J Orofac Pain
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Pain-pressure thresholds of the head and neck region of 31 female patients (aged 13 to 50 years; mean, 28.4 +/- 9.6 years) suffering from episodic tension-type headache and 32 female control subjects (aged 15 to 46 years; mean, 26.6 +/- 8.6 years) were recorded with an electronic algometer by the same blinded observer. The multivariate analysis of variance revealed that the algometer values obtained from different age groups of patients and control subjects were statistically different, but the values for the right-side muscles were not statistically different from the corresponding values for the left-side muscles. ⋯ The results may indicate that pain-pressure thresholds of the head and neck region should be considered in the diagnosis of episodic tension-type headache. The results may also propose that the increased pain sensitivity of the head and, especially, the neck region, may be included in the pathogenetic mechanism in episodic tension-type headache.
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Comparative Study Clinical Trial Controlled Clinical Trial
Thermographic assessment of neuropathic facial pain.
Ongoing pain, intermittent sharp pain, or intermittent dull aching pain around the teeth can evoke the suspicion of tooth pathology. However, when no dental cause can be found clinically or radiographically, the differential diagnosis involving neuropathic pain and pulpal pathology is still a challenge. Neuropathic facial pains are still too often misdiagnosed as tooth pain of dental origin, resulting in unnecessary dental extraction or endodontic therapy. ⋯ The other half of the patients with sympathetically independent traumatic trigeminal neuralgia displayed "cold" thermograms in the area of their pain complaints. Electronic thermography was the least selective test for the group showing "cold" thermogram patterns (80% agreement with the thermographic characterization criteria). These data suggest that electronic thermography may be helpful in differentiating neuropathic pains from pulpal pathology.
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Case Reports
Fibrous ankylosis of the temporomandibular joint: report of a case with atypical presentation.
A case of chronic unilateral mandibular dislocation with development of fibrous ankylosis is presented. This was an unusual presentation of intracapsular tissue ankylosis to the eminentia, as well as retrocondylar cicatrix combined with contralateral mandibular osseous compensations and remodeling with resulting ramus impingements upon relocation of the condyle. Various diagnostic and therapeutic considerations are reviewed and discussed.
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Case Reports
Temporomandibular joint derangement with multiple surgical interventions: a case report.
This case report describes the experience of a 26-year-old woman who underwent multiple jaw surgeries. An initial 22 months of unsuccessful nonsurgical therapy was followed by a 7-year period during which the following were performed: 12 surgeries of her right temporomandibular joint; one surgery of her left temporomandibular joint; bilateral coronoidectomies; one surgery of her right mandible; and three surgeries of her left mandible. This case is important because although the existence of multiple jaw surgery cases are widely noted throughout the literature, this is the first case report that presents in-depth prospective documentation.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized clinical trial of intraoral soft splints and palliative treatment for masticatory muscle pain.
Thirty subjects seeking treatment for masticatory muscle pain at a university-based TMJ clinic were randomly assigned to soft-splint, palliative-treatment, and no-treatment groups. After 4 to 11 weeks of treatment, subjects were evaluated for changes from their baseline levels of symptoms, maximum pain-free opening, pain thresholds measured by a pressure algometer, and occlusal contacts. ⋯ The soft-splint group had fewer occlusal contact changes assessed with shimstock compared to the palliative-treatment and no-treatment groups. The findings of this study suggest that the soft splint is an effective short-term treatment for reducing the signs and symptoms of masticatory muscle pain in patients, and the soft splint does not cause occlusal changes.