Journal of Dental Medicine

Masticatory muscle pain is the second most frequent cause of orofacial pain after dental pain. Myofascial pain dysfunction syndrome (MPDS) is the most common form of temporomandibular joint dysfunction. MPDS is a pain that triggers from [sensitive] points in the muscles and fascia and is followed by spasm, tenderness to palpation, restricted movement, fatigue, and sometimes dysfunction. The researchers intended to collect comprehensive information about therapeutic interventions for myofascial pain through the conduction of a critical study based on evidence in the literature. In this review, 51 English articles, published between 1981 and 2013, were extracted from PubMed, Medline, Ovid, and Google Scholar. These articles were then reviewed in detail in two categories, namely pharmaceutical and non-pharmaceutical treatments. MPDS treatment should be first focused on the identification and correction of underlying causes. Thiocolchicoside (TCC), non-steroidal anti-inflammatory drugs (NSAIDs), and Cox-2 inhibitors are among promising pharmaceutical methods. On the other hand, ultrasound and laser therapy are among promising non-pharmaceutical methods. The complex mechanism of MPDS, along with its underlying peripheral and central nervous mechanisms may make MPDS, difficult to treat, especially in its chronic form.

Background and Aims: Atypical facial pain (AFP) is a chronic disease associated with local pain in the craniofacial area. A wide range of treatments including drug therapy, psychiatric methods and open surgery are used for its treatment. Opiorphin is a pentapeptide that can block pain and also has proven antidepressant effects. The aim of this study was conducted to investigate the opiorphin concentration in AFP patients and to compare it with healthy people.
Materials and Methods: This study was performed on 30 AFP patients and 40 healthy individuals. Unstimulated saliva was collected from both groups by spitting method. HAD-A (Hamilton Anxiety Test) and HAD-D (Hamilton Depression Test) questionnaires were completed for all patients and controls. Psychological interview with the patients and psychological analysis were performed to determine anxiety and depression scores. Data analysis was done using SPSS (ver.24) statistical software
Results: The subjects of two groups were homogeneous in terms of age and sex. The mean salivary opiorphin concentrations in the case and control groups were 1.8050±0.2923 and 1.8032±0.3682 ng/ml, respectively. According to the results of t-Test, no significant difference was observed in the mean opiorphin concentration between the AFP group and control group (P=1.000). According to the Pearson's test, no significant relationship was found between the opiorphin levels and the age, sex, and anxiety or depression score in the patient and control groups (P>0.05). Also, there was no remarkable correlation between initial VAS, duration of pain and previous treatments with opiorphin levels in the AFP patients (P>0.05). No significant correlation was found between the opiorphin concentration and menopausal period in the case and control women (P>0.05).
Conclusion: The results showed that most AFP patients had some degree of anxiety and depression. However, salivary opiorphin concentration did not significantly increase in the AFP patients.

Background and Aims: Multiple sclerosis (MS) is an autoimmune disease. Oral manifestations in these patients include paralysis or spasm of facial muscles, temporomandibular joint disorders (TMJ), trigeminal neuralgia, dysphagia, or dysarthria. The aim of the study was to investigate the characteristics of orofacial pain in patients with MS.
Materials and Methods: The current cross-sectional study was conducted on 250 patients with a definite diagnosis of MS referred to Iran MS Association and Iran MS Research Center. The patients were in the age group of 17 to 57 years and were selected completely randomly. Data were obtained based on two checklists and clinical examination. Finally, DC/TMD criterion was used to check TMD problems. Then the data was analyzed by SPSS version 26 software and by Fisher's Test.
Results: The prevalence of MS disease was higher in women and the average age of patients was 37 years and the average duration of MS disease among patients was 8 years. The most common pain was related to shooting and shock-like pain with a frequency of 40.4% and the lowest quality was related to dull and diffuse pain with a frequency of 5.3%. In total, 24.5% of patients with buccal-oral pain had TMD, and in this case, the DC/TMD criterion was used.
Conclusion:  Temporomandibular disorders and shooting and shock-like pains are usually observed in a number of patients with MS.  As a result, dentists should be aware of the presence of these pains in the patient, the pain trigger, and the drugs used by the patients, in order to provide medical services and being aware of drug interactions.