J Orofac Pain
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Randomized Controlled Trial Clinical Trial
Counseling and physical therapy as treatment for myofascial pain of the masticatory system.
To prospectively evaluate the effectiveness of a treatment regimen comprising counseling and physical therapy in patients with myofascial pain of the masticatory system, and to explore whether the duration of the physical therapy offered (4 vs 6 weeks) would influence the treatment result. ⋯ A conservative approach involving counseling and physical therapy resulted in significant improvement in parameters of pain and jaw function in patients with myofascial pain. A controlled study will be necessary to elucidate the specific effectiveness of physical therapy over counseling or no treatment.
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Randomized Controlled Trial Clinical Trial
Spread and referral of experimental pain in different jaw muscles.
To test the hypothesis that there would be no differences in perceived pain intensity and spread and referral of pain evoked by injection of a similar amount of hypertonic saline into 6 different jaw-muscle sites in healthy female subjects. ⋯ The data suggest no major differences in pain sensitivity between the examined jaw-muscle sites, but pain in the anterior temporalis muscle spreads to a larger area independent of pain intensity. There are subtle but detectable differences in the location and referral of pain patterns between jaw muscles. This will be helpful in the differential diagnosis of myofascial temporomandibular disorder 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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Randomized Controlled Trial Comparative Study Clinical Trial
Diffusion model of pain language and quality of life in orofacial pain patients.
To address the following questions: (1) Which words are preferred by different groups of orofacial pain patients to describe their pain experience? (2) Is it possible, based on such descriptions, to obtain a clinical differential diagnosis in these patients? (3) Is there any relationship between the verbal description of pain and self-rated quality of life (QOL)? (4) Can a pattern of modulation of pain language by affective variables (diffusion model) be recognized in orofacial pain patients, as it has in other chronic pain patients? and (5) If so, what might be the clinical usefulness of assessing pain language in these patients? ⋯ Although trends in patients' choice of descriptors were evident, differential diagnosis based on only a pain questionnaire was not possible in the different groups of orofacial pain patients examined in this study. The present study suggests the presence of a phenomenon of diffusion in the language of those patients who were experiencing a worsening of their QOL as a result of pain and consequent psychologic distress. This observation can be of clinical usefulness by enhancing the sensitivity of the clinician to the suffering and affective distress experienced by the patient, and it also can be helpful in refining the therapeutic approach for each individual patient.