56. Diseases assoc. with masticatory muscles & other structures

Question 1

Underlying mechanisms that cause masticatory muscle pain

Answer 1

• Overuse
• Localized ischemia:
• Endogenous substances=>bradykinin, serotonin, prostaglandins
• Deep tissue inflammation

Question 2

Systemic conditions that produce masticatory muscle pain

Answer 2

• Polymyalgia rheumatica
• Polymyositis
• Lupus erythematosus
• Fibromyalgia

Question 3

Masticatory muscle disorders classified

Answer 3

• Local myalgia
• Myofascial pain
• Centrally mediated myalgia
• Myospasm or trismus
• Myositis and tendonitis
• Myofibrotic contracture
• Neoplasia

Question 4

Clinical features of local myalgia in masticatory muscles

Answer 4

• Localized or regional dull ache and stiffness
• Little to no pain at rest=> increases with jaw function
• Muscle weakness, fatigue, and increased pain =>
• Eating hard foods, yawning, and prolonged opening

Question 5

Clinical features of myofascial pain

Answer 5

• Regional or local dull, aching muscle pain =>
• Increases during function
• Localized tender trigger points=> Palpation provokes pain referral to distant sites=>
• Teeth, ear, or head
• Muscle stiffness, ear symptoms (e.g., tinnitus), decreased mouth opening

Question 6

Centrally mediated myalgia clinical presentation

Answer 6

• Continuous, aching pain in many areas of the body
• Generalized fatigue, chronic headache, irritable sleep disturbance

Question 7

clinical characteristics of myospasm or trismus

Answer 7

• Sudden, involuntary, contraction
• Acute pain => at rest and during function=>
• Significantly limited function

Question 8

Clinical features of myositis and tendonitis

Answer 8

• True inflammation of the muscle=> direct trauma and/or infection
• Swelling, erythema, and increased temperature over entire muscle.
• Continuous severe pain => significant motion range limitation

Question 9

Clinical characteristics of Muscle contracture or myofibrotic contracture

Answer 9

• Painless shortening of a muscle =>
• Fibrosis or scarring
• Limited jaw opening=>
• Not painful except when muscle extended beyond functional length

Question 10

Clinical characteristics of muscle neoplasia

Answer 10

• New, abnormal, or uncontrolled growth of muscle tissue=>
• Benign or malignant
• Tumors=>within muscle or as extensions from adjacent structures or metastases
• Swelling
• Trismus, paresthesias, and possibly pain

Question 11

Imaging used in the diagnosis of masticatory muscle and orofacial disorders

Answer 11

• CBCT
• MRI

Question 12

Adjunctive diagnostic devices used in the assessment of jaw disorders

Answer 12

• Electronic devices=>Electromyography testing, jaw tracking
• Thermography, sonography

Question 13

Key components of patient education and self-care in the management of masticatory muscle and orofacial disorders

Answer 13

• Educating patients on correct relaxed jaw posture=>
• Preventing habits=> clenching and grinding
• Soft diet, slower mastication, and avoiding prolonged jaw opening
• Moist heat or ice=> pain and inflammation management
• Self-massage and gentle range-of-motion exercises

Question 14

Pharmacological agents used in the treatment of masticatory muscle and orofacial disorders

Answer 14

• Analgesics and NSAIDs=>pain and inflammation
• Corticosteroids=> severe joint inflammation.
• Benzodiazepines=>short-term use in acute muscle pain/spasm and anxiety
• Muscle relaxants=>acute and chronic muscle pain