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Quintessence Publishing: Journals: OFPH
Journal of Oral & Facial Pain and Headache

Edited by Barry J. Sessle, BDS, MDS, BSc, PhD, FRSC

Official Journal of the American Academy of Orofacial Pain,
the European, Asian, and Ibero-Latin Academies of Craniomandibular
Disorders, and the Australian Academy of Orofacial Pain

ISSN 2333-0384 (print) • ISSN 2333-0376 (online)

Winter 2013
Volume 27 , Issue 1

Share Abstract:

Effect of Contingent Electrical Stimulation on Masticatory Muscle Activity and Pain in Patients with a Myofascial Temporomandibular Disorder and Sleep Bruxism

Karen G. Raphael, PhD/Malvin N. Janal, PhD/David A. Sirois, DMD, PhD/Peter Svensson, DDS, PhD, Dr Odont

Pages: 21-31
PMID: 23424717
DOI: 10.11607/jop.1029

Aims: To determine whether an intervention reduces oromotor activity and masticatory muscle pain in myofascial temporomandibular disorder (M/TMD) patients with high levels of masticatory muscle activity associated with sleep bruxism. Methods: Fourteen women with M/TMD and prior polysomnographic evidence consistent with sleep bruxism participated in a 10-week single-group pre-test/ post-test mechanistic clinical trial. A 2-week period of baseline monitoring of individually biocalibrated electromyographic (EMG) events associated with sleep bruxism was followed by 6 weeks of EMG-event-contingent treatment via an innocuous electrical pulse to the skin overlying the temporalis muscle. Treatment was discontinued during 2-week follow-up monitoring. Each night before sleep, subjects recorded their average daily pain. Results: Mixed-model analysis of variance showed a reliable reduction of EMG events during contingent stimulation treatment periods, but frequency of EMG events returned to baseline levels during follow-up (linear term, P = .002; quadratic term, P = .001). In contrast, nightly pain reports failed to show any systematic changes during treatment (linear and quadratic trends, both P > .10). Conclusion: Spontaneous pain severity and nighttime oromotor activity vary independently over nights, even in M/TMD patients selected for relatively high levels of both ­characteristics. J OROFAC PAIN 2013;27:21–31. doi: 10.11607/jop.1029

Key words: bruxism, electromyography, orofacial pain, temporomandibular disorders

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