Aims: To highlight and discuss the term "refractory" when used to describe pain conditions and its application to orofacial pain, as well as to highlight the factors that must be considered in a refractory patient.
Methods: A scoping review of recent publications (2010 to 2021) applying the term "refractory" to orofacial pain was conducted, and this paper presents their limitations and definitions.
Results: The term "refractory" is often used to describe pain instead of "persistent" or "nonresponsive." There are clear definitions in the use of refractory for migraine, cluster headaches, and other nonheadache disorders. Currently, the term is applied to pain conditions in order to alter the patient pathway of treatment, sometimes to escalate a patient from one care sector to another and sometimes to escalate treatment to more costly surgical interventional techniques.
Conclusion: There is a need for a clear definition for use of the term "refractory" in orofacial pain conditions, excluding migraine and cluster headaches. In addition, there is a requirement for a consensus on the implications of the use of refractory when assessing and managing patients.
{"title":"Refractory Orofacial Pain: Is It the Patient or the Pain?","authors":"Tara Renton","doi":"10.11607/ofph.3009","DOIUrl":"https://doi.org/10.11607/ofph.3009","url":null,"abstract":"<p><strong>Aims: </strong>To highlight and discuss the term \"refractory\" when used to describe pain conditions and its application to orofacial pain, as well as to highlight the factors that must be considered in a refractory patient.</p><p><strong>Methods: </strong>A scoping review of recent publications (2010 to 2021) applying the term \"refractory\" to orofacial pain was conducted, and this paper presents their limitations and definitions.</p><p><strong>Results: </strong>The term \"refractory\" is often used to describe pain instead of \"persistent\" or \"nonresponsive.\" There are clear definitions in the use of refractory for migraine, cluster headaches, and other nonheadache disorders. Currently, the term is applied to pain conditions in order to alter the patient pathway of treatment, sometimes to escalate a patient from one care sector to another and sometimes to escalate treatment to more costly surgical interventional techniques.</p><p><strong>Conclusion: </strong>There is a need for a clear definition for use of the term \"refractory\" in orofacial pain conditions, excluding migraine and cluster headaches. In addition, there is a requirement for a consensus on the implications of the use of refractory when assessing and managing patients.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39667305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dentistry and specifically orofacial pain have been involved in the science of sleep and its interactions with pain and various other relevant disorders for decades. Yet we have not yet explored dreams; an amazing phenomenon occurring during sleep where brain activity can induce a virtual reality that includes visual, auditory, olfactory, taste, and emotional experiences as true as their waketime counterparts. Humans spend about 2 hours dreaming per night, and we have established that most, but not all, of our dreaming occurs during REM (rapid eye movement) sleep. While neuroscientists routinely examine neural activity during sleep, capturing dreams so that they can be evaluated presents obvious challenges. There is general agreement about what dreams are, but ongoing debate remains over why we dream. We may dream to augment rest and repair for our mind and body. We may dream for psychologic reasons. In fact, there are several dream theories, from Sigmund Freud’s interpretations to hypotheses that claim dreams are just random. Many of the theories on the function of dreams are contradicted by the sparse, hallucinatory, and narrative nature of dreams, a nature that seems to lack any specific function; the answer to why we dream remains nebulous. The recent advent of deep neural networks (DNNs) has provided a novel conceptual framework within which to understand the evolved function of dreams1—fascinating, but beyond the scope of this editorial. Dreams, it seems, are not just “sleep-time” entertainment. Dreams can provide much information about our state of mind, problems, and wishes for our future. Answers to our problems may be found in our dreams, which may also try to offer solutions.2 The “dream machine” works efficiently, with insights and “advice” occurring the night of and about a week after a triggering event. This would suggest that dreams serve social and emotional adaptive functions. Would this include pain-related disorders? A relevant question is: Does pain occur in dreams? It has been shown that realistic, localized painful sensations can be experienced in dreams, either through direct incorporation or from past memories. Nevertheless, the frequency of pain dreams in healthy subjects is low. In one study, dreams often reflected attempts to obtain pain relief.3 So although pain is rare in dreams, it is compatible with the representational code of dreaming.3 Patients suffering from burn pain dream more frequently of pain than controls.4 Findings have indicated that dreaming about pain may be an added stress for pain patients and may contribute to both poor sleep and higher pain intensity, which could evolve into a cycle of pain–anxiety–sleeplessness.4 Researchers have found that during dreams in REM sleep, our stress responses shut down, and the neurochemicals responsible for stressful feelings stop being released.5 In addition to this, REM helps reduce the negative effects of difficult memories. Although not studied, this suggests to
{"title":"Editorial: “The stuff that dreams are made of”","authors":"R. Benoliel","doi":"10.11607/ofph.2021.4.e","DOIUrl":"https://doi.org/10.11607/ofph.2021.4.e","url":null,"abstract":"Dentistry and specifically orofacial pain have been involved in the science of sleep and its interactions with pain and various other relevant disorders for decades. Yet we have not yet explored dreams; an amazing phenomenon occurring during sleep where brain activity can induce a virtual reality that includes visual, auditory, olfactory, taste, and emotional experiences as true as their waketime counterparts. Humans spend about 2 hours dreaming per night, and we have established that most, but not all, of our dreaming occurs during REM (rapid eye movement) sleep. While neuroscientists routinely examine neural activity during sleep, capturing dreams so that they can be evaluated presents obvious challenges. There is general agreement about what dreams are, but ongoing debate remains over why we dream. We may dream to augment rest and repair for our mind and body. We may dream for psychologic reasons. In fact, there are several dream theories, from Sigmund Freud’s interpretations to hypotheses that claim dreams are just random. Many of the theories on the function of dreams are contradicted by the sparse, hallucinatory, and narrative nature of dreams, a nature that seems to lack any specific function; the answer to why we dream remains nebulous. The recent advent of deep neural networks (DNNs) has provided a novel conceptual framework within which to understand the evolved function of dreams1—fascinating, but beyond the scope of this editorial. Dreams, it seems, are not just “sleep-time” entertainment. Dreams can provide much information about our state of mind, problems, and wishes for our future. Answers to our problems may be found in our dreams, which may also try to offer solutions.2 The “dream machine” works efficiently, with insights and “advice” occurring the night of and about a week after a triggering event. This would suggest that dreams serve social and emotional adaptive functions. Would this include pain-related disorders? A relevant question is: Does pain occur in dreams? It has been shown that realistic, localized painful sensations can be experienced in dreams, either through direct incorporation or from past memories. Nevertheless, the frequency of pain dreams in healthy subjects is low. In one study, dreams often reflected attempts to obtain pain relief.3 So although pain is rare in dreams, it is compatible with the representational code of dreaming.3 Patients suffering from burn pain dream more frequently of pain than controls.4 Findings have indicated that dreaming about pain may be an added stress for pain patients and may contribute to both poor sleep and higher pain intensity, which could evolve into a cycle of pain–anxiety–sleeplessness.4 Researchers have found that during dreams in REM sleep, our stress responses shut down, and the neurochemicals responsible for stressful feelings stop being released.5 In addition to this, REM helps reduce the negative effects of difficult memories. Although not studied, this suggests to ","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90471710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: To evaluate the efficacy of intravenous preemptive analgesia on postoperative pain in children undergoing dental rehabilitation under general anesthesia.
Methods: In this prospective randomized clinical trial, 70 children aged 3 to 7 years were scheduled for dental treatment and randomized into two groups: the control group or the preemptive group. Patients received 15 mg/kg of intravenous paracetamol either before the start of treatment (preemptive group, n = 35) or at the end of treatment (control group, n = 35). Postoperative pain scores were recorded at 1, 2, 4, 6, 8, 12, and 24 hours using the Wong-Baker FACES Pain Rating Scale (WBFS). Additionally, the need for rescue analgesic and the total opioid consumption of the patients were recorded during the first 24 hours postoperative.
Results: The pain scores in the preemptive group were significantly lower than those in the control group at the postanesthesia care unit and at 2, 4, and 8 hours postoperative (P < .05). However, there were no statistically significant differences in pain scores between groups at 12 and 24 hours postoperative. Need for rescue analgesics and total intravenous fentanyl consumption were significantly higher in the control group than in the preemptive group (P < .05). The percentage of children who received medication for pain relief at home was higher in the control group than in the preemptive group, but the difference was not statistically significant (P > .05).
Conclusion: Preemptive use of intravenous paracetamol reduces postoperative pain scores and postoperative opioid consumption. However, there is a need to evaluate pain levels in children who receive comprehensive dental treatment under general anesthesia after hospital discharge for effective postoperative pain control.
{"title":"Efficacy of Preemptive Analgesia on Postoperative Pain Control in Children Who Underwent Full-Mouth Dental Rehabilitation Under General Anesthesia: A Randomized Controlled Clinical Trial.","authors":"Sultan Keles, Ozlem Kocaturk, Pinar Demir","doi":"10.11607/ofph.2960","DOIUrl":"https://doi.org/10.11607/ofph.2960","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the efficacy of intravenous preemptive analgesia on postoperative pain in children undergoing dental rehabilitation under general anesthesia.</p><p><strong>Methods: </strong>In this prospective randomized clinical trial, 70 children aged 3 to 7 years were scheduled for dental treatment and randomized into two groups: the control group or the preemptive group. Patients received 15 mg/kg of intravenous paracetamol either before the start of treatment (preemptive group, n = 35) or at the end of treatment (control group, n = 35). Postoperative pain scores were recorded at 1, 2, 4, 6, 8, 12, and 24 hours using the Wong-Baker FACES Pain Rating Scale (WBFS). Additionally, the need for rescue analgesic and the total opioid consumption of the patients were recorded during the first 24 hours postoperative.</p><p><strong>Results: </strong>The pain scores in the preemptive group were significantly lower than those in the control group at the postanesthesia care unit and at 2, 4, and 8 hours postoperative (P < .05). However, there were no statistically significant differences in pain scores between groups at 12 and 24 hours postoperative. Need for rescue analgesics and total intravenous fentanyl consumption were significantly higher in the control group than in the preemptive group (P < .05). The percentage of children who received medication for pain relief at home was higher in the control group than in the preemptive group, but the difference was not statistically significant (P > .05).</p><p><strong>Conclusion: </strong>Preemptive use of intravenous paracetamol reduces postoperative pain scores and postoperative opioid consumption. However, there is a need to evaluate pain levels in children who receive comprehensive dental treatment under general anesthesia after hospital discharge for effective postoperative pain control.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39651187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mustafa Sami Demirsoy, Aras Erdil, Mehmet Kemal Tümer
Aims: To investigate the effectiveness of the auriculotemporal nerve block (ATNB) technique in conjunction with noninvasive therapies for the treatment of disc displacement with reduction (DDWR) or without reduction (DDWOR) in addition to arthralgia of the temporomandibular joint (TMJ).
Methods: The data of 22 patients diagnosed with DDWR and DDWOR whose clinical conditions did not improve despite noninvasive treatments were analyzed. ATNB was applied to each patient during the first visit and readministered at 1- and 4-week follow-up visits. Pain intensity values (0 to 10 visual analog scale [VAS] scores) were evaluated pre-ATNB and at the 6-month follow-up visit, and the maximal mouth opening values were measured pre-ATNB and at the 1-week, 4-week, and 6-month follow-up visits.
Results: Noninvasive therapies did not make a significant difference in the outcomes between the initial visit and first administration of ATNB (VAS P = .913, MMO P = .151). However, there were significant differences in outcomes between pre-ATNB and the 1-week (MMO P = .000), 4-week (MMO P = .000), and 6-month (VAS P = .027, MMO P = .000) follow-ups.
Conclusion: ATNB may be considered as a supportive treatment approach in noninvasive TMJ disorder therapies.
目的:探讨耳颞神经阻滞(ATNB)技术联合无创治疗颞下颌关节(TMJ)关节痛伴椎间盘移位复位(DDWR)或不复位(DDWOR)的疗效。方法:对22例经无创治疗后无明显改善的DDWR和DDWOR患者的临床资料进行分析。每位患者在第一次访问时应用ATNB，并在1周和4周随访时重新给予。在atnb前和随访6个月时评估疼痛强度值(0 ~ 10视觉模拟量表[VAS]评分)，并在atnb前和随访1周、4周和6个月时测量最大开口值。结果:无创治疗在首次就诊和首次给药ATNB之间的结果无显著差异(VAS P = 0.913, MMO P = 0.151)。然而，atnb前与1周(MMO P = 0.000)、4周(MMO P = 0.000)和6个月(VAS P = 0.027, MMO P = 0.000)随访的结果存在显著差异。结论:ATNB可作为无创治疗颞下颌关节紊乱的一种辅助治疗方法。
{"title":"Evaluation of the Efficacy of Auriculotemporal Nerve Block in Temporomandibular Disorders.","authors":"Mustafa Sami Demirsoy, Aras Erdil, Mehmet Kemal Tümer","doi":"10.11607/ofph.2949","DOIUrl":"https://doi.org/10.11607/ofph.2949","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the effectiveness of the auriculotemporal nerve block (ATNB) technique in conjunction with noninvasive therapies for the treatment of disc displacement with reduction (DDWR) or without reduction (DDWOR) in addition to arthralgia of the temporomandibular joint (TMJ).</p><p><strong>Methods: </strong>The data of 22 patients diagnosed with DDWR and DDWOR whose clinical conditions did not improve despite noninvasive treatments were analyzed. ATNB was applied to each patient during the first visit and readministered at 1- and 4-week follow-up visits. Pain intensity values (0 to 10 visual analog scale [VAS] scores) were evaluated pre-ATNB and at the 6-month follow-up visit, and the maximal mouth opening values were measured pre-ATNB and at the 1-week, 4-week, and 6-month follow-up visits.</p><p><strong>Results: </strong>Noninvasive therapies did not make a significant difference in the outcomes between the initial visit and first administration of ATNB (VAS P = .913, MMO P = .151). However, there were significant differences in outcomes between pre-ATNB and the 1-week (MMO P = .000), 4-week (MMO P = .000), and 6-month (VAS P = .027, MMO P = .000) follow-ups.</p><p><strong>Conclusion: </strong>ATNB may be considered as a supportive treatment approach in noninvasive TMJ disorder therapies.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39667306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Hietaharju, Ritva Näpänkangas, Kirsi Sipilä, Tuija Teerijoki-Oksa, Johanna Tanner, Pentti Kemppainen, Mimmi Tolvanen, Tuija Suvinen
Aims: To compare the suitability of Graded Chronic Pain Scale (GCPS) pain intensity and interference assessments (GCPS version 1.0 vs 2.0) for the biopsychosocial screening and subtyping of Finnish tertiary care referral patients with TMD pain.
Methods: Altogether, 197 TMD pain patients participated in this study. All patients received Axis II specialist-level psychosocial questionnaires from the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD-FIN) and Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD-FIN), as well as questionnaires for the assessment of additional pain-related, biopsychosocial, and treatment-related variables. Clinical examinations were performed according to the DC/TMD Axis I protocol. The patients were categorized into TMD subtypes 1, 2, and 3 (GCPS I and II-low; II-high; and III and IV, respectively) based on their biopsychosocial profiles according to GCPS versions 1.0 and 2.0.
Results: The distribution of TMD pain patients into TMD subtypes was similar according to the GCPS 1.0 compared to the GCPS 2.0. Over 50% of the patients were moderately (TMD subtype 2) or severely (TMD subtype 3) compromised. Patients in subtype 3 experienced biopsychosocial symptoms and reported previous health care visits significantly more often than patients in subtypes 1 and 2. Patients in subtype 2 reported intermediate biopsychosocial burden compared to subtypes 1 and 3.
Conclusion: TMD pain patients differ in their biopsychosocial profiles, and, similarly to the GCPS 1.0, the GCPS 2.0 is a suitable instrument for categorizing TMD tertiary care pain patients into three biopsychosocially relevant TMD subtypes. The GCPS 2.0 can be regarded as a suitable initial screening tool for adjunct personalized or comprehensive multidisciplinary assessment.
{"title":"Importance of the Graded Chronic Pain Scale as a Biopsychosocial Screening Instrument in TMD Pain Patient Subtyping.","authors":"Maria Hietaharju, Ritva Näpänkangas, Kirsi Sipilä, Tuija Teerijoki-Oksa, Johanna Tanner, Pentti Kemppainen, Mimmi Tolvanen, Tuija Suvinen","doi":"10.11607/ofph.2983","DOIUrl":"https://doi.org/10.11607/ofph.2983","url":null,"abstract":"<p><strong>Aims: </strong>To compare the suitability of Graded Chronic Pain Scale (GCPS) pain intensity and interference assessments (GCPS version 1.0 vs 2.0) for the biopsychosocial screening and subtyping of Finnish tertiary care referral patients with TMD pain.</p><p><strong>Methods: </strong>Altogether, 197 TMD pain patients participated in this study. All patients received Axis II specialist-level psychosocial questionnaires from the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD-FIN) and Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD-FIN), as well as questionnaires for the assessment of additional pain-related, biopsychosocial, and treatment-related variables. Clinical examinations were performed according to the DC/TMD Axis I protocol. The patients were categorized into TMD subtypes 1, 2, and 3 (GCPS I and II-low; II-high; and III and IV, respectively) based on their biopsychosocial profiles according to GCPS versions 1.0 and 2.0.</p><p><strong>Results: </strong>The distribution of TMD pain patients into TMD subtypes was similar according to the GCPS 1.0 compared to the GCPS 2.0. Over 50% of the patients were moderately (TMD subtype 2) or severely (TMD subtype 3) compromised. Patients in subtype 3 experienced biopsychosocial symptoms and reported previous health care visits significantly more often than patients in subtypes 1 and 2. Patients in subtype 2 reported intermediate biopsychosocial burden compared to subtypes 1 and 3.</p><p><strong>Conclusion: </strong>TMD pain patients differ in their biopsychosocial profiles, and, similarly to the GCPS 1.0, the GCPS 2.0 is a suitable instrument for categorizing TMD tertiary care pain patients into three biopsychosocially relevant TMD subtypes. The GCPS 2.0 can be regarded as a suitable initial screening tool for adjunct personalized or comprehensive multidisciplinary assessment.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39651188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giancarlo De la Torre Canales, Rodrigo Lorenzi Poluha, Yeidi Natalia Alvarez Pinzón, Paulo César Rodrigues Conti, Daniele Manfredini, Alfonso Sánchez-Ayala, Célia Marisa Rizzatti-Barbosa
Aims: To determine the effects of botulinum toxin type A (BoNT-A) on the psychosocial features of patients with masticatory myofascial pain (MFP).
Methods: A total of 100 female subjects diagnosed with MFP were randomly assigned into five groups (n = 20 each): oral appliance (OA); saline solution (SS); and three groups with different doses of BoNT-A. Chronic pain-related disability and depressive and somatic symptoms were evaluated with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis II instruments at baseline and after 6 months of treatment. Differences in treatment effects within and between groups were compared using chi-square test, and Characteristic Pain Intensity (CPI) was compared using two-way ANOVA. A 5% probability level was considered significant in all tests.
Results: Most patients presented low pain-related disability (58%), and 6% presented severely limiting, high pain-related disability. Severe depressive and somatic symptoms were found in 61% and 65% of patients, respectively. In the within-group comparison, BoNT-A and OA significantly improved (P < .001) scores of pain-related disability and depressive and somatic symptoms after 6 months. Only the scores for pain-related disability changed significantly over time in the SS group. In the between-group comparison, BoNT-A and OA significantly improved (P < .05) scores of all variables at the final follow-up when compared to the SS group. No significant difference was found between the BoNT-A and OA groups (P > .05) for all assessed variables over time.
Conclusion: BoNT-A was at least as effective as OA in improving pain-related disability and depressive and somatic symptoms in patients with masticatory MFP.
{"title":"Effects of Botulinum Toxin Type A on the Psychosocial Features of Myofascial Pain TMD Subjects: A Randomized Controlled Trial.","authors":"Giancarlo De la Torre Canales, Rodrigo Lorenzi Poluha, Yeidi Natalia Alvarez Pinzón, Paulo César Rodrigues Conti, Daniele Manfredini, Alfonso Sánchez-Ayala, Célia Marisa Rizzatti-Barbosa","doi":"10.11607/ofph.2917","DOIUrl":"https://doi.org/10.11607/ofph.2917","url":null,"abstract":"<p><strong>Aims: </strong>To determine the effects of botulinum toxin type A (BoNT-A) on the psychosocial features of patients with masticatory myofascial pain (MFP).</p><p><strong>Methods: </strong>A total of 100 female subjects diagnosed with MFP were randomly assigned into five groups (n = 20 each): oral appliance (OA); saline solution (SS); and three groups with different doses of BoNT-A. Chronic pain-related disability and depressive and somatic symptoms were evaluated with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis II instruments at baseline and after 6 months of treatment. Differences in treatment effects within and between groups were compared using chi-square test, and Characteristic Pain Intensity (CPI) was compared using two-way ANOVA. A 5% probability level was considered significant in all tests.</p><p><strong>Results: </strong>Most patients presented low pain-related disability (58%), and 6% presented severely limiting, high pain-related disability. Severe depressive and somatic symptoms were found in 61% and 65% of patients, respectively. In the within-group comparison, BoNT-A and OA significantly improved (P < .001) scores of pain-related disability and depressive and somatic symptoms after 6 months. Only the scores for pain-related disability changed significantly over time in the SS group. In the between-group comparison, BoNT-A and OA significantly improved (P < .05) scores of all variables at the final follow-up when compared to the SS group. No significant difference was found between the BoNT-A and OA groups (P > .05) for all assessed variables over time.</p><p><strong>Conclusion: </strong>BoNT-A was at least as effective as OA in improving pain-related disability and depressive and somatic symptoms in patients with masticatory MFP.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39651186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: To understand the experiences of patients diagnosed with chronic facial pain (CFP) who attended a specialist facial pain management program (PMP); specifically, to explore how they experienced attending the facial PMP itself and how they felt it impacted their management of CFP.
Methods: Qualitative methodology and focus groups were used to gather patients' views and experiences of attending a facial PMP. Two focus groups were conducted for patients who had all completed the facial PMP. Discussions were recorded and transcribed. Data were then analyzed using thematic analysis to establish key themes relating to participants' experiences of the facial PMP.
Results: Thematic analysis identified three main themes, with numerous subthemes within them. The theme "psychologic change" had subthemes of self-compassion, acceptance, and reflection. The theme "behavioral change" contained subthemes of re-engagement with valued activity, medication, and communication. The theme "structure and process" contained subthemes of concentration, need for one-on-one time with the clinician, meeting others, and not enough time (clinical and nonclinical).
Conclusion: Facial PMPs may provide a valuable treatment to support long-term coping and adaptation for patients with CFP. Positive changes to coping include both psychologic and behavioral elements. Further research is necessary to clarify how group-based facial PMPs should be structured and delivered.
{"title":"Experiences and Outcomes of Attending a Facial Pain Management Program: A Qualitative Study.","authors":"Christian Ainsley, Alison Bradshaw, Calum Murray, Nathan Goss, Samantha Harrison, Rajiv Chawla","doi":"10.11607/ofph.2858","DOIUrl":"https://doi.org/10.11607/ofph.2858","url":null,"abstract":"<p><strong>Aims: </strong>To understand the experiences of patients diagnosed with chronic facial pain (CFP) who attended a specialist facial pain management program (PMP); specifically, to explore how they experienced attending the facial PMP itself and how they felt it impacted their management of CFP.</p><p><strong>Methods: </strong>Qualitative methodology and focus groups were used to gather patients' views and experiences of attending a facial PMP. Two focus groups were conducted for patients who had all completed the facial PMP. Discussions were recorded and transcribed. Data were then analyzed using thematic analysis to establish key themes relating to participants' experiences of the facial PMP.</p><p><strong>Results: </strong>Thematic analysis identified three main themes, with numerous subthemes within them. The theme \"psychologic change\" had subthemes of self-compassion, acceptance, and reflection. The theme \"behavioral change\" contained subthemes of re-engagement with valued activity, medication, and communication. The theme \"structure and process\" contained subthemes of concentration, need for one-on-one time with the clinician, meeting others, and not enough time (clinical and nonclinical).</p><p><strong>Conclusion: </strong>Facial PMPs may provide a valuable treatment to support long-term coping and adaptation for patients with CFP. Positive changes to coping include both psychologic and behavioral elements. Further research is necessary to clarify how group-based facial PMPs should be structured and delivered.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39486226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrew Young, Samantha Gallia, John F Ryan, Atsushi Kamimoto, Olga A Korczeniewska, Mythili Kalladka, Junad Khan, Noboru Noma
Aims: To assess the speed and accuracy of a checklist user interface for the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD).
Methods: A diagnostic tool formatted as a checklist was developed and compared to an existing diagnostic tool, the DC/TMD diagnsostic decision trees. Both types of tools use the DC/TMD and were tested by dental students, interns, and residents in the USA and Japan for diagnosis of hypothetical patients. The comparisons were done in a randomized, crossover, controlled, double-blinded trial.
Results: Overall, subjects using the experimental tool answered 25% more correct diagnoses (P < .001) and missed 27% fewer diagnoses (P < .01). They were also able to finalize their diagnoses faster than those using the control tool, in 16% less time (P < .05). The difference in accuracy was more pronounced in complex cases, while the difference in speed was more pronounced in simple cases.
Conclusion: This checklist is an alternative user interface for the DC/TMD.
{"title":"Diagnostic Tool Using the Diagnostic Criteria for Temporomandibular Disorders: A Randomized Crossover-Controlled, Double-Blinded, Two-Center Study.","authors":"Andrew Young, Samantha Gallia, John F Ryan, Atsushi Kamimoto, Olga A Korczeniewska, Mythili Kalladka, Junad Khan, Noboru Noma","doi":"10.11607/ofph.3008","DOIUrl":"https://doi.org/10.11607/ofph.3008","url":null,"abstract":"<p><strong>Aims: </strong>To assess the speed and accuracy of a checklist user interface for the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD).</p><p><strong>Methods: </strong>A diagnostic tool formatted as a checklist was developed and compared to an existing diagnostic tool, the DC/TMD diagnsostic decision trees. Both types of tools use the DC/TMD and were tested by dental students, interns, and residents in the USA and Japan for diagnosis of hypothetical patients. The comparisons were done in a randomized, crossover, controlled, double-blinded trial.</p><p><strong>Results: </strong>Overall, subjects using the experimental tool answered 25% more correct diagnoses (P < .001) and missed 27% fewer diagnoses (P < .01). They were also able to finalize their diagnoses faster than those using the control tool, in 16% less time (P < .05). The difference in accuracy was more pronounced in complex cases, while the difference in speed was more pronounced in simple cases.</p><p><strong>Conclusion: </strong>This checklist is an alternative user interface for the DC/TMD.</p>","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39486124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.11607/ofph.2021.3.commentary
R. Ohrbach, C. Greene
{"title":"Commentary: Temporomandibular Disorders: Priorities for Research and Care. A New Milestone for the Specialty of Orofacial Pain","authors":"R. Ohrbach, C. Greene","doi":"10.11607/ofph.2021.3.commentary","DOIUrl":"https://doi.org/10.11607/ofph.2021.3.commentary","url":null,"abstract":"","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78455624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.11607/ofph.2021.3.announcement
C. Greene, J. Kusiak, Terrie Cowley, A. Cowley
{"title":"NASEM Announcement: Recently Released Report by Major Scientific Academy Proposes Significant Changes in Understanding and Managing Temporomandibular Disorders","authors":"C. Greene, J. Kusiak, Terrie Cowley, A. Cowley","doi":"10.11607/ofph.2021.3.announcement","DOIUrl":"https://doi.org/10.11607/ofph.2021.3.announcement","url":null,"abstract":"","PeriodicalId":48800,"journal":{"name":"Journal of Oral & Facial Pain and Headache","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76359060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号