The Minnesota TMD IMPACT Collaborative: Integrating Basic/Clinical Research Efforts and Training to Improve Clinical Care

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SUMMARY Temporomandibular disorders (TMD) is an umbrella term that includes dysfunction and pain involving the temporomandibular joint (TMJ) as well as the masticatory muscles. TMD is the second most common chronic musculoskeletal condition after chronic low back pain, affecting approximately 10 to 15% for adults and 4% to 7% for adolescents. The etiology of TMD is considered multifactorial, and several risk factors appear to predispose, precipitate, or prolong pain during TMD, including biological factors (e.g., sex hormones), endogenous opioid function, differences in anatomical genotypes, trauma, oral parafunctions, and psychosocial factors (e.g., stress exposure, pain coping, stress, catastrophizing). The mechanisms that initiate and promote pain during TMD have not been determined. TMD pain can severely affect the individual’s daily activities, causing psychosocial dysfunction and worsening quality of life, thus it is important to develop means for early detection and provide effective treatments for those afflicted. This proposal aims to establish a collaborative group with an overall goal to improve the diagnosis and treatment of TMD patients with pain. To accomplish this goal, a collaborative team will work to create a multidisciplinary program composed of clinical and basic researchers, dentists, physicians, and patient advocates focused on the following four pillars: clinical care, research, education, and consumer engagement. Several of the focus areas for the Minnesota Collaborative align with the NIH initiative, TMD Collaborative for Improving Patient-Centered Translational Research (TMD IMPACT). In order to position this collaborative to achieve these four pillars, a patient registry will be established to collect and make data ready for analysis for clinical and basic research to improve the diagnosis and treatment of pain in TMD patients. Four specific aims were designed to support the collaborative effort in the initial phase: an infrastructure for patient enrollment and pilot data collection will be established (Aim 1); a comprehensive patient database for the adaptive trial on TMD will be developed and implemented (Aim 2); a biobank and biomarker analysis pipeline will be established (Aim 3); and a plan to combine research training with specialty training in TMD will be developed (Aim 4). The overall objective of this proposal is to establish and nurture a collaborative of principal investigators that includes clinicians and basic researchers with the common goal to improve the diagnosis and treatment of TMD pain patients by the means of a patient registry which will collect data and make it ready for analysis for clinical, translational, and basic research.