J Orofac Pain
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Randomized Controlled Trial Comparative Study
Conditioned pain modulation evoked by different intensities of mechanical stimuli applied to the craniofacial region in healthy men and women.
To investigate systematically whether conditioned pain modulation (CPM) evoked by tonic mechanical stimuli applied to the craniofacial region is intensity-, assessment site-, and gender-dependent. ⋯ CPM evoked by mechanical stimulation of the craniofacial region is intensity-dependent but not assessment site- or gender-dependent.
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Controlled Clinical Trial
A mandibular advancement appliance reduces pain and rhythmic masticatory muscle activity in patients with morning headache.
To evaluate the influence of an oral appliance on morning headache and orofacial pain in subjects without reported sleep-disordered breathing (SDB). ⋯ Short-term use of an MAA is associated with a significant reduction in morning headache and orofacial pain intensity. Part of this reduction may be linked to the concomitant reduction in RMMA.
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To use magnetic resonance imaging (MRI) and voxel-based morphometry (VBM) to search for evidence of altered brain morphology in patients with temporomandibular disorders (TMD). ⋯ These data support previous findings by showing that TMD, like other chronic pain states, is associated with changes in brain morphology in brain regions known to be part of the central pain system.
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To compare kinematic parameters (ie, amplitude, velocity, cycle frequency) of chewing and pain characteristics in a group of female myofascial temporomandibular disorder (TMD) patients with an age-matched control female group, and to study correlations between psychological variables and kinematic variables of chewing. ⋯ This exploratory study has provided data suggesting that psychological factors, manifesting in depression and stress, play a role in influencing the association between pain and motor activity.
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Practice Guideline
Position paper: appropriate use of pharmacotherapeutic agents by the orofacial pain dentist.
Orofacial Pain Dentistry is concerned with the prevention, evaluation, diagnosis, treatment, and management of persistent and recurrent orofacial pain disorders. The American Dental Association, through the Commission on Dental Accreditation (CODA), now recognizes Orofacial Pain as an area of advanced education in Dentistry. It is mandated by CODA that postgraduate orofacial pain programs be designed to provide advanced knowledge and skills beyond those of the standard curriculum leading to the DDS or DMD degrees. ⋯ It is the responsibility of the orofacial pain dentist to accurately diagnose the cause(s) of the pain and decide if treatment should be dentally, medically, or psychologically oriented, or if optimal management requires a combination of all three treatment approaches. Management may consist of a number of interdisciplinary modalities including, eg, physical medicine, behavioral medicine, and pharmacology or, in rare instances, surgical interventions. Among the essential armamentarium is the knowledge and proper use of pharmacologic agents.