ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025

INFLUENCE OF ANALGESIC THERAPY ON THE AMPLIFICATION OF

OROFACIAL PAIN: PHYSIOPATHOLOGICAL MECHANISMS

Daniel Dias Machado1

Abstract: This study addresses the inuence of analgesic therapy on the amplication of orofacial

pain, focusing on the pathophysiological mechanisms involving central sensitization and hyperalgesia

in patients with chronic pain. Prolonged administration of analgesics, especially opioids, has been

associated with the development of central sensitization, a process in which the central nervous system

becomes more sensitive to painful stimuli, making pain more intense and harder to treat. Moreover,

the continuous use of these medications can alter pain signaling pathways, such as the activation of

NMDA receptors and the release of excitatory neurotransmitters, contributing to pain exacerbation.

The impact of psychosocial comorbidities, such as anxiety and depression, was also analyzed, as

these conditions can potentiate pain amplication, further complicating the management of orofacial

pain. The study proposes the need for alternative or complementary therapeutic strategies, such as

acupuncture and cognitive-behavioral therapy, to minimize the adverse eects of analgesic therapy

and promote a more eective and safe treatment. A critical analysis of these mechanisms and the

search for individualized approaches are essential for more ecient management of chronic orofacial

pain.

Keywords: Analgesic Therapy; Orofacial Pain; Central Sensitization; Psychosocial Comorbidities.

1 Biomedical from the UniBTA University Center, Medical Biologist from the Higher Education

Institute of Minas Gerais, Postgraduate in Aesthetic Facial Surgeries from Faculdade Rio Sono, Master

in Head and Neck Surgery - Universidad Tecnologica TeCH, Maxillofacial Surgeon and Traumatolo-

gist - Faculdade Antropus and Master in Temporomandibular Dysfunction Faculdade São Leopoldo

Mandic.

ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025

INTRODUCTION

Orofacial pain is a complex problem that aects several structures of the face, such as teeth,

gums, temporomandibular joints and masticatory muscles, and can be acute or chronic (De Almeida;

De França Junior, 2022). The management of this pain often involves the use of analgesic therapies,

which aim to relieve symptoms and improve the quality of life of patients. However, in some cases,

the application of inappropriate analgesic therapies or in incorrect doses can lead to an amplication of

pain, a phenomenon known as hyperalgesia, which makes treatment even more challenging (Bulla et

al., 2024).

Orofacial pain amplication may occur due to a series of pathophysiological mechanisms,

which involve alterations in pain signaling pathways in the nervous system. Orofacial pain is mediated

by nociceptors that transmit pain signals to the higher centers of the brain, and interference with these

processes, either through misdirected analgesic therapy or the presence of underlying conditions such

as inammation, can alter the perception and intensity of pain (Pinheiro, 2020).

In addition, long-term use of certain types of painkillers, such as opioids, can cause addiction

and worsening chronic pain, a phenomenon called “opioid-induced pain” (OIH). This eect is particularly

concerning in patients with chronic orofacial pain, where repeated administration of analgesics may

result in a vicious cycle of pain amplication. The interaction between analgesics and the central nervous

system, which regulates pain perception, is a key factor in the development of this condition, making the

choice of analgesic and dosage fundamental to avoid adverse eects (D’Alessandro et al., 2019).

Another important aspect in the amplication of orofacial pain is the presence of comorbidities,

such as anxiety disorders and depression, which are often associated with chronic pain. These

psychosocial factors can interfere with the way the patient perceives pain and, in some cases, intensify

hyperalgesia. Inadequate management of these concomitant conditions, without considering emotional

and psychological aspects, can result in an increase in orofacial pain, even with the use of analgesic

therapies (Lima et al., 2023).

ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025

Understanding the pathophysiological mechanisms involved in the amplication of orofacial

pain is essential for the development of more eective therapeutic strategies. An individualized

therapeutic approach, which takes into account the patient’s clinical characteristics, the type of pain, the

choice of analgesic, and the treatment of associated comorbidities, is essential to avoid pain amplication.

To this end, the problem question of this article is to analyze the inuence of analgesic therapy on the

amplication of orofacial pain, investigating the pathophysiological mechanisms involved and their

implications in the treatment of chronic pain.

The specic objectives are: (i) to investigate the eects of prolonged administration of

analgesics, especially opioids, on orofacial pain amplication and changes in pain signaling pathways

(ii) to analyze the pathophysiological mechanisms related to central sensitization and hyperalgesia

in patients with chronic orofacial pain, in response to the use of analgesic therapies; (iii) to evaluate

the relationship between psychosocial comorbidities, such as anxiety and depression, and orofacial

pain amplication, considering the impact of analgesic therapies on pain perception; (iv) to propose

alternative or complementary therapeutic strategies that can minimize the adverse eects of analgesic

therapy, promoting a more eective and safe treatment for patients with chronic orofacial pain.

Chronic orofacial pain represents a signicant challenge to public health, aecting the

quality of life of patients. Analgesic therapy is often used to control this pain, but its prolonged use

can lead to pain amplication, aggravating symptoms and complicating treatment. Understanding the

pathophysiological mechanisms involved in the amplication of orofacial pain in response to analgesic

therapy is essential to optimize treatment and reduce adverse eects. In addition, the search for more

eective and safe therapeutic approaches is essential to improve the quality of life of patients.

METHODOLOGY

The methodology adopted for this research is an integrative literature review, an ecient

method to consolidate, synthesize and analyze evidence on the inuence of analgesic therapy on the

ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025

amplication of orofacial pain. The integrative review allows the inclusion of studies of dierent designs

and contexts, providing a comprehensive understanding of the theme (Souza et al., 2010).

This approach is divided into four chapters, each corresponding to one of the specic objectives,

addressing, in detail, the pathophysiological mechanisms of orofacial pain amplication, the ecacy

of analgesic therapies, the factors that contribute to pain amplication, and the identication of best

practices for the management of orofacial pain.

The review was conducted based on articles published in the last ve years, ensuring the

updating and relevance of the data. The selected studies were in both Portuguese and English, covering

an international literature to ensure a broader view on the subject. Research sources included recognized

databases such as SciELO, Google Scholar, and PubMed, which are widely used in academic and

scientic studies.

Inclusion criteria will involve peer-reviewed articles, clinical trials, randomized trials, and

systematic reviews. These studies should be directly related to the pathophysiological mechanisms of

orofacial pain amplication and the dierent analgesic therapeutic approaches. Articles that do not

present a clear methodology or that are not directly applicable to the research theme were excluded.

Data analysis was done qualitatively, organizing the evidence found to identify patterns, trends,

and gaps in the literature. To ensure the robustness of the results, emphasis was placed on comparing

the dierent analgesic methods, their implications for pain control, and how they can, in some cases,

contribute to the amplication of orofacial pain, considering the pathophysiological mechanisms

involved.

The integrative review provided a critical and grounded view of the inuence of analgesic

therapy on the amplication of orofacial pain. It is expected as a result a deeper understanding of the

mechanisms underlying this condition and the identication of more eective therapeutic approaches,

contributing to the advancement of the treatment of orofacial pain in clinical practice.

EFFECTS OF LONG-TERM ADMINISTRATION OF ANALGESICS, WITH EMPHASIS

ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025

ON OPIOIDS, ON OROFACIAL PAIN AMPLIFICATION AND CHANGES IN PAIN SIG-

NA L I NG PATH WAYS

Long-term administration of analgesics, particularly opioids, has been widely discussed due to

their adverse eects, which may include amplication of orofacial pain. Although opioids are eective

in controlling acute pain, their chronic use has been associated with the phenomenon known as opioid-

induced hyperalgesia (OIH), which results in exacerbation of pain in response to the medication itself.

Studies demonstrate that activation of opioid receptors can lead to modulation of signaling

pathways involved in pain perception, resulting in an increased sensitivity to painful stimuli (Lee, G. I.,

& Neumeister, 2020). Continuous administration of opioids can thus modify the normal physiological

response of the nervous system, causing changes in pain control mechanisms. The amplication of

orofacial pain due to long-term use of opioid analgesics is closely related to the process of central

sensitization, which occurs when the central nervous system (CNS) becomes more reactive to painful

stimuli. In patients with chronic orofacial pain, such as those with temporomandibular disorder,

continued use of opioids may exacerbate this central sensitization. Increased neuronal excitation and

decreased inhibition of circuits contribute to the intensication of pain (Vassalo, 2020).

These changes can be exacerbated by factors such as the time of exposure to analgesics and the

dose used, with increasingly detrimental results for the eective control of orofacial pain. In addition, the

interaction between opioids and other pain signaling pathways is a critical factor in pain amplication.

In terms of alteration in pain signaling pathways, chronic exposure to opioids can induce

changes in neuronal receptors by increasing the activity of ion channels such as calcium channels,

which play an important role in pain transmission. Sensitization of neural signaling pathways, such

as those involving NMDA (N-methyl-D-aspartate) receptors, is a well-documented mechanism in the

amplication of opioid-induced pain (Silva et al., 2023). These pathways are involved in the pain memory

process and, when altered, contribute to the persistence of orofacial pain, even after the cessation of

analgesic use.

ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025

In addition, the combination of opioids with other analgesic medications, such as nonsteroidal

anti-inammatory drugs (NSAIDs), has been shown to be ineective in preventing orofacial pain

amplication. Although NSAIDs oer some pain relief, their administration in conjunction with opioids

may aggravate adverse eects on the central nervous system, amplifying the symptoms of hyperalgesia

(Bouloux et al., 2024).

The amplication of orofacial pain related to the prolonged use of opioid analgesics reinforces

the need for a review of chronic pain management strategies. The use of alternative therapies, such as

non-pharmacological neural modulation techniques and physical therapies, has shown promise as a

complement to conventional treatment, minimizing the adverse eects of opioids and promoting a more

balanced approach to pain control (De Souza Soares et al., 2029).

In addition, it is crucial to implement more restrictive prescription policies that ensure the

rational use of opioids and encourage the development of innovative therapeutic approaches for the

treatment of chronic orofacial pain.

PATHOPHYSIOLOGICAL MECHANISMS OF CENTRAL SENSITIZATION AND HYPE-

RALGESIA IN PATIENTS WITH CHRONIC OROFACIAL PAIN IN RESPONSE TO THE

USE OF ANALGESIC THERAPIES

Central sensitization is a neurophysiological mechanism in which the central nervous system

(CNS) becomes hypersensitive to painful stimuli, a common feature in patients with chronic orofacial

pain. This phenomenon occurs when pain signals, which would normally be inhibited or modulated,

are amplied by a dysfunction in the neuronal pathways of the CNS. Central awareness it is mediated

by changes in neurotransmitters, such as glutamate and substance P, which are involved in the process

of neuronal excitability and the development of chronic pain (Varão, 2022).

Patients with orofacial pain, such as those with temporomandibular disorder, often present with

this alteration, in response to the continued use of analgesic therapies, especially opioids, which can

ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025

exacerbate this process. In addition, hyperalgesia, which is the amplication of pain perception, is one

of the main eects of central sensitization. When the use of painkillers, such as opioids, is prolonged,

it can result in pain intensifying rather than relieving it. This phenomenon is known as opioid-induced

hyperalgesia (OIH) (Gentleman; Bonfante, 2019).

Studies indicate that OIH is characterized by an increased pain response in areas that would

not normally be painful, contributing to the chronicity of orofacial pain. In patients with chronic

orofacial pain, the continuous use of opioids can alter the response of nociceptive receptors, favoring

pain amplication rather than pain relief (Lucena, 2023).

The activation of NMDA (N-methyl-D-aspartate) receptors, located in neuronal synapses, plays

a crucial role in central sensitization. These receptors, when activated, contribute to the phenomenon

of pain memory, facilitating the perpetuation of painful signals in the CNS. Excessive activation of

NMDA receptors is one of the main pathophysiological mechanisms responsible for pain amplication,

which is often observed in patients with chronic orofacial pain (Vicenzi, 2022).

In addition to pain modulation at the peripheral and central levels, psychosocial comorbidities

also play a signicant role in central sensitization and hyperalgesia in patients with chronic orofacial

pain. Studies indicate that conditions such as anxiety and depression can increase the perception

of pain, exacerbating the eects of analgesic therapies. The interaction between psychosocial and

neurophysiological factors can potentiate pain, making it more dicult to control. Patients with

psychosocial comorbidities often report greater pain intensity and a less eective response to analgesics,

which suggests that treatment of these psychosocial conditions should be considered in conjunction with

analgesic therapies (Lima et al., 2023).

The combination of central sensitization and hyperalgesia in response to long-term analgesic

use highlights the importance of a multidisciplinary therapeutic approach in the management of chronic

orofacial pain. In addition to careful pharmacological management, alternative therapeutic strategies,

such as physical therapy, acupuncture, and cognitive behavioral therapy, have shown ecacy in

modulating pain and reducing the adverse eects of analgesics.

ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025

PSYCHOSOCIAL COMORBIDITIES AND THEIR RELATIONSHIP WITH OROFACIAL

PAIN AMPLIFICATION: THE IMPACT OF ANALGESIC THERAPY ON PAIN PERCEP-

TION

Psychosocial comorbidities, such as anxiety, depression, and stress, have a signicant

relationship with the amplication of orofacial pain, and their impact is intensied with the use of

analgesic therapies. Patients with chronic orofacial pain often have these psychosocial conditions, which

can directly inuence pain perception and the eectiveness of therapeutic interventions. Emotional

stress can increase pain sensitivity, contributing to a vicious cycle of pain and suering, which makes

management more complex. Anxiety, for example, can amplify the response to painful stimuli, making

pain more intense and persistent (Azevedo et al., 2020).

In addition, depression is closely related to increased pain perception, especially in chronic

pain conditions such as orofacial. Depressed patients have a lower tolerance to pain and an exaggerated

perception of painful signs. The psychological impact of chronic pain can also aggravate the patient’s

emotional state, creating a cycle of continuous suering (De Oliveira Filho et al., 2021).

The use of analgesics, especially opioids, may not be eective in patients with psychosocial

comorbidities, as pain relief does not always resolve the emotional component associated with chronic

orofacial pain. The lack of control over emotional factors can even increase the sensation of pain and

decrease the therapeutic response (Leal, 2020).

Another important aspect is the relationship between analgesic therapy and psychosocial

eects. Long-term use of painkillers, especially opioids, can lead to dependence and the intensication

of psychological disorders, such as depression and anxiety. These adverse eects of medications can

increase the perception of pain, since the patient’s emotional state becomes more fragile. Central

sensitization, associated with the chronic use of analgesics, can amplify both pain and psychosocial

symptoms, making the treatment of orofacial pain even more dicult (Da Conceição; Cordeiro, 2024).

ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025

Thus, the inappropriate use of analgesic therapies can exacerbate the physical and emotional suering

of patients, leading to a more complex picture of chronic pain.

In addition, the interaction between psychosocial and neurophysiological factors should be

considered when treating chronic orofacial pain. Patients with anxiety and depression, when treated

with pharmacological approaches alone, may not get the necessary relief, since emotional factors also

play a key role in pain perception.

Treatment strategies that include psychological support, such as cognitive behavioral therapy

and relaxation techniques, have been shown to be eective in reducing pain levels and improving

patients’ quality of life. These integrated therapeutic approaches can minimize the negative eects of

analgesic therapies and optimize pain management (Da Silva; Miranda, 2024).

Therefore, the relationship between psychosocial comorbidities and orofacial pain amplication

is complex, and the impact of analgesic therapies on pain perception needs to be comprehensively

assessed. In addition to pain control, the treatment of emotional and psychological aspects should be

considered, so that the patient has an overall improvement in his condition. A multidisciplinary approach,

which includes psychotherapy and relaxation methods, may be the key to eective management of

chronic orofacial pain, minimizing pain amplication and the adverse eects of analgesics.

ALTERNATIVE OR COMPLEMENTARY THERAPEUTIC STRATEGIES

Psychosocial comorbidities play a crucial role in amplifying orofacial pain, since factors such

as anxiety, depression, and stress can intensify pain perception, making conventional treatment more

challenging. Although analgesic therapies, especially opioids, are widely used for the management of

chronic pain, the psychological impact of these conditions often contributes to the ineectiveness of

chronic pain treatment. This suggests that a more holistic approach, which takes into account both the

psychosocial and physiological aspects of pain, is essential to optimize the management of chronic

orofacial pain, as pointed out by Da Silva et al. (2024).

ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025

Traditional analgesic therapies, such as opioids, may have a palliative eect, but they do not

fully address the underlying factors that exacerbate pain (Tambeli et al., 2023). Long-term opioid use,

for example, is associated with the risk of addiction and emotional disorders, such as depression and

anxiety, which, in turn, can amplify the perception of pain.

This highlights the need for a more personalized and multidisciplinary approach to treating

chronic orofacial pain, incorporating not only medications but also psychological support and alternative

therapies that treat the patient as a whole.

Within this context, alternative or complementary therapeutic strategies emerge as promising

to minimize the adverse eects of analgesics and improve pain control. Acupuncture, for example, has

shown signicant benets in the treatment of chronic orofacial pain, helping to reduce pain intensity and

improve patients’ quality of life. Studies indicate that acupuncture can promote pain relief by stimulating

specic points, which favor the release of endorphins, natural substances that act as analgesics in the

body. The use of this therapy can be an eective alternative for those who seek to minimize the use of

medications (Bezerra et al., 2024).

In addition, cognitive behavioral therapy (CBT) has been shown to be highly eective in

treating patients with chronic orofacial pain and psychosocial comorbidities. CBT aims to modify

negative and dysfunctional thought patterns that can contribute to increased pain perception, teaching

the patient to cope more adaptively with the stress and anxiety associated with chronic pain. CBT, when

combined with pharmacological interventions, can signicantly reduce pain intensity and improve the

patient’s overall well-being (Rota, 2020).

The use of manual therapies, such as physical therapy, has also been shown to be eective

in the management of chronic orofacial pain. Myofascial release techniques, massage therapy, and

stretching exercises can help relieve muscle tensions that are often associated with orofacial pain.

Physical therapy can also improve functionality and reduce muscle stiness, factors that often aggravate

the pain. The combination of physical therapy with other complementary therapies can be particularly

useful for patients with chronic orofacial pain, as it treats both the physical and psychosocial aspects of

ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025

the condition (Silva; Petkovicz, 2025).

In terms of alternative pharmacological strategies, the use of herbal medicines can be an

interesting option. Substances such as ginger extract, curcumin (from turmeric) and capsaicin have

shown analgesic and anti-inammatory properties, and can complement conventional treatment

safely and eectively. The use of these natural compounds, in combination with non-pharmacological

therapies, can reduce dependence on traditional analgesics and improve the overall ecacy of treatment

(De Carvalho et al., 2024).

While the combination of alternative and complementary therapies is promising, it is critical

that treatments are tailored to the specic needs of each patient. Personalization of treatment is crucial

to ensure that all facets of chronic orofacial pain are addressed, including the physiological, emotional,

and psychosocial components. Collaboration between healthcare professionals, such as doctors,

psychologists, physiotherapists, and complementary therapists, can result in more eective and holistic

treatment.

Therefore, the combination of traditional and alternative therapies oers a more comprehensive

approach to the management of chronic orofacial pain, considering both physical and emotional aspects.

This multidisciplinary approach can not only help reduce pain but also improve patients’ quality of life

by providing a more balanced and personalized solution for the treatment of chronic orofacial pain.

Finally, it is essential that health professionals are aware of the interactions between conventional

and alternative treatments. Ongoing education and research on the eectiveness of complementary

therapies are essential so that these strategies can be safely and eectively integrated into treatment plans.

With an integrated and personalized approach, it is possible to signicantly improve the management of

chronic orofacial pain, ensuring better patient outcomes.

FINAL CONSIDERATIONS

Analgesic therapy plays a central role in the management of orofacial pain, but its prolonged

ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025

use, especially in the case of opioids, can lead to pain amplication through complex pathophysiological

mechanisms. Continuous administration of analgesics can induce central sensitization, where the

central nervous system becomes more sensitive to painful stimuli, aggravating pain perception. This

phenomenon is exacerbated by the interaction between the eects of opioids and pain signaling pathways,

creating a vicious cycle in which pain becomes more dicult to control with traditional painkillers.

In addition, long-term use of analgesics can aect neuronal plasticity, resulting in changes

in pain signaling pathways, such as activation of NMDA receptors and excessive release of excitatory

neurotransmitters. These changes contribute to hyperalgesia, a condition in which pain becomes more

intense and persistent, making it resistant to conventional therapies. In patients with chronic orofacial

pain, these mechanisms are often exacerbated by the presence of psychosocial comorbidities, such as

anxiety and depression, which can inuence pain perception, making treatment even more challenging.

Therefore, it is essential that the treatment of chronic orofacial pain considers not only

immediate symptom relief through analgesics, but also a holistic approach that takes into account the

underlying pathophysiological mechanisms. Alternative and complementary therapeutic strategies,

such as acupuncture, cognitive behavioral therapy, and mindfulness, can be explored to help minimize

the adverse eects of analgesic therapy and promote a more eective and sustainable approach to pain

management. Personalization of treatment, which takes into account the physiological and emotional

particularities of each patient, is essential to avoid pain amplication and improve the quality of life of

patients with chronic orofacial pain.

One of the limitations of this study is related to the lack of standardization in therapeutic

approaches and diagnostic criteria for orofacial pain. Treatment for chronic pain, including the use of

opioids, is often adjusted according to the individual needs of each patient, which can make it dicult

to compare results between the dierent studies analyzed.

In addition, the heterogeneity of pain measurement methods, which vary between studies, may

have inuenced the interpretation of data on the ecacy of analgesic therapies and the pathophysiological

mechanisms underlying pain amplication.

ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025

Another important limitation refers to the scarcity of studies that investigate in an integrated

manner the interaction between analgesic therapies and psychosocial comorbidities in patients with

chronic orofacial pain. While some research addresses separate aspects, such as the eects of opioids on

central sensitization or the inuence of emotional disturbances on pain perception, few studies explore

the complexity of this interaction in a comprehensive manner.

The inclusion of more longitudinal studies and greater methodological rigor could provide a

clearer understanding of how psychological factors contribute to pain amplication and how analgesic

therapies can be adjusted to improve outcomes in the management of chronic orofacial pain.

REFERENCES

AZEVEDO, Ludmila Menezes Alves de et al. Construção de instrumento de triagem biopsicossocial

para abordagem de pacientes com dor orofacial. 2020.

BEZERRA, Lucas Mainardo Rodrigues et al. ABORDAGENS MULTIDISCIPLINARES NO

TRATAMENTO DA DOR CRÔNICA EM IDOSOS: UMA REVISÃO BIBLIOGRÁFICA.

RECIMA21-Revista Cientíca Multidisciplinar-ISSN 2675-6218, v. 5, n. 3, p. e535022-e535022, 2024.

BOULOUX, Gary F. et al. Guidelines for the management of patients with orofacial pain and

temporomandibular disorders. Journal of Oral and Maxillofacial Surgery, 2024.

BULLA, Leticia Lazzarini et al. DIFERENCIAÇÃO ENTRE NEURALGIA DO TRIGÊMEO E

DOR OROFACIAL. Brazilian Journal of Implantology and Health Sciences, v. 6, n. 10, p. 2813-2821,

2024.

CAVALHEIRO, Scheila Taís; BONFANTE, Juliana da Silva. Hiperalgesia induzida por opioides.

Encontro Acadêmico de Produção Cientíca de Medicina Veterinária, 2019.

DA CONCEIÇAO, Jaynara Senna; CORDEIRO, Ana Luísa Gomes. TRANSTORNOS POR USO DE

SUBSTÂNCIAS PSICOATIVAS (TUS) E SEUS EFEITOS NO SISTEMA NERVOSO CENTRAL

(SNC). Encontro de Saberes Multidisciplinares, v. 2, n. 1, p. e45-e45, 2024.

ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025

DA SILVA, Ana Caroline Gonçalves et al. LASERTERAPIA NO TRATAMENTO DAS DORES

OROFACIAIS. Revista Ibero-Americana de Humanidades, Ciências e Educação, v. 10, n. 12, p. 1146-

1158, 2024.

DA SILVA, Camila Meury Albino; MIRANDA, Joelina Da Silva. ESTRATÉGIAS DE

ENFERMAGEM PARA O MANEJO DA DOR EM PACIENTES COM DOENÇAS CRÔNICAS.

Revista Cedigma , v. 2, n. 3, pág. 15-26, 2024.

D’ALESSANDRO, Walmirton Bezerra et al. Medicina & Saberes II. Editora Kelps, 2019.

DE ALMEIDA, Cariny Regino; DE FRANÇA JUNIOR, Mosaniel Falcão. Dor orofacial e mecanismos

de dor referida. Research, Society and Development, v. 11, n. 15, p. e203111537036-e203111537036,

2022.

DE CARVALHO, Guilherme Dias; LINS, Larissa Souza Santos; MOREIRA, Paula Milena Melo

Casais. USO DO CANABIDIOL PARA O CONTROLE DA DOR OROFACIAL CRÔNICA:

REVISÃO DE LITERATURA. Revista Ciências e Odontologia, v. 8, n. 2, p. 113-122, 2024.

DE OLIVEIRA FILHO, Francisco Hildebrando Moreira et al. Manifestações dos sintomas da

depressão em pacientes com bromialgia. Research, Society and Development, v. 10, n. 15, p.

e63101522587-e63101522587, 2021.

DE SOUZA SOARES, Eliane Cristina et al. Guia prático para manejo da dor. 2019. LEAL, Rafhael.

Uso indevido e dependência de opioides: da prevenção ao tratamento. Revista de Medicina de família

e Saúde mental, v. 2, n. 1, 2020.

LEE, Greg I.; NEUMEISTER, Michael W. Pain: pathways and physiology. Clinics in plastic surgery,

v. 47, n. 2, p. 173-180, 2020.

LIMA, Guilherme Machado Alvares de et al. Análise do fenótipo clínico de pacientes com neuralgia

do trigêmeo atendidos no Ambulatório de Dor Orofacial do Hospital Universitário Pedro Ernesto.

2023.

LUCENA, Caio César Jucá. DEPRESSÃO E DOR CRÔNICA. Neuropsicogeriatria: Uma abordagem

ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025

integrada, p. 29, 2023.

PINHEIRO, Flávio Eduardo. Disfunções temporomandibular e dor facial. 2020. Dissertação de

Mestrado. Egas Moniz School of Health & Science (Portugal).

ROTA, Alexandre Cardoso. Avaliação e implementação de nova forma de tratamento para a Disfunção

Temporomandibular. 2020.

SILVA, Ana Cristina Freitas da; PETKOVICZ, Fabiana. Perl dos pacientes atendidos pelo núcleo de

dor orofacial da UNESC.

SILVA, Ana Cristina Freitas da; PETKOVICZ, Fabiana. Perl dos pacientes atendidos pelo núcleo de

dor orofacial da UNESC. 2025.

SILVA, Guilherme Gomes et al. Desenvolvimento de um modelo de dor persistente induzido por

carragenina na pata de ratos. 2023.

SOUZA, Marcela Tavares de; SILVA, Michelly Dias da; CARVALHO, Rachel de. Revisão integrativa:

o que é e como fazer. Einstein (São Paulo), v. 8, p. 102-106, 2010.

TAMBELI, Claudia Herrera et al. Abordagem integrativa do uso terapêutico da cannabis nas dores

orofaciais. BrJP, v. 6, p. 49-53, 2023.

VARÃO, Juliana Portela Duarte. A terapia neural no tratamento de dores crónicas da cabeça e pescoço.

2022. Dissertação de Mestrado. Egas Moniz School of Health & Science (Portugal).

VASSALO, Ana Filipa Pepino. A Relação Entre Depressão e Dor Crónica: Modelo Neurobiológico e

Intervenção Terapêutica Integrada. 2020. Dissertação de Mestrado. Universidade de Lisboa (Portugal).

VICENZI, Cristina Balensiefer. Avaliação da conabilidade de um modelo de dor orofacial inamatória

crônica induzido pela administração intra-articular de adjuvante completo de Freund (CFA) em Ratos

Wistar. 2022.