Temporomandibular joint dysfunction and myofascial pain dysfunction syndromes: Parameters, etiology, and treatment.

Adams²

1984

Myofascial pain dysfunction syndrome and temporomandibular joint (TMJ) dysfunction syndrome have been suggested as resulting from masticatory muscle hyperactivity. Furthermore, this hyperactivity has been viewed as a response-specific reaction to stress. The present study was designed to assess the effects of laboratory-induced stress (i.e., startle stimulus, buzzer series, serial sevens tasks, and pain threshold/tolerance tests) on physiological responses (i.e. bilateral masseter EMG, skin conductance level, and heart rate) of ten patients (TMJ pain) with a history of facial pain and TMJ sounds. The two control groups, one with TMJ sounds only (TMJ sound) and the other with no history of these symptoms (non-TMJ), were matched for sex and age. The results indicated that the TMJ pain group did not exhibit different masseter EMG levels when comparing symptomatic versus asymptomatic sides. Few significant differences were noted in the masseter EMG recordings of the TMJ pain and non-TMJ group, while no difference occurred between the EMG levels of the TMJ pain and TMJ sound group. Little support was found for the assertion that TMJ pain subjects show greater EMG reactivity and less adaptation than do non-TMJ subjects. Finally, no differences were found among groups in relation to the latency to ischaemic pain onset or tolerance. The discussion focuses on reasons for the findings of the present study being discrepant from previously reported research.

Physiological reactions to stress in subjects with and without myofascial pain dysfunction symptoms

Adams²

1984

Common migraine: a review and proposal for a non‐vascular aetiology

Ruff

Lombardo

1986

A brief review of the literature related to migraine headaches is presented. Information is presented on the epidemiology and diagnostic criteria of migraine headaches and is followed by a discussion on the problems inherent in the current classification system. Previously proposed vascular mechanisms of common migraine are discussed in the light of recent non-supporting data and a possible link between common migraine and orofacial pain dysfunction syndromes is proposed. The role of oral behavioural patterns and related muscular/temporomandibular joint problems are advanced as probable factors related to common migraine. The discussion focuses on the need to distinguish classic from common migraine headache sufferers in assessment and treatment outcome studies, as well as suggesting future avenues of research.

Masticatory muscle activity as a function of parafunctional, active and passive oral behavioural patterns

Villarosa

Cooley

et al. 1987

Oral behavioural patterns have received limited empirical support for their causal role in the development of head and facial pain. The present study was designed to assess electromyographic (EMG) variations in six muscle groups (i.e., bilateral masseter, temporalis and orbicularis oris) as a function of various oral behavioural patterns. A second purpose was to determine whether mandibular movement patterns and specific oral behaviours could be predicted by EMG patterns. Eleven non-pain subjects followed each of twenty oral behavioural patterns while EMG was recorded. Electromyographic change scores were computed for each behaviour relative to baseline measures. Initial analyses were performed using factorial repeated measures ANOVAS. Using post hoc analyses as general guides, specific EMG criteria were developed for classifying mandibular movements. For most subjects, EMG patterns accurately classified teeth clenching, protrusive/retrusive movements, right movements, left movements and lip movement patterns. Wide individual variations were found among muscle groups for identical behaviours. The association between particular oral behaviours and EMG patterns may explain 'sinus' headaches and certain types of facial pain.