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Query: UMLS:C0016053 (fibromyalgia)
 4,687 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The oral health of twenth-two patients with a diagnosis of myofascial pain dysfunction syndrome was evaluated. Radiographs, photographs, study casts, visual and digital clinical examinations, hematologic data, blood pressure, and periodontal examinations were used with each patient. A review of the literature indicated a variety of causes for facial pain, including Costen's syndrome, muscle fatique and spasm, occlusion, and psychogenic factors. This study revealed the following trends: (1) The periodontal health of patients with the myofascial pain dysfunction syndrome appears to be better than anticipated. (2) Bruxism accounts for a healthy dental apparatus when other diseases are not present. (3) Groups of muscles, other than the masticatory group, may contribute to the myofascial pain dysfunction syndrome. (4) Patients presented with various ranges of malocclusions and normal occlusions, deep overbites and overjets, complete dentitions, and missing teeth (either equally missing right and left or unequally missing right and left). This article also discusses clinical considerations in the diagnosis of the myofascial pain dysfunction syndrome and offers a practical, physiologic approach to treatment. We conclude that how one uses his mandible is more of a causative factor than the relationships of the teeth.
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PMID:Oral considerations of the myofascial pain dysfunction syndrome. 106 26

The use of tricyclic antidepressants as opposed to hypnotics in treating insomnia is reviewed. Available data indicate that TCAs alleviate sleep disturbances related to depression (often before antidepressant effects are seen) and, in selected cases, may prove effective in disturbed sleep related to sleep apnea, fibrositis, and sleep related bruxism, as well as in adults with childhood onset insomnia or a history of hyperkinesis. However, TCAs share many of the problems reported for hypnotics, as well as having some potentially serious side effects not present with benzodiazepines. The need for determination of the etiology of sleep disorders, and specific pharmacotherapy directed toward identified causes rather than the symptom of insomnia, is stressed.
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PMID:Tricyclic antidepressants in the treatment of insomnia. 635 74

Occlusal splints constructed at three different vertical heights were used to study the influence of vertical dimension in the etiology of bruxism and MPD syndrome. The vertical dimension of least EMG activity was determined for each of 75 patients who were randomly divided into three groups according to the vertical dimension at which the occlusal splint was constructed. Group I occlusal splints were constructed at 1 mm from the occlusal vertical dimension, group II splints at 4.42 mm, and group III splints at 8.15 mm. Results showed a faster and more complete reduction in clinical symptoms for groups II and III than for group I. The temporary use of occlusal splints with a vertical height exceeding the physiologic rest position did not encourage a greater muscular tonus or hyperactivity of jaw muscles. It can be concluded that elongation of elevator muscles to or near the vertical dimension of least EMG activity by means of occlusal splints is more effective in producing neuromuscular relaxation.
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PMID:Influence of the vertical dimension in the treatment of myofascial pain-dysfunction syndrome. 658 Apr 39

Six of seven women were recalled after 1 year to remeasure their right- and left-side working disclusion times. Before the occlusal adjustment technique known as immediate complete anterior guidance development (ICAGD), these patients presented lengthy mean disclusion times (> 1.0 second) and multiple chronic myofascial pain dysfunction syndrome (MPDS) symptoms. After ICAGD, these patients presented with short mean disclusion times (< 0.7 second) and no chronic MPDS symptoms were observed. At 1-year follow-up, there was no statistical difference between present measurements of disclusion time and those of 1 year earlier. In addition, all six posttreatment patients demonstrated no observed chronic MPDS symptoms. However, the symptom of nocturnal bruxism appeared to recur with some chronic regularity. These results suggest that, for this population, disclusion time was stable over the 1-year period of observation, and the short disclusion time appears to allow normal daily muscle function with significantly lessened appearance of chronic myofacial pain dysfunction symptoms.
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PMID:Disclusion time measurement studies: stability of disclusion time--a 1-year follow-up. 793 63

This review discusses the clenching-grinding spectrum from the neuropsychiatric/neuroevolutionary perspective. In neuropsychiatry, signs of jaw clenching may be a useful objective marker for detecting or substantiating a self-report of current subjective emotional distress. Similarly, accelerated tooth wear may be an objective clinical sign for detecting, or substantiating, long-lasting anxiety. Clenching-grinding behaviors affect at least 8 percent of the population. We argue that during the early paleolithic environment of evolutionary adaptedness, jaw clenching was an adaptive trait because it rapidly strengthened the masseter and temporalis muscles, enabling a stronger, deeper and therefore more lethal bite in expectation of conflict (warfare) with conspecifics. Similarly, sharper incisors produced by teeth grinding may have served as weaponry during early human combat. We posit that alleles predisposing to fear-induced clenching-grinding were evolutionarily conserved in the human clade (lineage) since they remained adaptive for anatomically and mitochondrially modern humans (Homo sapiens) well into the mid-paleolithic. Clenching-grinding, sleep bruxism, myofacial pain, craniomaxillofacial musculoskeletal pain, temporomandibular disorders, oro-facial pain, and the fibromyalgia/chronic fatigue spectrum disorders are linked. A 2003 Cochrane meta-analysis concluded that dental procedures for the above spectrum disorders are not evidence based. There is a need for early detection of clenching-grinding in anxiety disorder clinics and for research into science-based interventions. Finally, research needs to examine the possible utility of incorporating physical signs into Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition posttraumatic stress disorder diagnostic criteria. One of the diagnostic criterion that may need to undergo a revision in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition is Criterion D (persistent fear-circuitry activation not present before the trauma). Grinding-induced incisor wear, and clenching-induced palpable masseter tenderness may be examples of such objective physical signs of persistent fear-circuitry activation (posttraumatic stress disorder Criterion D).
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PMID:The clenching-grinding spectrum and fear circuitry disorders: clinical insights from the neuroscience/paleoanthropology interface. 1578 58

This study aimed to investigate the prevalence of clinical features of temporomandibular disorders (TMD) in patients with fibromyalgia. The test group (FMG) consisted of 40 women with fibromyalgia (FM) compared to the control group of 40 healthy subjects using the research diagnostic criteria for temporomandibular disorders (RDC/TMD). The variables were compared using Fisher's exact test and a Mann-Whitney test. Facial pain was reported by 85% of the FM group, and 77.5% were diagnosed with myofascial TMD. Muscle pain during jaw movements, daytime bruxism/clenching, and limited mouth opening were significantly higher in the test group. There was no difference between groups in: (1) joint noises; (2) sleep bruxism/clenching; and (3) excursive or non-excursive movements. Classic signs of TMD, such as joint noise and self-reporting of clenching at night, are not associated with fibromyalgia syndrome as demonstrated in the current study. However, the self-reported daytime parafunctions, muscle pain in jaw movements, and limited mouth opening are features of the patients in the current study. This study revealed specific muscle involvement of TMD is also presence in FM.
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PMID:Features of temporomandibular disorders in fibromyalgia syndrome. 2346 Dec 61

A 44-year-old woman, who was suffering from widespread musculoskeletal pain, fatigue, and sleep disorder, was diagnosed as fibromyalgia. There was no apparent organic disease. Duloxetine therapy was introduced with a dose of 60 mg/day at bedtime. A few days later her husband noted severe teeth clenching and associated loud grinding noises during sleep. Then, duloxetine dosage was reduced to 30 mg/day. The bruxism continued with this dosage, thus the therapy was discontinued. The bruxism resolved after cessation. Three weeks later, duloxetine therapy was restarted at the dosage of 60 mg/day. On the third day of the therapy, bruxism started again and amitriptyline therapy at the dosage of 10 mg/day was added to duloxetine therapy. The dosage of amitriptyline was incrementally adjusted to 25 mg/ day. On the fourth day of the combined therapy, bruxism symptoms improved. Two months later, the bruxism symptoms were resolved and the complaints for fibromyalgia were under control. Although bruxism has been reported due to venlafaxine use, there is only one duloxetine-induced bruxism case in the literature which was treated with buspirone. However, we report duloxetine-induced bruxism treated successfully with amitriptyline in a patient with fibromyalgia. Tricyclic antidepressants have a suppression effect on the REM phase of the sleep cycle; this may help to cease the bruxism symptoms appearing in that phase of the sleep cycle. This is the first reported case of fibromyalgia with duloxetine-induced sleep bruxism successfully treated with amitriptyline.
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PMID:Duloxetine-induced Sleep Bruxism in Fibromyalgia Successfully Treated With Amitriptyline. 2692 6