1/21. The interdisciplinary approach to oral, facial and head pain.BACKGROUND: Chronic oral, facial and head pain is a common clinical problem, and appropriate diagnosis and management are a challenge for health care professionals. patients often will first seek the care of dentists because of the pain's localization in the oral cavity and surrounding structures. This article emphasizes the importance of establishing accurate diagnoses and conducting appropriate triage of the patient with complex orofacial pain. CASE DESCRIPTIONS: The authors present two case reports illustrating the complex nature of oral, facial and head pain, and the potential and actual pitfalls in management of this condition. These representative cases demonstrate how orofacial pain--which appears to be localized in the peripheral dental and oral structures--can have extremely complex etiologies involving other anatomical structures, the central nervous system and psychological factors. The reports point to the need for the expertise of a number of specialists in such cases. CLINICAL IMPLICATIONS: If the symptoms and clinical findings do not appear to be consistent with typical oral disease, or if standard treatments do not alleviate the pain, the dental clinician must consider other, more complex orofacial pain diagnoses. The dental professional should not hesitate to make referrals to key specialists or to members of an interdisciplinary team at a pain treatment center who have the expertise to appropriately diagnose and manage chronic oral, facial and head pain.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
2/21. An adult case of TMJ osteoarthrosis treated with splint therapy and the subsequent orthodontic occlusal reconstruction: adaptive change of the condyle during the treatment.This article reports treatment for a 21-year 11-month old female patient with severe osteoarthrosis of the TMJ with a special reference to adaptive changes of the condyle during the treatment. She had severe open bite with a Class II molar relationship; she had limited mouth opening, TMJ sounds, pain, and tinnitus. Lateral tomograms showed flattening and deep erosion on the left condyle, and an MRI revealed anterior disk displacement without reduction. By manipulation and splint therapy, TMJ pain and tinnitus were eliminated, then orthodontic treatment was initiated, maintaining the splint-induced position of the condyles. After 2 years of orthodontic treatment with a multibracket appliance, an acceptable occlusion was achieved with a Class I molar relationship. On lateral tomograms after treatment, bony deformation of the left condyle disappeared and adaptive remodeling was recognized with a uniform joint space in the left TMJ. However, repositioning of the disk was not achieved. Adaptive changes or functional remodeling experienced in this patient may be due to stable occlusion, uniform joint space, and the consequent biomechanical equilibrium in the TMJ.- - - - - - - - - - ranking = 0.31666743894627keywords = mouth (Clic here for more details about this article) |
3/21. arthrogryposis multiplex congenita in a patient with limited mouth opening: a case report.This report describes a case of arthrogryposis multiplex congenita and concomitant bruxism with limited mouth opening and pain in the temporomandibular joints (TMJ). A conservative treatment with a myorelaxing splint and physiotherapeutic exercises was prescribed resulting in improvement to the muscular and joint conditions and a reduction in pain.- - - - - - - - - - ranking = 1.5833371947313keywords = mouth (Clic here for more details about this article) |
4/21. Influence of galvanic phenomena on the occurrence of algic symptoms in the mouth.The presence of more than one dental alloy in the oral cavity often causes pathological galvanic currents and voltage. Due to various and multi-faceted symptomathology, they tend to be a source of significant problems not only for the patient but also for the attending dentist. Very discreet and uncharacteristically objective diagnosis during a regular examination frequently causes this state to be ascribed to a completely different illness.- - - - - - - - - - ranking = 2.2666697557851keywords = oral cavity, mouth, cavity (Clic here for more details about this article) |
5/21. Orofacial pain of cardiac origin: a case report.It is the responsibility of the dentist to make the differential diagnosis of pain in the region of the oral cavity. Cardiac pain most commonly radiates to the left arm, shoulder, neck and face. In rare instances the pain may present as dental pain. In this case report, the patient presented with complaints of intense bilateral pain in the jaws which was diagnosed as pain of cardiac origin.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
6/21. Synovial osteochondromatosis accompanying an ossified articular disk in the temporomandibular joint: a case report.A 51-year-old woman was referred for pain in the right temporomandibular joint (TMJ) and the trismus. Conventional radiography showed a radiopaque area in the disk, which suggested calcification. At surgery, multiple, round-to-ovoid cartilagenous nodules were found in the joint cavity. Synovectomy and diskectomy were carried out via a pre-auricular incision to remove the nodules. Examination under light microscopy confirmed the diagnosis of synovial osteochondromatosis (SOC). The disk contained a large ossified mass. To our knowledge, this is the first reported example of SOC accompanied by ossification of a large part of the disk.- - - - - - - - - - ranking = 0.10072339706829keywords = cavity (Clic here for more details about this article) |
7/21. Eagle's syndrome.Eagle's syndrome is an uncommon condition resulting from an elongated styloid process, which causes cervico facial pain, tinnitus and otalgia. A 48-year-old female presented to the clinic with bilateral upper neck pain radiating to the ears with tinnitus for almost one-year duration. Examination of the oral cavity revealed atrophic tonsils and palpable bony projection deep in the tonsillar fossa. Plain lateral neck X-ray and CT scan confirmed the presence of bilateral elongated styloid processes, which were subsequently resected surgically through an oropharyngeal approach. The patient was asymptomatic at follow up at 2 years.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
8/21. Use of advanced imaging modalities for the differential diagnosis of pathoses mimicking temporomandibular disorders.The medical records of 3 patients who visited our hospital with preauricular pain and limited jaw movement were retrospectively reviewed. All were clinically evaluated, diagnosed through the use of conventional radiographs, and initially treated as having temporomandibular disorders (TMD). However, their symptoms did not improve and even increased or facial swelling occurred, so advanced imaging modalities were used to make a differential diagnosis. The final diagnoses of the patients were cellulitis, an inflammatory pseudotumor, and pigmented villonodular synovitis. In addition to these 3 patients, 50 others who were initially misdiagnosed during a clinical examination as having TMD on conventional radiographs were reviewed in the English-language literature. When diagnosing patients with TMD symptoms, we must consider the possibility of unusual causes, including tumors and infections or inflammations. Furthermore, in addition to usual TMD treatment procedures, an advanced radiologic examination should be performed to aid in the differential diagnosis of all patients with unceasing pain and mouth-opening limitation.- - - - - - - - - - ranking = 0.31666743894627keywords = mouth (Clic here for more details about this article) |
9/21. Endoscopic assistance in the removal of a foreign body in the condylar process.This case report describes the application of the endoscopic technique in the removal of a metallic foreign body in the condylar process in an 81-year-old man. The patient's history indicated 60 years of pain in the left preauricular region as well as complaints of localized headaches. physical examination revealed multiple scars on the patient's left preauricular region. No limitation of mandibular movement and no joint clicking were detected. Maximal mouth opening was 45 mm. According to the patient, masticatory function was normal. Digital palpation of the temporomandibular joint did not produce pain. Radiographic diagnosis was performed, which showed a pointed metallic foreign body lodged in the left condylar process. The removal of the foreign body was performed under endoscopic visualization via an intraoral approach. A 30 degrees-angled 4-mm diameter endoscope (Karl Storz, Tuttlingen, germany) with a xenon light source was used.- - - - - - - - - - ranking = 0.31666743894627keywords = mouth (Clic here for more details about this article) |
10/21. Pleomorphic adenoma of the nasal septum.Pleomorphic adenoma may occur in any site in which there is salivary gland tissue. It has rarely been described arising in the nasal cavity. We report a case of septal pleomorphic adenoma and discuss the clinical presentation and surgical management.- - - - - - - - - - ranking = 0.10072339706829keywords = cavity (Clic here for more details about this article) |
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