Myofascial pain associated to trigger points: a literature review. Part 2: differential diagnosis and treatment.

During the last decades the advance in knowledge of myofascial pain has been constant in the medical and dental community. However, although several aspects have been clarified in relation to its epidemiology, clinical characteristics and etiopathogenesis, many uncertainties remain. Many clinical conditions are included in the differential diagnosis of myofascial pain associated to trigger points. A good anamnesis and clinical exploration is thus required in order to ensure correct diagnosis and treatment. Among the numerous treatments used in application to trigger points, the spray-and-stretch technique and direct injection targeted to such trigger points have been found to be the most effective options. In chronic cases, psychosocial intervention is required, due to the high incidence of mood disorders and/or anxiety observed in these patients, who in turn present a poorer prognosis. This underscores the importance of early diagnosis and treatment.

Myofascial pain syndrome associated with trigger points: a literature review. (I): Epidemiology, clinical treatment and etiopathogeny.

Over the last few decades, advances have been made in the understanding of myofascial pain syndrome epidemiology, clinical characteristics and aetiopathogenesis, but many unknowns remain. An integrated hypothesis has provided a greater understanding of the physiopathology of trigger points, which may allow the development of new diagnostic, and above all, therapeutic methods, as well as the establishment of prevention policies and protocols by the health profession. Nevertheless, randomized studies are needed to provide a better understanding and detection of the different factors involved in the origin of trigger points.

The use of tricyclic antidepressants in the treatment of temporomandibular joint disorders: systematic review of the literature of the last 20 years.

Many therapies have been proposed for the management of temporomandibular disorders, including the use of different drugs. However, lack of knowledge about the mechanisms behind the pain associated with this pathology, and the fact that the studies carried out so far use highly disparate patient selection criteria, mean that results on the effectiveness of the different medications are inconclusive. This study makes a systematic review of the literature published on the use of tricyclic antidepressants for the treatment of temporomandibular disorders, using the SORT criteria (Strength of recommendation taxonomy) to consider the level of scientific evidence of the different studies. Following analysis of the articles, and in function of their scientific quality, a type B recommendation is given in favor of the use of tricyclic antidepressants for the treatment of temporomandibular disorders.

Accidental dental displacement into the maxillary sinus during extraction maneuvers: a case series

BACKGROUND: The aims of this study were to describe the clinical findings of patients that suffered teeth displacement into the maxillary sinus, and to report the surgical technique used to solve this complication. MATERIAL AND METHODS: A retrospective observational study was conducted involving patients that suffered a displacement of teeth into the maxillary sinus. Demographic and clinical data were recorded from the affected patients and a descriptive statistical analysis was made of the study variables. RESULTS: A total of nine patients were enrolled, six males (66.7%) and three females (33.3%), with a mean age of 36.0 years (range 22-54). In five patients (55.5%) the displaced teeth remained asymptomatic; however, dental fragments were retrieved from the maxillary sinus using Caldwell-Luc technique or endoscopic approach. CONCLUSIONS: Dental displacement into the maxillary sinus during the extraction manoeuvres is an uncommon finding. Even in asymptomatic cases, these displaced teeth should be extracted in order to avoid the development of sinus pathology

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Myofascial pain associated to trigger points: A literature review. Part 2: Differential diagnosis and treatment

During the last decades the advance in knowledge of myofascial pain has been constant in the medical and dental community. However, although several aspects have been clarified in relation to its epidemiology, clinical characteristics and etiopathogenesis, many uncertainties remain. Many clinical conditions are included in the differential diagnosis of myofascial pain associated to trigger points. A good anamnesis and clinical exploration is thus requiredin order to ensure correct diagnosis and treatment. Among the numerous treatments used in application to trigger points, the spray-and-stretch technique and direct injection targeted to such trigger points have been found to be the most effective options. In chronic cases, psychosocial intervention is required, due to the high incidence of mood disorders and/or anxiety observed in these patients, who in turn present a poorer prognosis. This underscores the importance of early diagnosis and treatment (AU)

The use of tricyclic antidepressants in the treatment of temporomandibular jointdisorders: Systematic review of the literature of the last 20 years

Many therapies have been proposed for the management of temporomandibular disorders, including the use of differentdrugs. However, lack of knowledge about the mechanisms behind the pain associated with this pathology, and the fact thatthe studies carried out so far use highly disparate patient selection criteria, mean that results on the effectiveness of the differentmedications are inconclusive. This study makes a systematic review of the literature published on the use of tricyclicantidepressants for the treatment of temporomandibular disorders, using the SORT criteria (Strength of recommendationtaxonomy) to consider the level of scientific evidence of the different studies. Following analysis of the articles, and infunction of their scientific quality, a type B recommendation is given in favor of the use of tricyclic antidepressants for thetreatment of temporomandibular disorders (AU)

Myofascial pain syndrome associated with trigger points: A literature review. (I): Epidemiology, clinical treatment and etiopathogeny

Over the last few decades, advances have been made in the understanding of myofascial pain syndrome epidemiology,clinical characteristics and aetiopathogenesis, but many unknowns remain. An integrated hypothesishas provided a greater understanding of the physiopathology of trigger points, which may allow the developmentof new diagnostic, and above all, therapeutic methods, as well as the establishment of prevention policies andprotocols by the health profession. Nevertheless, randomized studies are needed to provide a better understandingand detection of the different factors involved in the origin of trigger points (AU)