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Sidebottom AJ. Current thinking in open temporomandibular joint surgery. Is this still indicated in the management of articular temporomandibular joint disorder? Br J Oral Maxillofac Surg 2024; 62:324-328. [PMID: 38453560 DOI: 10.1016/j.bjoms.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 01/16/2024] [Indexed: 03/09/2024]
Abstract
Management of temporomandibular disorders (TMD) follows a stepwise approach of conservative management, minimally invasive surgery (arthrocentesis and arthroscopy), open surgery and alloplastic replacement. The majority of patients treated in primary care and managed initially in secondary care have myofascial pain and can be managed conservatively with rest, topical NSAIDs, muscle massage, and a bite orthosis. Those who fail to improve and have articular related pain with limitation of function should initially undergo arthroscopic investigation and arthrocentesis, which is effective at resolving symptoms in 80% of patients. Arthroscopy provides the best diagnostic aid should there be a failure to improve and should enable the surgeon to appropriately plan open surgery. Historically, surgical intervention was based on a 'one size fits all' philosophy with the surgeon carrying out a procedure which they are used to doing regardless of the pathology. Prior to arthroscopy this carried an '80% chance of getting 80% better' regardless of approach. Prior arthroscopy reduced success rates to 50%-60% and a better success rate is needed. Basing surgical intervention on the pathology encountered is a sensible approach to joint management, with the surgeon performing surgery on the articular surfaces or disc as indicated. Having used this approach over the last 15 years the author has achieved success rates of 80% in the longer term and this philosophy, rationale, and technique will be discussed along with analysis of more recent publications in the field.
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Affiliation(s)
- Andrew J Sidebottom
- Consultant Oral and Maxillofacial Surgeon Spire Nottingham Hospitals, NG12 4GA Nottingham, UK.
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2
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Narouze S. Why pain physicians should consider becoming headache specialists: bridging the gap in patient care. Reg Anesth Pain Med 2024; 49:77-78. [PMID: 37968061 DOI: 10.1136/rapm-2023-105060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 10/26/2023] [Indexed: 11/17/2023]
Affiliation(s)
- Samer Narouze
- Center for Pain Medicine, Western Reserve Hospital, Cuyahoga Falls, Ohio, USA
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Shah A, Guduba V, Tejaswini K, Kothari C. Elongated Pterygoid Hamulus: A case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:3830-3833. [PMID: 37974797 PMCID: PMC10645959 DOI: 10.1007/s12070-023-03853-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 05/02/2023] [Indexed: 11/19/2023] Open
Abstract
A case is reported of a patient suffering from pain and swelling on the left side of the palate. Elongated pterygoid hamulus appeared to be the cause of his discomfort. we report on a case of elongation of pterygoid hamulus that was managed successfully by surgical treatment and a review of the literature. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03853-8.
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Affiliation(s)
- Ashwin Shah
- Department of Oral and Maxillofacial Surgery, Al Badar Rural Dental College and Hospital, Kalaburagi, India
| | - Vijay Guduba
- Department of Oral Medicine and Radiology Tanvi dental health, Shahapur, India
| | - K Tejaswini
- Department of Oral and Maxillofacial Surgery, Al Badar Rural Dental College and Hospital, Kalaburagi, India
| | - Chaitanya Kothari
- Department of Oral and Maxillofacial Surgery, Al Badar Rural Dental College and Hospital, Kalaburagi, India
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Silva-Ortiz VM. Comments on: Pulsed radiofrequency treatment of the Gasserian ganglion for trigeminal neuralgia - a retrospective study (PROGRESS). Reg Anesth Pain Med 2023:rapm-2023-104858. [PMID: 37709511 DOI: 10.1136/rapm-2023-104858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 09/16/2023]
Affiliation(s)
- Victor M Silva-Ortiz
- Hospital Zambrano Hellion, San Pedro Garza Garcia, NLE, Mexico
- Latin American Pain Society, New York
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5
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McMahon RE. Challenging NICO again? Oral Dis 2023; 29:1885-1886. [PMID: 34614291 DOI: 10.1111/odi.14041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/30/2021] [Accepted: 10/02/2021] [Indexed: 11/29/2022]
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Jerman A, Umek N, Cvetko E, Snoj Ž. Comparison of the feasibility and safety of infrazygomatic and suprazygomatic approaches to pterygopalatine fossa using virtual reality. Reg Anesth Pain Med 2023; 48:359-364. [PMID: 36657956 DOI: 10.1136/rapm-2022-104068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 01/05/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND Injections of local anesthetics into pterygopalatine fossa gained popularity for treating acute and chronic facial pain and headaches. Injury of maxillary artery during pterygopalatine fossa injection can result in pseudoaneurysm formation or acute bleeding. We aimed to identify the optimal approach into pterygopalatine fossa by comparing feasibility and safety of suprazygomatic and two infrazygomatic approaches. METHODS We analyzed 100 diagnostic CT angiographies of cerebral arteries using 3D virtual reality. Each approach was determined as a target point in pterygomaxillary fissure and an array of outermost edges trajectories leading to it. The primary outcomes were feasibility and safety for each approach. The secondary outcome was the determination of maxillary artery position for each approach to identify the safest needle entry point. RESULTS Suprazygomatic approach was feasible in 96.5% of cases, while both infrazygomatic approaches were feasible in all cases. Suprazygomatic approach proved safe in all cases, posterior infrazygomatic in 73.5%, and anterior infrazygomatic in 38%. The risk of maxillary artery puncture in anterior infrazygomatic approach was 14.7%±26.4% compared to 7.5%±17.2%. in posterior infrazygomatic with the safest needle entry point in the upper-lateral quadrant in both approaches. CONCLUSION The suprazygomatic approach proved to be the safest, however not always feasible. The posterior infrazygomatic approach was always feasible and predominantly safe if the needle entry point was just anterior to the condylar process. The anterior infrazygomatic approach was always feasible, however least safe even with an optimal needle entry point just anterior to the coronoid process.
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Affiliation(s)
- Anže Jerman
- Institute of Anatomy, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Nejc Umek
- Institute of Anatomy, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Erika Cvetko
- Institute of Anatomy, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Žiga Snoj
- Institute of Radiology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Department of Radiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Shahsavari F, Abbasnejad M, Esmaeili-Mahani S, Raoof M. The ability of orexin-A to modify pain-induced cyclooxygenase-2 and brain-derived neurotrophic factor expression is associated with its ability to inhibit capsaicin-induced pulpal nociception in rats. Korean J Pain 2022; 35:261-270. [PMID: 35768981 PMCID: PMC9251390 DOI: 10.3344/kjp.2022.35.3.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/30/2022] [Accepted: 04/08/2022] [Indexed: 11/26/2022] Open
Abstract
Background The rostral ventromedial medulla (RVM) is a critical region for the management of nociception. The RVM is also involved in learning and memory processes due to its relationship with the hippocampus. The purpose of the present study was to investigate the molecular mechanisms behind orexin-A signaling in the RVM and hippocampus’s effects on capsaicin-induced pulpal nociception and cognitive impairments in rats. Methods Capsaicin (100 g) was applied intradentally to male Wistar rats to induce inflammatory pulpal nociception. Orexin-A and an orexin-1 receptor antagonist (SB-334867) were then microinjected into the RVM. Immunoblotting and immunofluorescence staining were used to check the levels of cyclooxygenase-2 (COX-2) and brain-derived neurotrophic factor (BDNF) in the RVM and hippocampus. Results Interdental capsaicin treatment resulted in nociceptive responses as well as a reduction in spatial learning and memory. Additionally, it resulted in decreased BDNF and increased COX-2 expression levels. Orexin-A administration (50 pmol/1 μL/rat) could reverse such molecular changes. SB-334867 microinjection (80 nM/1 μL/rat) suppressed orexin’s effects. Conclusions Orexin-A signaling in the RVM and hippocampus modulates capsaicin-induced pulpal nociception in male rats by increasing BDNF expression and decreasing COX-2 expression.
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Affiliation(s)
- Fatemeh Shahsavari
- Department of Biology, Faculty of Sciences, Shahid Bahonar University, Kerman, Iran
| | - Mehdi Abbasnejad
- Department of Biology, Faculty of Sciences, Shahid Bahonar University, Kerman, Iran
| | - Saeed Esmaeili-Mahani
- Department of Biology, Faculty of Sciences, Shahid Bahonar University, Kerman, Iran.,Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Raoof
- Academisch Centrum Tandheelkunde Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Fernandes G, Selms MKAV, Lobbezoo F, Aarab G, Braido GVDV, Campi LB, Jordani PC, Gonçalves DADG. Subjective Sleep Complaints were Associated with Painful Temporomandibular Disorders in Adolescents: the Epidor-Adolescere Study. J Oral Rehabil 2022; 49:849-859. [PMID: 35620883 DOI: 10.1111/joor.13344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/18/2022] [Accepted: 05/17/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Sleep disturbances in adolescents has received a lot of attention in the literature and it is recognized as a serious health concern. The association between pain and sleep disturbances in adolescents has been extensively studied. However, to the best of our knowledge, there is a lack of studies investigating the association between various subjective sleep variables and painful TMD in adolescents. OBJECTIVES to investigate the association between painful TMD and subjective sleep variables in adolescents' non-clinical sample. We conducted a cross-sectional study. TMD was classified according to the RDC/TMD criteria. The Revised Face Scale evaluated TMD pain intensity, and pressure pain thresholds (PPTs) were assessed in trigeminal and extra-trigeminal areas. The subjective sleep variables were assessed according to the Sleep Disturbance Scale for Children and Sleep Behavior Questionnaire. RESULTS The final sample consisted of 690 adolescents (12.7±0.76 years), with 16.2% of them presenting painful TMD. Adolescents who frequently reported waking up more than twice per night and feeling tired when awake were more likely to present painful TMD symptoms [OR= 1.7 (95% CI: 1.04-2.90); p=0.034 and OR= 1.6 (95% CI: 1.01-2.48); p=0.046, respectively]. The intensity of TMD pain was negatively associated with sleep quality (p=0.015). Also, PPT values in the trigeminal and extra-trigeminal areas were negatively associated with total sleep time (p= 0.048 and p=0.042, respectively). CONCLUSIONS the present results point out the importance of considering sleep complaints associated with painful TMD in adolescents.
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Affiliation(s)
- Giovana Fernandes
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, where the work was conducted, Araraquara
| | - Maurits K A van Selms
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Guilherme Vinícius do Vale Braido
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, where the work was conducted, Araraquara
| | - Leticia Bueno Campi
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, where the work was conducted, Araraquara
| | - Paula Cristina Jordani
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, where the work was conducted, Araraquara
| | - Daniela Aparecida de Godoi Gonçalves
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, where the work was conducted, Araraquara
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Cintra DN, de Oliveira SAS, Lorenzo IA, Costa DMF, Bonjardim LR, Costa YM. The detrimental impact of temporomandibular disorders (mis)beliefs and possible strategies to overcome. J Oral Rehabil 2022; 49:746-753. [PMID: 35388515 DOI: 10.1111/joor.13330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/25/2022] [Accepted: 03/30/2022] [Indexed: 11/27/2022]
Abstract
AIM This topical review presents common patients' misbeliefs about temporomandibular disorders (TMD) and discusses their possible impact on the diagnosis, treatment and prognosis. We also discussed the possible influence of the beliefs and behaviors of health care providers on the beliefs of patients with TMD and present possible strategies to overcome the negative impacts of such misbeliefs. METHODS This topical review was based on a non-systematic search for studies about the beliefs of patients and professionals about TMD in PubMed and Embase. RESULTS Patients' beliefs can negatively impact the diagnosis, treatment, and prognosis of TMD. These beliefs can be modulated by several factors such as culture, psychosocial aspects, gender, level of knowledge, and previous experiences. Moreover, primary health care professionals, including dentists, may lack sufficient experience and skills regarding TMD diagnosis and treatment. Misbeliefs of the health care professionals can be based on outdated evidence that is not supported by rigorous methodological investigations. Education and dissemination of knowledge to patients and the general population are effective for prevention, promotion of health and disruption of the cycle of misinformation and dissemination of misbeliefs. CONCLUSION The lack of basic information about TMD and the dissemination of mistaken and outdated concepts may delay the diagnosis, hinder the treatment, and consequently increase the risk of worsening the condition. Education is key to overcome TMD misbeliefs.
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Affiliation(s)
- Débora N Cintra
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Sara A S de Oliveira
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Isadora A Lorenzo
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Dyna Mara F Costa
- Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Leonardo R Bonjardim
- epartment of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Yuri M Costa
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Elwany S, Ibrahim AA, Hussein WKA, Medra AM, Elwany N. Ten-year experience with multidisciplinary diagnosis and treatment of odontogenic sinusitis. J Laryngol Otol 2021; 135:987-92. [PMID: 34470684 DOI: 10.1017/S0022215121002310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Odontogenic sinusitis is an underdiagnosed entity and is one cause of failure of conventional treatments of sinusitis. Unfortunately, there is no consensus so far on the best management protocol. This retrospective study aimed to suggest a practical management protocol that can reduce misdiagnosis and improve treatment outcomes. METHODS The study included 74 patients with confirmed odontogenic sinusitis who were diagnosed and treated over 10 years (2010-2019). The patient data were recorded and analysed. RESULTS Dental pain was reported in only 31.1 per cent of patients. Fifty-six patients (75.7 per cent) had received dental treatment during the last year, but only 13 (23.1 per cent) reported it. Dental pathology was missed on initial computed tomography evaluation in 24 patients (32.4 per cent). Forty-one patients (55.4 per cent) were successfully treated by dental procedures and antibiotics. Fourteen patients needed functional endoscopic sinus surgery in addition to dental procedures. CONCLUSION Successful management of odontogenic sinusitis requires good communication between rhinologists, radiologists and dentists. Dental treatment should be the logical first step in the treatment protocol, unless otherwise indicated.
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Lee CH, Jang HY, Won HS, Kim JS, Kim YD. Epidemiology of trigeminal neuralgia: an electronic population health data study in Korea. Korean J Pain 2021; 34:332-338. [PMID: 34193639 PMCID: PMC8255158 DOI: 10.3344/kjp.2021.34.3.332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/14/2021] [Accepted: 05/04/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Trigeminal neuralgia (TN) is one of the most painful disorder in the orofacial region, and many patients have suffered from this disease. For the effective management of TN, fundamental epidemiologic data related to the target population group are essential. Thus, this study was performed to clarify the epidemiological characteristics of TN in the Korean population. This is the first national study to investigate the prevalence of TN in Korean patients. METHODS From 2014 to 2018, population-based medical data for 51,276,314 subscribers to the National Health Insurance Service of Korea were used for this study. RESULTS The incidence of TN was 100.21 per 100,000 person-years in the year of 2018 in Korea, and the male to female ratio was 1:2.14. The age group of 51-59 years had the highest prevalence of TN. Constant increases in medical cost, regional imbalance, and differences in prescription patterns by the medical specialties were showed in the management of TN. CONCLUSIONS The results in this study will not only help to study the characteristics of TN, but also serve as an important basis for the effective management of TN in Korea.
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Affiliation(s)
- Cheol-Hyeong Lee
- Department of Anesthesiology and Pain Medicine, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
| | - Ho-Yeon Jang
- Department of Anesthesiology and Pain Medicine, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
| | - Hyung-Sun Won
- Department of Anatomy, Wonkwang University School of Medicine, Iksan, Korea
- Jesaeng-Euise Clinical Anatomy Center, Wonkwang University School of Medicine, Iksan, Korea
| | - Ja-Sook Kim
- Department of Nursing, Kunsan National University, Gunsan, Korea
| | - Yeon-Dong Kim
- Department of Anesthesiology and Pain Medicine, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
- Jesaeng-Euise Clinical Anatomy Center, Wonkwang University School of Medicine, Iksan, Korea
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Leite WB, Oliveira ML, Ferreira IC, Anjos CF, Barbosa MA, Barbosa AC. Effects of 4-Week Diacutaneous Fibrolysis on Myalgia, Mouth Opening, and Level of Functional Severity in Women With Temporomandibular Disorders: A Randomized Controlled Trial. J Manipulative Physiol Ther 2020; 43:806-815. [PMID: 32893024 DOI: 10.1016/j.jmpt.2020.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 08/23/2019] [Accepted: 01/06/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The purpose of this study was to assess the effects of 4-week protocol of diacutaneous fibrolysis (DF) compared with simulated DF (sham-DF) on myalgia and mouth opening. METHODS In a sham randomized controlled trial, 34 women with temporomandibular disorders and myofascial pain were randomly divided as intervention group (IG) and sham-DF group (SG). The IG received 4 weeks of real DF, and the SG received sham. Pain was assessed through the visual analog scale and pressure pain thresholds (PPTs) on the temporomandibular joint (TMJ), and over the temporal and masseter muscles. The Mandibular Function Impairment Questionnaire was used to classify the participants regarding to the severity of the functional limitation related to TMD. RESULTS Pain scores decreased for both groups, but the IG showed lower values at week 4, with between-group differences. Bilateral temporal PPT showed higher values at week 4, with between-group differences. The SG had lower PPTs but the IG had higher PPTs, both compared to baseline results. The time-by-group interaction and the frequency of participants above 40 mm of mouth opening showed a significant difference for the IG over time with higher results at the 4-week assessment compared to its own baseline. Both groups showed lower MFIQ scores from baseline to 4-week assessment. There was a lower frequency of a moderate level of severity for the IG. No differences were observed for TMJ or for the masseter muscles PPT. CONCLUSION Improvements were observed for visual analog scale scores and PPTs on temporal muscles. There was a group-by-time interaction in the IG, suggesting a possible potential use of DF for mouth opening.
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Affiliation(s)
- William B Leite
- Musculoskeletal Research Group - NIME, Department of Physical Therapy, Federal University of Juiz de Fora, Governador Valadare, Minas Gerais, Brazil
| | - Matheus L Oliveira
- Musculoskeletal Research Group - NIME, Department of Physical Therapy, Federal University of Juiz de Fora, Governador Valadare, Minas Gerais, Brazil; Master Degree Program in Rehabilitation and Physical Performance, Federal University of Juiz de Fora, Governador Valadare, Minas Gerais, Brazil
| | - Isabella C Ferreira
- Musculoskeletal Research Group - NIME, Department of Physical Therapy, Federal University of Juiz de Fora, Governador Valadare, Minas Gerais, Brazil
| | - Carolina F Anjos
- Musculoskeletal Research Group - NIME, Department of Physical Therapy, Federal University of Juiz de Fora, Governador Valadare, Minas Gerais, Brazil; Master Degree Program in Rehabilitation and Physical Performance, Federal University of Juiz de Fora, Governador Valadare, Minas Gerais, Brazil
| | - Michelle A Barbosa
- Musculoskeletal Research Group - NIME, Department of Physical Therapy, Federal University of Juiz de Fora, Governador Valadare, Minas Gerais, Brazil; Master Degree Program in Rehabilitation and Physical Performance, Federal University of Juiz de Fora, Governador Valadare, Minas Gerais, Brazil
| | - Alexandre C Barbosa
- Musculoskeletal Research Group - NIME, Department of Physical Therapy, Federal University of Juiz de Fora, Governador Valadare, Minas Gerais, Brazil; Master Degree Program in Rehabilitation and Physical Performance, Federal University of Juiz de Fora, Governador Valadare, Minas Gerais, Brazil; Master Degree Program in Applied Health Sciences, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil.
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13
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Pastore GP, Goulart DR, Pastore PR, Prati AJ, de Moraes M. Self-medication Among Myofascial Pain Patients: A Preliminary Study. Open Dent J 2018; 12:347-353. [PMID: 29875887 PMCID: PMC5958295 DOI: 10.2174/1874210601812010347] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 04/12/2018] [Accepted: 04/23/2018] [Indexed: 11/22/2022] Open
Abstract
Background Self-medication has been reported as an option which people choose to relieve the suffering of conditions that cause pain, however, this could delay the correct diagnosis and therapy. Objective The aim of the present study was to determine the prevalence of self-medication among patients with Temporomandibular Disorder (TMD), and to analyze correlations with the severity of the disease. Methods A prospective study was conducted with patients who had been diagnosed with TMD. The patients were submitted to anamnesis and a physical examination. This research also used the Fonseca`s Anamnestic Index (FAI) and a questionnaire that was developed specifically for this study, containing questions related to the first health professional contacted and self-medication. The data were analyzed using comparative and correlative analysis (Version 18.0 of SPSS software), with the level of significance set at p<0.05. Results Thirty-four patients were included, with a prevalence of females (91.2%) and a mean age of 39.76 years. Half of the patients claimed to have chosen their own medications at time, especially analgesics. Sodium dipyrone was used by 12 of the participants. Dentists were the most commonly contacted health professionals (55.5%). No correlation was found between self-medication and the severity of TMD according to the FAI. Furthermore, the time period between the onset of symptoms and the first consultation was not affected by self-medication. Conclusion Self-medication seems to be highly prevalent among patients with TMD, although this practice does not seem to alter the severity of the disease.
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Affiliation(s)
- Gabriel Pires Pastore
- Department of Oral and Maxillofacial Surgery, Paulista University - UNIP, São Paulo, Brazil.,Institute of Education and Research - IEP / Sírio Libanês Hospital, São Paulo, Brazil.,Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
| | - Douglas Rangel Goulart
- Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil.,Department of Dentistry, UNIEURO University Center, Brasília, Brazil
| | | | | | - Márcio de Moraes
- Department of Oral Diagnosis, Oral and Maxillofacial Surgery Division, State University of Campinas, Piracicaba Dental School, Piracicaba, Brazil
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14
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Omolehinwa TT, Mupparapu M, Akintoye SO. Incidental finding of an extensive oropharyngeal mass in magnetic resonance imaging of a patient with temporomandibular disorder: A case report. Imaging Sci Dent 2016; 46:285-290. [PMID: 28035308 PMCID: PMC5192028 DOI: 10.5624/isd.2016.46.4.285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 07/27/2016] [Accepted: 08/11/2016] [Indexed: 11/18/2022] Open
Abstract
In this report, we describe the incidental finding of an oropharyngeal mass in a patient who presented with a chief complaint of temporomandibular pain. The patient was initially evaluated by an otorhinolaryngologist for complaints of headaches, earache, and sinus congestion. Due to worsening headaches and trismus, he was further referred for the management of temporomandibular disorder. The clinical evaluation was uneventful except for limited mouth opening (trismus). An advanced radiological evaluation using magnetic resonance imaging revealed a mass in the nasopharyngeal/oropharyngeal region. The mass occupied the masticatory space and extended superioinferiorly from the skull base to the mandible. A diagnostic biopsy of the lesion revealed a long-standing human papilloma virus (HPV-16)-positive squamous cell carcinoma of the oropharynx. This case illustrates the need for the timely radiological evaluation of seemingly innocuous orofacial pain.
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Affiliation(s)
- Temitope T Omolehinwa
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mel Mupparapu
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sunday O Akintoye
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Guerrero ME, Beltran J, de Laat A, Jacobs R. Can pterygoid plate asymmetry be linked to temporomandibular joint disorders? Imaging Sci Dent 2015; 45:89-94. [PMID: 26125003 PMCID: PMC4483625 DOI: 10.5624/isd.2015.45.2.89] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 03/08/2015] [Accepted: 04/01/2015] [Indexed: 11/18/2022] Open
Abstract
Purpose This study was performed to evaluate the relationship between pterygoid plate asymmetry and temporomandibular joint disorders. Materials and Methods Cone-beam computed tomography (CBCT) images of 60 patients with temporomandibular disorders (TMD) involving pain were analyzed and compared with images of 60 age- and gender-matched controls. Three observers performed linear measurements of the lateral pterygoid plates. Results Statistically significant differences were found between measurements of the lateral pterygoid plates on the site that had pain and the contralateral site (p<0.05). The average length of the lateral pterygoid plates (LPPs) in patients with TMD was 17.01±3.64 mm on the right side and 16.21±3.51 mm on the left side, and in patients without TMD, it was 11.86±1.97 mm on the right side and 11.98±1.85 mm on the left side. Statistically significant differences in the LPP length, measured on CBCT, were found between patients with and without TMD (p<0.05). The inter-examiner reliability obtained in this study was very high for all the examiners (0.99, 95% confidence interval: 0.98-0.99). Conclusion Within the limits of the present study, CBCT lateral pterygoid plate measurements at the side with TMD were found to be significantly different from those on the side without TMD. More research is needed to explore potential etiological correlations and implications for treatment.
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Affiliation(s)
- Maria Eugenia Guerrero
- OIC, OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium
| | - Jorge Beltran
- Oral and Maxillofacial Radiology, Post-Graduate School, Universidad Privada Cayetano Heredia, Peru
| | - Antoon de Laat
- Stomatology and Maxillofacial Surgery, Department of Oral Health Sciences, KU Leuven, Belgium
| | - Reinhilde Jacobs
- OIC, OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium
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Pezzoli M, Ugolini A, Rota E, Ferrero L, Milani C, Pezzoli L, Pecorari G, Mongini F. Tinnitus and its relationship with muscle tenderness in patients with headache and facial pain. J Laryngol Otol 2015; 129:638-43. [PMID: 26091105 DOI: 10.1017/S0022215115001425] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study aimed to examine tinnitus prevalence in patients with different types of headache and the relationship between tinnitus and the pericranial muscle tenderness and cervical muscle tenderness scores. METHODS A cross-sectional study was conducted of 1251 patients with migraine and/or myogenous pain, arthrogenous temporomandibular joint disorders and tension-type headache. Standardised palpation of the pericranial and cervical muscles was carried out and univariable and multivariable analysis was used to measure the odds ratio of suffering tinnitus by the different diagnoses and muscular tenderness grade. RESULTS A univariable analysis showed that myogenous pain, pericranial muscle tenderness and cervical muscle tenderness scores, sex, and age were associated with tinnitus. When a multivariable model including only age, sex and a headache diagnosis was used, myogenous pain, migraine and age were found to be associated with tinnitus. When muscle tenderness scores were also included, only the cervical muscle tenderness and pericranial muscle tenderness scores were found to be significantly associated with tinnitus. CONCLUSION In a population of patients with headache and craniofacial pain, tinnitus was related to increased cervical muscle tenderness and pericranial muscle tenderness scores, rather than to any particular form of headache.
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Vagić D, Prica N, Shejbal D. Posttraumatic Stress Disorder and Oro facial Pain. Acta Stomatol Croat 2015; 49:54-9. [PMID: 27688386 DOI: 10.15644/asc49/1/7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Chronic orofacial pain occurs frequently in patients with posttraumatic stress disorder (PTSD) and at the same time any pathological process involving orofacial area can be reflected in emotional interpretation of pain and can trigger a series of reactions associated with the PTSD group of symptoms in patients with PTSD. Painful stimuli caused in this way may occur after the primary cause ceased, and because of convergence can cause referred pain outside of the anatomical site where the primary injury occurred. Chronic orofacial pain and PTSD are diagnosed on the basis of subjective testimony and this regularly occurs in the context of social interaction between patients, doctors, medical staff or researchers making it difficult to standardize the results and introduces many cultural phenomena.
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Affiliation(s)
- Davor Vagić
- School of Dental Medicine, University of Zagreb, Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia
| | | | - Dražen Shejbal
- General Hospital Varaždin, Department of Otorhinolaryngology
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Gomes CA, Politti F, Andrade DV, de Sousa DF, Herpich CM, Dibai-Filho AV, Gonzalez Tde O, Biasotto-Gonzalez DA. Effects of massage therapy and occlusal splint therapy on mandibular range of motion in individuals with temporomandibular disorder: a randomized clinical trial. J Manipulative Physiol Ther 2014; 37:164-9. [PMID: 24387891 DOI: 10.1016/j.jmpt.2013.12.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 08/02/2013] [Accepted: 10/23/2013] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the effects of massage therapy compared with occlusal splint therapy on mandibular range of motion (ROM) in individuals with temporomandibular disorder (TMD) and compare the results with ROM obtained in a group of individuals without this disorder. METHODS A blinded randomized clinical trial was conducted. Twenty-eight volunteers with TMD were randomly distributed into either a massage therapy group or an occlusal splint group. Both treatments were provided for 4 weeks. Fourteen individuals without TMD were consecutively allocated to a comparison group. Fonseca anamnestic index was used to characterize TMD and allocate the volunteers to either of the intervention groups or asymptomatic comparison group. Mandibular ROM was evaluated before and after treatment using a digital caliper. Two-way repeated-measures analysis of variance with a post hoc Bonferroni testing was used for intergroup and intragroup comparisons (level of significance was set to 5%). Cohen d was used to calculate the effect size. RESULTS In the intragroup analysis, significant increases in ROM were found for all measures in both the massage and occlusal splint groups (P < .05). A small to moderate clinical effect of treatment with the occlusal splint was found regarding right and left lateral excursion in comparison with the massage therapy and asymptomatic comparison groups (0.2 <d < 0.5). CONCLUSION Massage therapy on the masticatory muscles and the use of an occlusal splint lead to an increase in mandibular ROM similar to that of the asymptomatic comparison group with regard to maximum active mouth opening and both right and left excursion in individuals with TMD.
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