J Orofac Pain
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Randomized Controlled Trial Clinical Trial
Capsaicin-induced muscle hyperalgesia in the exercised and non-exercised human masseter muscle.
Strong jaw muscle exercises such as tooth grinding in sleep bruxism are frequently believed to be a predisposing factor in myogenous types of temporomandibular disorders. However, it is not known whether tooth grinding in sleep bruxism is associated with increased sensitivity to intramuscular stimuli. This study therefore compared the hyperalgesic effects of an intramuscular injection of capsaicin into the right masseter with and without a prior experimental tooth-grinding exercise. ⋯ Increased sensitivity to percutaneous pressure stimuli probably reflects a post-exercise muscle soreness following tooth grinding, whereas intramuscular sensitivity to noxious chemical stimuli immediately following exercise seems to be unchanged.
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A review of the literature on gender and clinical pain reveals a disproportionate representation of women receiving treatment for many pain conditions and suggests that women report more severe pain, more frequent pain, and pain of longer duration than do men. Gender differences in pain perception have also been extensively studied in the laboratory, and ratings of experimentally induced pain also show some sex disparity, with females generally reporting lower pain thresholds and tolerance than males. ⋯ We will review the evidence concerning gender differences in the prevalence of pain conditions, with a focus on orofacial pain conditions. Evidence and hypotheses concerning biologic and psychosocial factors that could influence prevalence rates will also be discussed.
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Comparative Study
Somatic, affective, and pain characteristics of chronic TMD patients with sexual versus physical abuse histories.
This study examined whether temporomandibular disorder (TMD) patients with sexual versus physical abuse histories differ in their pain report, psychological distress, and somatic symptoms. ⋯ Based on the differences found, it can be argued that assessment of physical abuse histories by appropriately trained clinicians should be a routine part of any multimodal assessment of female chronic TMD patients.
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To estimate the intra- and interrater reliability of current perception threshold (CPT) evaluation, especially within the infraorbital nerve territory (ION) and inferior alveolar nerve territory (IAN) of the orofacial region, and to characterize the CPTs of ION and IAN in the normal population. ⋯ Evaluation of CPTs within ION and IAN revealed good intra- and interrater reliability. The study also provided normative data of CPTs of ION, IAN, and the between-site and within-site ratios of CPTs of ION and IAN. This should prove useful in the diagnosis of orofacial neuropathy.
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Patients with different facial pain/headache pathologies usually complain of numerous accompanying symptoms relative to systemic dysfunctions or to the patient's personality characteristics. The purpose of this work was: (1) to determine the prevalence of accompanying symptoms in groups of patients with temporomandibular joint (TMJ) dysfunction and other types of facial pain or headache disorders, (2) to assess the patients' personality characteristics and anxiety levels, and (3) to see whether significant differences were found between the groups. ⋯ It is concluded that some types of headache and facial pain seem to correlate with the presence of a number of accompanying symptoms and with some changes in personality. These changes are particularly relevant in patients with chronic daily headache and facial pain disorder. In contrast, patients with TMJ intracapsular disorders tended to show a low prevalence of accompanying symptoms and a normal personality profile.