J Orofac Pain
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized clinical trial of intraoral soft splints and palliative treatment for masticatory muscle pain.
Thirty subjects seeking treatment for masticatory muscle pain at a university-based TMJ clinic were randomly assigned to soft-splint, palliative-treatment, and no-treatment groups. After 4 to 11 weeks of treatment, subjects were evaluated for changes from their baseline levels of symptoms, maximum pain-free opening, pain thresholds measured by a pressure algometer, and occlusal contacts. ⋯ The soft-splint group had fewer occlusal contact changes assessed with shimstock compared to the palliative-treatment and no-treatment groups. The findings of this study suggest that the soft splint is an effective short-term treatment for reducing the signs and symptoms of masticatory muscle pain in patients, and the soft splint does not cause occlusal changes.
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Comparative Study
Pain-related limitation in activities of daily living in patients with chronic orofacial pain: psychometric properties of a disability index.
Pain-related limitations in activities of daily living are presented for 272 patients reporting orofacial pain of the temporomandibular region using the seven-item Pain Disability Index. Results showed that the factor structure for orofacial pain patients differed little from the factor structure for outpatients visiting chronic pain clinic settings. ⋯ The factor analytical findings indicated that these patients share common pain-related limitations in activities of daily living. These findings are also consistent with previous results indicating greater pain in orofacial pain patients diagnosed with pain complaints primarily myogenous in origin than in pain patients having discal disorders.
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Case Reports
Benign indomethacin-responsive headaches presenting in the orofacial region: eight case reports.
Indomethacin-responsive headaches can present in the orofacial region. According to the classification of headache by the International Headache Society, indomethacin-responsive headaches include chronic paroxysmal hemicrania, hemicrania continue, benign cough headache, benign exertional headache, and sharp, short-lived headache pain syndrome. ⋯ Because these headache disorders are rare but may present as facial pain, they should be considered in the differential diagnosis of orofacial pain. A comprehensive evaluation prior to performing irreversible treatments is essential when an idiopathic facial pain presents to the dental clinician.
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Temporomandibular disorders is a common form of chronic pain affecting the head, face, and jaw. The distinguishing symptoms of this disorder include pain and impairment of the masticatory function, and frequent display of symptoms, ranging from aches in the head, neck, ears, and eyes, to atypical toothaches, throat symptoms, and occlusal changes. ⋯ This article is a review of the literature on the psychophysiologic factors contributing to temporomandibular disorders and its limitations. Recommendations for future research are also given.