ABSTRACT
OBJECTIVE: To compare the efficacy of a regional masseteric nerve block (MNB) in the management of myofascial pain of masseteric origin, relative to trigger point injection (TrP-Inj) and intra-oral stabilization appliance (IOA). STUDY DESIGN: A retrospective chart review of 200 patients treated for myofascial pain of masseteric origin was performed. Sixty patients met the eligibility criteria and were grouped based on their treatment regimen; IOA, TrP-Inj or MNB. Pain scores recorded at pre-treatment (baseline), 30 minutes post-treatment, and 2 weeks post-treatment were analyzed. RESULTS: Treatment with MNB resulted in significant reduction in pain at 30 minutes and two weeks post-treatment compared to TrP-Inj and IOA. CONCLUSION: MNB provided an immediate and sustained therapeutic effect for the management of myofascial pain for at least up to two weeks. MNB is a simple and valuable tool in the management of myogenous pain, especially for the non-orofacial pain practitioner.
Subject(s)
Masseter Muscle/innervation , Nerve Block/methods , Temporomandibular Joint Dysfunction Syndrome/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Anesthetics, Local/administration & dosage , Female , Follow-Up Studies , Humans , Injections , Male , Masseter Muscle/drug effects , Middle Aged , Occlusal Splints , Pain Measurement/methods , Retrospective Studies , Time Factors , Treatment Outcome , Trigger Points , Young AdultABSTRACT
OBJECTIVE: The aim of this study was to examine atypical odontalgia (AO) patients with extraoral quantitative sensory testing (EQST) and an intraoral mucosal cold test. STUDY DESIGN: Twenty-one subjects with AO and 18 control subjects underwent EQST for electrical and thermal pain and detection thresholds. Cold was applied to painful mucosal areas in AO patients and randomly in control subjects. RESULTS: Electrical pain thresholds were higher in AO patients than in control subjects in the same dermatome affected by the pain (P = .03), but no significant differences were observed in electrical detection thresholds and heat pain and detection thresholds at other sites. Cold application was painful in control and AO subjects, but duration of pain sensation was significantly longer in AO patients (P = .019 in contralateral side; P = .029 in affected side). CONCLUSIONS: The finding of extended painful aftersensation following cold application in AO patients supports the involvement of central mechanisms. The cold test is clinically easy to apply and of clinically significant value.
