Journal of dental research
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The U. S. biomedical research community finds itself at a particularly consequential moment. Since the end of the Fiscal Year (FY) 1998-2003 NIH budget doubling period, brought to fruition with bipartisan leadership, the Federal investment in biomedical research has been declining. ⋯ However, the advocacy effort must be broad-based and repeatedly presented to effect change. The figures on economic return from spending on biomedical research are compelling, but they do not tell the entire story. The results of biomedical research improve and save lives every single day, a fact that should not be lost on our elected leaders.
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This study compared the jaw-muscle electromyographic (EMG) activity during sleep in patients with craniofacial pain (n = 63) or no painful conditions (n = 52) and between patients with tension-type headache (TTH: n = 30) and healthy control individuals (n = 30). All participants used a portable single-channel EMG device (Medotech A/S) for four nights. There was no significant difference in EMG activity between craniofacial pain (24.5 ± 17.9 events/hr) and no painful conditions (19.7 ± 14.5), or between TTH (20.8 ± 15.0) and healthy control individuals (15.2 ± 11.6, p >.050). ⋯ This short-term observational study suggests that there are no major differences between patients with different craniofacial pain conditions and pain-free individuals in terms of jaw-muscle EMG activity recorded with a single-channel EMG device during sleep. However, some associations may exist between the level of EMG activity and various parameters of craniofacial pain. Longitudinal studies are warranted to further explore the relationship between sleep bruxism and craniofacial pain.
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Randomized Controlled Trial Comparative Study
Randomized controlled trial on physical therapy for TMJ closed lock.
This study evaluated the one-year effect of physical therapy on pain and mandibular dysfunction associated with anterior disc displacement without reduction of the temporomandibular joint (closed lock). Forty-nine individuals were randomly assigned to either a physical therapy group [n = 23, mean age (SD) 34.7 (14.0) yrs] or a control group [n = 26, mean age 38.5 (15.1) yrs]. At baseline and after 3, 6, 12, 26, and 52 wks, pain and mandibular function were evaluated. ⋯ All pain variables decreased, and all function variables increased significantly over time for both groups. The interaction between time and treatment group was not significant. Hence, physical therapy had no significant additional effect in patients with anterior disc displacement, without reduction, of the temporomandibular joint (ClinicalTrials.gov number, CT01475630).
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Identification of brain regions that differentially respond to pain intensity may improve our understanding of trigeminally mediated nociception. This report analyzed cortical responses to painless and painful electrical stimulation of a right human maxillary canine tooth. Functional magnetic resonance images were obtained during the application of five graded stimulus strengths, from below, at, and above the individually determined pain thresholds. ⋯ Based on hemodynamic responses of all pooled stimuli, a cerebral network was identified that largely corresponds to the known lateral and medial nociceptive system. Further analysis of the five graded stimulus strengths revealed positive linear correlations for the anterior insula bilaterally, the contralateral (left) anterior mid-cingulate, as well as contralateral (left) pregenual cingulate cortices. Cerebral toothache intensity coding on a group level can thus be attributed to specific subregions within the cortical pain network.
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Randomized Controlled Trial Comparative Study
Randomized trial on the effectiveness of dexamethasone in TMJ arthrocentesis.
The aim of this study was to compare the effectiveness of dexamethasone administration following arthrocentesis of the temporomandibular joint (TMJ) with a placebo (saline). Twenty-eight participants with TMJ arthralgia were randomly assigned to two groups of a parallel double-blind RCT. In both groups, an arthrocentesis procedure was carried out. ⋯ During each visit, TMJ pain (on a 100-mm VAS) and jaw stiffness (mouth opening in mm) were scored. In the statistical analysis, generalized estimating equation (GEE) models showed no differences between the two study groups, although pain and jaw stiffness were both reduced over 24 weeks. In conclusion, intra-articular dexamethasone following arthrocentesis did not improve the procedure's effect in patients presenting with TMJ arthralgia (ClinicalTrials.gov number CT01275014).