Cranio
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Using a new electronic algometer, the mean values and standard deviations of pressure pain threshold and the intrarater and interrater reliability were evaluated on 13 muscles of the human head and neck region. The subjects were 40 healthy individuals, 21 females and 19 males. ⋯ Statistically significant correlation coefficients were obtained from the values of intra-examiners and inter-examiners in all muscles except the medial pterygoid and middle sternocleidomastoid muscle in male subjects (p < 0.05). This study showed that the electronic algometer could be recommended for evaluation of the pressure pain threshold of human head and neck muscles in clinical and experimental studies.
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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.
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The reliability and validity of an algometer pressure threshold meter (PTM) was evaluated on 45 individuals, 25 healthy volunteers and 20 patients with craniomandibular dysfunction. Tenderness upon palpation was measured at six points located on the masseter muscle, the anterior temporal muscle, and on the zygomatic arch. The validity of the PTM was evaluated by comparison of the PTM values obtained by one examiner with the finger palpation score obtained by another examiner (Part 1). ⋯ High reliability coefficients (r = 0.79-0.94) were found at all the points. The study also showed that if the points were located with a certain inaccuracy (1.0 mm less than x less than 2.6 mm), the reliability coefficients were still of the same magnitude. The PTM can be recommended for evaluation of pressure pain thresholds in the masticatory system in clinical and experimental studies.