Twin Block in Myogenous Orofacial Pain: Applied Anatomy, Technique Update, and Safety.
Samuel Y P Quek, Julyana Gomes-Zagury, Gayathri Subramanian
https://pubmed.ncbi.nlm.nih.gov/32633773/Actively Recruiting
Led by Rutgers, The State University of New Jersey · Updated on 2025-12-05
20
Participants Needed
1
Research Sites
13 weeks
Total Duration
Researchers are evaluating the Temporo-masseteric Nerve Block TMNB injection in healthy adults aged 18 to 64 to better understand its effects on jaw muscles. The TMNB targets specific nerves supplying the temporalis and masseter muscles, which are involved in jaw closure and clenching. This pilot study aims to explore how TMNB changes bite force and muscle activity, shedding light on its potential for relieving jaw muscle pain. The study involves a single group of 20 healthy volunteers receiving a unilateral TMNB injection using 1.8 mL of 2% lidocaine with epinephrine. The injection targets nerve branches of the mandibular division of the trigeminal nerve. The side of injection left or right is randomly assigned. Assessments of bite force distribution and surface electromyographic activity of the temporalis and masseter muscles will be performed before injection and at 30 minutes, 2 hours, and 2 weeks after. Participants will undergo bite force and muscle activity tests at rest and during clenching using specialized devices. They will also complete surveys about their experience with the injection on the day of treatment and again at 2 weeks. The study monitors changes over time to capture both immediate and longer-term effects. The total study duration per participant is 2 weeks, with safety and tolerability closely observed throughout.
CONDITIONS
Characterization of the Temporo-masseteric Nerve Block (TMNB) in Healthy Subjects
G
Gayathri D Subramanian
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Rutgers, The State University of New Jersey
Lead Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Temporomasseteric Nerve Block | Standard Diagnostic Pathway |
|---|---|---|
| What it is | A local anesthetic nerve block (twin block injection) targeting the masseteric and anterior deep temporal nerves, performed in healthy adults using surface landmarks and lidocaine with epinephrine. | Standard diagnostic assessment involving clinical examination and surface electromyography (EMG) to evaluate jaw muscle function without use of nerve block injection. |
| Role in the study | This is the sole intervention in the study, performed to characterize the effects of the nerve block on muscle activity and bite force in healthy individuals. | Not directly tested in the trial. Represents the established approach for characterizing jaw function among healthy adults without the use of anesthesia. |
| Primary use or purpose | Characterize muscle function and bite force distribution after nerve block in healthy adults, providing a baseline for future diagnostic or pain studies. | Routine diagnostic assessment of orofacial muscle function and occlusion in the absence of interventional nerve block. |
| How it is given or performed | Local anesthetic injection is administered at the specified surface landmark to block the nerves, using a dental needle and specific technique under standard precautions. | Clinical orofacial examination and surface EMG recording are performed without anesthesia, using non-invasive clinical protocols. |
| Evidence status or maturity | Ongoing clinical trial in healthy adults; outcomes for changes in muscle function and occlusion distribution have not yet been published. | Surface EMG and clinical examination are widely used to assess masseteric/temporalis function, with supporting evidence and published validity in healthy and patient cohorts. |
| Important limitations | Limited to healthy adults, so findings may not generalize to clinical populations or those with temporomandibular or orofacial pain; pilot data only, without published diagnostic accuracy. | Routine assessment may not reveal subtle neurogenic or muscular contributions and does not test response to anesthetic blockade, though it is validated for current diagnostic use. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Single administration with follow-up assessments over 2 weeks
Participants receive a unilateral Temporo-masseteric Nerve Block (TMNB) injection, a local anesthetic targeting specific nerve branches in the jaw muscles.
1 injection visit and 3 assessment visits at 30 minutes, 2 hours, and 2 weeks post-injection
Duration - 2 weeks following the injection
Participants are monitored for changes in bite force distribution and muscle activity, and surveyed about their experience with the TMNB injection.
Survey administered on injection day and at 2 weeks post-injection
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NON_RANDOMIZED
Model
SINGLE_GROUP
Primary Purpose
DIAGNOSTIC
Number of Arms
1
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https://pubmed.ncbi.nlm.nih.gov/28990015/Rutgers, The State University of New Jersey
Lead Sponsor