Incidence of otolaryngological symptoms in patients with temporomandibular joint dysfunctions

The functional disorders of the masticatory organ are the third stomatological disease to be considered a populational disease due to its chronicity and widespread prevalence. Otolaryngological symptoms are a less common group of dysfunction symptoms, including sudden hearing impairment or loss, ear plugging sensation and earache, sore and burning throat, difficulties in swallowing, tinnitus, and vertigo. The diagnostic and therapeutic problems encountered in patients with the functional disorders of the masticatory organ triggered our interest in conducting retrospective studies with the objective of assessing the incidence of otolaryngological symptoms in patients subjected to prosthetic treatment of the functional disorders of masticatory organ on the basis of the analysis of medical documentation containing data collected in medical interviews. Material and Methods. Retrospective study was conducted by analyzing the results of medical interviews of 1208 patients, who had reported for prosthetic treatment at the Functional Disorders Clinic of the Department of Dental Prosthetics of Jagiellonian University Medical College in Cracow between 2008 and March 14, 2014. Results. Otolaryngological symptoms were observed in 141 patients. The most common symptoms in the study group were earache and sudden hearing impairment; no cases of sudden hearing loss were experienced

Changes in cognitive functioning as an effect of complex treatment of myofascial pain in temporomandibular disorders

Introduction: Pain reduction is a benefit that comprehensive treatment of myalgic temporomandibular disorders can provide. Myalgic pain reduction is associated with a series of changes at the neurophysiological level, which are inseparably connected with psychoemotional and cognitive changes. It has not been established if the course of these changes is the same for chronic myofascial pain in temporomanibular disorders as it is for other types of chronic pain. Objectives: The present study examined changes in cognitive functioning among patients with myofascial pain before and after three months of prosthetic treatment supplemented with psychoeducational and physiotherapeutic therapy. Material and methods: Participants were 45 patients, 23 were people with painful myofascial temporomandibular disorders and 22 were people with disorders of the same type who did not complain about pain symptoms. Statistical analysis included group comparisons of verbal learning, perceptiveness, attention, verbal fluency, immediate and working memory as well as selected executive functions measured with a number of psychological tests and neuropsychological clinical trials. Results: Analyses based on two-sided dependent samples t-tests as well as the Fisher’s LSD tests conducted in the analysis of variances showed therapeutic effects, both, with reference to chosen spheres of cognitive functioning, which initially differentiated the control and research groups, as well as the ones which did not differentiate these two groups. Conclusions: The results of this study indicate that cognitive functioning undergoes dynamic changes in the initial phase of treatment. Some of these changes may be specific for myofascial pain. The awareness about those changes may appear to be essential for planning therapeutic procedures and beneficial to maintain patient’s engagement in the process of treatment

Cognitive functioning and myofascial pain in temporomandibular disorders

Introduction: Physical examination of patients suffering from temporomandibular disorders is increasingly accompanied by monitoring their psychological functioning. It includes basic diagnostics of the emotional and motivational sphere as well as, although rarely, the social sphere. Analysis of the pain profile changing under the influence of the therapeutic process and including the psychoneurophysiological aspect of the phenomenon suggests the need to extend the scope of assessment. Specific aspects of cognitive functioning covered by the research are mental activities that allow to create and modify knowledge about the environment and to control one’s own reactions. Objectives: The aim of this article is to describe in detail the cognitive functioning of patients suffering from temporomandibular disorders at various stages of prosthetic treatment, with particular emphasis on the experience of chronic pain. Material and methods: The study included 45 patients, 23 were diagnosed with myofascial pain form of temporomandibular disorders and 22 diagnosed with temporomandibular disorders showing the same pathomechanism, but not reporting pain. Scheduled analysis included a number of inter-group comparisons based on the data obtained by using selected psychological tests and neuropsychological clinical trials. Results: Statistically significant differences in cognitive functioning of patients suffering from pain due to temporomandibular disorders and those patients who did not experience pain, although were diagnosed with temporomandibular disorders, were observed. Conclusions: It is important to take into account the psychological functioning of patients in a broader sense, including the neuropsychological mechanism of temporomandibular disorders myofascial pain

Evaluation of pain regression in patients with temporomandibular dysfunction treated by intra-articular platelet-rich plasma injections : a preliminary report

Objective. The objective of this study was to evaluate the regression of temporomandibular pain as a result of intra-articular injections of platelet-rich plasma (PRP) to patients with temporomandibular joint dysfunction previously subjected to prosthetic treatment. Materials and Methods. The baseline study material consisted of 10 patients, both males and females, aged 28 to 53 years, previously treated due to painful temporomandibular joint dysfunction using occlusal splints. All patients were carried out to a specialist functional assessment of the dysfunction using the Polish version of the RDC/TMD questionnaire axis I and II. Intra-articular injections were preceded by a preparation of PRP. The injection sites were determined by the method used during arthroscopic surgical procedures. Following aspiration, 0.5 mL of plasma was injected into each temporomandibular joint. Results. The comparison of the intensity of pain during all examinations suggests a beneficial effect of the procedure being performed as the mean VAS score was 6.5 at examination I, 2.8 at examination II, and 0.6 at examination III. Conclusion. Application of the intra-articular injections of platelet-rich plasma into the temporomandibular joints has a positive impact on the reduction of the intensity of pain experienced by patients treated for temporomandibular joint dysfunction

Oral health-related quality of life and cognitive functioning in myofascial temporomandibular disorders pain

Aim: The aims of the study were to assess whether the Oral Health Related Quality of Life (OHRQoL) is decreased in patients with temporomandibular disorders –myalgic type, to evaluate to what extent myofascial pain intensity affects OHRQoL and to investigate the relationships between cognitive function and OHRQoL. Subject or material and methods: The study included 45 patients diagnosed with the muscle-related temporomandibular disorders. The study group consisted of twenty three people with painful form of disorder. The control consisted of twenty two people without pain experience. The study was a part of a larger research project. The data to be analyzed for this article was obtained in the course of a single questionnaire survey conducted prior to the start of the treatment process. Results: The results show that the study group suffering from myofascial pain experiences related to temporomandibular disorders of myalgic type consistently reported higher quality of life levels than the patient group who reported lack of pain experiences. In principle the better OHRQoL, the poorer cognitive functioning in most neurocognitive domains investigated in the study. Discussion: The results, however surprising, may indicate specific relationships between factors analyzed in the study. These need to be confirmed with larger sample, taking into account general quality of patients life and psychoemotional factors. Conclusions: OHRQoL of patients with temporomandibular disorders shows a co-variation with certain aspects of cognitive functioning. The results should be considered with a caution that is resulting from the limitations of the research sample

The efficiency of botulinum toxin type A for the treatment of masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache

BACKGROUND: Temporomandibular joint dysfunction are often accompanied by symptoms of headache such as tension-type headache which is the most frequent spontaneous primary headache. Masseter muscle pain is commonly reported in this group. The purpose of the study was to assess the efficiency of intramuscular botulinum toxin type A injections for treating masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache. METHODS: This prospective outcome study consisted of 42 subjects of both genders aged 19–48 years diagnosed with masseter muscle pain related to temporomandibular joint dysfunction and tension-type headache. The subjects were treated by the intramuscular injection of 21 U (mice units) of botulinum toxin type A (Botox, Allergan) in the area of the greatest cross-section surface of both masseter bellies. Pain intensity was evaluated using visual analogue scale (VAS) and verbal numerical rating scale (VNRS) 1 week before the treatment and 24 weeks after the treatment. The obtained data were analyzed using the Wilcoxon matched pairs test (p ≤ 0,005). RESULTS: The results of this study showed a decrease in the number of referred pain episodes including a decrease in pain in the temporal region bilaterally, a reduction of analgesic drugs intake as well as a decrease in reported values of VAS and VNRS after injections (p = 0,000). CONCLUSIONS: The intramuscular botulinum toxin type A injections have been an efficient method of treatment for masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache