CANNABIDIOL IN THE MANAGEMENT OF PAIN ASSOCIATED WITH TEMPOROMANDIBULAR DISORDERS
DOI:
https://doi.org/10.56238/levv17n58-080Keywords:
Cannabidiol, Temporomandibular Disorder, Orofacial Pain, Myofascial Pain, Endocannabinoid SystemAbstract
Temporomandibular disorder (TMD) comprises a group of conditions affecting the temporomandibular joint and associated structures, representing one of the main causes of non-odontogenic orofacial pain. Given the limitations of conventional therapeutic approaches, cannabidiol (CBD) has emerged as a potential alternative for pain management due to its analgesic, anti-inflammatory, and endocannabinoid system-modulating properties. This study aimed to critically analyze the scientific evidence regarding the use of cannabidiol in the management of pain associated with TMD. This is a narrative literature review with a qualitative approach, conducted in the PubMed, SciELO, and ScienceDirect databases, including publications from 2015 to 2025. Clinical studies, reviews, and experimental research addressing the use of CBD in orofacial pain, myofascial pain, or TMD were included. The findings revealed a predominance of indirect evidence, including reviews and experimental models, with a limited number of randomized clinical trials. Two recent clinical studies demonstrated significant reductions in pain and muscle activity in TMD patients treated with cannabidiol. Additionally, preclinical evidence supports the analgesic and anti-inflammatory effects of CBD, reinforcing its biological plausibility. However, methodological heterogeneity and the scarcity of robust clinical evidence limit the generalization of the findings. It is concluded that cannabidiol presents therapeutic potential in managing pain associated with TMD, particularly of muscular origin, although further clinical studies are required to establish its efficacy, safety, and clinical applicability.
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BARON, E. P. et al. Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort. The Journal of Headache and Pain, v. 19, n. 1, p. 37, 2018. DOI: https://doi.org/10.1186/s10194-018-0862-2.
BOYCHUK, D. G. et al. The effectiveness of cannabinoids in the management of chronic nonmalignant neuropathic pain: a systematic review. Journal of Oral & Facial Pain and Headache, v. 29, n. 1, p. 7–14, 2015. DOI: https://doi.org/10.11607/ofph.1274.
BRUNI, N. et al. Cannabinoid delivery systems for pain and inflammation treatment. Molecules, v. 23, n. 10, p. 2478, 2018. DOI: https://doi.org/10.3390/molecules23102478.
BURSTEIN, S. Cannabidiol (CBD) and its analogs: a review of their effects on inflammation. Bioorganic & Medicinal Chemistry, v. 23, n. 7, p. 1377–1385, 2015. DOI: https://doi.org/10.1016/j.bmc.2015.01.059.
DAVID, C. et al. Cannabidiol in dentistry: a scoping review. Dentistry Journal, v. 10, n. 10, p. 193, 2022. DOI: https://doi.org/10.3390/dj10100193.
GOLANSKA, P. et al. Temporomandibular myofascial pain syndrome—Aetiology and biopsychosocial modulation: a narrative review. International Journal of Environmental Research and Public Health, v. 18, n. 15, p. 7807, 2021. DOI: https://doi.org/10.3390/ijerph18157807.
GROSSMAN, S.; TAN, H.; GADIWALLA, Y. Cannabis and orofacial pain: a systematic review. British Journal of Oral and Maxillofacial Surgery, v. 60, n. 6, p. e677–e690, 2021. DOI: https://doi.org/10.1016/j.bjoms.2021.03.004.
MARTINEZ NAYA, N. et al. Molecular and cellular mechanisms of action of cannabidiol. Molecules, v. 28, n. 16, p. 5980, 2023. DOI: https://doi.org/10.3390/molecules28165980.
MENA, M. et al. Efficacy of topical interventions for temporomandibular disorders compared to placebo or control therapy: a systematic review with meta-analysis. Journal of Dental Anesthesia and Pain Medicine, v. 20, n. 6, p. 337–356, 2020. DOI: https://doi.org/10.17245/jdapm.2020.20.6.337.
MLOST, J. et al. Cannabidiol for pain treatment: focus on pharmacology and mechanism of action. International Journal of Molecular Sciences, v. 21, n. 22, p. 8870, 2020. DOI: https://doi.org/10.3390/ijms21228870.
NITECKA-BUCHTA, A. et al. Myorelaxant effect of transdermal cannabidiol application in patients with temporomandibular disorders: a randomized, double-blind trial. Journal of Clinical Medicine, v. 8, n. 11, p. 1886, 2019. DOI: https://doi.org/10.3390/jcm8111886.
PISANTI, S. et al. Cannabidiol: state of the art and new challenges for therapeutic applications. Pharmacology & Therapeutics, v. 175, p. 133–150, 2017. DOI: https://doi.org/10.1016/j.pharmthera.2017.02.041.
QIAO, Y. et al. Chemokine regulation in temporomandibular joint disease: a comprehensive review. Genes, v. 14, n. 2, p. 408, 2023. DOI: https://doi.org/10.3390/genes14020408.
SERMET, S. et al. Cannabidiol selectively modulates interleukin (IL)-1β and IL-6 production in human peripheral blood monocytes. Toxicology, v. 464, p. 153016, 2021. DOI: https://doi.org/10.1016/j.tox.2021.153016.
VIVANCO-ESTELA, A. N. et al. Cannabidiol has therapeutic potential for myofascial pain in parkinsonian rats. Neuropharmacology, v. 196, p. 108700, 2021. DOI: https://doi.org/10.1016/j.neuropharm.2021.108700.
WALCZYŃSKA-DRAGOŃ, K. et al. Cannabidiol intervention for muscular tension, pain, and sleep bruxism intensity: a randomized, double-blind clinical trial. Journal of Clinical Medicine, v. 13, n. 5, p. 1417, 2024. DOI: https://doi.org/10.3390/jcm13051417.
WEERATHATAPHAN, S. et al. Cannabinoids and orofacial pain management: a review. International Journal of Dentistry and Oral Science, v. 8, p. 5123–5132, 2021.
WONG, H.; CAIRNS, B. E. Cannabidiol, cannabinol and their combinations act as peripheral analgesics in a rat model of myofascial pain. Archives of Oral Biology, v. 104, p. 33–39, 2019. DOI: https://doi.org/10.1016/j.archoralbio.2019.05.012.
WU, M. et al. Therapeutic agents for the treatment of temporomandibular joint disorders: progress and perspective. Frontiers in Pharmacology, v. 11, p. 596099, 2021. DOI: https://doi.org/10.3389/fphar.2020.596099.
ZWIRI, A. et al. Biomarkers for temporomandibular disorders: current status and future directions. Diagnostics, v. 10, n. 5, p. 303, 2020. DOI: https://doi.org/10.3390/diagnostics10050303.
ZUBRZYCKI, M. et al. Effects of centrally administered endocannabinoids and opioids on orofacial pain perception in rats. British Journal of Pharmacology, v. 174, n. 21, p. 3780–3789, 2017. DOI: https://doi.org/10.1111/bph.13906.