How is pain typically perceived when there is a disc perforation in the TMJ?

In the context of disc perforation in the temporomandibular joint (TMJ), pain is primarily perceived through subchondral nociceptors. These nociceptors are located within the subchondral bone beneath the cartilage and are activated in response to inflammatory changes or mechanical stress associated with joint pathology.

When a disc perforation occurs, it often leads to changes in the biomechanics of the TMJ, resulting in increased stress on the joint surfaces and the underlying bone. This can stimulate the subchondral nociceptors, leading to the sensation of pain. Additionally, inflammatory mediators released in response to joint damage can further sensitize these nociceptors, enhancing the perception of pain in the affected area.

While peripheral nociceptors do contribute to pain perception in some contexts, in TMJ disorders specifically, the subchondral nociceptors are more directly involved when there is a structural issue like disc perforation. Central nervous system receptors play a role in processing pain signals but are not the primary source for the initial pain perception at the site of the injury. Visceral nociceptors, which respond to pain from internal organs, are not relevant in the context of TMJ function