J Orofac Pain
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This paper discusses the role of oral medicine in the teaching of temporomandibular disorders (TMD) and orofacial pain. Education in orofacial pain and TMD has traditionally been managed in academic dental settings as 2 distinct processes separate from the teaching of diagnosis and management as applied to systemic diseases and oral conditions. ⋯ Management of such conditions should include acute and long-term pain management strategies when the underlying condition has no definitive cure and the pain is disabling. An argument is made for integrating the teaching of oral medicine and orofacial pain to enhance a broad-based approach to the assessment and management of primary pain disorders and to assure appropriate management of pain that is associated with mucosal disease and other forms of regional or systemic pathology including behavioral disorders that present as somatic and painful complaints.
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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.
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Whiplash injury to the neck is often considered a significant risk factor for development of temporomandibular disorders (TMD), and has been proposed to produce internal derangements of the temporomandibular joint (TMJ). Few studies, however, have examined TMD-related pain in acute whiplash patients compared with a matched control group. The aim of the present study was to assess pain and sensorimotor function in the craniofacial region in an unselected group of patients sustaining a motor vehicle accident involving a rear collision. ⋯ TMD pain after whiplash injury and ankle injury is rare, suggesting that whiplash injury is not a major risk factor for the development of TMD problems. Further studies are needed to identify which other factors may contribute to TMD pain.