Browse > Article

Treatment Outcome and Prognosis of the Outpatients with Orofacial Pain  

Choi, Sea-Hun (Department of Oral Medicine, School of Dentistry, Dankook University)
Kim, Ki-Suk (Department of Oral Medicine, School of Dentistry, Dankook University)
Kim, Mee-Eun (Department of Oral Medicine, School of Dentistry, Dankook University)
Lee, Dong-Ju (Department of Oral Medicine, School of Dentistry, Dankook University)
Jin, Sang-Bae (Department of Oral Medicine, College of Dentistry, Kyung-Hee University)
Publication Information
Journal of Oral Medicine and Pain / v.31, no.2, 2006 , pp. 155-165 More about this Journal
Abstract
The purpose of this study was to evaluate treatment outcome and prognosis of the patients with orofacial pain disorders who visited for treatment in the Department of Oral Medicine, Dankook University Dental Hospital from January 2002 to December 2004. Orofacial pain disorders were categorized into TMD(myogenous, arthrogenous and muscle-joint combined TMDs), neuropathic pain disorder, oral soft tissue disease and complex condition simultaneously having more and two aforementioned categories and treatment period, method and treatment outcome were evaluated. The results of this study were as follows; 1. Average longevity of treatment period was the longest in the neuropathic pain, followed by soft tissue disease, complex conditions, arthrogenous TMD, muscle-joint combined TMD and myogenous TMD in order. 2. When treatment methods were largely categorized into pharmacologic, physical and oral appliance therapy, pharmacologic therapy was used the most frequently for the patients with neuropathic pain or oral soft tissue diseases, oral appliance therapy for those with arthrogenous TMD and physical therapy for those with myogenous TMD. 3. Of physical therapeutic methods used in our clinic, EAST and microwave was employed the most frequently in the patients with myogenous TMD, ultrasound for those with arthogenous TMD and LLLT for those with neuropathic pain or oral soft tissue disease. 4. In comparison with change of pain after treatment, there existed a tendency that pain from neuropathic pain disorders persisted while pain from TMD was getting better or totally disappeared. 5. Concerning the change of mouth opening range in the TMD subgroups, there was no significant difference among the subgroups but significant difference existed among opening ranges, indicating comfortable maximum mouth opening increased the most following treatment. Improvement of active range of mouth opening was the most considerable in those with disc displacement without reduction. It can be said on the basis of the findings from this study that various treatments currently used for the orofacial pain showed good results with TMD in regards with pain control and improvement of function, suggestive of favorable prognosis, while neuropathic pain or soft tissue disease was the clinical conditions difficult to resolve, requiring a long and persistent treatment.
Keywords
Orofacial pain; TMD; Treatment; Prognosis;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Zakrzewska JM, Harrison SD. Pain research and clinical management Vol.14 Assessment and management of orofacial pain. 2002 Elsevier Amsterdam
2 Clark GT, Beemsterboer PL, Rugh JD. Nocturnal masseter hyperactivity and the symptoms of masticatory dysfunction. J Oral Rehabil 1981;8:279-286   DOI
3 Okeson JP, Kemper JT, Moody PM. A study of the use of occlusion splints in the treatment of acute and chronic patients with craniomandibular disorders. J Prosthet Dent. 1982;48:708-712   DOI   ScienceOn
4 정성창, 김영구 외. 구강안면동통과 측두하악장애. 신흥 인터내셔날, 서울, 1996
5 Yap AU, Tan KB, Chua EK, Tan HH. Depression and somatization in patients with temporomandibular disorders. J Prosthet Dent 2002;88:479-484   DOI   ScienceOn
6 Abergel RP, lyons RF, Castel JC, Dwyer RM, Unitto J. Biostimulation of wound healing by laser: experimental approaches in animal models and in fibroblast cultures. J Dermatol Surg Oncol 1987;13:127-133   DOI
7 Cho SH, Park JS, Ko MY. Immediate effect of low level laser therapy in the temporomandibular joint disorders. Korean J Oral Med 2003;28:281-294
8 김선영, 박준상. 저출력레이저를 이용한 교근 및 승모근 발통점의 치료에 관한 연구. 대한구강내과학회지 1996;21:25-36
9 Kleinkort JA, Wood F. Phonophoresis with 1 percent versus 10 percent hydrocortisone. Phys Ther 1975;55:1320-1324   DOI
10 Lundh H, Westesson PL, Eriksson L, Brooks SL. Temporomandibular joint disk displacement without reduction. Treatment with flat occlusal splint versus no treatment. Oral Surg Oral Med Oral Pathol 1992;73:655-658   DOI   ScienceOn
11 Chung SC, Kim HS. The effect of the stabilization splint on the TMJ closed lock. J Craniomandib Pract 1993;11:95-101
12 Esposito CJ, Veal SJ, Farman AG. Alleviation of myofascial pain with ultrasonic therapy. J Prosthet Dent 1984;51:106-108   DOI   ScienceOn
13 Kai S, Kai H, Tabata O, Shiratsuchi Y, Ohishi M. Long-term outcomes of nonsurgical treatment in nonreducing anteriorly displaced disk of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;85:258-267   DOI   ScienceOn
14 Kleinknecht RA, Mahoney ER, Alexander LD. Psychosocial and demographic correlates of temporomandiblar disorders and related symptoms: An assessment of community and clinical findings. Pain 1987;29:313-324   DOI   ScienceOn
15 Serpell MG. Neuropathic pain study group. Gabapentin in neuropathic pain syndromes: a randomized, double-blind, placebo-controlled trial. Pain 2002;99:557-566   DOI   ScienceOn
16 Lowe AS, Walker MD, O'Byrne M, Baxter GD, Hirst DG. Effect of low intensity monochromatic light therapy (890nm) on a radiation-impaired, wound healing model in murine skin. Lasers Surg Med. 1998;23:291-298   DOI   ScienceOn
17 Kurita K, Westesson PL, Yuasa H, Toyama M, Machida J, Ogi N. Natural course of untreated symptomatic temporomandibular joint disc displacement without reduction. J Dent Res 1998;77:361-365   DOI   ScienceOn
18 Eckerdal A, Bastian HL. Can low reactive-level laser therapy be used in the treatment of neurogenic facial pain? A double-blind, placebo controlled investigation of patients with trigeminal neuralgia. Laser therapy. 1996;8:247-252   DOI   ScienceOn
19 Shin SM, Choi JK. Effect of indomethacin phonophoresis on the relief of temporomandibular joint pain. Cranio. 1997;15:345-348   DOI
20 Brown TS, Bottomley WK. The utilization and mechanism of action of tricyclic antidepressants in the treatment of chronic facial pain: A review of the literature. Anesth Prog 1990;37:223-239
21 Sharav Y, Singer E, Schmidt E, Dionne RA, Dubner R. The analgesic effect of amitriptyline on chronic facial pain. Pain. 1987;31:199-209   DOI   ScienceOn
22 Rice ASC, Maton S. Postherpetic neuralgia study group. Gabapentin in postherpetic neuralgia: a randomized double-blind placebo-controlled study. Pain. 2001;94:215-224   DOI   ScienceOn
23 McCluskey A, Currer BA, Sayeed I. The efficacy of 5% lidocaine-prilocaine (EMLA) cream on pain during intravenous injection of propofol. Anesth Analg 2003;97:713-714
24 Kreiner M, Betancor E, Clark GT. Occlusal stabilization appliances. Evidence of their efficacy. Am J Dent Assoc 2001;132:770-777   DOI
25 Khullar SM, Emami B, Westermark A, Haanaes HR. Effect of low-level laser treatment on neurosensory deficits subsequent to saggittal split ramus osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;82:132-138   DOI   ScienceOn
26 Backonja M, Beydoun A, Edwards KR, et al. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus : a randomized controlled trial. J Am Med Assoc. 1998;280:1831-1836   DOI   ScienceOn
27 Zinman LH, New KT, Ngo M, Gogov S, Ng ET, Bril V. Low-intensity laser therapy for painful symptoms of diabetic sensorimotor polyneuropathy. Diabetic care 2004;27:921-924   DOI   ScienceOn
28 Solberg WK, Clark GT, Rugh JD. Nocturnal electromyographic evaluation of bruxism patients undergoing short term splint therapy. J Oral Rehabil 1975; 2:215-223   DOI
29 Okeson JP. Orofacial pain: Guidelines for assessment, classification, and management/ the AAOP 1996, Quintessence Publishing Co, Inc
30 Mester E, Mester AF, Mester A. The biomedical effects of laser application. Lasers Surg Med. 1985;5:31-39   DOI   ScienceOn
31 Clark GT. A critical evaluation of orthopedic interocclusal appliance therapy: Design, theory, and overall effectiveness. J Am Dent Assoc 1984;108: 359-364   DOI
32 Okeson JP. Bell's Orofacial Pain. 6th ed. 2004, Quintessence Publishing Co., Inc
33 Okeson JP. Management of temporomandibular disorders and occlusion. 5th ed. Elsevier Pet, Ltd
34 Karu T, Kalendo G, Lethokov V, Lobko V. Biostimulation of HeLa cells by low-intensity visible light II. Stimulation of DNA and RNA synthesis in a wide spectral range. Nuevo Cimento 3rd ed. pp 309-318, 1984
35 Dao TT, Lavigne GJ. Oral splints: the crutches for temporomandibular disorders and bruxism? Crit Rev Oral Biol Med 1998;9:345-361   DOI   ScienceOn
36 Kreisberg MK. Tricyclic antidepressants: Analgesic effect and indications in orofacial pain. J Craniomandib Disord Facial Oral Pain. 1988;2:171-177
37 Rowbotham M, Harden N, Stacey B, Bernstein P, Magnus-Miller L. Gabapentin for the treatment of postherpetic neuralgia: a randomized controlled trial. J Am Med Assoc.1998;280:1837-1842   DOI   ScienceOn
38 Kurita H. Kurashina K, Kotani A. Clinical effect of full coverage occlusal splint therapy for specific temporomandibular disorder conditions and symptoms. J Prosthet Dent 1997;78:506-510   DOI   ScienceOn
39 Epstein JB, Marcoe JH. Topical application of capsaicin for treatment of oral neuropathic pain and trigeminal neuralgia. Oral Surg Oral Med Oral Pathol 1994;77:135-140   DOI   ScienceOn
40 dos Santos JD Jr, de Rijk WG. Vectorial analysis of the equilibrium of forces transmitted to TMJ and occlusal biteplane splints. J Oral Rehabil 1995;22:301-310   DOI   ScienceOn