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- Baad-Hansen, L, et al.
(author)
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Blink reflexes in patients with atypical odontalgia
- 2005
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In: Journal of Orofacial Pain. - 1064-6655 .- 1945-3396. ; 19:3, s. 239-247
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Journal article (peer-reviewed)abstract
- Aims: To use the human blink reflex (BR) to explore possible neuropathic pain mechanisms in patients with atypical odontalgia (AO). Methods: In 13 AO patients, the BR was elicited using a concentric electrode and recorded bilaterally with surface electromyographic (EMG) electrodes on both orbicularis oculi muscles. Electrical stimuli were applied to the skin above branches of the V1, V2, and V3 nerves and to the V branch contralateral to the painful branch. Sensory and pain thresholds were determined. The BR examination of the painful V branch was repeated during a capsaicin pain-provocation test. The data were analyzed with nonparametric statistics. Results: The BR responses (R2 and R3) evoked by stimulation of V3 were significantly smaller than the BR responses evoked by stimulation of V1 and V2 (P < .004). There were no differences in BR (R2 or R3) between the painful and nonpainful sides (P > .569), and the BR (R2 and R3) was not significantly modulated by experimental pain (P > .080). The sensory thresholds were significantly lower on the painful side compared to the nonpainful side (P = .014). The pain thresholds were not different between sides (P > .910). Conclusion: No major differences between the V nociceptive pathways on the right and left sides were found in a relatively small group of AO patients. Future studies that compare BRs in AO patients and healthy volunteers are needed to provide further knowledge on the pain mechanisms in AO.
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| 8. |
- Baad-Hansen, Lene, et al.
(author)
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Blink reflexes in patients with atypical odontalgia
- 2005
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In: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 19:3, s. 223-247
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Journal article (other academic/artistic)abstract
- Aim: To examine the blink reflex (BR) evoked by stimulation of the trigeminal (V) nerve branches, to examine the painful V branch before and during a pain provocation test, and to compare the painful and the contra lateral non-painful branch in patients with atypical odon-talgia (AO). Methods: In thirteen patients with AO, the BR was elicited with the use of a concentric electrode and recorded bilaterally with surface EMG electrodes on both orbicularis oculi muscles. Electrical stimuli were applied to the skin above the V1, V2 and V3 nerve branches and to the V branch contralateral to the painful branch. The sensory and pain thresholds were determined. The BR examination of the painful V branch was repeated during a capsaicin pain provocation test. The data were analysed with use of non-parametric statistics. Results: The BR responses evoked by stimulation of the V3 were significantly lower than the BR responses evoked by stimulation of the V1 and V2 (P < 0.004). There were no differences in BR between the painful and non-painful side (P > 0.569), and the BR was not significantly modulated by experimental pain (P > 0.080). The sensory thresholds were significantly lower on the painful side compared to the non-painful side (P = 0.017). The pain thresholds were not different between sides (P > 0.910). Conclusion: These preliminary findings did not indicate major differences in the V nociceptive pathways between sides in AO patients. Future studies comparing the BR in AO patients with healthy volunteers are needed to provide further knowledge on the pain mechanisms in AO.
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| 9. |
- Baad-Hansen, Lene, et al.
(author)
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Chairside intraoral qualitative somatosensory testing : reliability and comparison between patients with atypical odontalgia and healthy controls
- 2013
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In: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 27:2, s. 165-170
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Journal article (peer-reviewed)abstract
- AIMS: To assess intraoral inter- and intraexaminer reliability of three qualitative measures of intraoral somatosensory function and to compare these measures between patients with atypical odontalgia (AO) and healthy controls. METHODS: Thirty-one AO patients and 47 healthy controls participated. Inter- and intraexaminer reliability was tested on a subgroup of 46 subjects (25 AO; 21 healthy). Sensitivity to touch, cold, and pinprick stimuli was evaluated on the painful gingival site and the corresponding contralateral site in AO patients, and bilaterally on the gingiva of the first maxillary premolars in controls. Patients were asked to report hypersensitivity, hyposensitivity, or normal sensitivity to stimuli on the painful site compared with the nonpainful site. Kappa values were calculated, and chi-square and Fisher's exact tests were used to compare frequencies between groups. RESULTS: Kappa values ranged between 0.63 and 0.75. The frequency of hypersensitivity to either modality was significantly higher in patients (29% to 61%) than in controls (9% to 17%) (P < .015), whereas reports of hyposensitivity were similar between groups (2% to 16%) (P > .057). Only 3.2% of the AO patients had no reports of abnormal sensitivity on any of the tests, compared with 59.6% of the healthy subjects (P < .001). CONCLUSION: Intraoral qualitative somatosensory testing can detect intraoral sensory disturbances in AO patients, and the reliability is sufficient for initial screening of orofacial somatosensory function.
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| 10. |
- Baad-Hansen, Lene, et al.
(author)
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Comparison of clinical findings and psychosocial factors in patients with atypical odontalgia and temporomandibular disorders
- 2008
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In: Journal of Orofacial Pain. - 1064-6655 .- 1945-3396. ; 22:1
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Journal article (peer-reviewed)abstract
- Aims: To systematically compare clinical findings and psychosocial factors between patients suffering from atypical odontalgia (AO) and an age- and gender-matched group of patients with temporomandibular disorders (TMD).Methods: Forty-six AO patients (7 men and 39 women, mean age, 56 years) were compared with 41 TMD patients (8 men and 33 women, mean age, 58 years). Results: Mean pain intensity at the time of inclusion in the study was similar between the groups (TMD: 5.3 ± 0.4, AO: 5.0 ± 0.3), but pain duration was longer in AO patients (AO: 7.7 ± 1.1 years, TMD: 4.5 ± 0.1 years). Eighty-three percent of the AO patients and 15% of TMD patients reported pain onset in relation to dental/surgical procedures. Episodic tension-type headache (TTH) occurred equally in both groups (TMD: 46%, AO: 46%), but TMD patients more frequently experienced chronic TTH (TMD: 35%, AO: 18%), myofascial TMD (TMD: 93%, AO: 50%), and temporomandibular joint disorders (TMD: 66%, AO: 2%). Overall, TMD patients had lower pressure pain thresholds and poorer jaw function than AO patients. Mean depression and somatization scores were moderate to severe in both groups, and widespread pain was most common in TMD patients.Conclusion: AO and TMD share some characteristics but differ significantly in report of dental trauma, jaw function, pain duration, and pain site.
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| 11. |
- Baad-Hansen, Lene, et al.
(author)
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Increased Pain Sensitivity to Intraoral Capsaicin in Patients with Atypical Odontalgia
- 2006
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In: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 20:2, s. 107-114
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Journal article (peer-reviewed)abstract
- AIMS: To use 2 well-characterized stimuli, the intraoral capsaicin model and the "nociceptive-specific" electrode, to compare superficial nociceptive function between patients with atypical odontalgia (AO) and matched healthy controls. Furthermore, the authors aimed to describe the sensitivity, specificity, and positive predictive values (PPV) of the techniques if group differences could be established. METHODS: Thirty-eight patients with AO and 27 matched healthy controls participated in this study. Thirty microliters of 5% capsaicin was applied to the gingiva on the left and right sides of all participants as a pain-provocation test. The participants scored the capsaicin-evoked pain continuously on a 0-to-10 visual analog scale (VAS). Furthermore, individual electrical sensory and pain thresholds to stimulation with a "nociceptive-specific" electrode on the facial skin above the infraorbital or mental nerve were determined. RESULTS: AO patients had higher VAS pain scores for capsaicin application than healthy controls (ANOVA: F > 4.88; P < .029). No differences between the painful sides and the nonpainful sides of the patients were found (ANOVA: F < 1.26; P > .262). No main effects of group or stimulation side on the electrical sensory and pain thresholds were detected (ANOVA: F < 0.309; P > .579). Sensitivity was 0.51; specificity, 0.81; and PPV, 0.77 when a VAS value of > or = 8 for capsaicin-evoked pain was used. CONCLUSION: AO patients show increased sensitivity to intraoral capsaicin but normal sensitivity to "nociceptive-specific" electrical stimulation of the face in an area proximal to the painful site. The use of the intraoral pain-provocation test with capsaicin as a possible adjunct to the diagnostic workup is hampered by the only moderately good sensitivity and specificity.
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- Dawson, Andreas, et al.
(author)
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Assessment of Proprioceptive Allodynia After Tooth-Clenching Exercises
- 2012
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In: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 26:1, s. 39-48
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Journal article (peer-reviewed)abstract
- AIMS: To (A) evaluate test-retest reliability of vibrotactile sensitivity in the masseter muscle and (B) test if (1) the vibration threshold is decreased after experimental tooth clenching, (2) intense vibrations exacerbate pain after tooth clenching, (3) pain and fatigue are increased after tooth clenching, and (4) pressure pain thresholds are decreased after tooth clenching. METHODS: In part A, 25 healthy female volunteers (mean age: 42 ± 12 years) participated, and 16 healthy females (mean age 32 ± 10 years) participated in three 60-minute sessions, each with 24- and 48-hour follow-ups in part B. Participants were randomly assigned tooth-clenching exercises with clenching levels of 10%, 20%, or 40% of maximal voluntary clenching. A Vibrameter applied to the right masseter muscle measured perceived intensity of vibration and perceived discomfort, which were assessed on 0-50-100 numeric rating scales. An electronic algometer measured pressure pain threshold (PPT). Two 0- to 100-mm visual analog scales measured pain intensity (VASpain) and fatigue (VASfatigue). Measurements were made on the right masseter muscle. Interclass correlation coefficient (ICC) was used to calculate test-retest reliability of VT measurements. Outcome variables were tested with two-way ANOVAs for repeated measures and Dunnett's post-hoc test. RESULTS: Moderate long-term (ICC 0.59) and good short-term (ICC 0.92) reliability was found for VT on the masseter muscle. Clenching level had no main effect on perceived intensity of vibration; time effects (P < .05) were only observed at 40 minutes (Dunnett's test: P < .01). Clenching level and time had no effect on perceived discomfort. Only time effects were significant for PPT (P < .01), with reductions at 50 and 60 minutes compared to baseline (Dunnett's test: P < .05). Clenching level and time had main effects for VASpain and VASfatigue (P < .001). Conclusion: Experimental tooth clenching appears to evoke moderate levels of pain and fatigue and short-lasting hyperalgesia to mechanical stimulation, but not proprioceptive allodynia. The absence of proprioceptive allodynia does not necessarily exclude delayed onset muscle soreness (DOMS) but warrants further studies on the clinical manifestations of DOMS in jaw muscles.
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| 19. |
- Dawson, Andreas, et al.
(author)
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Development of a quality-assessment tool for experimental bruxism studies : reliability and validity
- 2013
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In: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 27:2, s. 111-122
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Journal article (peer-reviewed)abstract
- AIMS: To combine empirical evidence and expert opinion in a formal consensus method in order to develop a quality-assessment tool for experimental bruxism studies in systematic reviews. METHODS: Tool development comprised five steps: (1) preliminary decisions, (2) item generation, (3) face-validity assessment, (4) reliability and discriminitive validity assessment, and (5) instrument refinement. The kappa value and phi-coefficient were calculated to assess inter-observer reliability and discriminative ability, respectively. RESULTS: Following preliminary decisions and a literature review, a list of 52 items to be considered for inclusion in the tool was compiled. Eleven experts were invited to join a Delphi panel and 10 accepted. Four Delphi rounds reduced the preliminary tool-Quality-Assessment Tool for Experimental Bruxism Studies (Qu-ATEBS)- to 8 items: study aim, study sample, control condition or group, study design, experimental bruxism task, statistics, interpretation of results, and conflict of interest statement. Consensus among the Delphi panelists yielded good face validity. Inter-observer reliability was acceptable (k = 0.77). Discriminative validity was excellent (phi coefficient 1.0; P < .01). During refinement, 1 item (no. 8) was removed. CONCLUSION: Qu-ATEBS, the seven-item evidence-based quality assessment tool developed here for use in systematic reviews of experimental bruxism studies, exhibits face validity, excellent discriminative validity, and acceptable inter-observer reliability. Development of quality assessment tools for many other topics in the orofacial pain literature is needed and may follow the described procedure.
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| 20. |
- Dawson, Andreas, et al.
(author)
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Pain and intramuscular release of algesic substances in the masseter muscle after experimental tooth-clenching exercises in healthy subjects
- 2013
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In: Journal of Orofacial Pain. - : Quintessence Publishing. - 1064-6655 .- 1945-3396 .- 2333-0384. ; 27:4, s. 350-360
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Journal article (peer-reviewed)abstract
- AIMS:To investigate whether experimental tooth clenching leads to a release of algesic substances in the masseter muscle.METHODS:Thirty healthy subjects (16 females, 14 males) participated. During two sessions, separated by at least 1 week, intramuscular microdialysis was performed to collect masseter muscle 5-hydroxytryptamine (5-HT) and glutamate as well as the metabolic markers pyruvate and lactate. Two hours after the start of microdialysis, participants were randomized to a 20-min repetitive experimental tooth-clenching task (50% of maximal voluntary contraction) or a control session (no clenching). Pain and fatigue were measured throughout. The Friedman and Wilcoxon tests were used for statistical analyses.RESULTS:No alterations were observed in the concentrations of 5-HT, glutamate, pyruvate, and lactate over time in the clenching or control session, or between sessions at various time points. Pain (P < .01) and fatigue (P < .01) increased significantly over time in the clenching session and were significantly higher after clenching than in the control session (P < .01).CONCLUSION:Low levels of pain and fatigue developed with this experimental tooth-clenching model, but they were not associated with an altered release of 5-HT, glutamate, lactate, or pyruvate. More research is required to elucidate the peripheral release of algesic substances in response to tooth clenching.
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| 21. |
- de Boever, Jan A, et al.
(author)
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Recommendations by the EACD for examination, diagnosis, and management of patients with temporomandibular disorders and orofacial pain by the general dental practitioner
- 2008
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In: Journal of Orofacial Pain. - 1064-6655 .- 1945-3396. ; 22:3, s. 268-278
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Journal article (peer-reviewed)abstract
- The Council fo the European Academy of Craniomandibular Disorders charged the Educational Committee with the task of establishing Guidelines and Recommendations for the examination, diagnosis, and management of patients with temporomandibular disorders and orofacial pain by the general dental practitioner. It was not their purpose to present a thorough and critical review of the vast amount of literature avaliable but to summarize the at-present generally accepted clinical approach. These recommendations are based as much as possible on scientific evidence and on sound clinical judgement in cases where only partial evidence or contradictory data were found.
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| 22. |
- Ekberg, EwaCarin, et al.
(author)
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The Efficacy of Appliance Therapy in Patients with Temporomandibular Disorders of Mainly Myogenous Origin. A Randomized, Controlled, Short-term Trial
- 2003
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In: Journal of Orofacial Pain. - 1064-6655 .- 1945-3396. ; 17:2, s. 133-139
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Journal article (peer-reviewed)abstract
- Aims: To compare the short-term efficacy of treatment with a stabilization appliance compared with that of a non-occlusal, control appliance in patients with temporomandibular disorders (TMD) of mainly myogenous origin. Methods: A randomized, controlled trial was performed with 60 patients suffering from myofascial pain. Patients were randomly assigned to a treatment or a control group. The treatment group was treated by means of a stabilization appliance and the control group by means of a non-occlusal appliance. Symptoms and signs were registered before and after 10 weeks of treatment. Results: Improvement of overall subjective symptoms was reported in both groups, but significantly more often in the treatment group than in the control group (P = .000). The prevalence of daily or constant pain showed a significant reduction in the treatment group (P = .028) compared with the control group. There was a significant decrease in the number of tender masticatory muscles in the treatment group (P = .018) compared with the control group. Conclusion: The results of this short-term evaluation suggest that the stabilization appliance is more effective in alleviating symptoms and signs in patients with TMD of mainly myogenous origin than a control, non-occlusal appliance. The stabilization appliance can therefore be recommended for the therapy of these patients.
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| 23. |
- Engström, Anna-Lena, et al.
(author)
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Juvenile arthritis and development of symptoms of temporomandibular disorders: a 15-year prospective cohort study.
- 2007
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In: Journal of orofacial pain. - 1064-6655 .- 1945-3396. ; 21:2, s. 120-6
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Journal article (peer-reviewed)abstract
- AIMS: To compare the development of symptoms of temporomandibular disorders (TMD) in a sample of patients with juvenile arthritis (JA) and a matched control sample. METHODS: In 1986, 40 patients with JA (28 girls and 12 boys; mean age +/- SD, 18 +/- 4.5 years) and an age- and sex-matched control sample were examined for signs and symptoms of TMD. Fifteen years later in 2001, a questionnaire concerning symptoms of TMD was sent to these subjects. Twenty-eight individuals (68%) in the JA sample (20 women and 8 men; mean age +/- SD, 35 +/- 5.2 years) and 26 controls (19 women and 7 men; 34 +/- 4.0 years) were available for the follow-up. RESULTS: The overall prevalence of symptoms of TMD increased between the 2 examinations in both groups. The prevalence of reported TMD symptoms, such as jaw pain, fatigue in the jaws, and difficulty opening the jaws wide, as well as awareness of tooth clenching, headaches, neck and shoulder pains, was significantly greater among the JA sample than among the controls at the follow-up. CONCLUSION: The study indicates that prevalence of pain and dysfunction in the craniofacial or cervical regions of JA patients is increased more than 20 years after the onset of JA compared to healthy individuals.
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| 31. |
- Häggman Henrikson, Birgitta, et al.
(author)
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Temporomandibular Disorder Pain After Whiplash Trauma: A Systematic Review
- 2013
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In: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 27:3, s. 217-226
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Research review (peer-reviewed)abstract
- Aims: To assess, by systematic review of the literature, (1) the prevalence and incidence of temporomandibular disorder (TMD) pain after whiplash trauma, and (2) whether treatment modalities commonly used for TMD are equally effective in patients with solely TMD pain and those with TMD/whiplash-associated disorders (WAD) pain. Methods: A systematic literature search of the PubMed, Cochrane Library, and Bandolier databases was conducted from January 1966 through October 2012. The systematic search identified 125 articles. After an initial screening of abstracts, 45 articles were reviewed in full text. Two investigators evaluated the methodological quality of each identified study. Results: Eight studies on prevalence/incidence of TMD pain in WAD and four studies on interventions in TMD pain and WAD met the inclusion criteria. The reported median prevalence of TMD pain after whiplash trauma was 23% (range 2.4% to 52%) and the incidence ranged from 4% to 34%. For healthy controls, the reported median prevalence was 3% (range 2.5% to 8%) and the incidence ranged from 4.7% to 7%. For patients with a combination of TMD pain and WAD, treatment modalities conventionally used for TMD, such as jaw exercises and occlusal splints, had less of an effect (median improvement rate of 48%, range 13% to 68%) compared to TMD patients without a whiplash injury (75%, range 51% to 91%). Conclusion: There is some evidence that prevalence and incidence of TMD pain is increased after whiplash trauma. The poorer treatment outcome suggests that TMD pain after whiplash trauma has a different pathophysiology compared to TMD pain localized to the facial region.
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| 32. |
- Johansson, Anders, et al.
(author)
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Gender difference in symptoms related to temporomandibular disorders in a population of 50-year-old subjects
- 2003
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In: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 17:1, s. 29-35
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Journal article (other academic/artistic)abstract
- Aims: To investigate, by means of a mail questionnaire, the prevalence of symptoms related to temporomandibular disorders (TMD) in 50-year-old subjects living in the counties of Örebro and Östergötland, Sweden. Methods: The total population comprised 8,888 individuals, and the overall response rate was 71%. A clinical evaluation of the masticatory system was performed in subgroups to validate the responses to the questionnaire. There was satisfactory correspondence between self-reports and welldefined clinical conditions. Results: Women reported, more often than men, pain from the temporomandibular joints (TMJs), TMJ sounds, bruxism, sensitive teeth, and burning mouth symptoms. The prevalences of difficulties in jaw opening, loss of anterior teeth due to trauma, and masticatory problems were greater in men than in women. No gender difference was found in the number of remaining teeth. Logistic regression analysis with pain from the TMJ as the dependent variable identified bruxism, impaired chewing efficiency, and gender (women) as the most significant risk factors. With reduced chewing ability as the dependent variable, several missing teeth constituted the highest risk, followed by pain from the TMJ, bruxism, gender (men), and loss of anterior teeth due to trauma. Conclusion: There were significant gender differences in reported TMD-related symptoms in 50-year-old Swedes. Bruxism was a significant risk factor for pain from the TMJ. Reduced number of teeth and pain from the TMJ were significant risk factors for impaired chewing ability.
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| 33. |
- Koh, Kwang-Joon, et al.
(author)
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Relationship between clinical and magnetic resonance imaging diagnoses and findings in degenerative and inflammatory temporomandibular joint diseases : a systematic literature review
- 2009
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In: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 23:2, s. 123-139
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Journal article (peer-reviewed)abstract
- AIM: To describe evidence for a relationship between diagnoses and findings of clinical examination and diagnoses and findings of magnetic resonance imaging (MRI) examination for degenerative and inflammatory temporomandibular joint diseases. METHODS: PubMed and the Cochrane Library were searched using specific indexing terms and reference lists were hand-searched. Included publications satisfied pre-established criteria. Primary studies were interpreted using a modification of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. RESULTS: The literature search yielded 219 titles and abstracts. Eighty-two studies were selected and read in full-text. After data extraction and interpretation with the QUADAS tool, 23 studies remained. There was a vast heterogeneity in study design, clinical examination methods, and diagnostic criteria. No clear evidence was found for a relationship between clinical and MRI diagnoses and findings. Several studies reported a relationship between clinical pain and internal derangements diagnosed with MRI, but the calculated odds ratio (OR) for this relationship was generally low (1.54-2.04). ORs for the relationship between pain and disc displacement without reduction (4.82) or between crepitation and disc displacement without reduction (3.71) were higher. CONCLUSION: This review reveals a need for studies with improved quality in reporting of samples, examination techniques, findings, and definitions and rationales for cutoffs, categories, and diagnoses. We recommend that standardized protocols such as the Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD) and the Standards for Reporting of Diagnostic Accuracy (STARD) statement be implemented in future studies.
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| 35. |
- Lindsten, Rune, et al.
(author)
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Effect of food consistency on temporomandibular joint morphology : An experimental study in pigs
- 2004
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In: Journal of Orofacial Pain. - 1064-6655 .- 1945-3396. ; 18:1, s. 56-61
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Journal article (peer-reviewed)abstract
- Aims: To investigate whether there are any correlations between increased masticatory loading, degree of tooth wear, and the size, form, and macroscopic surface of the temporomandibular joints (TMJs).Methods: The degree of tooth wear and different TMJ variables were compared in 2 groups of domestic pigs. One group of 8 pigs had been raised indoors (ID group), and the other group of 9 pigs had been raised outdoors (OD group). The pigs in the ID group were fed a soft diet and were not provided any straw in their pens. The OD group was fed a solid diet and could also grub in the soil, resulting in an exposure to more abrasive components and to greater chewing demands. All pigs were sacrificed at the age of 22 months.Results: The pigs in the OD group exhibited significantly more tooth wear compared to the ID group. No difference in mediolateral size of the condyles could be found between the 2 groups. Form and surface changes of the TMJs varied substantially between individuals, but not between the 2 groups. No correlation could be found between the degree of tooth wear and any of the TMJ variables.Conclusion: Exposure to a tougher diet containing more abrasive substances has a significant impact on the degree of tooth wear but seems to have no consequences either for the size of the TMJ condyles or for form or surface changes of the TMJs.
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| 36. |
- List, Thomas, et al.
(author)
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Clinical findings and psychosocial factors in patients with atypical odontalgia : A case-control study
- 2007
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In: Journal of Orofacial Pain. - 1064-6655 .- 1945-3396. ; 21:2, s. 89-98
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Journal article (peer-reviewed)abstract
- Aim: To provide a systematic description of clinical findings and psychosocial factors in patients suffering from atypical odontalgia (AO). Methods: Forty-six consecutive AO patients (7 men and 39 women, mean age, 56 years, range, 31 to 81 years) were compared with 35 control subjects (11 men and 24 women, mean age, 59 years, range, 31 to 79 years). Results: The pain of the AO patients was characterized by persistent, moderate pain intensity (mean, 5.6 +/- 1.9) with long pain duration (mean, 7.7 +/- 7.8 years). Eighty-three percent reported that onset of pain occurred in conjunction with dental treatment. No significant difference was found between the groups in number of remaining teeth or number of root fillings. Temporomandibular disorder (TMD) pain (P < .001), tension-type headache (P < .002), and widespread pain (P < .001) were significantly more common among AO patients than controls. Significantly higher scores for somatization (P < .01) and depression (P < .01) and limitations in jaw function (P < .001) were found for the AO group compared with the control group. Significant differences between groups were found in 4 general health domains: role-physical (P < .001), bodily pain (P < .001), vitality (P < .004), and social functioning (P < .001). Conclusion: A majority of the AO patients reported persistent, moderately intense intraoral pain that in most cases had an onset in conjunction with dental treatment. AO patients had more comorbid pain conditions and higher scores for depression and somatization. Significant limitation in jaw function and significantly lower scores on quality of life measures were found for AO patients compared with controls.
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| 37. |
- List, Thomas, et al.
(author)
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Influence of temple headache frequency on physical functioning and emotional functioning in subjects with temporomandibular disorder pain
- 2012
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In: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 26:2, s. 83-90
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Journal article (peer-reviewed)abstract
- AIMS: To investigate the relationship of headache frequency with patient-reported physical functioning and emotional functioning in temporomandibular disorder (TMD) subjects with concurrent temple headache. METHODS: The Research Diagnostic Criteria for TMD (RDC/TMD) Validation Project identified, as a subset of 614 TMD cases and 91 controls (n = 705), 309 subjects with concurrent TMD pain diagnoses (RDC/TMD) and temple headache. The temple headaches were subdivided into infrequent, frequent, and chronic headache according to the International Classification of Headache Disorders, second edition (ICHD-II). Study variables included self-report measures of physical functioning (Jaw Function Limitation Scale [JFLS], Graded Chronic Pain Scale [GCPS], Short Form-12 [SF-12]) and emotional functioning (depression and anxiety as measured by the Symptom Checklist-90R/SCL-90R). Differences among the three headache subgroups were characterized by increasing headache frequency. The relationship between ordered headache frequency and physical as well as emotional functioning was analyzed using linear regression and trend tests for proportions. RESULTS: Physical functioning, as assessed with the JFLS (P < .001), SF-12 (P < .001), and GCPS (P < .001), was significantly associated with increased headache frequency. Emotional functioning, reflected in depression and anxiety, was also associated with increased frequency of headache (both P < .001). CONCLUSION: Headache frequency was substantially correlated with reduced physical functioning and emotional functioning in subjects with TMD and concurrent temple headaches. A secondary finding was that headache was precipitated by jaw activities more often in subjects with more frequent temple headaches.
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| 38. |
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| 39. |
- List, Thomas, et al.
(author)
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Pharmacologic interventions in the treatment of temporomandibular disorders, atypical facial pain, and burning mouth syndrome. A qualitative systematic review
- 2003
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In: Journal of Orofacial Pain. - 1064-6655 .- 1945-3396. ; 17:4, s. 301-310
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Research review (other academic/artistic)abstract
- AIMS: To carry out a systematic review of the literature in order to assess the pain-relieving effect and safety of pharmacologic interven-tions in the treatment of chronic temporomandibular disorders (TMD), including rheumatoid arthritis (RA), as well as atypical facial pain (AFP), and burning mouth syndrome (BMS). METHODS: Study selection was based on randomized clinical trials (RCTs). Inclusion criteria included studies on adult patients (> or = 18 years) with TMD, RA of the temporomandibular joint (TMJ), AFP, or BMS and a pain duration of > 3 months. Data sources included Medline, Cochrane Li-brary, Embase, and Psych Litt. RESULTS: Eleven studies with a total of 368 patients met the inclusion criteria. Four trials were on TMD patients, 2 on AFP, 1 on BMS, 1 on RA of the TMJ, and 3 on mixed groups of patients with TMD and AFP. Of the latter, amitriptyline was effective in 1 study and benzodiazepine in 2 studies; the effect in 1 of the benzodiazepine studies was improved when ibuprofen was also given. One study showed that intra-articular injection with glucocorti-coid relieved the pain of RA of the TMJ. In 1 study, a combination of paracetamol, codeine, and doxylamine was effective in reducing TMD pain. No effective pharmacologic treatment was found for BMS. Only minor adverse effects were reported in the studies. CONCLUSION: The common use of analgesics in TMD, AFP, and BMS is not sup-ported by scientific evidence. More large RCTs are needed to deter-mine which pharmacologic interventions are effective in TMD, AFP, and BMS.
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- List, T, et al.
(author)
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Psychosocial functioning and dental factors in adolescents with temporomandibular disorders : A case-control study
- 2001
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In: Journal of Orofacial Pain. - 1064-6655 .- 1945-3396. ; 15:3, s. 218-227
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Journal article (peer-reviewed)abstract
- Aims: To examine the influence of psychosocial functioning and dental factors in adolescents with temporomandibular disorders (TMD) versus healthy, subjects. Methods: The TMD sample comprised 63 patients (21 boys and 42 girls, 33% and 67%, respectively, with a mean age of 14.9 years, range 12 to 18 years) and was compared with 64 healthy control subjects (17 boys and 47 girls, 27% and 73%, respectively, with a mean age of 14.8 years). Subjects in the TMD group had to report pain once a week or more and to have a TMD pain diagnosis according to the Research Diagnostic Criteria for TMD. Participants were clinically examined and filled out a questionnaire in which self-reported psychosocial functioning was assessed on standardized measures, including the Youth Self-Report (YSR), somatic complaints, and stress. Results: No significant differences were found in dental factors among adolescents in the TMD group compared with those in the control group. Multiple pains in the body and fatigue were significantly more common in the TMD group compared with the control group. Adolescents with TMD also reported significantly higher levels of stress, somatic complaints, and aggressive behavior than their counterparts in the control group. In particular, young adolescents with TMD reported high levels of psychosocial problems. Conclusion: In adolescents with TMD, psychosocial factors such as increased levels of stress, somatic complaints, and emotional problems seem to play a more prominent role than dental factors.
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| 48. |
- Nilner, Maria, et al.
(author)
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Short-term Effectiveness of a Prefabricated Occlusal Appliance in Patients with Myofascial Pain
- 2008
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In: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 22:3, s. 209-218
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Journal article (peer-reviewed)abstract
- Aims: To compare the short-term effectiveness of a stabilization appliance with a prefabricated occlusal appliance in myofascial pain patients in a randomized controlled trial. Methods: Sixty-five patients at 2 centres were assigned to a stabilization appliance group (S group, n = 33) or a prefabricated appliance (Relax) group (R group, n = 32). The patients had been suffering from temporomandibular disorder (TMD) pain for 3 months to 40 years. The patients were examined for symptoms and signs of temporomandibular disorders according to the Research Diagnostic Criteria for TMD and treated by a general practitioner. Treatment outcomes regarding pain, registered on a visual analogue scale, and overall ratings of pain, registered on a verbal scale, were evaluated at 6- and 10- week follow-up appointments, and the data from the groups were compared statistically, results: The main treatment outcome in the 2 groups was a positive improvement of overall symptoms without any statistically significant differences between groups at either 6 or 10 weeks. At the 6-week follow-up, 72% of ala patients reported a 30% reduction of the worst pain, and 55% of the patients reported a 50% reduction of the worst pain, whereas at the 10-week follow-up, the percentages were 69% and 61%, respectively. According to the verbal scale, 85% of all patients reported themselves to be “better,” “much better,” or “symptom-free” at the 6-week follow-up, and 83% reported this at the 10-week follow-up. Conclusion: The effectiveness of the prefabricated occlusal appliance seemed to be the same as that of the stabilization appliance. The prefabricated appliance can therefore be recommended as a short-term therapy in adult patients with myofascial pain.
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| 49. |
- Nilsson, Ing-Marie, et al.
(author)
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Adolescents with Temporomandibular Disorder Pain : The Living with TMD Pain Phenomenon
- 2011
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In: Journal of Orofacial Pain. - : Quintessence publishing co. inc.. - 1064-6655 .- 1945-3396. ; 25:2, s. 107-116
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Journal article (peer-reviewed)abstract
- Aim: To acquire a deeper understanding of adolescents' experiences of living with temporomandibular disorder (TMD) pain. Methods: twenty-one adolescents with TMD pain, aged 15 to 19, were strategically selected from a group of patients referred to an orofacial pain clinic. The patients were examined and received diagnoses per the Research Diagnostic Criteria for TMD. One-on-one interviews that followed a semistructured protocol focused on the patient's experiences of living with TMD pain. The interviews were recorded and transcribed verbatim, followed by content analysis to obtain a deeper understanding of adolescents' experieces living with TMD pain. Results: Content analysis led to the overall theme "Adolescents with TMD live with recurrent pain; physical problems and daily demands form a vicious circle that causes adolescents to oscillate between hope and despondency." The latent content forming the theme is grounded in three categories that evolved from 13 subcategories. For instance, five subcategories - headache; headache on awakening; jaw and tooth pain; constant thoughts of pain; and popping, cracking, clicking, and locking - formed the category that was labeled TMD pain is recurrent. The latent interpretation, ie, the meaning, of this category was that adolescents with TMD pain constantly thought about the pain, even when it was absent. Conclussion: TMD pain is a substantial problem for affected adolescents and has consequences for all aspects of their lives. In this study, the adolescents were able to talk openly and introduce issues outside of the interview protocol. Qualitative analysis deepens our understanding of the adolescent patient with TMD pain.
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| 50. |
- Nilsson, Ing-Marie, et al.
(author)
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Impact of temporomandibular disorder pain in adolescents : differences by age and gender
- 2009
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In: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 23:2, s. 115-122
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Journal article (peer-reviewed)abstract
- AIMS: To evaluate the impact of temporomandibular disorder (TMD) pain by age and gender in adolescents, with assessments of this impact specifically on school absence, medication consumption, perceived need for treatment, jaw function limitation, depressive symptoms scores and somatic complaints, and graded chronic pain scale. METHODS: In a population-based sample, a mailed questionnaire was sent to 350 patients with self-reported TMD pain (group 1) and 350 healthy age- and sex-matched individuals (group 2) aged 12 to 19 years 2 to 4 weeks after their annual dental examination. The groups were divided into younger (age 12 to 15) and older (age 16 to 19) groups. Descriptive statistics and 95% confidence intervals were used, and chi-square and t-tests were calculated for analyzing group differences. Odds ratios were estimated using logistic regression. RESULTS: As expected, groups 1 and 2 differed significantly in most variables related to psychosocial and behavioral factors. For adolescents reporting TMD pain once a week or more, no gender or age differences in pain intensity were seen. Jaw function limitation, depressive symptoms scores, somatic complaints, graded chronic pain, and perceived need for TMD treatment were all significantly higher in girls than in boys. Older girls reported higher analgesic consumption and school absences than older boys. CONCLUSION: Girls reporting TMD pain had significantly greater impact on behavioral and psychosocial factors than boys. Almost one third of older girls, compared to one out of 10 older boys, reported school absences and analgesic consumption because of their TMD pain.
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