Objective Aim of the study was to test if orofacial pain patients 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 (prior to the COVID-19 pandemic). Exploratory aim was to describe demographic factors that may influence the patients to start and complete PSR. Methods Retrospective medical charts of all patients seen at a university-affiliated tertiary orofacial pain clinic between July–December 2019 (in person, pre-pandemic) and July–December 2020 (telehealth, during 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 2019 period, 25 started PSR in-person (10.08%). Of 252 new patients seen during 2020 period, 53 started PSR via telehealth (21.03%). Patients were more likely to start PSR (OR = 6.21, p<.001, CI = 2.499 to 15.435) and more likely to complete all three sessions of PSR (OR = 5.69, p<.001, CI = 2.352 to 13.794) when it was offered via telehealth than 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=.045). Conclusions Offering brief psychological pain interventions via telehealth in tertiary orofacial pain clinics has demonstrated feasibility and may improve willingness to participate in psychological treatments. Results need to be replicated with prospective data as modality was confounded with pandemic in the current study.

Objetive:The degenerative diseases of the tempo-romandibular joint (TMJ) are characterized by a progressive destruction of the articular tissues of the condyle and the glenoid fossa. The main aim of this review is to describe the effectiveness of the hyaluronic acid (HA) in the treatment of degenerative diseases of the TMJ in accordance with the available scientific evidence. Material and Methods: A literature search was made in the following databases EBSCO, Pubmed, Cochrane and Trip Database, using the keywords hyaluronic, hyaluronan, NaH, hyaluronate, TMJ, TMD, CMD, craniomandibular, orofacial pain and temporomandibular. There were no date or language restrictions applied. Results: After applying inclusion and exclusion criteria, 14 studies were included in this review (11 randomized controlled clinical trials and 3 non-randomized clinical trials). Conclusion: The studies reported a decrease in pain and improvement in functional parameters after treatment of TMJ osteoarthritis with HA. The use of arthrocentesis associated with the administration of HA provides effects synergistic, reaching a superiority the protocols with multiple injections with respect to those of a single session. The adverse effects related to the injection of HA with or without associated arthrocentesis were minor and transitory.

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(1) Background: Painful nervus intermedius neuropathy (e.g., geniculate neuralgia) involves continuous or near-continuous pain affecting the distribution of the intermedius nerve(s). The diagnosis of this entity is challenging, particularly when the clinical and demographic features do not resemble the typical presentation of this condition. To the best of our knowledge, only three case reports have described the occurrence of nervus intermedius neuropathy in young patients. (2) Case Description: A 13-year-old female referred to the Orofacial Pain clinic with a complaint of pain located deep in the right ear and mastoid area. The pain was described as a constant throbbing and dull, with an intensity of 7/10 on numerical rating scale, characterized by superimposed brief paroxysms of severe sharp pain. The past treatments included ineffective pharmacological and irreversible surgical approaches. After a comprehensive evaluation, a diagnosis of idiopathic painful nervus intermedius neuropathy was given, which was successfully managed with the use of gabapentin. (3) Conclusions and Practical Implications: The diagnosis and treatment of neuropathic pain affecting the nervus intermedius can be challenging due to the complex nature of the sensory innervation of the ear. The diagnosis can be even more challenging in cases of atypical clinical and demographic presentations, which in turn may result in unsuccessful, unnecessary, and irreversible treatments. Multidisciplinary teams and constant knowledge update are fundamental to provide good quality of care to our patients and to not overlook any relevant signs or symptoms.

Study Objectives: To evaluate the efficacy of three mandibular advancement device (MAD) designs in terms of apnea-hypopnea index (AHI), minimum blood oxygen saturation (min SpO2), and Epworth Sleepiness Scale (ESS) between pretreatment and posttreatment sleep studies for the management of obstructive sleep apnea (OSA). The protrusive range at the time of the second sleep study was correlated with the effectiveness of MAD designs. Methods: Retrospective data from 49 patients with OSA referred to the Orofacial Pain Clinic at University of Kentucky (March 2016-March 2021) treated with MAD, with a post-treatment sleep study, were included. Treatment success was defined as 50% improvement in AHI, or as 50% improvement with residual AHI < 10/h. Results: Posttreatment AHI improved with Herbst and SomnoDent-Classic (P =.003 and P =.000, respectively). Posttreatment ESS score improved with Herbst, SomnoDent-Classic, and D-SAD designs (P =.004, P = .000, and P =.018, respectively). No differences were found between the three MADs in terms of change in AHI, min SpO2, and ESS (all P >.050). Treatment success was achieved in 59.18% and 48.97%, according to the criteria, with no difference between the appliances and no correlation with the range of protrusion. Conclusion:The three MADs were efficacious in improving AHI and ESS, but not min SpO2, in patients with OSA, with no differences between MAD designs. Because some patients showed a worsening in AHI, a posttreatment sleep study is of great importance. Clinical Implications: MAD should be selected on an individual basis, according to patient preference and trained dentist recommendation, as the design did not affect the effectiveness in terms of AHI improvement.