J Orofac Pain
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To estimate the clinically important change (CIC) on a 100-mm visual analog scale for pain intensity (VAS-PI) by relating it to the patient's global impression of change (PGIC) in patients with chronic temporomandibular disorder (TMD) pain and to assess the dependency of the CIC on their baseline pain scores. ⋯ Providing a standard definition of the CIC adds to the interpretability of study results, ie, the estimates will aid in understanding individual patient outcomes.
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To derive reliable and valid revised Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms for clinical TMD diagnoses. ⋯ Revised RDC/TMD Axis I TMD diagnostic algorithms are recommended for myofascial pain and joint pain as reliable and valid. However, revised clinical criteria alone, without recourse to imaging, are inadequate for valid diagnosis of two of the three disc displacements as well as osteoarthritis and osteoarthrosis.
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Review Comparative Study
Reviewing the evidence: can cognitive behavioral therapy improve outcomes for patients with chronic orofacial pain?
To review evidence for chronic orofacial pain management using cognitive behavioral therapy (CBT). ⋯ CBT, either alone or in combination with biofeedback, conservative treatment and/or self-care, can improve outcomes for patients with TMD in secondary care. However, further research is needed to assess its effectiveness in primary care and in management of other chronic orofacial pain conditions. Further, the number of sessions needed, mode of delivery, and cost-effectiveness also remain unclear.
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The primary aim was to determine new estimates for the measurement reliability of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms. A second aim was to present data on the reliability of key clinical measures of the diagnostic algorithms. ⋯ Reliability of the RDC/TMD protocol was good to excellent for myofascial pain, arthralgia, disc displacement with reduction, and disc displacement without reduction with limited opening. Reliability was poor to marginally fair for disc displacement without reduction without limited opening and osteoarthrosis.
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Comparative Study
Changes in human primary motor cortex activity during acute cutaneous and muscle orofacial pain.
To use functional magnetic resonance imaging (fMRI) to determine whether orofacial cutaneous or muscle pain is associated with changes in primary motor cortex (M1) activity that outlast the duration of perceived pain, and whether these M1 changes are different during cutaneous pain compared with muscle pain. ⋯ The transient contralateral M1 signal intensity increase during orofacial muscle pain may underlie escape-like motor patterns. However, once the initial threat has subsided, longer-term reductions in M1 activity and/or excitability may occur to aid in minimizing movement of the affected part, an effect consistent with the general proposals of the Pain Adaptation Model.