Pain Dysfunction Syndrome Research Articles

Temporomandibular disorders in North Indian population visiting a tertiary care dental hospital.

Background:The terminology “temporomandibular disorders” (TMDs) encompasses a wide spectrum of conditions. Several hypothesized causes are occlusal disharmony, muscle hyperactivity, central pain mechanisms, psychological distress, and trauma. In day-to-day practice, TMDs had become more prevalent in Indian population due to changed dietary pattern and food habits, excessive stress of modern life, and other environmental causes. This study is an attempt to find the prevalence of TMDs in North Indian population.Aims:The present study is taken into account to determine the prevalence of TMDs on the basis of signs and symptoms based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD).Materials and Methods:The present cross-sectional study was conducted in the Department of Oral Medicine and Radiology. A total of 1009 patients aged between 6 and 80 years with a mean age of 42.04 ± 16.8 years seeking dental treatment from January 2016 to June 2017 were included in the study. All the patients were screened for TMD sign and symptoms. The demographic data and the signs and symptoms of TMDs were recorded in designed structured questionnaires which were based on the RDC/TMD criteria.Results:The study population consisted of 1009 patients aged between 6 and 80 years. In the present study population, based on RDC/TMD criteria, the incidence of clicking sound (42.5%) was highest in TMD joint followed by deviation of mandible on mouth opening (40.8%), internal derangement (36.8%), myofacial pain dysfunction syndrome (33.7%), osteoarthritis (29.5%), crepitus (25.8%), joint tenderness (5.8%), and pain on mouth opening (4.8%).Conclusion:Clicking sound was the most common sign of TMD disorders in Indian population.

Laser therapy for myofascial pain dysfunction syndrome

Myofascial pain dysfunction syndrome (MPDS) has been a very prevalent disorder with an enigmatic etiology and even difficult treatment protocol. Patients suffering from MPDS are difficult to diagnose and require exclusion of various symptoms and signs to formulate a treatment plan. In recent years, low-level laser therapy has been advocated as an effective way to counter and alleviate the resulting pain caused due to MPDS. This article is a case report on a successful reduction of pain in a patient diagnosed with the same.

Low-level laser therapy vs local anesthetic injection with muscle relaxant splint as a combination therapy for myofascial pain dysfunction syndrome a clinical study

Purpose This study aims to evaluate the efficiency of low-level laser therapy vs injection of long acting anesthetic drug as an adjunctive treatment in combination with muscle relaxant splint in treating patients suffering from myofascial pain dysfunction syndrome (MPDS). Patients and methods A total of 36 MPDS female patients represented the candidates of the present study. They were all treated with muscle relaxant splint then randomly divided into three equal groups; group 1 was treated solely with occlusal splints; group 2 was treated with long acting anesthetic injection of both the masseter and temporalis muscles bilaterally in combination with the splint therapy, while group 3 was treated with low-level laser therapy in combination with the splint therapy. Results All patients completed the study period with improvement in their visual analog scale, mouth opening and electromyography. Group 3 showed statistical significant improvement in all measures compared to group 1 and group 2. Conclusion All the utilized treatment modalities aided in reliving the signs and symptoms of the MPD patients and improved their mouth opening and muscle activity. Utilizing low-level laser therapy in combination with splint therapy was found to be the best adjunctive treatment modality, compared to the injection of long acting anesthetic agent and splint therapy.

A Comparative Study of Low-Level Laser Therapy and Transcutaneous Electrical Nerve Stimulation as an Adjunct to Pharmaceutical Therapy for Myofascial Pain Dysfunction Syndrome: A Randomized Clinical Trial

Objectives: Myofascial pain dysfunction syndrome (MPDS) is the most common form of temporomandibular disorders. Because of the multifactorial nature of the problem, its management usually involves several treatment modalities to maximize their synergistic effects. This randomized clinical trial aimed to assess the efficacy of low-level laser therapy (LLLT) and transcutaneous electrical nerve stimulation (TENS) as an adjunct to pharmaceutical therapy for treatment of MPDS.
 Materials and Methods: This clinical trial evaluated 108 MPDS patients. First, the initial pain intensity of patients was determined using a visual analogue scale (VAS). The first phase of the study included education, awareness, self-care, behavior and relaxation therapy. After 1 month, the pain score was measured again using VAS. Patients who acquired a pain score >1 were divided into three groups of LLLT with diode (GAAlAr) laser with 0.2 W power, TENS, and control, using block randomization. All groups received 10 mg fluoxetine once daily, 0.25 mg clonazepam once daily and 10 mg baclofen three times a day. ANOVA was used to compare the recovery rate of the three groups.
 Results: Pain in the trapezius muscle and pain on mouth opening resolved faster in the laser + medication group. The recovery rate was faster in the mean muscle pain, general pain reported by patients, pain in the masseter and pterygoid muscles and pain and limitation in lateral movements in both laser + medication and TENS groups.
 Conclusion: Combination of LLLT and TENS with medication accelerated pain relief and resolved movement restrictions in MPDS patients.
 (IRCT registration number: IRCT201411113144N4)

Genetic risk factors of syndrome pain dysfunction of the temporomandibular joint

Currently, the syndrome of pain dysfunction of the temporomandibular joint is not considered exclusively a local disorder, but rather is considered as a clinical outcome of the combined effect of many factors (local and systemic), which act simultaneously and determine, ultimately, the manifestation of the disease. In the framework of the biopsychosocial concept, a hypothesis has been formulated about the importance of the polymorphism of the COMT and ADRB-2 genes for the development of SDJ TMJs, which make these individuals “vulnerable” to the development of chronic pain syndromes. It was found that a decrease in COMT activity leads to an increase in the level of catecholamimes, in particular, such as adrenaline, which contribute to the formation of persistent pain states by stimulating β2-adrenergic receptors in the peripheral and central nervous system.

SPIELBERGER STATE-TRAIT ANXIETY INVENTORY FOR PATIENTS WITH EXCESSIVE TOOTH ABRASION AND TEMPOROMANDIBULAR DISORDERS

Hypertonia and parafunction of masticatory muscles (bruxism), which cause prolonged non-functional sliding movements of the mandible against the maxilla with teeth closed, contribute to the development of functional overload. Increased activity of masticatory muscles may occur due to the agitation of the central nervous system. On the periphery, its action manifests itself in the form of dysfunctions and bruxism, which leads to fatigue in the masticatory muscles, their spasm and the development of symptoms of the pain dysfunction syndrome. There is also an inverse relationship between local disturbances of occlusion and the development of stress. This case occurs, because in stress situations the adaptive capacity for local disturbances of the motor part of the masticatory system, including the disturbances of occlusion, is reduced. This causes a motor reaction in the form of dysfunctions of closing masticatory apparatus, which, in long-term stressful situations, can turn into well-established habits. This explains the appearance of pain symptoms of dysfunction in stressful situations. Consequently, there is convincing evidence that psychological and psychosocial factors play an important role in understanding the TMDs, but there is no conclusive evidence that these factors are etiologic ones.
 The purpose of the study is to determine personal and situational anxiety in patients with excessive tooth abrasion alone and those with both excessive tooth abrasion and temporomandibular disorders, comparing them with each other.
 Materials and Methods. 68 patients were included in the study, 31 (45.6%) included male and 37 (54.4%) contained female patients aged 21 to 70. Studied patients were divided into two groups: the control group and the study group. The control group included 31 patients diagnosed only with excessive tooth abrasion in combination with possible other occlusal disorders. The study group included 37 patients with excessive tooth abrasion, possibly with other occlusal disorders and various forms of temporomandibular disorders: muscle, articular, and combined. The study was conducted individually using the Spielberger State-Trait Anxiety Inventory (STAI), which included instructions and 40 questions, 20 of which were designed to assess the level of situational anxiety (SA) and 20 – to assess the level of personal anxiety (PA). Online questionnaire at: http://psytests.org/psystate/spielberger-run.html was used for automatic data processing of Spielberger psychological evaluation of patients.
 Results. A high level of personal anxiety was observed in patients of the study group with both excessive tooth abrasion and TMDs, in comparison with patients in the control group (48.6% of patients in the study group vs. 0% in the control group), p<0.001.
 Furthermore, a significant prevalence of patients with a high level of situational anxiety was determined among the patients in the study group with excessive tooth abrasion and TMDs, in comparison with patients in the control group with excessive tooth abrasion alone (64.0% in the study group vs. 3.2% in the control group, p<0.001). Thus, statistically significant signs of a high level of personal and situational anxiety were found among patients with excessive tooth abrasion and present temporomandibular disorders in comparison with patients who have only excessive tooth abrasion.

Biochemical Parameters of Temporemandibular Joint Pain Dysfunction Syndrome

The complex approach to the treatment of patients with rheumatic diseases (RD) has been elaborated at the department. Considering the above, this paper focuses on studying the biochemical parameters of blood serum characterizing the body's response to pain and stress. This is achieved by examining the content of histamine and hormones (adrenaline, cortisol, TSH, total alkaline phosphatase) (Total ALP) in patients with pain dysfunction syndrome of the TMJ, taking into account changes in the blood biochemical composition (K, Na, Ca, Mg, Cl, protein, glucose, Vitamin D, and adenosine triphosphate acid). Objective: To evaluate the efficiency of Biochemical Parameters of Temporemandibular Joint Pain Dysfunction Syndrome. Patients and Methods: The study of biochemical parameters of blood serum was held in patients with temporomandibular joint pain dysfunction syndrome. Biochemical studies were conducted in 61 patients with TMJ pain dysfunction syndrome at the age of 20 to 40 years (1st, main group) and in 10 healthy people of similar age who do not show any complaints characteristics of the studied pathology (2nd, control). Results and Discussion: There is a significant increase in the level of sodium and total protein, which has not been statistically confirmed. For vitamin D (total 40.98IU/ml) and alkaline phosphatase activity, there was a significant decrease in vitamin D in temporom and ibular disorder patients when compared to the controls (P=0.001). Also, there was a significant negative correlation between serum vitamin D activity with total alkaline phosphatase activity in temporomandibular disorder patients (P=0.001). In addition, there was a significant increase in serum total alkaline phosphatase as bone marker in temporomandibular disorder patients which provides a more reliable and complete profile of inflammatory contributors to temporomandibular disorder. A tendency to decreasing in the content of calcium, total protein, and glucose in the blood serum were found. Thus, this indicates the activation of stress systems and the enhancement of protein catabolism. A significant increase in the content of ATP, histamine, adrenaline, and cortisol confirms the important role of psycho-emotional disorders in the pathogenesis of temporomandibular joint pain dysfunction syndrome.

Self-Care Management in Myofascial Pain Dysfunction Syndrome

Laskin introduced the term Myofascial pain-dysfunction syndrome (MPDS) and reemphasized that the disease entity is primarily in the muscles and only secondarily a joint problem. It is one of the commonest causes of chronic pain in oro-facial region.

ROLE OF PHARMACOTHERAPY AS DIAGNOSTIC THERAPEUTIC TEST IN MANAGEMENT OF PERSISTENCE OF PAIN ASSOCIATED WITH MYOFASCIAL PAIN DYSFUNCTION SYNDROME IN PATIENTS WITH ELONGATED STYLOID PROCESS.

01Jan 2019 ROLE OF PHARMACOTHERAPY AS DIAGNOSTIC THERAPEUTIC TEST IN MANAGEMENT OF PERSISTENCE OF PAIN ASSOCIATED WITH MYOFASCIAL PAIN DYSFUNCTION SYNDROME IN PATIENTS WITH ELONGATED STYLOID PROCESS. Abeer Kamal and Nesrine khairy. Associate Professor of Oral and Maxillofacial Surgery, College Of Oral and Dental Surgery, Misr University for Science and Technology, Egypt. Lecturer of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt.

Miseries and remedies of myofascial pain dysfunction syndrome: Comparative study

Background: Myofascial pain dysfunction syndrome (MPDS) has been recognized as the most common, nontooth-related chronic orofacial pain condition that confronts dentists. A variety of therapies have been described in literature for its management. Objectives: This study is a prospective study carried out to evaluate the efficacy of occlusal splint therapy and compare it with transcutaneous electrical nerve stimulation (TENS) in the management of MPDS. Materials and Methods: Sixty patients who reported to the Department of Oral Medicine and Radiology, Pacific Dental College, Udaipur, since September 2009, in the age range of 17–55 years were included in the study and were randomly assigned to two equally sized groups, A and B. Group A patients received TENS therapy, whereas Group B patients received soft occlusal splint therapy. All the patients were evaluated for pain using visual analog scale (VAS), maximum comfortable mouth opening, temporomandibular joint (TMJ) clicking, and tenderness during rest and movement, as well as for the number of tender muscles at the time of diagnosis, after the first week of initiation of therapy, and every month for 3 months of follow-up. Results: There was a progressive decrease in VAS, number of tender muscles, TMJ clicking, and tenderness with various jaw movements, and there was a significant improvement in mouth opening in patients on occlusal splint therapy during the follow-up period when compared with TENS therapy group. Conclusion: Occlusal splint therapy has better long-term results in reducing the symptoms of MPDS. It has better patient compliance, has fewer side effects, and is more cost-effective than TENS therapy; hence, it can be chosen for the treatment of patients with MPDS.

A Comparative Study of Low-Level Laser Therapy and Transcutaneous Electrical Nerve Stimulation as an Adjunct to Pharmaceutical Therapy for Myofascial Pain Dysfunction Syndrome: A Randomized Clinical Trial

Objectives:Myofascial pain dysfunction syndrome (MPDS) is the most common form of temporomandibular disorders. Because of the multifactorial nature of the problem, its management usually involves several treatment modalities to maximize their synergistic effects. This randomized clinical trial aimed to assess the efficacy of low-level laser therapy (LLLT) and transcutaneous electrical nerve stimulation (TENS) as an adjunct to pharmaceutical therapy for treatment of MPDS.Materials and Methods:This clinical trial evaluated 108 MPDS patients. First, the initial pain intensity of patients was determined using a visual analogue scale (VAS). The first phase of the study included education, awareness, self-care, behavior and relaxation therapy. After 1 month, the pain score was measured again using VAS. Patients who acquired a pain score >1 were divided into three groups of LLLT with diode (GAAlAr) laser with 0.2 W power, TENS, and control, using block randomization. All groups received 10 mg fluoxetine once daily, 0.25 mg clonazepam once daily and 10 mg baclofen three times a day. ANOVA was used to compare the recovery rate of the three groups.Results:Pain in the trapezius muscle and pain on mouth opening resolved faster in the laser + medication group. The recovery rate was faster in the mean muscle pain, general pain reported by patients, pain in the masseter and pterygoid muscles and pain and limitation in lateral movements in both laser + medication and TENS groups.Conclusion:Combination of LLLT and TENS with medication accelerated pain relief and resolved movement restrictions in MPDS patients.(IRCT registration number: IRCT201411113144N4)

Transcutaneous electrical nerve stimulation therapy as compared to placebo transcutaneous electrical nerve stimulation therapy for the management of myofascial pain dysfunction syndrome patients: A clinical study

Aims:The aim of this study was to determine the effectiveness of transcutaneous electrical nerve stimulation (TENS) therapy in the management of pain in myofascial pain dysfunction syndrome patients and to determine the effectiveness of placebo TENS therapy in the management of pain in myofascial pain dysfunction syndrome patients. Materials and Methods: Thirty patients received active TENS therapy and placebo TENS therapy. The Visual Analog Scale was used to measure the changes in pain and tenderness in the muscles of mastication. Results:A significant improvement was observed in active TENS therapy as compared to placebo TENS therapy regarding muscle tenderness. Conclusion:This study justifies the use of TENS therapy as well as placebo in the management of temporomandibular dysfunction. TENS therapy appears to be useful in relieving muscle pain.

Myofascial pain syndrome in the dysfunction of the temporomandibular joint

Selection of the clinical characteristics of pain syndrome in the orofacial region in temporomandibular joint pain dysfunction syndrome (TMJ PDS). One hundred and two patients with TMJ PDS were examined using the Verbal Descriptive Pain Rating Scale of the orofacial area. The Clinical Index of TMJ dysfunction (CID) by Helkimo M. was used for objectification of the level of musculo-tonic disorders in the area of the chewing muscles. The psychopathological status of patients with TMJ PDS was assessed with HRDS and SCL-90-R. A significant proportion of patients with TMJ PDS, in addition to algic symptoms, have hypertonus of the facial muscles, the nature and severity of which require not only a special diagnostic assessment, but also follow-up treatment. The analysis of data allowed us to identify three clinical groups of patients: with isolated (muscular-tonic), neurological symptoms; with mixed (combination of muscular-tonic and somatoform manifestations) neurological and psychopathological symptoms and with somatoform symptoms. Patients with TMJ PDS are clinically heterogeneous and require clinical differentiation, distinguishing the common group of patients with muscular dysfunction accompanied by pain and emotional response to it (anxiety and minor depressive symptoms) and the group of patients with a somatoform disorder (and manifestations as general anxiety).

Effect of low-level LASER therapy combined with conventional physiotherapy on pain and quality of life in patients with Myofascial pain dysfunction syndrome

Background: Temporomandibular Joint Disorders (TMDs) are considered the most commonchronic orofacial pain conditions. It is characterized by pain in the Temporomandibular Joint (TMJ)area, masticatory muscles and associated musculoskeletal structures with the affection of mouthopening. Conventional physiotherapy and Low-Level LASER Therapy (LLLT ) are safe and noninvasivemodalities that each therapist focuses on to relieve pain and increase the quality of life.Aim: The aim of this study was to investigate the effect of low-level LASER therapy combinedwith conventional physiotherapy on pain and quality of life in patients with Myofascial paindysfunction syndrome (MPDS).Methods: 60 patients (45 females and 15 males) with MFDS of TMJ were divided randomlyinto study and control groups. The study group received conventional physiotherapy consisting ofactive and stretching exercises for mandibular muscles with ultrasound and LLLT application onTMJ area. Control group received conventional physiotherapy only. Pressure pain threshold wasevaluated using hand-held pressure algometer and quality of life was evaluated using the WorldHealth Organization Quality of Life (WHOQOL-BREF) assessment instrument at baseline and 4weeks after the treatment.Results: There was a significant increase (p<0.05) in the quality of life, with a significantincrease (p<0.05) in pressure pain threshold for TMJ, masseter and anterior temporalis muscles atboth sides in the study group compared with control group.Conclusion: The combination of conventional therapy with LLLT was more effective in painrelief and improvement of the quality of life than the conventional therapy alone for patients withMPDS.

In quest of the longest-lasting and most annoying pain for patients and for dentists. Quantitative and qualitative characteristics of temporomandibular myofascial pain dysfunction syndrome – a questionnaire study

BackgroundDysfunctions in the face, due to the psychological importance of the structures in the face and head, have long been a subject of interest for researchers exploring issues concerning health-related quality of life. The surprising results of previous clinical trials for myofascial pain dysfunction syndrome of the temporomandibular joints encouraged the present authors to plan a study focused on obtaining systematic knowledge of the issue.Participants and procedureThe study included 26 patients of the Masticatory System Disorders Laboratory of the Dental Prosthetic Clinic at the Jagiellonian University Medical College diagnosed with the painful form of muscle-related functional masticatory organ disorders. The study was part of a larger research project. The data to be analysed for this article was obtained in the course of a single questionnaire survey conducted prior to the start of the treatment process.ResultsThe results showed the quantitative characteristics of pain experiences in the clinical group, observed in the context of the circadian dynamics, psychophysical factors, and the location of pain, as well as their quality characteristics. The analyses showed negative covariances of the quality of life perceived by patients and the length of periods without pain, pain intensifying factors, and emotional image of pain. The strongest pain experienced by the patients negatively correlated with the quality of life related to the sphere of physical pain and mental distress, whereas the weakest pain correlated with the quality of life related to the social sphere. The lower quality of life occurred together with the frontal, zygomatic, mental, parotideomasseteric, and occipital region.ConclusionsIt is necessary to further analyse the issue on a larger sample in order to explain and clarify the obtained results.

PHONOPHORESIS VERSUS ULTRASOUD THERAPY IN MYOFASCIAL PAIN DYSFUNCTION SYNDROME

Purpose: Myofascial pain dysfunction syndrome (MPDs) coupled by trigger points (TPs) has been conversed medically and dentally for over a century. Phonophoresis (PH) is a non-invasive transdermal drug delivery system that use ultrasound (US) to enhance the distribution of topically applied drugs which provide less chance of an overdose and permit both local and systemic treatment effects. The aim: of this study was to assess the outcome of phonophoresis with Extrauma and ultrasound therapies in the treatment of myofascial pain dysfunction syndrome. Patients and method: twenty cases with MPDs of TPs in the masseter muscle were selected and divided into two groups; study group (PH): comprised ten female patients that were treated with phonophoresis (PH) using Extrauma gel for 10 sessions over three weeks. Control group (US): comprised ten female patients that were treated with ultrasound (US) for 10 sessions over three weeks. Postoperative clinical assessment including visual analogue scale (VAS) and maximum mouth opening (MMO) were assessed. Results: Comparison of VAS between the two groups at immediate post-operative period showed that PH group recorded decrease and significant values and at six months post-operative period the two groups showed non-significant decrease in VAS. MMO showed non-significant increase values in both groups along the follow up periods. Conclusion: Extrauma phonophoresis in the masseter muscle trigger points considered an effective treatment option for myofascial pain dysfunction syndrome.

The Relationship of Tempromandibular joint disorders with Bony Exostosis in the Oral Cavity

The temporomandibular joint (TMJ) may be affected by inflammatory, traumatic, infectious, congenital, and developmental, as seen in other joints. However, the most common affliction of the TMJ and masticatory apparatus is a group of functional disorders with associated pain that occurs predominantly in women and was previously known as the TMJ pain dysfunction syndrome. Since 1978, there have been substantial changes in the study of etiologic factors, pathophysiology, diagnosis, and management of what are now called temporomandibular disorders (TMD).(1)The general perception that all symptoms in the head, face, and jaw region without an identifiable cause constitute a "TMJ" problem is clearly unfounded.Although some oral lesions, such as torus palatinus and torus mandibularis are normal variants, but require prompt diagnosis and sometime treatment to reduce the potential for serious complication and enhance prosthodontic treatment. The purpose of this study is to inspect the relation of TMJ dysfunction syndrome to the presence of oral exostosis, and find the prevalence of torus palatinus (TP) and torus mandibularis (TM)The sample consisted of 932 teachers, 301 males and 631 females were examined for the presence of TMD, TP and / or TM. Analysis was carried out according to age, gender, TMJ dysfunction and the presence of TP and TM.Results indicated that 123(16.1%) had at least one symptoms of TMD, where as 49 (5.3%) had TP; and 67 (7.2) had TM. The male: female prevalence ratios of TP and TM were 1: 3.42 and 1: 1.81 respectively. The results revealed that significant relationship between TMD and tori, and increase in percentage of mandibular tori with the presence of TMJ dysfunctional syndrome more than maxillary tori were found.TP and TM were more frequent in females and there is significant relation between the TP and TM with presence of TMJ dysfunction syndrome ( P&lt; 0.05 ) especially TM , the presence of TM might be useful to look for sign of dysfunction.

POSITION OF THE TEMPOROMANDIBULAR JOINT DYSFUNCTION SYNDROME AMONG FACIAL PAIN SYNDROMES

At the present time, the actual problem of dentistry is the study of the issues of the syndrome of pain dysfunction (SPD) of the temporomandibular joint (TMJ), which is found in 14-20% of teenagers and significantly increases with age (Siemkin V.A, Rabukhina N.A., 2000 ; Khavatova VA, 2005). The pathology of TMJ dysfunction was detected in 80% of the examined patients (Bezrukov V.M, 2002). Separately allocated dysfunction of TMJ in dysplastic-dependent form of joint pathology, thereby emphasizing that dysfunction is a characteristic manifestation of dysplasia of connective tissue in the maxillofacial area (Statovskaia Ye.Ye, 2005; Kozlov D.L., Viazmin A.Y., 2007). According to observations of A.I Mirza, I.V. Mikheieva, V.M. Novikov and according to our data, in more than 90% of people, pathological phenomena in the area of the temporomandibular joint have nothing to do with the inflammatory processes of this combination. At the same time, various dysfunctions and pain spasm of separate areas of chewing muscles occupy the main place.&#x0D; The aim of the work was to analyze the causes and clinical symptoms of patients with SPD. In this regard, as it turned out from the anamnesis, many patients had been undergoing inappropriate treatment for a long time. The cavity of the temporomandibular joint was repeatedly injected emulsion hydrocortisone acetate, antibiotics and other medications, which do not work in case of SPD of the temporomandibular joint. In some cases, after such therapy, dysfunction of the mandible occurred, leading to an even greater disruption of the joint function and increased pain. A number of patients with SPD of the temporomandibular joint due to a false diagnosis for a long time received treatment for neuralgia of the trigeminal nerve by drugs, Novocain blockade or alcoholization of sensitive branches of the trigeminal nerve. These patients often had neuritis, which greatly worsened the patient’s condition and the prognosis of the disease. The clinical picture of the SPD of the temporomandibular joint and a number of such diseases (syndromes of Slider, Sikara, etc.) is often so obscure and confusing that a large clinical experience is needed to evaluate individual symptoms. In addition, it should be noted that dysfunction of the mandible occurs with lesions of any part of the temporomandibular complex. Thus, limitation of the mobility of the mandible usually develops with arthritis of the temporomandibular joint, abscesses and phlegmons of the parotideomasseterica, temporal regions, pterygomandibulare, parapharingenal space, jaw-tongue groove and osteomyelitis of the branches of the mandible. Diagnostic difficulties often increase due to the fact that it is not always possible to find out the atypical etiological origin of the SPD of the temporomandibular joint. Against the background of the listed objective adverse factors, the presence of diagnostic errors largely contributes to insufficient knowledge of dentists who have clinical questions and questions on treatment of the SPD TMJ due to the difficulty in differential diagnosis, which is not fully covered in textbooks on dentistry.&#x0D; Control of correctness of the established diagnosis is the blockade of the motor branches of the trigeminal nerve subcutaneously using the Yehorov's method, which results in the removal of muscle spasm, stops pain and improves the mobility of the mandible. Conducting additional paraclinical examination methods such as dynamic MRT, 3-D MRT, CT and electromyography should be done.

Enigma of myofascial pain-dysfunction syndrome - A revisit of review of literature

Enigma of myofascial pain-dysfunction syndrome - A revisit of review of literature

Study of stress-induced temporomandibular disorders among dental students: An institutional study.

Aim and Objectives:The aim and objectives of this study are to investigate the various types of stress-inducing factors, most prevalent etiological factor and to determine the correlation between stress and temporomandibular disorders (TMDs) in Dental students in Modinagar, Ghaziabad, Uttar Pradesh.Materials and Methods:A sample of 450 students were selected for the study divided into two groups of undergraduate (UG) and postgraduate (PG) students further subdivided into UG (1st, 2nd, 3rd, and 4th, interns) and PG (1st, 2nd, 3rd year). Study includes clinical evaluation of temporomandibular joint (TMJ) system (TMJ sounds, muscles of mastications, mouth opening, and range of mandibular motion) and questionnaire which covers demographic data (i.e., age, sex, and academic year), TMD symptoms and TMD signs along with standardized scales related to stress dental environmental stress scale and perceived stress scale (PSS).Results:Most of the students included into study are mostly of 21–25 years of age (64.3%), males (52.7%), females 47.3% with more number of UGs (91.4%) predominantly 1st year students (23.9%). Headache was found to be the most prevalent TMD symptom (26.2%) followed by clicking (24.9%), pain on clicking (5.5%), jaw lock (3.4), and difficulty in mouth opening (0.9%). Clicking was found to be the most prevalent TMD sign (24.9%) among dental students followed by deviation (16.3%), muscle tenderness (14.3%), and TMJ pain (5.7%). The most prevalent TMD was disc displacement 22.6% followed by myofascial pain dysfunction syndrome (MPDS) with disc displacement (13.5%) and MPDS (3.8%). TMD was higher in UG females students of 21–-25 years of age group, dental environment stress scale score and PSS score shows statistically significant results.Conclusion:Stress is a significant etiologic factor involved in initiation and maintenance of TMDs in Dental students.