Myofascial Temporomandibular Disorder Pain

Schindler, H. J.; Svensson, Peter

doi:10.1159/000101970

Cited by 14 publications

(8 citation statements)

References 94 publications

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“…Regarding localized myofascial pain of the masticatory musculature, an alternative explanation is based on the heterogeneous activation capability of these muscles [ 37 , 49 - 51 ]: Experimental results in healthy volunteers indicate that a temporary positional alteration of the mandible (e.g., an increase of the vertical dimension after insertion of an occlusal appliance) changes the intramuscular recruitment pattern, which is often followed by a pain reduction [ 52 - 55 ]. Although this biomechanical hypothesis needs further studies to be validated [ 56 ], it provides a physiologically plausible explanation for the therapeutic success gained with oral splints.…”

Section: Discussionmentioning

confidence: 99%

The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache – Where do we stand? A qualitative systematic review of the literature

Stapelmann¹,

Türp²

2008

BMC Oral Health

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BackgroundThe NTI-tss device is an anterior bite stop, which, according to the manufacturer, is indicated for the prevention and treatment of bruxism, temporomandibular disorders (TMDs), tension-type headaches, and migraine. The aim of this systematic review was to appraise the currently available evidence regarding the efficacy and safety of the NTI-tss splint.MethodsWe performed a systematic search in nine electronic databases and in NTI-tss-associated websites (last update: December 31, 2007). The reference lists of all relevant articles were perused. Five levels of scientific quality were distinguished. Reporting quality of articles about randomized controlled trials (RCTs) was evaluated using the Jadad score. To identify adverse events, we searched in the identified publications and in the MAUDE database.ResultsNine of 68 relevant publications reported about the results of five different RCTs. Two RCTs concentrated on electromyographic (EMG) investigations in patients with TMDs and concomitant bruxism (Baad-Hansen et al 2007, Jadad score: 4) or with bruxism alone (Kavaklı 2006, Jadad score: 2); in both studies, compared to an occlusal stabilization splint the NTI-tss device showed significant reduction of EMG activity. Two RCTs focused exclusively on TMD patients; in one trial (Magnusson et al 2004, Jadad score: 3), a stabilization appliance led to greater improvement than an NTI-tss device, while in the other study (Jokstad et al 2005, Jadad score: 5) no difference was found. In one RCT (Shankland 2002, Jadad score: 1), patients with tension-type headache or migraine responded more favorably to the NTI-tss splint than to a bleaching tray. NTI-tss-induced complications related predominantly to single teeth or to the occlusion.ConclusionEvidence from RCTs suggests that the NTI-tss device may be successfully used for the management of bruxism and TMDs. However, to avoid potential unwanted effects, it should be chosen only if certain a patient will be compliant with follow-up appointments. The NTI-tss bite splint may be justified when a reduction of jaw closer muscle activity (e.g., jaw clenching or tooth grinding) is desired, or as an emergency device in patients with acute temporomandibular pain and, possibly, restricted jaw opening.

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Section: Discussionmentioning

confidence: 99%

The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache – Where do we stand? A qualitative systematic review of the literature

Stapelmann¹,

Türp²

2008

BMC Oral Health

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“…The jaw muscles are involved in a multitude of complex oral behaviours, such as mastication, swallowing and talking, and functions which are based on precise control of speed, force and jaw movements (1). Morphological differences exist within the jaw‐elevator muscles because different muscle portions are specialised for different functions (2). Indeed, morphological, histological and electrophysiological data indicate a functional compartmentalisation of the masseter muscle (3–6).…”

Section: Introductionmentioning

confidence: 99%

“…High‐density, two‐dimensional surface EMG (37–39) provides information on the spatial distribution of the electric potential over the skin surface during muscle contraction, permitting a topographical mapping of EMG activity. Muscle pain and jaw motion function are known to be interrelated (2, 21, 24–26). In TMD pain patients, the maximum voluntary occlusal force and the EMG activity are reduced (2), yet knowledge of how the jaw muscles are affected during submaximal contractions when pain is present is still unclear.…”

Section: Introductionmentioning

confidence: 99%

“…Muscle pain and jaw motion function are known to be interrelated (2, 21, 24–26). In TMD pain patients, the maximum voluntary occlusal force and the EMG activity are reduced (2), yet knowledge of how the jaw muscles are affected during submaximal contractions when pain is present is still unclear. High‐density surface EMG has revealed heterogeneities in muscle activation during both short and sustained contractions (40), thus indicating possible spatial adaptation of activation within individual muscles during, e.g., muscle pain or fatigue.…”

Section: Introductionmentioning

confidence: 99%

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Effect of experimental jaw‐muscle pain on the spatial distribution of surface EMG activity of the human masseter muscle during tooth clenching

Castroflorio

Falla

Wang

et al. 2011

J of Oral Rehabilitation

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This study tested the hypothesis that painful injections of glutamate into the human masseter muscle differentially affect the distribution of the electromyographic (EMG) activity in the masseter muscle at rest and during tooth clenching. Surface EMG signals were recorded bilaterally from the superficial masseter of nine healthy men with a grid of 32 electrodes, before and after intramuscular injection of glutamate or isotonic saline, during rest and isometric contractions at 20%, 40%, 60% and 80% of the maximal voluntary bite force. Intramuscular injection of glutamate evoked moderate pain (0-10 visual analogue scale: 6·4 ± 1·4), with sensory-discriminative characteristics of the perceived pain, evaluated with the use of the McGill Pain Questionnaire (MPQ), similar to those previously reported for patients with temporomandibular disorders. There was no effect of the glutamate injection on EMG amplitude during rest, whereas during tooth clenching, the spatial distribution of the masseter EMG activity on both sides was more uniform in the painful condition compared to the control condition. Moreover, the overall EMG amplitude decreased on both sides during the more forceful tooth clenching following glutamate injection. In conclusion, a unilateral painful stimulation was associated with a bilateral inhibition of the masseter muscles during tooth clenching which resulted in a more uniform distribution of EMG activity.

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“…1,2 Myofascial pain, disc displacements, and arthralgia/osteoarthrosis constitute this diagnostic grouping. 4,5 It is well known that cervical spine tissues can refer pain to the head and orofacial region. 3 Nevertheless, some patients may suffer persistent pain, and their prognosis is determined by psychometric evaluation (Axis II of the RDC/TMD).…”

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confidence: 99%

The Influence of Cranio-cervical Posture on Maximal Mouth Opening and Pressure Pain Threshold in Patients With Myofascial Temporomandibular Pain Disorders

Touche

Paris‐Alemany²,

Piekartz

et al. 2011

The Clinical Journal of Pain

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The results of this study shows that the experimental induction of different cranio-cervical postures influences the MMO and PPT values of the temporomandibular joint and muscles of mastication that receive motor and sensory innervation by the trigeminal nerve. Our results provide data that supports the biomechanical relationship between the cranio-cervical region and the dynamics of the temporomandibular joint, as well as trigeminal nociceptive processing in different cranio-cervical postures.

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Myofascial Temporomandibular Disorder Pain

Cited by 14 publications

References 94 publications

The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache – Where do we stand? A qualitative systematic review of the literature

The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache – Where do we stand? A qualitative systematic review of the literature

Effect of experimental jaw‐muscle pain on the spatial distribution of surface EMG activity of the human masseter muscle during tooth clenching

The Influence of Cranio-cervical Posture on Maximal Mouth Opening and Pressure Pain Threshold in Patients With Myofascial Temporomandibular Pain Disorders

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