Abstract：
Pain is a common symptom associated with many disorders affecting the craniofacial tissues that include the teeth and their supporting structures, the jaw, face and tongue muscles, and the temporomandibular joint. Most acute craniofacial pain states are easily recognized and readily treated, but chronic craniofacial pain states (e.g., temporomandibular disorders [TMD], trigeminal neuropathies, and some headaches) may be especially challenging to manage successfully. This chapter provides an overview of the processes that underlie craniofacial pain, with a focus on the pain-modulatory mechanisms operating in craniofacial tissues and in the central nervous system (CNS), including the role of endogenous chemical processes such as those involving opioids. The chapter outlines in particular findings from preclinical studies that have provided substantial information about the neural as well as nonneural (e.g., glial) processes involved in the initiation, transmission, and modulation of nociceptive signals in the trigeminal system, and also draws attention to their clinical correlates. The increased understanding gained from these preclinical studies of how nociceptive signals can be modulated will contribute to improvements in presently available therapeutic approaches to manage craniofacial pain as well as to the development of novel analgesic approaches.
摘要：
疼痛是与影响包括牙齿及其支撑结构在内的颅面组织的许多疾病相关的常见症状。下巴，面部和舌头肌肉，和颞下颌关节。大多数急性颅面疼痛状态很容易识别和治疗，但慢性颅面疼痛状态(例如，颞下颌关节紊乱病[TMD],三叉神经病变,和一些头痛)可能对成功管理特别具有挑战性。本章概述了颅面疼痛背后的过程，重点关注颅面组织和中枢神经系统（CNS）中的疼痛调节机制，包括内源性化学过程的作用，例如涉及阿片类药物的过程。本章特别概述了临床前研究的发现，这些研究提供了有关神经和非神经的大量信息（例如，神经胶质)参与启动的过程，传输,和三叉神经系统中伤害性信号的调节，并提请注意它们的临床相关性。从这些关于如何调节伤害性信号的临床前研究中获得的越来越多的理解将有助于改善目前可用的治疗方法来管理颅面疼痛以及新型镇痛方法的开发。
