J Orofac Pain
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Review Meta Analysis Comparative Study
Systematic review and meta-analysis of randomized controlled trials evaluating intraoral orthopedic appliances for temporomandibular disorders.
To conduct a systematic review with meta-analysis of randomized controlled trials (RCTs) that have assessed the efficacy of intraoral orthopedic appliances to reduce pain in patients with temporomandibular disorders affecting muscle and joint (TMJD) compared to subjects receiving placebo control, no treatment, or other treatments. ⋯ Hard stabilization appliances, when adjusted properly, have good evidence of modest efficacy in the treatment of TMJD pain compared to non-occluding appliances and no treatment. Other types of appliances, including soft stabilization appliances, anterior positioning appliances, and anterior bite appliances, have some RCT evidence of efficacy in reducing TMJD pain. However, the potential for adverse events with these appliances is higher and suggests the need for close monitoring in their use.
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To examine the long-term prognosis of 46 previously examined atypical odontalgia (AO) patients. ⋯ A third of the AO patients improved considerably over time, but for many of the patients, AO was a persistent and treatment-resistant condition.
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Pain and tenderness at trigger points and referral sites may be modified in subjects with myofascial pain in the head and neck region by injecting local anesthetic into active trigger points, but the effect of injection on jaw muscle pain-pressure thresholds has not been measured. The mechanism by which trigger-point injection affects muscle tenderness is also unclear and may be related to the "hyper-stimulation analgesia" induced by stimulation of an acupuncture point. A pressure algometer was used before and after an active trigger point injection in the masseter to measure the pain-pressure threshold in the masseter and temporal muscles of 10 subjects with jaw muscle pain of myogenous origin. ⋯ In the control group, the pain-pressure threshold increased significantly at all recording sites in the masseter after acupuncture-point injection. Although local anesthetic injection acts peripherally at the painful site and centrally where pain is sustained, pain-pressure thresholds were not dramatically increased in myofascial pain subjects, in contrast to controls. This suggests that in subjects with myofascial pain, there was continued excitability in peripheral tissues and/or central neural areas which may have contributed to the persistence of jaw muscle tenderness.
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To evaluate the efficacy of topical nonsteroidal anti-inflammatory drugs (NSAID) to relieve temporomandibular joint (TMJ) degenerative joint disease (DJD) pain. ⋯ Presently, there is insufficient evidence to support the use of topically applied NSAID medications to palliate TMJ DJD pain.
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To assess the influence of myofascial temporomandibular disorder (TMD) pain on the pressure pain threshold (PPT) of masticatory muscles in women during a migraine attack. ⋯ Migraine attack is associated with a significant reduction in PPT values of masticatory muscles, which appears to be influenced by the presence of myofascial TMD pain.