Pain Dysfunction Syndrome Research Articles

Clinical experience of the carboxytherapy method in the treatment of patients with temporomandibular joint pain dysfunction syndrome (К07.60)

Objective. Improving the effectiveness of treatment of patients with TMJ PDS myogenic origin. Material and methods. According to the purpose of the study, a group of 10 patients (8 women and 2 men aged 14 to 60 years) was formed with the coincidence of a triad of signs: pain during movements of the lower jaw, a feeling of heaviness and tension in the chewing and facial muscles, restriction of mouth opening. A set of diagnostic measures has been implemented in the following scope: clinical and radiological examination methods, TMJ MRI, ultrasound and surface EMG of the chewing muscles, digital axiography. In the treatment of patients in the study group, the method of invasive carboxytherapy was used, based on dosed injections of CO2 in the projection of trigger points of the masticatory muscles. The research examines the therapeutic value of using of CO2 in the protocol of functional rehabilitation of patients with TMJ diseases of myogenic origin. Results. The analysis of the effectiveness of treatment of patients in the study group was carried out to assess the dynamics of key parameters: the severity of the pain syndrome according to VAS, the magnitude of the IMPACT index values and the magnitude of mouth opening. The severity of pain in patients in the study group, according to average values, decreased by 86% from the initial values, an increase in the amplitude of mouth opening by 28.5%, a decrease in the IMPACT index values by 42.5% from the initial values of hypertonicity of the masticatory muscles, an increase in blood flow speed of superficial temporal artery at 52.5%. Conclusion. The results of the clinical application of the carboxytherapy method in the treatment of patients with TMJ PDS allow us to recommend this method for implementation in the rehabilitation protocols of patients with TMJ PDS of myogenic origin, trismus and hypertonus of the masticatory muscles. Carboxytherapy as a method of etiopathogenetic rehabilitation contributes to the early relief of pain syndrome, normalization of the bioelectric activity of the chewing muscles and restoration the physiological kinematics of the lower jaw’s movements.

Laser therapy versus occlusal splint and local anesthesia injection in management of myofascial pain dysfunction syndrome.

Laser therapy versus occlusal splint and local anesthesia injection in management of myofascial pain dysfunction syndrome.

Efficacy of different low-level laser therapy sessions in the management of masseter muscle trigger points

BackgroundLow-level laser therapy (LLLT) is one of the recent treatment modalities for myofascial pain dysfunction syndrome with trigger points. The objective of the present study was to examine the impact of varying LLLT sessions on the treatment of masseter muscle trigger points.Methods90 patients diagnosed with orofacial pain and trigger points in the masseter muscle for at least 6 months were selected and divided into 3 groups (n = 30) based on the number of LLLT sessions provided to patients. Patients in Group I received one session/per week, group II received two sessions/per week, and Group III received three sessions/per week. The sessions continued for 4 weeks, evaluations of pain levels, maximum mouth opening (MMO), and quality of life were conducted before and after the procedure at 1, 2, 3, 4, and 8 weeks.ResultsThe pain scores exhibited a highly statistically significant difference among the three groups (p < 0.001) over the 8-week study period. MMO was statistically significantly different between groups at week 4 and week 8. The Oral Health Impact Profile-14 (OHIP-14) score was statistically significant difference between groups at week 8. The time showed a highly significant effect on the study outcomes within each group.ConclusionIncreased the number of LLLT sessions reduced the pain improved the MMO, and subsequently improved the quality of life.ClinicalTrials.gov IDNCT06327204 - retrospectively registered.

Evaluation of lignocaine HCl as a therapeutic and diagnostic tool in myofascial pain dysfunction syndrome and internal derangement

Background: Myofascial pain syndrome MPS is one of the most common causes of chronic musculoskeletal pain. It clinically presents with hypersensitive points in the muscle called “trigger points”. Most of the time it remains undiagnosed/undertreated and this leads to severity in symptoms. Deactivation/elimination of trigger points (TrPs) remains the cornerstone of myofascial pain dysfunction syndrome (MPDS) management. The most commonly employed techniques clinically are dry needling of the TrP, local anesthetics or saline injections into TrP, spray and stretch, and ultrasound/electrogalvanic stimulation. Although peripheral nerve blocks are widely used for chronic pain management, their role in myofascial pain dysfunction syndrome is not yet well established. Our study aims to demonstrate the role of mandibular nerve block using lignocaine hydrochloride in the management of MPDS. Materials and Method: Our study is a single-centered randomized control trial performed to evaluate the diagnostic and therapeutic role of mandibular nerve block in treating myofascial pain dysfunction syndrome. A total of 20 subjects fulfilling the inclusion criteria were enrolled in the study. Clinical parameters (pain, mouth opening, and mandibular deviation) were assessed at each follow-up appointment. Result: All of our patients had significant pain relief at the end of 1 month (P &lt; 0.001), and a substantial improvement in mouth opening is also noted (P &lt; 0.001). There was a significant improvement in deviation immediately after nerve block, and further gradual improvement was observed during each follow-up. Conclusion: Our study confirmed the role of mandibular nerve block in myofascial pain management. The diagnostic value of mandibular nerve block in differentiating MPDS from internal derangement is also highlighted.

Prevalence of stress associated oral mucosal disorders among patients from Southern Rajasthan, India

Data on the prevalence of stress associated oral mucosal lesions/conditions such as Oral lichen planus, Apthous ulcers, Burning mouth syndrome, Headache, Xerostomia, Halitosis, Myofacial pain Dysfunction syndrome amongst population of Southern Rajasthan is of interest to dentists. Cross sectional study had been conducted on 5214 patients from 18-60 years age group who visited the Department of the Oral Medicine and Radiology, Pacific Dental College and Research Centre, Bedla, Udaipur. Findings such as burning of oral mucosa, presence of vesicles and ulcers, striation in oral cavity, limitation of jaw movement, muscular pain were assessed for the establishment of diagnosis. Prevalence of stress associated oral mucosal lesions/conditions like Oral lichen planus, Apthous ulcers, Burning mouth syndrome, Headache, Xerostomia, Halitosis, Myofacial pain Dysfunction syndrome was reported to be 12%, 17%, 3%, 21%, 6 %, 23 and 18% respectively. Besides stress management therapy, Professional consultation along with proper investigation and medicinal treatment is required

Prognostic model of pain syndrome of temporomandibular joint dysfunction in patients with occlusion-articulation disorders

Resume. Diagnostic efficiency and treatment of TMJ dysfunction was and remains an important problem modern dentistry. The urgency of this problem is determined by the great the prevalence of this pathology, the annual increase in the number of patient appeals, variety of clinical manifestations, significant difficulties in diagnosis and treatment. The aim of the work was to predict the pain syndrome of functional disorders of the masticatory apparatus when planning orthopedic treatment. Research materials and methods. Clinical and laboratory examination and orthopedic treatment of 150 patients with various variants of occlusal disorders were carried out, in 90 of them functional disorders of the masticatory apparatus were not accompanied by pain syndrome (comparison group), in 60 patients (main group) - TMJ dysfunction with pain syndrome Research results. The statistically significant data obtained by us demonstrate that the multi-level mechanism of changes in microarchitectonics due to occlusal and articulatory disorders, the influence of gender and age, and other unmodified factor balance of the work of muscle-articular structures of the dento-maxillary system can clinically manifest as a pain syndrome, and therefore requires orthopedic treatment taking into account correction of intra-articular disorders. Conclusions. Multivariate analysis of the cumulative effect of factors on the risk of pain syndrome development of functional disorders of the masticatory apparatus in case of violation of occlusal-articulatory relations allowed to create a prognostic model (model sensitivity - 0.967%, specificity - 0.971%) with a Youden index of 1.0. This prognostic model can serve as an accurate tool for the development of TMJ dysfunction pain syndrome at the stage of orthopedic treatment planning.

Etiological factors of temporomandibular joint disorders

The temporomandibular joint disorders are defined as a collective term embracinga number of clinical problems that involve the masticatory muscles, the TMJ andassociated structures. Myofacial pain dysfunction syndrome (MPDS) is the most common.functional disorder of TMJMany etiological factors have been blamed to produce pain and dysfunction of.TMJ such as stress, malocclusion and parafunctional habitsStress is thought to be responsible for hyperactivity of the muscles of mastication.which leads to muscle fatigue then muscle spasm and painThe purpose of this study was to determine the role of stress as an ctiological.)factor in (MPDSOne hundred dental students were used in this study and evaluated for havingMPDS. Another sample of one hundred persons from the general population were.evaluated in the same manner to be used as controlThe results of this study indicated that (55%) of participating students haveMPDS) because of the great amotmts of stress they are going through. While in control group there was only (7%).&#x0D;

Targeted Drug Designing for Treating Masticatory Myofascial Pain Dysfunction Syndrome: An In Silico Simulation Study.

Background Masticatory Myofascial Pain Dysfunction Syndrome (MMPDS) is a musculoligamentous disorder that shares similarities with temporomandibular joint pain and odontogenic pain. It manifests as dull or aching pain in masticatory muscles, influenced by jaw movement. Computer-aided drug design (CADD) encompasses various theoretical and computational approaches used in modern drug discovery. Molecular docking is a prominent method in CADD that facilitates the understanding of drug-bimolecular interactions for rational drug design, mechanistic studies & the formation of stable complexes with increased specificity and potential efficacy. The docking technique provides valuable insights into binding energy, free energy, and complex stability predictions. Aim The aim of this study was to use the docking technique for myosin inhibitors. Materials and methods Four inhibitors of myosin were chosen from the literature. These compound structures were retrieved from the Zinc15 database. Myosin protein was chosen as the target and was optimized using the RCSB Protein Data Bank. After pharmacophore modeling, 20 novel compounds were found and the SwissDock was used to dock them with the target protein. We compared the binding energies of the newly discovered compounds to those of the previously published molecules with the target. Results The results indicated that among the 20 molecules ZINC035924607 and ZINC5110352 exhibited the highest binding energy and displayed superior properties compared to the other molecules. Conclusion The study concluded that ZINC035924607 and ZINC5110352 exhibited greater binding affinity than the reported inhibitors of myosin. Therefore, these two molecules can be used as a potential and promisingleadfor the treatment of MMPDSand could be employed in targeted drug therapy.

Digital and Clinical evaluation of temporomandibular disorders in full dentition and free end extension patients.

Background: Temporomandibular disorders (TMD) Which are a subgroup of craniofacial pain disorders involving chronic pain, dysfunction of the temporomandibular joint (TMJ), masticatory muscles and associated musculoskeletal structures of the head and neck. Pain is one of the most frequent clinical features for these TMD in addition to the clicking, limitation of mouth opening and deviation. This study aimed to evaluate Digital evaluation of the occlusal instability parameters (Disclusion Time, Occlusion Time, trajectory of force Index and Occlusal Interferences). Method: the study including 180 patients with free end extension and full dentition (kennedy classification class I and II) their age was between (20-50) years old .they had either disc displacement or myofascial pain dysfunction syndrome according to shiffman criteria.and also examined by digital T scan. Result: the result showed significant pain difference between free end extension and full dentition patients. Conclusion: The trajectory of force distribution is highly variable between the two major groups, the full dentition exhibit more posterior force while The free end patients tend to establish more anterior force which lead to a series of temporomandibular disorders.

Change in the clinical status of a patient with dysfunction of the temporomandibular joint after osteopathic correction of somatic dysfunctions

The described clinical case shows positive results of osteopathic correction in the complex treatment of syndrome of pain dysfunction of the temporomandibular joint (DTMDJ). Diagnosis and treatment of this syndrome attract attention because of the ambiguity of the etiology, pathogenesis and lack of effectiveness the treatment algorithm to achieve a stable result. In order to increase the adaptive capabilities of the body to the changes occurring in the stomatognathic system in the treatment of DTMDJ, we have developed and put into practice an interdisciplinary principle of diagnosis and treatment, which consists in an objective assessment of the clinical manifestations of somatic dysfunctions and their elimination before the start of dental intervention, which is carried out with adequate osteopathic support, leveling the increased load on the adaptation mechanisms. The dental intervention itself is carried out with adequate osteopathic support, leveling the increased load on the adaptation mechanisms. Interdisciplinary interaction allows you to optimize the approach to dental treatment.

Efficacy of Low-Level Laser Therapy in the Management of Myofascial Pain Dysfunction Syndrome. Comparative Controlled Clinical Trial

Efficacy of Low-Level Laser Therapy in the Management of Myofascial Pain Dysfunction Syndrome. Comparative Controlled Clinical Trial

ORTHODONTIC PATHOLOGY IN THE SYNDROME OF PAIN DYSFUNCTION OF THE TEMPOROMANDIBULAR JOINT IN CHILDREN AND ADOLESCENTS

The number of patients with temporomandibular joint pain dysfunction syndrome (TMJ) is increasing every year, and the number of children and adolescents is also growing. One of the causes of the disease is considered to be dental pathology, in particular dental anomalies.&#x0D; A survey of 622 students of gymnasiums and lyceums was carried out, which were divided into 2 age groups according to the main periods of the formation of the dental system and the scheme of age periodization of human ontogenesis.&#x0D; An increase in the prevalence of TMJ SBD in adolescence was found (weak reliable relationship, r=0.10, p0.05).&#x0D; In two age groups, correlation analysis revealed a weak reliable relationship between HR and TMJ SBD (r=0,21 in children and r=0,16 in adolescents) (p0,01); as well as a weak significant association of distal bite (r=0,13, p0.01), and excessively deep vertical bite with TMJ SBD (r=0,15, p0,01) in adolescence.&#x0D; Key words: syndrome of pain dysfunction of the temporomandibular joint, dentomandibular anomalies, cervical vertebral dystrophy syndrome

New Avenue for Treatment of Dentinal Hypersensitivity Assisted with Tekscan a Diagnostic Tool

ABSTRACT Background: Occlusion is dynamic and plays an important role in the functioning of the stomatognathic system. Disturbance in one of the components of the stomatognathic system may result in hypersensitivity of teeth, orofacial pain, migraine, and temporomandibular joint (TMJ) disorders. Coronoplasty done using articulating paper is the conventional method for occlusal corrections. T-scan is a computerized occlusal analysis system that overcomes the limitations of articulating paper. Methods: Patients with Myofacial pain dysfunction syndrome (MPDS) having dentinal hypersensitivity were taken into consideration. The case series included three cases. A joint vibratory analysis (JVA) is performed using a JVA device to rule out any TMJ disorders. T-scan-assisted coronoplasty is performed. Patients are asked to score for dentinal hypersensitivity on the VAS scale pre and postoperative. Results: Occlusion and disocclusion time is reduced along with hyperactivity of the muscles after T-scan-assisted coronoplasty. There is a reduction in dentinal hypersensitivity postoperative. Conclusion: T-scan quantifies the forces and hence proved a boon in the field of dentistry. The present case series highlights coronoplasty assisted with a T-scan for diagnosis and treatment planning of hypersensitivity of teeth; hence it is the future of dentistry. Practical Implications: T-scan is a device that is assisted with electromyography. It projects the forces of mastication at every contact point of maxillary and mandibular teeth and reveals muscular hyperactivity. It can be used in MPDS patients with dental hypersensitivity due to occlusal discrepancy as it can guide elective coronoplasty relieving pain and dentinal hypersensitivity.

Photobiomodulation therapy: an exemplary therapeutic approach to myofascial pain dysfunction syndrome—a randomized controlled trial and review of the literature

Photobiomodulation therapy: an exemplary therapeutic approach to myofascial pain dysfunction syndrome—a randomized controlled trial and review of the literature

Medical rehabilitation of patients with flat feet after surgical treatment: scientometric analysis

Background: In the postoperative rehabilitation of patients operated on for a flat foot, an important task is to relieve pain and locomotor dysfunction syndrome, since these disorders reduce the quality of life of patients, and can also lead to relapse and the appearance of new deformities. Currently, an urgent issue is the choice of rehabilitation technologies that have a high level of evidence. In order to determine the totality of such technologies, it is necessary to conduct a scientometric analysis of publications in available databases. The purpose of the study: to conduct a scientometric analysis of evidence-based studies with high methodological quality on the use of rehabilitation technologies in patients with flat feet after surgical treatment. Methods: The analysis included the publications for the period from 2000 to 2023 from 4 databases: eLibrary, PubMed, Cochrane Library, and PEDro. Publications were evaluated on a ten-point PEDro score. The level of evidence was assessed according to GOST R 56034–2014 in accordance with the Order of the Ministry of Health of the Russian Federation No. 103n dated 28.02.2019. Results: 4,187 unique publications on flat feet were extracted from the databases. Of these, 479 were devoted to rehabilitation and conservative treatment. The final analysis included 4 publications devoted to the conservative treatment of a flat foot. According to the results of the analysis, a decrease in pain syndrome and an improvement in the quality of life in patients were revealed with the use of physical exercises, orthotics, and myofascial release in conservative therapy of the flat foot. There was also an improvement in biomechanical parameters when using orthotics and myofascial release. The data on the effect of orthotics and physical exercises on foot deformities are contradictory. Conclusion: Due to the common pathogenesis of pain syndrome and biomechanical disorders in patients with flat feet and in patients in the postoperative period, physical exercises, orthotic insoles, and myofascial release can be used as rehabilitation techniques, but evidence of their effectiveness for this group of patients requires additional research.

Treatment approach to patients with distal malocclusion complicated by temporomandibular joint pain-dysfunction syndrome

Research is effective sequencing of measures for orthodontic treatment active period and unfavorable course of retention period predictors in patients with distal malocclusion, complicated by temporomandibular joint pain-dysfunction syndrome. The retrospective study consists of 102 case reports of patients from 18 to 37 (average age is 26.75±3.25 years) with distal malocclusion (Angle Class II division 2 subdivision) associated with temporomandibular joint pain-dysfunction syndrome. Cases of successful treatment were 30.4% (n=31), semi-successful - 42.2% (n=43), semi-unsuccessful - 18.6% (n=19), unsuccessful - 8.8% (n=9). ANOVA analysis of orthodontic treatment stages reveals main risk factors for pain syndrome recurrence in retention period. The ineffective morphofunctional compensation and unsuccessful orthodontic treatment predictors are: incomplete pain syndrome elimination, persistent masticatory muscles dysfunction, distal malocclusion recurrence, condylar process distal position recurrence, deep overbite, upper incisors retroinclination for more than 15°, single posterior tooth interference. Thus, pain syndrome recurrence prevention in retention orthodontic treatment period includes pain and masticatory muscles dysfunction elimination in pre-treatment period, physiological dental occlusion and condylar process central position in active period.

Osteopathic correction as part of the complex treatment of temporomandibular disorder

Described clinical case shows positive results of osteopathic correction in the complex treatment of syndrome of pain dysfunction of the temporomandibular joint (TMJ). Diagnosis and treatment of this syndrome attract attention because of the ambiguity of the etiology, pathogenesis and lack of effectiveness the treatment algorithm to achieve a stable result. We have developed and put in our practice own interdisciplinary algorithm which allows us to diagnose and resolve somatic dysfunctions before dental treatment. The purpose of that is increasing of adaptive functions of the body to changes in the dental system during the treatment. At the same time, dental treatment has to be with osteopathic support which levels increased load on adaptation mechanism which changes during dental bite correction. The interdisciplinary algorithm proposed by us allows us to evaluate the prognosis of the effectiveness of treatment of TMJ at the earliest diagnostic stages.

Comparative Evaluation of Efficacy of Therapeutic Ultrasound and Phonophoresis in Myofascial Pain Dysfunction Syndrome

Introduction: Myofascial pain dysfunction syndrome (MPDS) is a common presenting condition in the dental office. No specific therapy has proven its superiority over the other in managing myofascial pain dysfunction syndrome. Since phonophoresis was beneficial for other musculoskeletal medical conditions, the same strategy was adopted to prove its efficacy in MPDS. Aim and Objective: The aim of the study is to compare and evaluate the effectiveness of therapeutic ultrasound (ThUS) and diclofenac and thiocolchicoside gel phonophoresis in MPDS. Materials and Methods: Thirty patients with MPDS were randomly assigned into two groups. Group 1 (n = 15), therapeutic ultrasound was applied with ultrasound gel without any therapeutic ingredient for 10 min and five sessions. Group 2 (n = 15), ultrasound was applied with ultrasound gel with diclofenac and thiocolchicoside gel for 10 minutes and five sessions. Pain and mouth opening was taken as evaluation parameters. Result: A comparison of results obtained from the two groups before and after treatment at the end of each session shows significant improvement in both the parameters. However, in Group 2 more improvement in all outcome variables can be seen compared with group 1. Conclusion: Phonophoresis with diclofenac and thiocolchicoside (analgesic and muscle relaxant) proved to be an excellent treatment in MPDS. They proved more effective than therapeutic ultrasound in controlling pain and improving mouth opening.

Comparative Efficacy of Low-Level Laser Acupuncture and Cupping for Treatment of Patients with Myofascial Pain Dysfunction Syndrome: A Double-blinded, Randomized Clinical Trial: Comparison of the Effects of LLL Acupuncture and Cupping.

Background: Myofascial pain dysfunction syndrome (MPDS) is among the most common causes of facial pain. This study compared the efficacy of low-level laser (LLL) acupuncture and cupping for the treatment of MPDS. Materials and Methods: This double-blind, before-after, randomized clinical trial evaluated 60 MPDS patients that were divided into two groups for LLL acupuncture (808 nm, 0.5 W, 30 J, 4 J/cm2 energy density, 60 seconds; group 1), and cupping (group 2) of masticatory muscle trigger points. Both treatments were performed for maximally eight sessions once every other day. The level of pain at the trigger points was measured upon admission, before and 5 minutes after treatment in each session, at ten days, and two months after treatment completion by a visual analog scale (VAS). The painless maximum mouth opening (MMO) and patient satisfaction with treatment were also assessed at the time as mentioned earlier points. Results: Averagely, 4.5 treatment sessions were required to achieve a 50% reduction in VAS pain score, with no significant difference between the two groups (P=0.9). Both treatments significantly decreased the number of trigger points and pain score, but this reduction occurred significantly sooner in the cupping group (P=0.01). MMO significantly improved in both groups after treatment with no significant difference between them (P=0.2). Patients were significantly more satisfied with LLL acupuncture (P=0.05). Conclusion: Both cupping and LLL acupuncture are equally effective for MPDS; thus, the patient can choose the type of treatment after receiving sufficient information regarding the two modalities.

Role of physiotherapy in M.P.D.S: Systematic review and meta-analysis

Aim: To analyze the methodologic quality, summarize the findings, and perform a meta-analysis of the results from randomized controlled trials that assessed the effects of physiotherapy management of Myofascial Pain Dysfunction syndrome (MPDS). Methodology: A literature review was performed using the electronic databases PubMed, Science Direct. Each article was independently assessed by two investigators using the Cochrane Risk of Bias tool. A meta-analysis was conducted to obtain summary estimates of the standardized mean differences (SMD) and the corresponding 95% confidence intervals (95% CI). Between-study heterogeneity was computed and publication bias was assessed. Results : Seven articles met the inclusion criteria and were used in the analysis, corresponding to nine estimates of SMD. The meta-analysis showed that for pain reduction, the summary SMD favored physiotherapy (SMD = −0.63; 95% CI: −0.95 to −0.31; number of studies = 8; I2 = 0.0%), while for active range of movement (ROM) the differences between the intervention and control groups were not statistically significant (SMD = 0.33; 95% CI: −0.07 to 0.72; number of studies = 9; I2 = 61.9%). Conclusion: Physiotherapy seems to lead to decreased pain and may improve active muscle movement.