Journal of oral rehabilitation
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Randomized Controlled Trial Multicenter Study
Pain relief following a single-dose intra-articular injection of methylprednisolone in the temporomandibular joint arthralgia-A multicentre randomised controlled trial.
Temporomandibular joint (TMJ) arthralgia is a painful condition assumed to be associated with local inflammation. ⋯ Methylprednisolone provided no additional benefit for reducing pain, but caused more harm compared with saline following a single-dose IA injection in patients with TMJ arthralgia.
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Cross-cultural differences in pain sensitivity have been identified in pain-free subjects as well as in chronic pain patients. The aim was to assess the impact of culture on psychophysical measures using mechanical and electrical stimuli in patients with temporomandibular disorder (TMD) pain and pain-free matched controls in three cultures. This case-control study compared 122 female cases of chronic TMD pain (39 Saudis, 41 Swedes and 42 Italians) with equal numbers of age- and gender-matched TMD-free controls. ⋯ Overall, Italian females reported the highest sensitivity to both mechanical and electrical stimulation, while Swedes reported the lowest sensitivity. Mechanical pain thresholds differed more across cultures than did electrical pain thresholds. Cultural factors may influence response to type of pain test.
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Multicenter Study Comparative Study
Reliability of intra-oral quantitative sensory testing (QST) in patients with atypical odontalgia and healthy controls - a multicentre study.
The reliability of comprehensive intra-oral quantitative sensory testing (QST) protocol has not been examined systematically in patients with chronic oro-facial pain. The aim of the present multicentre study was to examine test-retest and interexaminer reliability of intra-oral QST measures in terms of absolute values and z-scores as well as within-session coefficients of variation (CV) values in patients with atypical odontalgia (AO) and healthy pain-free controls. Forty-five patients with AO and 68 healthy controls were subjected to bilateral intra-oral gingival QST and unilateral extratrigeminal QST (thenar) on three occasions (twice on 1 day by two different examiners and once approximately 1 week later by one of the examiners). ⋯ Most of the standardised intra-oral QST measures showed fair to excellent interexaminer (9-12 of 13 measures) and test-retest (7-11 of 13 measures) reliability. Furthermore, no robust differences in reliability measures or within-session variability (CV) were detected between patients with AO and the healthy reference group. These reliability results in chronic orofacial pain patients support earlier suggestions based on data from healthy subjects that intra-oral QST is sufficiently reliable for use as a part of a comprehensive evaluation of patients with somatosensory disturbances or neuropathic pain in the trigeminal region.
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Multicenter Study
Self-reported bruxism and temporomandibular disorders: findings from two specialised centres.
The aims of this investigation were to report the frequency of temporomandibular disorders (TMD) diagnoses and the prevalence of self-reported awake and sleep bruxism as well as to describe the possible differences between findings of two specialised centres as a basis to suggest recommendations for future improvements in diagnostic homogeneity and accuracy. A standardised Research Diagnostic Criteria for TMD (RDC/TMD) assessment was performed on patients attending both TMD Clinics, viz., at the University of Padova, Italy (n=219; 74% women) and at the University of Tel Aviv, Israel (n=397; 79% women), to assign axis I physical diagnoses and to record data on self-reported awake and sleep bruxism. ⋯ The more widespread use of TMJ imaging techniques in one clinic sample led to a higher prevalence of multiple diagnoses, and the higher prevalence of self-reported bruxism in patients with myofascial pain alone described in the other clinic sample was not replicated, suggesting that the different adoption of clinical and imaging criteria to diagnose TMD may influence also reports on their association with bruxism. From this investigation, it emerged that the features of the study samples as well as the different interpretation of the same diagnostic guidelines may have strong influence on epidemiological reports on bruxism and TMD prevalence and on the association between the two disorders.
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Multicenter Study
Some remarks on the RDC/TMD Validation Project: report of an IADR/Toronto-2008 workshop discussion.
A large-scale, multi-site study has been performed to examine the reliability and validity of the research diagnostic criteria for temporomandibular disorders (RDC/TMD) and to suggest revisions of the current RDC/TMD. During an International Association for Dental Research (IADR) Workshop in July 2008, preliminary results of this RDC/TMD Validation Project were presented. One of us was invited to be the critical discussant of the Workshop session in which the Study Group's papers were presented. ⋯ Further, to come to a revised RDC/TMD, it is crucial to know not only how the test outcomes are capable of discriminating between patients with TMD pain and pain-free subjects, as studied in this Validation Project, but also, more importantly, how they discriminate between patients with TMD pain and patients with oro-facial pain (OFP) complaints of non-TMD origin. We welcome the suggestion of an international expert panel to consider, deliberate, and reach consensus on a revised version of the RDC/TMD. Finally, we agree that the suggested expansions of the RDC/TMD taxonomy stress the need for the development of an RDC for OFP, which would include, as an integral part, the revised RDC/TMD.