Journal of oral rehabilitation
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Cervical spine disorders are frequently associated with temporomandibular disorders (TMDs). Although headache is common in TMD, few studies have considered headache regarding the functional performance of the cervical spine in TMD. ⋯ Women with TMDs, regardless of self-reported headaches, showed limited flexion/extension ROM, limited upper cervical spine (C1-C2) mobility and poor deep cervical flexor performance. Neck disability and temporomandibular pain showed a moderate correlation with the functional test findings, that is FRT and CCFT, in subjects with TMDs.
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Abnormal endogenous pain modulation (EPM) was suggested as a pathophysiological characteristic of chronic pain. EPM has been investigated using psychophysical tests for pain facilitation and inhibition such as temporal summation of pain and conditioned pain modulation, respectively. Another psychophysical test for pain inhibition is offset analgesia (OA), where small variations in noxious stimulus intensity over time elicit a disproportionately large analgesic response. OA has been investigated in patients with mixed pain conditions, but not in chronic temporomandibular disorder (TMD) patients. ⋯ Chronic TMD cases presented with similar OA response over the forearm as controls; however, they experienced greater pain during testing. Future studies including this patient population should investigate OA responses over painful body sites, for example, jaw/face.
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The total tenderness score (TTS) is commonly used in headache practice and contributes valuable information. ⋯ Muscle tenderness scores were positively associated with TMD disease characteristics and co-morbid pain conditions, which may reflect associations with disease severity. MTS differed between TMD populations and may be used in routine patient workup, to assess MMD severity and changes over time as well as treatments response and as a research tool. MTS can be used as a common methodology to describe both headaches and masticatory muscle disorders and to facilitate interprofessional research and crosstalk between a headache and oro-facial pain practitioners.
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Endogenous pain modulation (EPM) reflects the brain's ability to modulate incoming nociceptive inputs, and deficient EPM was implicated as a chronic pain mechanism. EPM status has been investigated in temporomandibular disorders (TMD) patients with conflicting results, and its relationship with clinical characteristics in this population is not well known. ⋯ Endogenous pain modulation responses over the face were similar between groups. TMD cases showed increased hand TSP compared to controls while both groups showed no significant hand CPM. PMP classification showed similar results between groups, and further refinement of PMP determination is warranted.
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The tongue is responsible for compressing food against the palate and squeezing it into the pharynx during the oral preparatory phase of swallowing. Tongue pressure (TP), an indicator of tongue muscle strength, has been observed to decline with age; maximum occlusal force (MOF), an indicator of chewing ability, is correlated with TP. However, no study has investigated the relationship between TP and MOF. ⋯ As age and MOF are each associated with TP in both elderly and adult patients, age-related TP decline can be prevented with routine lingual exercises, even before the onset of old age. Additionally, MOF deterioration may indicate a decline in TP for elderly.