Masticatory Muscle Pain Research Articles

Health and TMJ Function in Adult Patients Treated for Dentoskeletal Open Bite with Orthognathic Surgery—A Retrospective Cohort Study

This study aims to assess the presence and progression of TMD in adult patients undergoing orthognathic surgery to correct dentoskeletal open bite and evaluate whether these changes can be attributed to the intervention. A retrospective cohort study was conducted on 44 adult patients (14 males and 30 females) aged 18 to 43 years. Articular assessments were performed to evaluate temporomandibular joint (TMJ) health and functionality before (T0) and after (T1) combined orthodontic-surgical treatment. TMJ health was assessed by maximum mouth opening, joint noises, parafunctions (bruxism or clenching), joint locking, TMJ pain, masticatory muscle pain, and headaches. Statistical analyses used McNemar’s Exact Test and paired T-tests. The study shows a significant reduction (p < 0.05) in symptoms, except for locking, with the most substantial decrease in headaches (p = 0.0001). Overall, articular symptoms markedly decreased post-surgery, with sustained joint functionality. Restoring physiological occlusion in patients with anterior open bite is crucial for maintaining the stomatognathic system’s balance. Orthognathic surgery, when indicated, appears beneficial in alleviating articular symptoms while preserving TMJ function.

Effectiveness of results of complex treatment of pathological wear of hard tissues of teeth

Background:Tooth wear is a multifactorial condition that results in the loss of hard dental tissue. Physiological wear does not usually result in any subjective symptoms. Pathological abrasion of hard dental tissues is accompanied by both morphological and functional disorders of the dental system Objective: To evaluate the functional and aesthetic results of complex treatment of pathological abrasion of dental hard tissues. Materials and methods: This is a prospective controlled study that included 82 patients with a clinically confirmed diagnosis of Increased tooth wear of the first and second degree of severity (from 2020 to 2024). The age of the patients ranged from 34 to 68 years (48 men, 34 women). The examination of patients included: collecting complaints and identifying concomitant somatic diseases, X-ray examination, photographs of the patient's face, bite height, and nasolabial folds. Distribution of the group: Group 1 included patients with the first degree of hard tissue loss 47 (29 men, 18 women) Group 2 included patients with the second degree of hard tissue damage 35 (21 men, 14 women). During examination, patients complained of aesthetic defects caused by tooth wear and discoloration, discomfort when closing, chewing and phonetic disorders, typical symptoms of TMJ dysfunction, such as pain and crunching in the joints, fatigue of the masticatory muscles and muscle pain, displacement of the lower jaw to the side during vertical movements, a feeling of distension in the ears, headaches and bruxism. In patients of group 1: tooth wear was restored with orthopedic structures. In patients of group 2: temporary prosthetic structures and occlusal splints were used to normalize occlusal relationships in case of TMJ and masticatory muscle dysfunction. Gradual raising of the bite was carried out by means of a set of kappa-splints for 14 days, 1 month and 3 months from 1.0 to 5.0 mm until complete restoration of the occlusal height depending on the severity of pathological abrasion of teeth, abrasion of teeth restored by orthopedic structures. Dynamic observation of the clinical condition of the prosthesis structure was carried out in the following periods: 1 week, 1, 6, 12, 24 months,assessment of the condition of the performed restorations were recorded in the medical record of the dental patient. Results:Clinical radiological results showed satisfactory results and are encouraging in patients of groups 1 and 2. After treatment in patients of groups 2, according to the analysis of the lateral teleroentgenogram of the head, an increase in the height of the lower third of the face is noted, in 28 patients the nasolabial folds were smoothed out. Patients were satisfied with the aesthetic and functional results of the treatment Conclusions: The results of the study showed that treatment using occlusal splints at the preparatory stage in patients of group 2 with occlusion disorders due to pathological abrasion of hard dental tissues and restoration with orthopedic structures is relevant for normalizing the occlusal relationships of the jaws and this complex treatment method provides a good aesthetic and functional result.

КРИТЕРИИ ЭФФЕКТИВНОСТИ ЛЕЧЕНИЯ ПАЦИЕНТОВ С МИОФАСЦИАЛЬНЫМ БОЛЕВЫМ СИНДРОМОМ ЖЕВАТЕЛЬНОЙ МУСКУЛАТУРЫ

There are quite a lot of predictor factors for the development of myofascial pain syndrome of the chewing muscles. At the moment, there is no single pathogenetic theory of the development of this pathology. Accordingly, uniform criteria for evaluating the effectiveness of the therapy have not been developed, which was the purpose of this study. The aim of the study is to develop and implement criteria for the effectiveness of treatment of patients with myofascial masticatory muscle pain syndrome. Materials and methods. 45 people with myofascial masticatory muscle pain syndrome were examined and treated. Screening diagnostics of 30 conditionally healthy people was carried out to obtain control values. The study was conducted in three stages – assessment of stress levels according to the data of filling out a questionnaire on the level of susceptibility to stress, clinical examination – determination of qualitative and quantitative criteria, ultrasound and electromyographic examination. Relief of myofascial pain syndrome of the masticatory muscles was performed by injections of botulinum toxin type A into the masticatory and temporal muscles. The dynamics was assessed at the time of 14 days and 1 month. Results. The developed criteria clearly reflect the effectiveness of the therapy. Statistically significant results of the effectiveness of treatment have been obtained, allowing timely optimal therapy and preventing the development of chronic disorders of the temporomandibular joint. Understanding the combined influence of the psychoemotional state and somatic factors led to the development of uniform criteria for the effectiveness of treatment of this category of patients. The analysis and dynamics of changes in qualitative and quantitative indicators reflect the current trend towards the development of minimally invasive approaches to diagnosis and treatment based on the principles of biofeedback, which prevent the chronization of the process and the development of temporomandibular joint dysfunction.

Prevention of Oral Injuries during Endotracheal Intubation: Patients' and Anesthesiologists' Perspective.

The aim was to design accessible, simple, inexpensive protection for teeth and soft tissues during ETI, compare damage occurrence with and without protection, and investigate post-ETI orofacial pain symptoms. The selection procedure for adequate protection was carried out after which a reduced elastomer mouthguard was selected. Fifty patients were divided into 2 groups. In the first group, ETI was carried out using a mouthguard, while in the second group it was performed without it. The mouthguard was fabricated by anesthesiologists. After the ETI procedure, the patients and anesthesiologists were asked to complete a survey. No difference in intubation severity and time required for intubation between the two groups was present. Seven patients from the non-mouthguard group suffered injuries during the ETI procedure. No injuries were present in the mouthguard group. In 92% of cases anesthesiologists agreed that mouthguards should be used during ETI. However, most of them (96% of cases) agree that the mouthguard should be used only when there is an increased risk of tooth loss and/or tooth damage. There was a significant ETI effect on the emergence of new orofacial pain cases. The mouthguard adequately protected dental and soft tissues and did not affect the work of the anesthesiologist. A significantly higher number of patients experiencing temporomandibular joint and masticatory muscles pain after surgery indicates that ETI might be a risk factor for orofacial pain.

β2-adrenergic receptor activation decreases the mechanical sensitivity of rat masticatory muscle afferent fibres.

Activation of β2 adrenergic receptors reduces cutaneous mechanical pain thresholds in rats. While β2 adrenergic receptor activation may contribute to mechanisms that underlie temporomandibular joint pain, its effect on masticatory muscle pain sensitivity is uncertain. The current study sought to determine the extent to which β adrenergic receptors are expressed by masticatory muscle afferent fibres, and to assess the effect of local activation of these receptors on the mechanical sensitivity of masticatory muscle afferent fibres in rats. Trigeminal ganglion neurons that innervate the rat (n = 12) masseter muscle and lower lip were identified by tissue injection of fluorescent dyes and were then stained with antibodies against β1 or β2 adrenergic receptors. Extracellular recordings from 60 trigeminal ganglion neurons that innervate the masticatory muscle were undertaken in a second group of anaesthetised rats of both sexes (n = 37) to assess afferent mechanical activation thresholds. Thresholds were assessed before and after injection of the β adrenergic receptor agonists into masticatory muscle. β1 and β2 adrenergic receptor expression was greater in labial skin than in masticatory muscle ganglion neurons (p < .05, one-way ANOVA, Holm-Sidak test). There was a higher expression of β2 adrenergic receptors in masticatory muscle ganglion neurons in males than in females. The mixed β agonist isoproterenol increased afferent mechanical activation threshold in male but not female rats (p < .05, Mann-Whitney test). In male rats, salbutamol, a β2 selective agonist, also increased afferent mechanical activation threshold but hydralazine, a vasodilator, did not (p < .05, Mann-Whitney test). Activation of β2 adrenergic receptors decreases the mechanical sensitivity of masticatory muscle afferent fibres in a sex-related manner.

High prevalence of orofacial pain in juvenile fibromyalgia as detected by a novel tool specifically devised for children and adolescents.

To examine the prevalence of temporomandibular disorders (TMD) in patients with juvenile fibromyalgia syndrome (JFS) and identify TMD characteristics specifically associated to JFS. Signs and symptoms of TMD were assessed using a novel clinical tool specifically devised for children that consists of: 1. a self-report multiple-choice questionnaire; 2. a protocol for the clinical examination of the orofacial region. Multivariate logistic regression model was used to identify TMD features associated with JFS. Thirty JFS patients (median age 15.5 years) and 45 healthy controls (median age 15.0 years) were included in this cross-sectional study. Orofacial pain was reported by 26 of 30 JFS patients (86.7%) and by 3 of 45 controls (6.7%; p<0.001). Pain on TMJ palpation was present in 18 of 30 JFS patients (60%) and in 5 of 45 controls (11.1%; p<0.001). Median values of maximum spontaneous mouth opening, voluntary active opening and assisted passive opening were significantly higher in JFS patients than in controls. On multiple regression analysis spontaneous orofacial pain (OR: 21.0; p=0.005), diffuse tenderness on palpation of the masticatory muscles (OR: 14.9; p=0.026) and TMJ hypermobility (OR 1.42; p=0.008) were independently associated with JFS. The high prevalence of TMD in JFS highlights the need for a broader interdisciplinary evaluation of JFS patients. TMJ hypermobility, in addition to orofacial and masticatory muscle pain, is an important clue for the diagnosis of TMD in adolescents with JFS. Elucidating the link between these disorders will advance individualised management and improve treatment efficacy.

Decrypting the putative interrelation between sleep bruxism, masticatory muscle pain and sleep breathing disorders: Nosology and the role of hypoxia.

This commentary on sleep medicine explores whether the potential relationship betweensleep bruxism (SB), masticatory muscle pain (MMP) and sleep breathing disorders (SBDs)contributes to improving the management of co-occurring conditions.The paper is divided into 2 sections: (1) reviewing the debate on SB nosology; and (2)based on the publications from the Martynowicz & Wieckiewicz research group, exploringthe role of intermittent hypoxia as a putative mechanism endotype that may link such co-occurrence among individuals for whom characteristics are not yet clear.

Disclosure orthodontic and TMD-new study.

Cooperative analysis of participants and controls. Wiley Online Library, National Institute of Health, ResearchGate, ScienceDirect, Google Scholar. Human clinical trials age 18-30 years old, a case-control study included 291 individuals, 192 TMDs and 99 controls. All patients underwent assessment based on a questionnaire and a clinical examination according to Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Patients who underwent orthodontic treatment were compared to those who did not, regarding their trauma history, bruxism, aggressive teeth brushing, level of oral hygiene, pain scores, muscle tenderness scores and subjective sleep quality. Medical and/or dental emergencies, subjects with a history of drug, alcohol or medication abuse, fibromyalgia, being pregnant or lactating, having a coexisting mental, psychiatric, or physical disability, cancerous or significant medical problems and the consumption of drugs and/or medications that affect the nervous system including narcotics, TCA (tricyclic antidepressants), anticonvulsant, muscle relaxants and medication overuse headache. To identify differences between groups, categorical independent variables were analysed using the chi-square test or likelihood ratio, while numeric independent variables were analysed using independent t-tests and analysis of variance (ANOVA). A two-tailed level of statistical significance (α) was established at 0.05. Analysis of multicollinearity was performed following the univariate analyses to examine the collinearity among the independent variables and select independent variables with minimal correlation. Among the highly correlated variables, only one was selected for inclusion in the multivariate model, with the specific variable chosen based on contextual considerations. The research comprised a total of 291 individuals, consisting of two distinct groups: the TMD group (192 participants, 66%) and the control group (99 participants, 34%). Within the TMD group, further subcategorization was conducted, including MMP (masticatory muscle pain) with 44 individuals (15%); TMJD with 26 individuals (9%); and TMP (both MMP and TMJ) with 122 individuals (42%). Using a "holistic" and a "collinearity statistical approach and the utilization of a multivariate model" the conclusion is that TMD is not associated with orthodontics.

Hemicrania paroxística com representação na face e associação com disfunção temporomandibular: relato de caso

ABSTRACT Paroxysmal Hemicrania is a trigeminal autonomic cephalalgia described as a severe and strictly unilateral pain, which occurs in paroxysms at orbital, supraorbital and/ or temporal region. A 45-year-old woman presented to an orofacial pain specialist reporting severe, burning, throbbing, strictly right-sided headache associated to ipsilateral autonomic symptoms and orofacial pain. The pain was perceived on the maxillary region followed by pain spread to the head. Interdisciplinary evaluation, along with absolute responsiveness to indomethacin and normal Brain Magnetic Resonance imaging, led to the diagnosis of primary Episodic paroxysmal hemicrania with facial representation and myofascial pain of masticatory muscles. Dentists should be aware of paroxysmal hemicrania with facial representation and the possibility of temporomandibular disorder coexistence, in order to avoid misdiagnosis and inadequate management. Paroxysmal hemicrania may be first perceived on the face and may be associated with interparoxysmal pain. In these cases, efficient anamnesis and clinical evaluation followed by interdisciplinary approach is needed.

The additional value of home exercises to self-management for the treatment of masticatory muscle pain. A clinical trial.

Initial management of temporomandibular disorders (TMD) based on self-management (SM) is strongly recommended by literature, nevertheless, research is needed to investigate the efficacy of different types of interventions under each component of SM against each other for the management of particular subtypes of TMD. The present study aimed to compare the clinical effectiveness of SM and SM with additional mandibular home exercises for the management of myalgia of masticatory muscles. A clinical trial was conducted with 54 subjects with a diagnosis of myalgia according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), which were randomised into two groups: treated with SM (SM group) and treated with SM and mandibular home exercises (SM+EX group). Follow-ups were carried out at 2, 6, and 10 weeks, where it was evaluated: pain in the masticatory muscles, jaw opening range of motion, and mandibular functional limitation. Data were analysed using Wilcoxon signed-rank test for comparisons between periods (baseline, and weeks 2, 6, and 10) and Wilcoxon rank-sum test for comparison between groups (p=0.05). All the variables showed significant improvement (p<0.05) from baseline to the first follow-up and were maintained later, i.e. both groups were able to reduce pain, increase the jaw opening range of motion, and improve the mandibular functional limitation, although no significant differences were found between groups (p>0.05). The self-management program was able to reduce pain intensity, increase the jaw opening range of motion and improve functional limitation, but the addition of mandibular home exercises do not have a significant impact on myalgia of the masticatory muscles in the short-term. Key words:Myalgia, Self-care, Self-management, Temporomandibular joint disorders.

Comparative efficacy of different thicknesses of soft and hard splints in reducing clinical symptoms in patients with temporomandibular disorders

Introduction: The effectiveness of two soft and hard splint thicknesses in reducing temporomandibular joint (TMJ) pain and dysfunction was compared.&#x0D; Materials and Methods: Sixty patients with TMJ pain and dysfunction were randomly assigned to four groups (n=15); the patients treated with hard occlusal splints of 1 and 3mm thicknesses were assigned to Groups A and B, respectively, and those treated with soft occlusal splints of 1 and 3mm thicknesses were assigned to Groups C and D, respectively. Maximum mouth opening (MMO) and the severity of pain based on the visual analog scale (VAS) were assessed before treatment and after 7, 30 and 90 days.&#x0D; Results: After both 7 and 30 days, no significant differences were found between the groups for any variable (P&gt;0.05). However, Group C had a significantly lower MMO compared to Groups A and B after 90 days (P=0.001). Additionally, and in relation to masticatory muscle pain, Group C had a significantly higher VAS score than other groups (P&lt;0.05). The VAS score for TMJ pain at rest was also significantly higher in Group C compared to Groups A and B (P&lt;0.05).&#x0D; Conclusion: A 3-mm hard occlusal splint seems to be the best treatment to reduce pain and dysfunction of the TMJ.&#x0D;

Comparison of the efficacy of occlusal splint and botulinum toxin therapies in patients with temporomandibular disorders with sleep bruxism.

This study aims to evaluate the efficacy of occlusal splint and botulinum toxin (BTX) therapies for improving the pain scores and mouth opening in patients with temporomandibular disorders (TMD) with sleep bruxism (SB). Aretrospective cohort study was conducted based on clinical record reviews of patients with TMD symptoms (e.g., temporomandibular joint [TMJ] pain, masticatory muscle pain, TMJ internal derangements, joint sounds, and limited mouth opening) and SB. The patients were divided into two groups: occlusal splint group and BTX group. Maximum unassisted mouth opening (MMO) and pain score on avisual analogue scale (VAS) before treatment and at 1‑, 3‑, and 6‑month follow-up were analyzed to evaluate the clinical outcomes. Atotal of 60patients (49women and 11men, mean age 34.63 ± 11.85 years) were enrolled. Each group had 30patients. The comparisons of the groups at 1and 3months after treatment indicated that the BTX group had higher MMO values (P = 0.013 and 0.034, respectively) and lower VAS scores than the occlusal splint group (P = 0.000 and 0.001, respectively). No difference between the two groups was observed 6months after treatment (P > 0.05). Both occlusal splint and BTX treatment methods were successful in treating TMD with SB. BTX provided patients with rapid relief in the early period; therefore, BTX can be recommended as aprimary treatment option in patients with greater pain.

Occurrence and Predictors of Postoperative Preauricular and Masticatory Muscle Pain Symptoms After Surgical Removal of Third Molars: A Single-Blind Randomized Controlled Trial Comparing Dental Assistants Supporting the Mandible and the Restful Jaw Device

During third molar removal, the mandible is supported by a dental assistant (DA) to counter downward forces during surgery, and with sedation, to maintain airway patency. The Restful Jaw device (PEP Design; Saint Paul) provides this support instead of the DA. This study compared the occurrence of postoperative preauricular and masticatory muscle pain symptoms (PMMPS) between the device and DAs providing mandibular support, using two outcome measures. Secondary aims identify predictors of outcome and providers' opinions of the device. In this multisite, single-blind, two-arm parallel randomized trial, participants without preoperative PMMPS had surgical removal of third molars, with sedation and bite blocks were randomly assigned to manual support or the device. The exposed group was randomly assigned to the device and the nonexposed group to manual support. The primary outcome was patient-reported PMMPS. Two secondary outcomes were pain assessed with the temporomandibular disorder Pain Screener and providers' views on the device. Outcomes were assessed at 1-, 3-, and 6-month postsurgery. The covariates are baseline demographics (eg, sex), clinical characteristics (eg, eruption status), and third molar surgeries. For occurrence of pain, generalized estimating equations assessed differences between groups. Logistic regression analysis assessed predictors of pain at 1month, per the Screener. The level for statistical significance was 5%. Enrollment was 86 and 83 participants in the device and DA groups, respectively. The average age was 20.8years; the majority were female (65%) and Caucasian (66%). The retention rate was ≥95.9%. The groups did not differ significantly for occurrence of pain using the primary and secondary outcome measures at any follow-up (P≥.46). Fully impacted molars were associated with occurrence of pain (odds ratio=3.44; 95% confidence interval 1.49-7.92; P=.004). Occurrence of pain using the primary and secondary outcome measures did not differ significantly between groups at any follow-up and was associated with removal of fully impacted third molars. Four out of five surgeons reported wanting to use the device on a regular basis when performing this procedure in sedated patients.

Effect of Botulinum Toxin on Masticatory Muscle Pain in Patients with Temporomandibular Disorders: A Randomized, Double-Blind, Placebo-Controlled Pilot Study.

This study aimed to evaluate the efficacy of botulinum toxin type A (BoNT/A) in patients with temporomandibular disorders (TMDs) associated with masticatory muscle pain (MMP) and headaches. This randomized, double-blind, placebo-controlled pilot study is the first clinical trial to evaluate both disorders simultaneously. Twenty-one patients with myogenous TMD were randomly assigned to two groups. The experimental and control groups received injections of either BoNT/A or saline into the sites showing tenderness after palpation of a total of 16 muscle areas, including each masseter, a temporalis, splenius capitis, sternocleidomastoid, and trapezius muscle. During each visit, the clinical effects, based on the intensity of orofacial pain (OVAS), headache (HVAS), number of tender points (TPs), maximum mouth opening (MMO), and headache frequency (HF), were evaluated at four time points, namely, pre-injection and 4, 8, and 12 weeks after the injection, in both groups. Friedman and Mann-Whitney tests were used for the analyses. In the experimental group, the reductions in OVAS, TP, HVAS, and HF showed significant differences over time, excluding MMO, whereas there was no significant difference in any of the variables in the control group. In addition, the decline in TPs was significantly different between the experimental and control groups at all time points, especially after 4 and 12 weeks, compared to that during pre-injection. In conclusion, treatment with BoNT/A was relatively effective for masticatory muscle pain caused by TMDs and headache compared to the saline placebo.

Childhood and Adolescents Sleep Bruxism Treatment: A Systematic Review.

Introduction Sleep Bruxism (SB) is a common condition in childhood that can cause multiple consequences such as abnormal tooth wear, tensional headaches, masticatory muscle pain, or fatigue. The literature reports some interventions, however the treatment for SB in children is not well-established. Objectives A systematic review was performed to investigate the effectiveness of the treatments described for SB in children and adolescents: pharmacological and psychological treatments; behavioral guidelines; and dental approaches. Materials and methods Randomized clinical trials comparing different SB treatments with a control group were searched in the electronic databases PubMed, Scopus, Web of Science, Cochrane Library, and VHL until August 04, 2021. Two independent reviewers selected the studies, extracted the data, and assessed the risk of bias. After a two-phase selection process, 07 articles were selected. The methodology of the selected studies was analyzed using the Cochrane Risk of Bias Tool. The criteria used to qualify the studies were based on randomization, allocation, blinding of participants and evaluators, and analysis of results. Results The signs and symptoms of SB were reduced with pharmacotherapy (hydroxyzine/diazepam) and medicinal extracts ( M. Officinalis ), but with occlusal splints and physiotherapy, this improvement was not statistically significant when compared to control groups. Conclusion Some evidence of the efficacy of pharmacotherapy (hydroxyzine/diazepam) and medicinal extracts ( M. Officinalis ) was found. However, this systematic review is not enough to establish a protocol for the treatment of SB. Besides, the individualized management of SB in this population should be considered, emphasizing the management of risk factors.

Obesity and temporomandibular joint disorders: a systematic review and meta-analysis

BackgroundTemporomandibular joint disorders (TMD) is the most common non-dental pain complaint in the maxillofacial region, which presents a variety of symptoms and signs, including temporomandibular joints (TMJ) and masticatory muscle pain, joint noise, tinnitus, headaches, irregular or restricted mandibular function, masticatory difficulty, and restricted mouth opening. When comes to the relationship between obesity and TMD, it has remained controversial and inconsistent, therefore, we first conducted this meta-analysis to estimate the unclear relationship between obesity and TMD.MethodsSearches were conducted in PubMed, Web of Science, Embase, and Cochrane Library. Subjects were divided into five groups according to BMI level in this study, including the normal weight group: 18.5 ≤ BMI < 25, overweight group: 25 ≤ BMI < 30, obesity group: BMI ≥ 30, control group: BMI < 25, and overweight and obesity group: BMI ≥ 25. Statistics analyses were conducted using Stata (15.0). The number of PROSPERO was CRD42022368315.ResultsEight studies were included in this study, and six articles with a total of 74,056 participants were synthesized for meta-analysis. Compared to normal weight individuals, overweight and obesity together decreased the risk of TMD (OR = 0.66, 95% CI = 0.46–0.95), and it was significantly decreased by obesity alone (OR = 0.58). Moreover, it was lower in obesity compared with control subjects (OR = 0.83, 95% CI = 0.73–0.94). Furthermore, in overweight and obese individuals, it was much lower in obesity than in overweight (OR = 0.82, 95% CI = 0.71–0.94).ConclusionsObesity is not a risk factor for TMD, and maybe a protective factor for TMD, of which patients with larger BMI are less likely to suffer from TMD pain. Therefore, the value of BMI should be taken into consideration in the assessment of TMD.

Effect of Sustained Jaw Opening on Fatigue, Pressure Pain Sensations, and Stiffness in the Masticatory Muscles

Although the effects of sustained jaw-closing activities on somatosensory sensitivity and fatigue have been investigated, the effects of sustained jaw-opening activities on somatosensory sensitivity in the masticatory muscles remain unclear. Therefore, this study aimed to investigate the effects of sustained jaw opening（e.g. during dental treatment）on fatigue, pressure pain sensations, and stiffness in the masticatory muscles. A total of 35 healthy volunteers performed 30 minutes each of two jaw motor tasks, with a 1-week interval between tasks: unassisted jaw opening and jaw opening assisted by a mouth prop set at the right tooth. The pressure pain threshold（PPT）and muscle stiffness of the left masseter were measured before and after both jaw motor tasks（at 0 and 30 minutes）. Masticatory muscle fatigue was measured every 10 minutes（at 0, 10, 20, and 30 minutes）during each jaw motor task. No significant differences in the PPT were found between before and after the assisted jaw-opening task, but the PPT was significantly lower after compared with before unassisted jaw opening（P < 0.05）. No significant differences in left masseter muscle stiffness were found between any measurement point in either jaw motor task. Masticatory muscle fatigue was significantly higher after 10, 20, and 30 minutes of each jaw motor task compared with that at baseline（0 minutes）. However, no significant differences in masticatory muscle fatigue were found at any measurement point between both jaw motor tasks. The present results suggest that sustained jaw opening during dental treatment may affect pressure pain sensations in the masticatory muscles. In addition, masticatory muscle pain due to sustained jaw opening seems to be affected not only by jaw-opening but also jaw-closing muscle（masseter muscle）.

Survey of Oral Manifestation of Covid-19 in Medical Specialties in Sulaimaniyah City Hospitals

Background: The coronavirus disease 2019 is a serious infection resulting in a global threat caused by coronavirus 2 (SARS-CoV-2) characterized by different symptoms, ranging from mild flu to severe pneumonia.&#x0D; Objective:To focus on the oral manifestations which could be present in some cases of COVID-19 and to assess the associations between oral health and COVID19.&#x0D; on188 medical specialists in Sulaimaniyah city. The questionnaire was composed of 3 parts; the 1st part included demographic features. The 2nd part was composed of questions concerning the oral hygiene condition of the participants, and the 3rd section encompassed questions about oral complications during infection with COVID-19.&#x0D; Results: Among 188 participants, 92% complained of oral manifestation while being infected with Covid-19 at significant levels. Facial and masticatory muscle pain 27.1%, facial or oral numbness 8%, jaw bones or joint pain 39.9%, changes in buccal mucosa and gingiva 10.1%, bleeding gingivitis 9%, Altered taste sensation 67.6%, altered smell sensation 69.1% and xerostomia 54.8% were highly associated with Covid-19.&#x0D; Conclusion: Some cases of Covid-19 usually present with different oral manifestations. Therefore, oral care monitoring should be enhanced for Covid-19 patients and maintain good oral health.

Survey of Oral Manifestation of Covid-19 in Medical Specialties in Sulaimaniyah City Hospitals

Background: The coronavirus disease 2019 is a serious infection resulting in a global threat caused by coronavirus 2 (SARS-CoV-2) characterized by different symptoms, ranging from mild flu to severe pneumonia. Objective: To focus on the oral manifestations which could be present in some cases of COVID-19 and to assess the associations between oral health and COVID19. Patients and Methods: An online questionnaire survey was performed on188 medical specialists in Sulaimaniyah city. The questionnaire was composed of 3 parts; the 1st part included demographic features. The 2nd part was composed of questions concerning the oral hygiene condition of the participants, and the 3rd section encompassed questions about oral complications during infection with COVID-19. Results: Among 188 participants, 92% complained of oral manifestation while being infected with Covid-19 at significant levels. Facial and masticatory muscle pain 27.1%, facial or oral numbness 8%, jaw bones or joint pain 39.9%, changes in buccal mucosa and gingiva 10.1%, bleeding gingivitis 9%, Altered taste sensation 67.6%, altered smell sensation 69.1% and xerostomia 54.8% were highly associated with Covid-19. Conclusion: Some cases of Covid-19 usually present with different oral manifestations. Therefore, oral care monitoring should be enhanced for Covid-19 patients and maintain good oral health.

Oral Health-Related Quality of Life in Patients with Temporomandibular Disorders and Effect of Anxiety: A Retrospective Case-Control Study.

To evaluate oral health-related quality of life (OHRQoL) in patients with temporomandibular disorders (TMDs) involving masticatory muscle pain, disc displacement with reduction, or both and to determine the associations of these disorders with anxiety. This study consisted of 150 patients with TMDs and 50 healthy controls. Patients were diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I and then divided into three diagnostic groups: masticatory muscle pain (group MP), disc displacement with reduction (group DD), or both (group MPDD). The participants completed the Oral Health Impact Profile-14 (OHIP-14) and Generalized Anxiety Disorder-7 (GAD-7) questionnaires for assessment of OHRQoL and anxiety, respectively. Statistical analyses were performed using Kruskal-Wallis test and Mann-Whitney U post hoc paired-comparison tests. A total of 121 of the patients (60.25%) were female and 79 (39.75%) were male, ranging from ages 18 to 68 years (mean age: 37.32 ± 13.62). Gender distribution, mean age, educational status, and occupational status were similar among groups. The OHIP-14 global and domain scores and distribution of GAD-7 levels were significantly different among groups (P < .001). For psychologic discomfort and disability domains, group MPDD statistically scored the highest, followed by group MP, group DD, and then the control group (P < .05). According to correlation analyses, there were positive correlations between the GAD-7 and all OHIP-14 scores (r = 0.438, P < .001) within group MPDD. OHRQoL is negatively affected by TMDs and worsens as the severity of anxiety increases. Therefore, physical conditions and anxiety levels in TMD patients should be simultaneously considered for treatment and maintenance. Int J Prosthodont 2023;36:148-154. doi: 10.11607/ijp.7587.