Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.252
Filtrar
1.
Dent Clin North Am ; 66(2): 229-244, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35365275

RESUMO

Nonodontogenic orofacial pain exists, and diagnosis and management of those conditions can be challenging. This article highlights and discusses how to take a complete and systematic pain history and the important red flags to recognize in patients presenting with perplexing nonodontogenic orofacial pain. Cause and epidemiology, clinical presentation, clinical evaluation and diagnosis, and management options for common neuropathic pain conditions are included. Neuralgia and neuropathic pain conditions and red flags as secondary cause of orofacial pain are more common in older-aged patients.


Assuntos
Neuralgia , Dor Facial/diagnóstico , Dor Facial/etiologia , Dor Facial/terapia , Humanos , Neuralgia/diagnóstico , Neuralgia/terapia
2.
Artigo em Inglês | MEDLINE | ID: mdl-35409806

RESUMO

Fibromyalgic syndrome and orofacial neuropathic pain are major public health concerns affecting up to 5% and 10%, respectively, of the general population. They generally require medications such as antidepressants and anticonvulsants, which may additionally impact the quality of life with their side effects. Modern technologies and related applications have changed several fields of human life, even in medicine. In the current study, the local administration of electromagnetic fields as add-on therapy for the treatment of cervical and facial pain in patients with fibromyalgia or neuropathic pain has been evaluated. A total of 15 patients were recruited, and an electromagnetic field was delivered through a small patch applied between C3 and C4. Patients were followed for 12 months, and pain levels were rated via the VAS scale; ∆% was calculated through the analysis of median VAS scale values at each time point. Mild-to-moderate improvements were found, especially after six months. Patients with fibromyalgic syndrome showed better response rates than those with orofacial neuropathic pain. Joint stiffness, masticatory fatigue, and sleep disturbances were also reduced. In conclusion, the local application of electromagnetic field appeared effective in treating fibromyalgic and neuropathic pain in the head and neck district, with broader improvements and no side effects.


Assuntos
Dor Crônica , Fibromialgia , Neuralgia , Dor Crônica/tratamento farmacológico , Campos Eletromagnéticos , Dor Facial/terapia , Fibromialgia/terapia , Humanos , Projetos Piloto , Qualidade de Vida
3.
Neurophysiol Clin ; 52(2): 95-108, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35339350

RESUMO

OBJECTIVE: We conducted an open-label cross-over study assessing the global effect of two high-frequency protocols of electric-field navigated repetitive transcranial magnetic stimulation (rTMS) targeted to functional facial motor cortex and comparing their efficacy and tolerability in patients with chronic facial pain. Outcome predictors were also assessed. METHODS: We randomized twenty consecutive patients with chronic facial pain (post-traumatic trigeminal neuropathic pain, n=14; persistent idiopathic facial pain, n=4; secondary trigeminal neuralgia, n=2) to receive two distinct 5-day rTMS interventions (10Hz, 2400 pulses and 20Hz, 3600 pulses) separated by six weeks. The target area was assessed by mapping of lower face representation. The primary endpoint was the change in weekly mean of pain intensity (numeric rating scale, NRS) between the baseline and therapy week (1st week), and follow-up weeks (2nd and 3rd weeks) for each rTMS intervention. Response was defined using a combination scale including the patient's global impression of change and continuance with maintenance treatment. RESULTS: Overall, pain intensity NRS decreased from 7.4 at baseline to 5.9 ten weeks later, after the second rTMS intervention (p=0.009). The repetition of the treatment had a significant effect (F=4.983, p=0.043) indicating that the NRS scores are lower during the second four weeks period. Eight (40%) patients were responders, 4 (20%) exhibited a modest effect, 4 (20%) displayed no effect, and 4 (20%) experienced worsening of pain. High disability and high pain intensity (>7) predicted a better outcome (p=0.043 and p=0.045). Female gender, shorter duration of pain and low Beck Anxiety Inventory scores showed a trend towards a better outcome (p=0.052, 0.060 and 0.055, respectively). CONCLUSIONS: High-frequency rTMS targeted to face M1 alleviates treatment resistant chronic facial pain. Repeated treatment improves the analgesic effect. A protocol with higher frequency (above 10Hz), longer session duration (more than 20 minutes) and higher number of pulses (above 2400 pulses/session) did not improve the outcome. The results support early consideration of rTMS.


Assuntos
Dor Crônica , Córtex Motor , Neuralgia , Dor Crônica/terapia , Estudos Cross-Over , Dor Facial/terapia , Feminino , Humanos , Manejo da Dor/métodos , Estimulação Magnética Transcraniana/métodos , Resultado do Tratamento
4.
Artigo em Inglês | MEDLINE | ID: mdl-35239486

RESUMO

In this paper, we monitored the accuracy of non-navigated application of repetitive Transcranial Magnetic Stimulation (rTMS) in 10 patients suffering from orofacial pain by using functional magnetic resonance (fMRI), computer modeling and numerical simulation. Through a unique process, each fMRI scan was used to define a Region of Interest (ROI) where the source of the orofacial pain was located, which was to be stimulated using rTMS. For each patient, MRI scans with a spatial resolution of 0.7 mm were converted into an anatomically accurate head model. The head model including the ROI was then co-registered with a model of the stimulation coil in an electromagnetic field numerical simulator. The accuracy of rTMS application was evaluated based on the calculations of electric field intensity distribution in the ROI. The research has yielded unique insight into ROIs (with average volume 904 mm3) in patients with orofacial pain and has also extended further possibilities of human head MRI image semi-automatic segmentation. According to the calculations performed, the average ROI volume that was stimulated by an electric field with an intensity of over 80 V/m was only 4.4%, with the maximum ROI volume being 20.5%. Furthermore, a numerical study of the impact of coil rotation and translation was performed. It demonstrated a) the optimal placement of the stimulation coil can significantly increase the volume of the stimulated ROI up to 60% and b) patients with orofacial pain would need precise coil positioning with a navigation error lower than 10 mm. Due to an acceptable proccessing time of up to 6 hours, described numerical simulation opens up new options for precise rTMS treatment planning. This planning platform together with patient-specific navigated rTMS, could lead to significant increase of treatment outcomes in patients suffering from orofacial pain.


Assuntos
Dor Facial , Estimulação Magnética Transcraniana , Campos Eletromagnéticos , Dor Facial/terapia , Humanos , Imageamento por Ressonância Magnética/métodos , Estimulação Magnética Transcraniana/métodos , Resultado do Tratamento
5.
J Oral Facial Pain Headache ; 36(1): 21-25, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35298572

RESUMO

AIMS: To evaluate About Face, a pain management program aimed at increasing quality of life in adults living with persistent facial pain through psychology- and physiotherapy-based skill development. METHODS: A total of 90 patients attended a six-session program with a 1-month follow-up between 2015 and 2019. Patients filled out self-reported outcome measures preprogram, postprogram, and at a 1-month follow-up visit. RESULTS: There was a significant reduction in pain catastrophizing and a significant increase in engagement in meaningful activity, as well as a reduction in pain-related interference. CONCLUSION: This evaluation adds to the small amount of existing literature on interventions aimed at increasing quality of life in patients living with persistent facial pain and provides suggestions for future research.


Assuntos
Manejo da Dor , Qualidade de Vida , Adulto , Dor Facial/terapia , Humanos , Medição da Dor , Modalidades de Fisioterapia
6.
Pain Res Manag ; 2022: 3115154, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35178136

RESUMO

INTRODUCTION: Pain is a natural response of the body to injury and one of the symptoms defining an inflammatory reaction. It is almost always present after orthognathic surgeries (OGS), but its severity is subjective in each patient. Postoperative care of the patient is aimed at minimizing of postoperative pain relief orofacial region. Options of physiotherapy include extremely low-frequency electromagnetic field (ELF EMF) and high-energy light-emitting diode (LED). Aim of the Study. The aim of this study was to evaluate the effects of physiotherapy combining ELF EMF and LED to reduce pain of the orofacial region in patients after OGS. Material and Methods. The study was conducted in thirty-two patients who underwent OGS to treat morphological defects. The participants were randomly divided into two groups: Physiotherapy group (PT) and Control group (CG). In both groups, patients were prescribed Paracetamol and nonsteroidal analgesics (NSAID-ibuprofen). Patients from the PT group additionally received postoperative physiotherapy immediately after leaving the surgical clinic in the form of ELF EMF and LED therapy. Physiotherapeutic treatments were performed for 10 days, three applications a day, at no cost to the patient. Pain intensity was assessed using the visual analogue scale (VAS), which is a reliable instrument for the measurement of pain intensity self-reported by the patient. RESULTS: Faster reduction of pain was the major observation made in patients who received physiotherapy treatments. In all subjects, after 5 days of therapy, the pain intensity was reduced by about 50% or resolved completely. Effects of therapy were measured with the relative changes in the pain intensity score, showing what fraction of the initial pain was eliminated at the first stage and throughout the whole therapy. The analysis of relative changes instead of absolute changes allowed us, among other things, to eliminate the bias of the higher initial pain intensity in the CG group compared to the PT group. CONCLUSIONS: The conducted research revealed that the combined use of ELF EMF and LED is beneficial in the reduction of pain of patients after OGS. The analgesic effects of physiotherapy in the treatment after OGS are necessary to continue research in this area and analyze the possibility of extending the indications for its use in other surgically treated maxillofacial diseases.


Assuntos
Acetaminofen , Campos Eletromagnéticos , Acetaminofen/uso terapêutico , Dor Facial/etiologia , Dor Facial/terapia , Humanos , Ibuprofeno , Projetos Piloto
7.
Otol Neurotol ; 43(3): e309-e315, 2022 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-35020685

RESUMO

BACKGROUND: Successful orofacial treatment can reduce tinnitus severity in patients with somatic tinnitus (ST). However, it is still unclear to what extent the degree of reduction in temporomandibular disorders (TMD) actually contributes to the decrease in tinnitus severity after orofacial treatment. Therefore, the aim of this study was to analyze the mediating effect of reduction in TMD pain on the improvement of tinnitus severity after multidisciplinary orofacial treatment. METHODS: A total of 80 patients with moderate to severe ST attributed to the temporomandibular region, were recruited from a tertiary tinnitus clinic. At baseline, patients were randomly assigned to the orofacial treatment group or to the control group. Both groups received a minimum of information and advice regarding their tinnitus complaints. The orofacial treatment group received orofacial physical therapy complemented with occlusal splints when needed, while the control group received no other treatment. A mediation analysis was performed according to the steps described by Baron and Kenny and the proportion of the mediating effect was calculated for the potential mediator: "change in TMD pain," measured by a one-point decrease in TMD pain screener score. RESULTS: Our analysis showed that 35% of the observed decrease in tinnitus severity can be attributed to a reduction in TMD pain. A significant total effect of orofacial treatment compared with control on the change in tinnitus functional index (TFI) score was found (B = 0.253 p = 0.025 Cl for B = 1.265-18.576). Orofacial treatment was also significantly related to the change in TMD pain (Exp (B) = 2.800, p = 0.034 Cl for Exp B 1.081-7.251). Additionally, the change in TMD pain screener score was significantly related to the change in TFI score (B = -0.273 p = 0.016 Cl for B = -19.875 to -2.119). CONCLUSION: Reduction of TMD pain is a mediating factor in the decrease of tinnitus severity after multidisciplinary orofacial treatment. PRACTICAL IMPLICATIONS: Orofacial treatment can be used to decrease tinnitus severity in patients with TMD related somatic tinnitus.


Assuntos
Transtornos da Articulação Temporomandibular , Zumbido , Dor Facial/terapia , Humanos , Dor , Modalidades de Fisioterapia , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/terapia , Zumbido/terapia
9.
J Am Dent Assoc ; 153(2): 144-157, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34973705

RESUMO

BACKGROUND: Patients often seek consultation with dentists for temporomandibular disorders (TMDs). The objectives of this article were to describe the methods of a large prospective cohort study of painful TMD management, practitioners' and patients' characteristics, and practitioners' initial treatment recommendations conducted by The National Dental Practice-Based Research Network (the "network"). METHODS: Participating dentists recruited into this study treated patients seeking treatment for painful TMDs. The authors developed self-report instruments based on well-accepted instruments. The authors collected demographics, biopsychosocial characteristics, TMD symptoms, diagnoses, treatments, treatment adherence, and painful TMDs and jaw function outcomes through 6 months. RESULTS: Participating dentists were predominately White (76.8%) and male (62.2%), had a mean age of 52 years, and were general practitioners (73.5%) with 23.8% having completed an orofacial pain residency. Of the 1,901 patients with painful TMDs recruited, the predominant demographics were White (84.3%) and female (83.3%). Patients' mean age was 44 years, 88.8% self-reported good to excellent health, and 85.9% had education beyond high school. Eighty-two percent had pain or stiffness of the jaw on awakening, and 40.3% had low-intensity pain. The most frequent diagnoses were myalgia (72.4%) and headache attributed to TMDs (51.0%). Self-care instruction (89.4%), intraoral appliances (75.4%), and medications (57.6%) were recommended frequently. CONCLUSIONS: The characteristics of this TMD cohort include those typical of US patients with painful TMDs. Network practitioners typically managed TMDs using conservative treatments. PRACTICAL IMPLICATIONS: This study provides credible data regarding painful TMDs and TMD management provided by network practitioners across the United States. Knowledge acquired of treatment recommendations and patient reports may support future research and improve dental school curricula.


Assuntos
Transtornos da Articulação Temporomandibular , Adulto , Dor Facial/terapia , Feminino , Cefaleia/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Autocuidado , Transtornos da Articulação Temporomandibular/terapia
10.
Pain Med ; 23(4): 799-806, 2022 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-34623433

RESUMO

OBJECTIVE: The aim of the study was to test whether patients with orofacial pain were more likely to start and complete a brief psychological intervention for managing certain chronic orofacial pain conditions (physical self-regulation [PSR]) via telehealth (during the COVID-19 pandemic) vs. in-person (before the COVID-19 pandemic). The exploratory aim was to describe demographic factors that could influence patients' likelihood of starting and completing PSR. METHODS: Retrospective medical charts of all patients seen at a university-affiliated tertiary orofacial pain clinic between July-December 2019 (in-person; before the pandemic) and July-December 2020 (telehealth; during the pandemic) were reviewed. Charts were examined for demographic information and to compare the number of patients who started and completed PSR during each study period (chi-squared test). RESULTS: Of 248 new patients seen in the clinic during the 2019 period, 25 started PSR in-person (10.08%). Of 252 new patients seen during the 2020 period, 53 started PSR via telehealth (21.03%). Patients were more likely to start PSR (odds ratio = 6.21, p < 0.001, 95% confidence interval = 2.499 to 15.435) and more likely to complete all three sessions of PSR (odds ratio = 5.69, p < 0.001, 95% confidence interval = 2.352 to 13.794) when it was offered via telehealth than when it was offered in-person. Among those who started PSR via telehealth, patients from metropolitan areas were more likely to start the intervention than those from non-metropolitan areas (p = 0.045). CONCLUSIONS: Offering brief psychological pain interventions via telehealth in tertiary orofacial pain clinics has demonstrated feasibility and may improve patients' willingness to participate in psychological treatments. Results need to be replicated with prospective data, as modality was confounded with the pandemic in the present study.


Assuntos
COVID-19 , Telemedicina , Dor Facial/terapia , Humanos , Pandemias , Estudos Prospectivos , Estudos Retrospectivos
11.
Oral Dis ; 28(3): 805-812, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33650141

RESUMO

OBJECTIVE: Neuropathic orofacial pain disorders are frequently managed with topical or systemic medications that carry a risk of dangerous side effects such as drowsiness, disorientation, and/or physical addiction. The aim of this paper is to report the use of neurosensory oral appliances as a safe means of providing symptomatic relief for neuropathic orofacial pain. STUDY DESIGN: This is a retrospective chart review of patients with diagnoses of persistent idiopathic facial pain (PIFP), painful post-traumatic trigeminal neuropathy (PTTN), or an oral dysesthesia, who utilized neurosensory appliances with or without the use of topical anesthetic gel. RESULTS: Eleven patients were identified. Eight patients (62.5%) found benefit with the neurosensory appliance alone, and three patients (37.5%) found relief with the addition of lidocaine 2% gel. All patients reported >50% resolution of their symptoms, with three (37.5%) reporting complete resolution. Seven patients maintained follow-up ≥3 months, with efficacy lasting for a range of at least 3-8 months. CONCLUSION: Oral neurosensory appliances, whether used alone as a physical barrier or as a vehicle to deliver topical anesthetic, represent a safe and effective modality for the management of neuropathic orofacial pain disorders. Additional studies are needed to assess long-term efficacy.


Assuntos
Neuralgia , Neuralgia do Trigêmeo , Dor Facial/etiologia , Dor Facial/terapia , Humanos , Lidocaína/uso terapêutico , Neuralgia/diagnóstico , Neuralgia/etiologia , Neuralgia/terapia , Estudos Retrospectivos , Neuralgia do Trigêmeo/diagnóstico
12.
Z Psychosom Med Psychother ; 67(4): 416-434, 2021 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-34904551

RESUMO

Studies on the psychodynamics of Chronic Orofacial Pain Disorder Objectives: Psychodynamic factors play an important role in its emergence and development of Chronic Orofacial Pain Disorder (COP), which is also known as Chronic Primary Orofacial Pain. This factors form the basis for differentiated psychotherapy. Methods: Seven female and two male patients with COP who had visited the Dental School, University Hospital, Ludwig Maximilian University of Munich, and the dental surgery of a practising dentist over the year were included in the study. Following a detailed dental examination, a psychodynamic interview was videotaped, reconstructing the connections between the life history and the development of the illness. Psychosomatic data were assessed by 3 psychotherapists based on a consensus model with regard to symptom trigger mechanisms such as conflicts and pressure, the development of symptoms, and the personality structure. Pathogenetically, we differentiated among conversion, somatization and projection. Results: The patients had a mean age of 57 years (range: 44-67) and an average illness duration of three (1-5) years. The average age where the illness had manifested was 54 (43-64). All patients showed clear psychodynamic factors in the development and course of the illness. The symptoms developed mainly during transitional situations during the life history, predominately in midlife. During this phase, dental treatment undertaken for whatever reason could trigger the chronic symptoms, which could then be further exacerbated by further dental interventions. The mode of symptom development by equal number of patients related to a somatoform disorder, such as a somatization of affect, a conversion with conflict symbolism and a projective-hypochondriac disorder. In the remaining patients, COP was an accompanying symptom of depressive disorder or the consequence of a posttraumatic stress disorder with self-mutilating tendencies. Conclusion: The consideration of psychosomatic connections and pathogenetic differentiation is helpful for the understanding and management of COP. This diagnostic differentiation could serve as a basis for prognosis and for specific therapeutic indications. Despite numerous general researches about chronic pain syndromes, there is a lack of intervention studies which take into account the specific conditions of COP on a larger sample.


Assuntos
Dor Crônica , Doença Crônica , Dor Crônica/terapia , Dor Facial/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade , Transtornos Psicofisiológicos/diagnóstico , Transtornos Psicofisiológicos/terapia , Transtornos Somatoformes/diagnóstico , Transtornos Somatoformes/terapia
13.
Med Sci Monit ; 27: e933017, 2021 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-34789713

RESUMO

BACKGROUND Infrared thermography is a diagnostic method used to monitor acute and chronic orofacial pain syndrome. Repetitive transcranial magnetic stimulation (rTMS) is a form of non-invasive brain stimulation. This prospective study from a single center aimed to investigate the effects of rTMS and used infrared thermography as a confirmatory test of orofacial pain. MATERIAL AND METHODS We used infrared thermography to examine the incidence of inflammatory changes as orofacial pain triggers. During the analysis of rTMS effects on patients with orofacial pain, we compared the decrease in pain and the thermal difference in the study group (n=17) and in the research group (n=13). RESULTS In the control group (n=13), there were no statistically significant changes. Both groups showed a significant decrease in self-reported pain. Numerical pain rating scores were significantly lower after S2 stimulation than after S1/M1 (P=0.0071) or sham (P=0.0187) stimulation. The Brief Pain Inventory scores were also lower 3 to 5 days after S2 stimulation than at the pretreatment baseline (P=0.0127 for the intensity of pain and p=0.0074 for the interference of pain), and after S1/M1 (P=0.001 and P=0.0001) and sham (P=0.0491 and P=0.0359) stimulations. CONCLUSIONS The findings from this study support the role of infrared thermography for the diagnosis of chronic orofacial pain, and showed that on the first and fifth days of rTMS therapy in the study group there was a significant reduction of the thermography findings when compared with the control group without rTMS therapy.


Assuntos
Dor Facial/diagnóstico , Dor Facial/terapia , Termografia/métodos , Estimulação Magnética Transcraniana/métodos , Dor Crônica/diagnóstico , Dor Crônica/terapia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Retratamento , Resultado do Tratamento
14.
J Oral Facial Pain Headache ; 35(3): 208-217, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34609379

RESUMO

AIMS: To understand the experiences of patients diagnosed with chronic facial pain (CFP) who attended a specialist facial pain management program (PMP); specifically, to explore how they experienced attending the facial PMP itself and how they felt it impacted their management of CFP. METHODS: Qualitative methodology and focus groups were used to gather patients' views and experiences of attending a facial PMP. Two focus groups were conducted for patients who had all completed the facial PMP. Discussions were recorded and transcribed. Data were then analyzed using thematic analysis to establish key themes relating to participants' experiences of the facial PMP. RESULTS: Thematic analysis identified three main themes, with numerous subthemes within them. The theme "psychologic change" had subthemes of self-compassion, acceptance, and reflection. The theme "behavioral change" contained subthemes of re-engagement with valued activity, medication, and communication. The theme "structure and process" contained subthemes of concentration, need for one-on-one time with the clinician, meeting others, and not enough time (clinical and nonclinical). CONCLUSION: Facial PMPs may provide a valuable treatment to support long-term coping and adaptation for patients with CFP. Positive changes to coping include both psychologic and behavioral elements. Further research is necessary to clarify how group-based facial PMPs should be structured and delivered.


Assuntos
Adaptação Psicológica , Manejo da Dor , Dor Facial/terapia , Grupos Focais , Humanos , Pesquisa Qualitativa
15.
PLoS One ; 16(10): e0258063, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34597318

RESUMO

BACKGROUND: Low level lasers have been used as an alternative pain relief therapy for muscle and joint pain, since it induces analgesic, anti-inflammatory, and biomodulation effects of the physiological cell functions. The effectiveness of low-level laser therapy in temporomandibular joint dysfunction (TMD) treatment, however, is not well established. Although Surface electromyography (sEMG) has been suggested as a complementary means in TMD diagnosis, the effect of conservative treatments on muscle activity has not yet been thoroughly correlated with (sEMG) findings. PURPOSE: To assess the efficacy of low-level laser therapy (LLLT) as compared to occlusive splint therapy (OST) on the TMJ opening index (TOI) and sEMG of masticatory muscles. MATERIALS AND METHODS: 112 female subjects suffering from unilateral myogenous TMD, aged 21-30 years-old, were recruited and divided into three groups: LLLT; soft occlusive splint therapy OST and a waitlist group as controls. OUTCOME MEASURES: TMJ opening index (TOI), Visual analogue scale (VAS), surface electromyography (sEMG). RESULTS: A significant reduction was reported in TOI, VAS and the sEMG within the LLLT and OST groups as well as significant decrease in all outcomes between groups in favor of the LLLT group (P< 0.0001). Meanwhile, there was a weak significant difference within the control group probably attributed to the analgesic. Post-hoc pairwise comparisons between groups [control vs occlusive splints, control vs low-level laser and low-level laser vs occlusive splints] revealed significant differences in the VAS and TOI [P = 0.0001; 95% CI: 0.9-2.2, 1.61-4.01, 0.65-1.96]. CONCLUSIONS: Findings support an evident short term therapeutic effect of the LLLT on improving VAS, TOI and sEMG in females suffering from myogenous TMD.


Assuntos
Eletromiografia/métodos , Dor Facial/terapia , Terapia com Luz de Baixa Intensidade/métodos , Transtornos da Articulação Temporomandibular/terapia , Adulto , Feminino , Humanos , Resultado do Tratamento , Adulto Jovem
16.
BMC Oral Health ; 21(1): 474, 2021 09 27.
Artigo em Inglês | MEDLINE | ID: mdl-34579713

RESUMO

BACKGROUND: There is limited data on Pakistani dental students perceived competence in managing orofacial pain (OFP). This study aims to evaluate dental students self-perceived competence regarding the management of orofacial pain. METHODS: This cross-sectional study was conducted in Karachi at randomly selected two public and four private dental schools. This survey was conducted online from November 2020 to December 2020 in six dental schools. A questionnaire link was sent to the 475 students. A chi-square test and independent-sample t-test were conducted to assess the frequency distribution and compare mean scores of knowledge, diagnosis, and management parameters. RESULTS: Of the 475 students, 280 students filled the online survey leaving a response rate of 59%. A significant number of fourth-year students, 65 (51%, p = 0.005), feels knowledgeable regarding neuropathic pain compared to third-year students. The majority of the fourth-year students, 100 (78%, p = 0.010), feel comfortable managing intraoral pain. Almost all the students reported thinking that they need more knowledge related to five types of OFP. The fourth-year students had high mean scores related to knowledge, comfort in diagnosing and managing OFP categories. CONCLUSION: This study found that dental students perceived competence regarding orofacial pain management varies in relation to specific categories, being lowest for psychogenic pain.


Assuntos
Estudantes de Odontologia , Transtornos da Articulação Temporomandibular , Competência Clínica , Estudos Transversais , Educação em Odontologia , Dor Facial/terapia , Humanos , Inquéritos e Questionários
17.
J Oral Rehabil ; 48(10): 1118-1128, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34273180

RESUMO

BACKGROUND: Aims of the study were to: Implement supported self-management for chronic primary oro-facial pain in a clinical setting. Evaluate its impact on consultation rates, pain severity, interference with life and patient experience. METHODS: Sixty-six patients with chronic primary oro-facial pain received the intervention at a facial pain clinic at Leeds Dental Institute, UK. Brief Pain Inventory (BPI) scores measured pain severity and interference with life before and after the intervention. Process mining outlined patient care pathways. Monthly consultation rates measured 12 months before and after the intervention were used to evaluate burden on healthcare services and economic impact. Patient feedback was assessed via Patient and Public involvement discussion groups. RESULTS: Mean BPI scores significantly improved after intervention-from 5.70 (SD 1.89) to 3.78 (SD 2.34) (p < .001); mean pain interference score reduced from 19.95 (SD 9.41) to 12.05 (SD 9.64) (p < .001). Average monthly consultations significantly (p = .001) reduced from 0.42/month before the intervention to 0.16/month after the intervention. Economic assessment showed cost savings of £293 per patient per year. Process mining showed high rates of service usage with 31 patients also attending 51 other specialist services between them. Patient and Public Involvement discussion groups with 5 patients identified that the intervention was a 'constant companion' and should be implemented at the outset in the care pathway. CONCLUSION: Supported self-management for chronic primary oro-facial pain has a positive impact on health outcomes (physical functioning, pain intensity and patient experience), as well as service usage and healthcare costs when implemented in a secondary care clinical setting. Reconfiguring current care pathways to upscale early implementation of such interventions should be a priority for future testing.


Assuntos
Dor Crônica , Autogestão , Transtornos da Articulação Temporomandibular , Dor Crônica/terapia , Face , Dor Facial/terapia , Humanos , Transtornos da Articulação Temporomandibular/terapia
18.
J Med Case Rep ; 15(1): 337, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34210351

RESUMO

BACKGROUND: Chronic facial pain is a serious condition affecting millions of people worldwide. The reasons for chronic facial pain vary, and currently, the methods of treating chronic facial pain are expensive, invasive, and, based on current findings, ineffective. The purpose of this study is to develop and test an effective, cost-friendly method to treat patients with chronic facial pain. This study will examine the effectiveness of a novel treatment of a patient suffering from trigeminal neuralgia. CASE PRESENTATION: A 70-year-old Thai female visited the advanced general dentistry clinic at the Faculty of Dentistry, Mahidol University, Bangkok, Thailand. She was suffering from facial pain on her left side and was diagnosed by a physician as having trigeminal neuralgia. She experienced a sharp shooting pain that was triggered by facial movements such as chewing, speaking, or brushing teeth, and touching certain areas of her face. Bouts of pain lasted from a few seconds to several minutes, and episodes of several attacks lasted days, weeks, months, or longer prior to her visit to the advanced general dentistry clinic at Mahidol University. Physician designed an occlusal equilibration appliance for treating the patient by inserting the appliance in the mouth for dental occlusal equilibration (deprogram). The patient used this appliance by placing it in the mouth continuously (day and night) and removed it only when eating. After using the appliance for 2 weeks, the patient appeared to feel and look better prior to taking medication and was able to eat normally. The patient was pain free after treatment for a duration of 9 months. However, after 9 months, the pain reoccurred and manifested itself. CONCLUSION: This novel treatment of recurrent facial pain showed an improvement of the patient's chronic facial pain and serves as evidence to being a novel method for treating those suffering from trigeminal neuralgia.


Assuntos
Dor Facial , Neuralgia do Trigêmeo , Idoso , Dor Facial/etiologia , Dor Facial/terapia , Feminino , Humanos , Tailândia , Neuralgia do Trigêmeo/terapia
19.
Int J Mol Sci ; 22(10)2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-34069553

RESUMO

Orofacial pain is a universal predicament, afflicting millions of individuals worldwide. Research on the molecular mechanisms of orofacial pain has predominately focused on the role of neurons underlying nociception. However, aside from neural mechanisms, non-neuronal cells, such as Schwann cells and satellite ganglion cells in the peripheral nervous system, and microglia and astrocytes in the central nervous system, are important players in both peripheral and central processing of pain in the orofacial region. This review highlights recent molecular and cellular findings of the glia involvement and glia-neuron interactions in four common orofacial pain conditions such as headache, dental pulp injury, temporomandibular joint dysfunction/inflammation, and head and neck cancer. We will discuss the remaining questions and future directions on glial involvement in these four orofacial pain conditions.


Assuntos
Dor Facial/metabolismo , Dor Facial/fisiopatologia , Neuroglia/fisiologia , Animais , Dor Facial/terapia , Neoplasias de Cabeça e Pescoço/fisiopatologia , Cefaleia/fisiopatologia , Humanos , Inflamação/fisiopatologia , Microglia/fisiologia , Neurônios/fisiologia , Nociceptividade/fisiologia , Gânglio Trigeminal/fisiologia
20.
Curr Neurol Neurosci Rep ; 21(8): 42, 2021 06 20.
Artigo em Inglês | MEDLINE | ID: mdl-34148140

RESUMO

PURPOSE OF REVIEW: Although sinus headache has been extensively reviewed and described, misdiagnosis remains common. This paper discusses the myths and truths about sinus headaches. RECENT FINDINGS: Sinus headache is used colloquially to attribute facial pain to allergies or a sinus infection; however, most sinus headaches are migraine. Sinus-region pain from sinusitis and migraine share the same origins in the trigeminovascular system, but their causes are very different. After reviewing sinus anatomy and sinogenic pain, we provide information to assist clinicians in correctly diagnosing patients with the additional goal of avoiding unnecessary investigations and treatments. Migraine medications can be used as both a treatment and a diagnostic tool. Other differential diagnoses of facial pain are discussed. Sinus headache is not a diagnosis. All patients with facial pain or pressure with sinus symptoms should be evaluated for migraine because most sinus headache presentations are migraine and require migraine-directed treatment.


Assuntos
Transtornos de Enxaqueca , Sinusite , Diagnóstico Diferencial , Dor Facial/diagnóstico , Dor Facial/etiologia , Dor Facial/terapia , Cefaleia/diagnóstico , Cefaleia/etiologia , Humanos , Transtornos de Enxaqueca/diagnóstico , Sinusite/complicações , Sinusite/diagnóstico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...