding in Cone-beam CT scans for routine dental assessment

Facial Pain and Sleep Center (Private Practice)1),

Columbia University2),

Aristotle University3),

University of Geneva4)

Ghabi Kaspo1), Christos Angelopoulos2)3), Stavros Kiliaridis4)

The goal of this study is to assess the incidence of TMJ degenerative changes in CBCT scans made for routine dental assessment in a period of 4 years. The radiologic reports of 9,374 CBCT scans included and reviewed retrospectively (over a period of 4 yrs) The CBCT scans were extended FOV ( the vast majority of the scans included both articulations) and were acquired by a variety of CBCT scanners All scans were prescribed for routine dental assessment (impacted teeth, implants, jaw pathology etc) Scans which were prescribed for TMJ assessment were excluded Based on the radiologic appearance the TMJ changes were classified as:No significant changes or within normal limits Mild degenerative changes Moderate degenerative changes Severe degenerative changes Conclusion:The incidence rate of TMJ degenerative changes is high TMJ should be included in the standardized review of a CBCT scan despite the prescription of the exam The radiologist should be alert for the appropriate recommendations if the observed findings are out of the ordinary Keywords: TMJ, Degenerative Changes, Occult findings

Sep 24 & 25

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EC19 Poster Presentations (9/24 &25) TMD

The long-term effect of anterior reposition splint for temporomandibular joint disc displacement with reduction

Mackay Memorial Hospital , Department of Prosthodontics1),

Mackay Memorial Hospital , Department of Radiology2)

Huey-Yuan Wang1), Sho-Jen Cheng2) Purpose: To evaluate the long-term effect of a modality of anterior repositioning splint (ARS) for TMJ disc displacement with reduction (DDwR) in clinical and MRI display. . Materials and methods: Retrospectively review ARS treated patients since 2007 to 2012. This modality was whole-day wearing ARS for at least 2 weeks and then progressively diminishing the wearing time to only sleep. The 20 experimental subjects had at least 4-week follow-up and the 2 control subjects had less than 1-week follow-up or no follow-up. Recall patients to take TMJ clinical and MRI examination in average period of 6.3 years (2.75 years to 8.5yers). Results: The average initial visiting age was 25.3 years. In the experimental group most had at least 3-month follow-up. In the first 2-week follow-up, 60% of subjects had joint sound (JS) and 45% of subjects had posterior open bite (POB). Continuing follow-up, 40% of subjects had no JS and no POB, 35% of subjects had JS and no POB, and 25% of subjects had no JS and had POB. All initial 34 DDwR joints became to normal in 14.7% and to DDw/oR in 14.7% & maintained DDwR in 70.6%. Conclusion: For TMJ DDwR, this modality of ARS was effective. Funding source: Mackay Memorial Hospital (MMH104-095). Keywords: disc displacement with reduction, anterior reposition splint, disc displacement without reduction

EC20 Poster Presentations (9/24 &25) TMD

Therapeutic mouth rehabilation training improves maximal interincisor opening and alleviates

pain in temporomandibular joint disorder patients College of Medicine, Korea University, Department of Oral and Maxillofacial Surgery1)

Aaron Besana1), Hak-Gi Lee1), Ho Kyeong Lim1), Choi Hyok1), Eui Seok Lee1) Objective: Aim of this study is to show evidence for safety and effectiveness of therapeutic mouth rehabilitation (TMR) training when used for treatment of TMJ patients. Methods: The electronic medical records of 70 patients at Department of Oral and Maxillofacial Surgery, Korea University Medical Center, Guro Hospital (ages 17-68 years) underwent therapy for TMD was separated into three groups: I) TMR training (group 1, n=20), II) Therapy with lidocaine iontophoresis (group 2, n=31) and III) The occlusal stabilization splint therapy (group 3, n=19) were included in the analysis. The effectiveness of TMR training was assessed through the comparison of maximal interincisor opening (MIO) before and after treatment, and utilization of the visual analogue scale for measurement of both TMJ pain and clicking. Results: Within each group, we identified statistically significant differences between the level of TMJ pain observed when pre-treatment and post-treatment levels were compared Conclusion: In this study, TMR training was confirmed to be an effective and safe initial treatment of TMD; however, future prospective controlled studies were required. Keywords: TMJ, rehabilitation, TMD

Sep 24 & 25

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EC21 Poster Presentations (9/24 &25) Tests

Repeatability of measurements of surface EMG variables during maximum voluntary contraction

of the temporalis and masseter muscles in normal adults

Chonnam National University Dental Hospital, Gwangju, Korea, Department of Oral Medicine1),

GnS International, Daejeon, Korea2),

Gwangju Health College, Gwangju, Korea, Department of Dental Hygiene3),

School of Dentistry, Chonnam National University, Gwangju, Department of Dental Education4),

School of Dentistry, Chonnam National University, Gwangju, Korea, Department of Oral Medicine5)

Yeong-Gwan Im1), Sang-Ho Han2), Ji-Il Park3), Hoi-Soon Lim4), Byung-Gook Kim5), Jae-Hyung Kim5)

This study evaluated the intra-examiner repeatability of the measurements of surface electromyography (EMG) variables and of functional indices of the myoelectric signals from the masseter and temporalis muscles bilaterally in 15 healthy men. The test was repeated on two different days without templates. The resting muscle activity was recorded once, and two kinds of maximum voluntary contraction (MVC) tasks were performed and recorded three times. The two MVC tasks were clenching the teeth and biting down on two cotton rolls bilaterally with the posterior teeth. The intra-class correlation coefficient (ICC) of the root-mean-square (RMS) amplitude was greater than 88%, and that of the median frequency was greater than 95% during the two MVC tasks, but not in the resting condition. The ICC of the asymmetry and activity indices during the two MVC tasks was greater than 76%. The Bland-Altman analysis revealed no significant differences in the amplitude or frequency, or in the two indices between the 2 days during the MVC tasks. In conclusion, the measurements of the surface EMG variables and of the indices obtained according to the study protocol were highly repeatable in healthy men. Further studies using templates and intra-examiner measurement errors in both men and women subjects are required for full validation of these findings. Acknowledgements and COI: This study was not funded. No conflict of interest has been reported by the authors or by any individual in control of the content of this article. Keywords: repeatability, surface electromyography, maximum voluntary contraction

EC22 Poster Presentations (9/24 &25) Tests

A novel test for assessing oral stereognosis ability - methods and preliminary results

School of Dentistry, National Yang-Ming University, Department of Dentistry1),

School of Dentistry, National Yang-Ming University, Department of Dentistry2)

Kai-Hsiang Chuang1), Chia-shu Lin2) Objective: Oral stereognosis ability (OSA), i.e., the intraoral ability to recognize and discriminate forms, is pivotal to mastication and swallowing in the elderly people. The study aimed to establish a clinical test for assessing OSA. Methods and Materials: We fabricated 9 flat resin discs that differ in diameters (8,10,12 mm) and thickness (2,3,4 mm). Five discs were selected for the current study. The participants evaluated the size of the discs intraorally (O) and manually (H), for 3 and 2 trials, respectively. The accuracy (Acc) and the response time (Rt) required to identify the size of the discs were indexed as OSA scores. Results: Twenty-three healthy participants (15 females and 8 males, mean age: 37.4±15.2) have completed the pilot study. In the first trial, RtO was positively correlated with RtH (Spearman’ rho rs=0.71, P<0.001). In contrast, in the second trial, AccO was positively correlated with AccH (rs=0.43, P=0.042). In the second trial, age was negatively correlated with AccO (rs=-0.47, P=0.024). Conclusion: The preliminary results revealed that test accuracy from the second trial may reflect the age-dependent decline in OSA. Keywords: oral stereognosis

Sep 24 & 25

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EC23 Poster Presentations (9/24 &25) Tests

Analyzing relationship between jaw stiffness and heart rate variability

Keio University, Department of Dentistry and Oral Surgery1)

Kawasaki Municipal Ida Hosital Department of Dentistry and Oral Surgery 2)

Showa University Department of dentistry and oral surgery 3)

Kanako Munakata1) Wataru Muraoka1,2) Hitoshi Sato3) Hironori Saisu1) Sho Usuda1) Mariko Inoue1) Taneaki Nakagawa1) Koichi Wajima1)

Aim: Jaw stiffness is a significant symptom seen in TMD patients. We have been trying to quantify the stiffness and adopt it in clinical practice as a biomarker. The OPPERA study showed that Heart Rate Variability is one of autonomic risk factors in chronic TMD patient. We focused on whether any relationship will be found between jaw stiffness, HRV and emotional stress. Material and methods: The analysis included 10 females, 20 years who underwent the measuring protocol: 1) measurement of autonomic profile, 2) measurement of jaw stiffness, 3) emotional intervention, during stress or relaxation, 4) measurement of autonomic profile, 5) measurement of jaw stiffness. This measuring was done twice in a week and the first time emotional stress was loaded and the second time autogenic training was done in 3) period. HRV was measured by digital pulse volume monitoring for evaluating the autonomic nervous system Results: After stress loaded in 3) period, 5 cases showed exacerbation of jaw stiffness and 4 cases of them showed decline of parasympathetic nerve activity. After autogenic training, 4 cases showed subside of jaw stiffness and 3 cases of them showed decline of parasympathetic nerve activity. Discussion: It was indicated that jaw stiffness, HRV and emotional stress have some relationship. Conflict of Interest (COI) of the Principal Presenter：No potential COI to disclose KEYWORDS: Heart Rate Variability, Jaw stiffness, TMD

EC24 Poster Presentations (9/24 &25) Tests

Validation of the Indonesian version of the oral health impact profile for TMDs (OHIP-TMDs-ID)

Prosthodontic Universitas Indonesia1),

Vivi Wira1), Laura S Himawan1), Ira Tanti1), Nina Ariani1 Objectives: The aim of this study was to evaluate the reliability and validity of Indonesian version of OHIP-TMDs (OHIP-TMDs-ID). Methods: The methodology involves translation, back-translation, pre-tested, cross cultural adaptation and evaluation of its measurement properties. The questionnaire was administered to 202 participants with temporomandibular disorders (TMDs). The reliability of OHIP-TMDs-ID was evaluated using internal consistency coefficient (Cronbach’s alpha) and test-retest methods (ICC value). Convergent validity and Spearman correlation coefficient was used to assess validity. Results: Cronbach’s alpha value (internal reliability) for OHIP-TMDs-ID was 0.951 and the intraclass correlation coefficient value (test-retest reliability) was 0.930. In terms of convergent validity, significant correlation between the total scores of OHIP-TMDs-ID and self-perceived oral health was identified. Spearman correlation coefficients showed a moderate to high association between subscales score of OHIP-TMDs-ID, with a positive correlation. All subscales were significantly correlated (p<0,05). Conclusion: OHIP-TMDs-ID has good reliability and validity, thus may be used as a valuable instrument in Indonesia. Acknowledgments / Funding sources and COI : none declared Keywords: OHIP-TMDs-ID, Indonesian version, validation

Sep 24 & 25

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Special thanks to:

Sunstar Suisse SA for their commercial exhibition

Nipro Co., Ltd. for their commercial exhibition

Ishiyaku Pub Inc. for their commercial exhibition and advertisement

Intercross Co., Ltd. for their advertisement

Kanagawa Dental Association for offering the venue

Japanese Association for Dental Sciences for their aegis

Japanese Denatal Association for their aegis

Japanese Dental Hygienists’ Association for their aegis

(Random order)

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Organizing Committee of the ICOP 2016

Yoshiki Imamura, DDS, PhD (Chair)

Rafael Benoliel (IASP SIG on OFP President)

Koichi Wajima (AACMD President)

Koichi Iwata (21st JSOP Scientific Meeting President)

Lene Baad-Hansen (IASP SIG on OFP Treasurer)

Akiko Okada-Ogawa (ICOP 2016 Treasurer)

ICOP2016 Office

Assiste Japan Co., Ltd.

Manoa Daiei 1F, 11-20 Sumiyoshi-cho, Shinjuku-ku

Tokyo, 162-0065 Japan

E-mail: icop2016@assiste-j.com