J Orofac Pain
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Randomized Controlled Trial Clinical Trial
A randomized clinical trial of a tailored comprehensive care treatment program for temporomandibular disorders.
To test the usefulness of tailoring cognitive-behavioral therapy (CBT) for patients with temporomandibular disorders (TMD) who demonstrated poor psychosocial adaptation to their TMD condition, independent of physical diagnosis. ⋯ The 6-session CBT intervention for patients with heightened psychologic and psychosocial disability was effective in improving pain-related variables over the course of the CBT in conjunction with usual treatment, but was too brief an intervention to result in further improvement after the sessions ended. Patient ratings of treatment satisfaction and helfulness were high for both groups, but they were significantly higher for the comprehensive care group.
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Randomized Controlled Trial Clinical Trial
A randomized clinical trial using research diagnostic criteria for temporomandibular disorders-axis II to target clinic cases for a tailored self-care TMD treatment program.
To carry out a randomized clinical trial (RCT) contrasting usual conservative treatment of TMD by clinical TMD specialists with a structured self-care intervention, targeted to clinic cases independent of TMD physical diagnosis, who were reporting minimal levels of psychosocial dysfunction; the intervention was delivered by dental hygienists in lieu of usual treatment. ⋯ Use of RDC/TMD psychosocial assessment criteria can contribute to successful clinical decision-making for the management of TMD.
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To analyze the reliability, validity, and clinical utility of the depression, non-specific physical symptoms, and graded chronic pain scales comprising the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis II. ⋯ The major RDC/TMD Axis II measures demonstrate psychometric properties suitable for comprehensive assessment and management of TMD patients.
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This article reviews the features of complex regional pain syndrome (CRPS), including its pathophysiology, diagnosis, and treatment. CRPS is a pathology that has been described as occurring almost always in a limb, but this review provides a focus on the literature reporting cases in which the face, head, and neck were affected. ⋯ Physical signs were reported less frequently. The treatment of choice was seen to be a series of stellate ganglion anesthetic blocks, which resulted in a good outcome in all the cases reviewed.
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The operational definitions for the Craniomandibular Index (CMI) were redesigned to conform precisely to those of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), resulting in a single examination protocol, the Temporomandibular Index (TMI). The objectives were to evaluate interexaminer reliability of the TMI as well as its criteria and construct validity for measurement of TMD severity. ⋯ This study has provided statistical evidence for the clinical reliability and validity of the TMI, which indicates that the RDC examination protocol is appropriate for determining TMD severity by the TMI algorithm, and diagnosis of TMD subtypes by the RDC algorithm.