Cranio
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The use of the iontophoresis modality for driving medications through the skin for treatment of certain TM dysfunction and myofascial pain dysfunction syndrome was first suggested by Gangarosa and Mahan in 1982. This paper introduces the iontophoresis technique for treatment of inflammatory and myofascial disorders of the craniomandibular system. The historical aspects of iontophoresis in medicine and dentistry is reviewed. ⋯ Reference is made to the advantages of iontophoresis over hypodermic injection. The basis materials and methods of use of the modality are shown along with a protocol for patient treatment. Several case studies are discussed with clinical observations given.
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An association exists between bruxism, tension headache, and sleep disorders, particularly sleep apnea, in the craniomandibular dysfunction patient. Understanding the relationship of these three entities provides the clinician with valuable information that enhances one's ability to make a differential diagnosis. A review of sleep disorders is presented so that a clearer understanding of them can be gained, with emphasis on obstructive sleep apnea. Current theories regarding bruxism, morning headache, and sleep disorders relate closely to altered muscle activity, altered breathing and fluctuation in oxygen saturation levels, which in turn can contribute to a patient's complaints of various types of facial pain.