Functional Disorders of the Masticatory Muscles

Question 1

what produces pain sensations?

Answer 1

vasoconstriction of the relevant nutrient arteries and the accumulation of metabolic waste products in the muscle tissues. within the ischemic area of the muscle, certain algogenic substances (bradykinins, prostaglandins) are released, causing muscle pain.

Question 2

T or F:

pain is far more complex than simple overuse and fatigue

Answer 2

true

Question 3

muscle pain can be greatly influenced by ___

Answer 3

central mechanisms

Question 4

dysfunction of the TMJ can manifest in what 3 ways?

Answer 4

• decrease in the range of mandibular movement
• acute malocclusion (premature contact on new restoration)
• change in the resting length of a muscle that controls jaw position (inferior lateral pterygoid muscle spasm)

Question 5

T or F:

pain and dysfunction are clinically the same

Answer 5

false

Question 6

what are 2 CNS influences muscle pain disorders?

Answer 6

myofascial (trigger point) pain and myospasm

Question 7

how is chronic centrally mediated myalgia treated?

Answer 7

often very difficult to resolve and treatment strategies are other than for acute myalgic disorders

Question 8

___ is a widespread global musculoskeletal pain disorder in which tenderness is found in 11 or more of 18 specific tender-point sites throughout the body

Answer 8

fibromyalgia

Question 9

when myogenous pain persists, more chronic and often complex muscle pain disorders can develop. chronic pain is considered to be pain that has been present for ___ months or longer

Answer 9

6 months

Question 10

the dentist must recognize that as myalgic complaints progress from an acute to a chronic disorder, the effectiveness of ___ is greatly reduced

Answer 10

local treatment

Question 11

what are the 4 types of perpetuating factors?

Answer 11

local perpetuating factors, protracted cause (clinician fails to eliminate cause), recurrent cause, therapeutic mismanagement (often as a result of improper diagnosis)

Question 12

what are 6 types of systemic perpetuating factors?

Answer 12

continued emotional stress, downregulation of the descending inhibitory system, sleep disturbances, learned behavior, secondary gain, depression

Question 13

___ is a chronic, continuous muscle pain disorder originating predominantly from CNS effects that are felt peripherally in the muscle tissues

Answer 13

centrally mediated myalgia (chronic myositis)

Question 14

myositis = ___

Answer 14

neurogenic inflammation

Question 15

what is the antidromic effect?

Answer 15

neurons that normally only carry information from the periphery into the CNS can now be reversed to carry information from the CNS out to the peripheral tissues. when this occurs, the afferent neurons in the periphery can release nociceptive neurotransmitters (substance P, bradykinins), which in turn causes peripheral tissue pain. this process is called neurogenic inflammation.

Question 16

the longer the patient complains of myogenous pain, the greater the likelihood of ___

Answer 16

chronic centrally mediated myalgia

Question 17

___% of fibromyalgia patients also report TMD-like symptoms

Answer 17

42%

Question 18

T or F:
because several chronic systemic muscle pain conditions can coexist, there is a need to recognize this and to refer those patients who require nondental treatment to the appropriate medical personnel

Answer 18

true