Dental clinics of North America
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Dent. Clin. North Am. · Jan 2007
ReviewA critical review of the use of botulinum toxin in orofacial pain disorders.
This article reviews the appropriate use, cautions, and contraindication for botulinum neurotoxin (BoNT) and reviews the peer-reviewed literature that describes its efficacy for treatment of various chronic orofacial pain disorders. The literature has long suggested that BoNT is of value for orofacial hyperactivity and more recently for some orofacial pain disorders; however, the results are not as promising for orofacial pain. ⋯ The one exception is that BoNT has reasonable RBCT data to support its use as a migraine prophylaxis therapy. The major caveat is that the use of BoNT in chronic orofacial pain is "off-label".
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Dent. Clin. North Am. · Jan 2007
ReviewOverview of orofacial pain: epidemiology and gender differences in orofacial pain.
Chronic orofacial pain is a prevalent problem that encompasses numerous disorders with diverse causes and presenting symptoms. Compared with men, women of reproductive age seek treatment for orofacial pain conditions, as well as other chronic pain disorders more frequently. Important issues have been raised regarding gender and sex differences in genetic, neurophysiologic, and psychosocial aspects of pain sensitivity and analgesia. Efforts to improve our understanding of qualitative sex differences in pain modulation signify a promising step toward developing more tailored approaches to pain management.
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Dent. Clin. North Am. · Jan 2007
ReviewNeuropathic orofacial pain: proposed mechanisms, diagnosis, and treatment considerations.
The most common reason patients seek medical or dental care in the United States is due to pain or dysfunction. The orofacial region is plagued by a number of acute, chronic, and recurrent painful maladies. Pain involving the teeth and the periodontium is the most common presenting concern in dental practice. ⋯ Therefore, it is mandatory for the dental professional to develop the necessary clinical and scientific expertise on which he/she may base diagnostic and management approaches. Optimum management can be achieved only by determining an accurate and complete diagnosis and identifying all of the factors associated with the underlying pathosis on a case-specific basis. A thorough understanding of the epidemiologic and etiologic aspects of dental. musculoskeletal, neurovascular, and neuropathic orofacial pain conditions is essential to the practice of evidence-based dentistry/medicine.
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Dent. Clin. North Am. · Jan 2007
ReviewMyogenous temporomandibular disorders: diagnostic and management considerations.
Myogenous temporomandibular disorders (or masticatory myalgia) are characterized by pain and dysfunction that arise from pathologic and functional processes in the masticatory muscles. There are several distinct muscle disorder subtypes in the masticatory system, including myofascial pain, myositis, muscle spasm, and muscle contracture. ⋯ Comorbid conditions and complicating factors also are common and are discussed. Management follows with stretching, posture, and relaxation exercises, physical therapy, reduction of contributing factors, and as necessary, muscle injections.