Abstract
Myofascial pain-dysfunction (MPD) syndrome is a muscle-contraction headache-like pain of the face. In the past this has also been called temporomandibular joint syndrome. This syndrome is thought to be, in part, a stress-related pain. This paper discusses and evaluates the following topics: (1) patient characteristics, (2) etiological hypotheses, (3) experimental models of the syndrome, (4) psychological characteristics of the patients, (5) psychophysiological characteristics of the patients, and (6) relaxation therapies. Future research is also discussed.
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References
Bakal, D. A. (1975). Headache: A biophysical perspective.Psychol. Bull. 82: 369–382.
Bell, W. E. (1969). Clinical diagnosis of the pain-dysfunction syndrome.J. Am. Dent. Assoc. 79: 154–160.
Berry, D. C., and Wilmot, G. (1977). The use of biofeedback technique in the treatment of mandibular dysfunction pain.J. Oral Rehab. 4: 255–260.
Block, L. S. (1947). Diagnosis and treatment of disturbances of the temporomandibular joint especially in relation to vertical dimension.J. Am. Dent. Assoc. 34: 253–260.
Bradley, L. A., Prokop, C. K., Margolis, R., and Gentry, W. D. (1978). Multivariate analyses of the MMPI profiles of low back pain patients.J. Behav. Med. 1: 253–272.
Carlsson, S. G., and Gale, E. N. (1976). Biofeedback treatment for muscle pain associated with the temporomandibular joint.J. Behav. Ther. Exp. Psychiat. 7: 383–385.
Carlsson, S. G., and Gale, E. N. (1977). Biofeedback in the treatment of long-term temporomandibular joint pain.Biofeed. Self-Regul. 2: 161–171.
Carlsson, S. G., Gale, E. N., and Ohman, A. (1975). Treatment of temporomandibular joint syndrome with biofeedback training.J. Am. Dent. Assoc. 91: 602–605.
Christensen, L. V. (1967). Facial pain from the masticatory system induced by experimental bruxism: A preliminary report.Tandlaegebladet. 71: 1171.
Christensen, L. V. (1970). Facial pain from experimental tooth clenching.Tandlaegebladet. 74: 175–182.
Christensen, L. V. (1971). Facial pain and internal pressure of masseter muscle in experimental bruxism in man.Arch. Oral Biol. 16: 1021–1031.
Christensen, L. V. (1975). Some effects of experimental hyperactivity of the manbidular locomotor system in man.J. Oral Rehab. 2: 169–178.
Clarke, N. G., and Kardachi, B. J. (1977). The treatment of myofascial pain-dysfunction syndrome using the biofeedback principle.J. Periodont. Res. 48: 643–645.
Costen, J. B. (1934). A syndrome of ear and sinus symptoms dependent upon disturbed function of the temporomandibular joint.Ann. Otol. Rhinol. Laryngol. 43: 1–15.
Costen, J. B. (1937). Some features of the mandibular articulation as it pertains to medical diagnosis, especially in otolaryngology.J. Am. Dent. Assoc. 24: 1507–1511.
Dawson, P. E. (1973). Temporomandibular joint pain-dysfunction problems can be solved.J. Prosthet. Dent. 29: 100–112.
Dohrmann, R. J., and Laskin, D. M. (1977). Treatment of myofascial pain-dysfunction syndrome with EMG biofeedback. In Rugh, J. D., Perlis, D. B., and Disraeli, R. I. (eds.),Biofeedback and Dentistry, Semantodontics, Phoenix, Ariz., p. 122.
Dohrmann, R. J., and Laskin, D. M. (1978). An evaluation of electromyographic biofeedback in the treatment of myofascial pain-dysfunction syndrome.J. Am. Dent. Assoc. 96: 656–662.
Fine, E. W. (1971). Psychological factors associated with non-organic temporomandibular joint pain dysfunction syndrome.Brit. Dent. J. 131: 402–404.
Franks, A. S. T. (1964). The social character of temporomandibular joint dysfunction.Dent. Pract. 15: 94–100.
Gale, E. N. (1978). Psychological characteristics of long-term female temporomandibular joint pain patients.J. Dent. Res. 57: 481–483.
Gale, E. N., and Carlsson, S. (1976). Look carefully: A short note on symptom substitution.Behav. Res. Ther. 14: 77.
Gessel, A. H. (1975). Electromyographic biofeedback and tricyclic antidepressants in myofascial pain-dysfunction syndrome: Psychological predictors of outcome.J. Am. Dent. Assoc. 91: 1048–1052.
Gessel, A. H., and Alderman, M. M. (1971). Management of myofascial pain dysfunction syndrome of the temporomandibular joint by tension control training.Psychosomatics 12: 302–309.
Gessel, A. H., and Harrison, S. (1977). Bilateral electromyographic feedback treatment of chronic mandibular dislocation: A case report. In Rugh J. D., Perlis, D. B., and Disraeli, R. I. (eds.),Biofeedback in Dentistry, Semantodontics, Phoenix, Ariz., pp. 144–147.
Goodfriend, D. J. (1933). Symptomotology and treatment of abnormalities of mandibular articulation.Dent. Cosmos 15: 947.
Goodman, P., Greene, C. S., and Laskin, D. M. (1976). Response of patients with myofascial pain-dysfunction syndrome to mock equilibration.J. Am. Dent. Assoc. 92: 755–758.
Greene, C. S., and Laskin, D. M. (1972). Splint therapy for the myofascial pain-dysfunction (MPD) syndrome: A comparative study.J. Am. Dent. Assoc. 84: 624–628.
Greene, C. S., Lerman, M. D., Sutcher, H. D., and Laskin, D. M. (1969). The TMJ pain-dysfunction syndrome: Heterogeneity of the patient population.J. Am. Dent. Assoc. 79: 1168–1172.
Gross, S. N. (1975). Biofeedback technique in treating myofascial pain dysfunction syndrome.J. N.J. Dent. Assoc. 46: 26–27.
Gross, S. M., and Vacchiano, R. B. (1973). Personality correlates of patients with temporomandibular joint dysfunction.J. Prosthet. Dent. 30: 326–329.
Harris, H. L. (1938). Effect of the loss of vertical dimension on the anatomical structures of the head and neck.J. Am. Dent. Assoc. 25: 175–193.
Harris, M. (1974). Psychogenic aspects of facial pain.Brit. Dent. J. 136: 199–202.
Haynes, S. N. (1981). Muscle-contraction headache: A psychophysical perspective of etiology and treatment. In Haynes, S. N., and Gannon, L. R. (eds.),Psychosomatic Disorders: A Psychophysiological Approach to Etiology and Treatment, Praeger Press, New York, N.Y.
Helkimo, M. (1976). Epidemiological surveys of dysfunction of the masticatory system.Oral Sci. Rev. 1: 54–69.
Kydd, W. L. (1959). Psychosomatic aspects of temporomandibular joint dysfunction.J. Am. Dent. Assoc. 59: 31–44.
Laskin, D. M. (1969). Etiology of the pain-dysfunction syndrome.J. Am. Dent. Assoc. 79: 147–153.
Laskin, D. M., and Greene, C. S. (1972). Influence of the doctor-patient relationship on placebo therapy for patients with myofascial pain-dysfunction (MPD) syndrome.J. Am. Dent. Assoc. 85: 892–894.
Lefer, L. (1971). Psychic stress and the oral cavity.Postgrad. Med. 49: 171–175.
Lupton, D. E. (1969). Psychological aspects of temporomandibular joint dysfunction.J. Am. Dent. Assoc. 79: 131–136.
Marbach, J. J., and Dworkin, S. F. (1975). Chronic MPD, group therapy and psychodynamics.J. Am. Dent. Assoc. 90: 827–833.
Marbach, J. J., Lipton, J. A., Lund, P. B., Delahanty, F., and Blank, T. B. (1978). Facial pain and anxiety levels: Consideration for treatment.J. Prothet. Dent. 40: 434–437.
McCall, C. M., Jr., Szmyd, L., and Ritter, R. M. (1961). Personality characteristics in patients with temporomandibular joint symptoms.J. Am. Dent. Assoc. 62: 694–698.
Moulton, R. E. (1966). Emotional factors in non-organic temporomandibular joint pain.Dent. Clin. No. Am. Nov.: 609–620.
Nally, F. F., and Moore, D. S. (1975). Psychogenic, diagnostic and therapeutic aspects of temporomandibular joint pain: An analysis of 232 patients with discussion.J. Can. Dent. Assoc. 7: 403–406.
Pomp, A. M. (1974). Psychotherapy for the myofascial pain-dysfunction syndrome: A study of factors coinciding with symptom remission.J. Am. Dent. Assoc. 89: 629–632.
Prentiss, H. J. (1918). Premilinary report upon temporomandibular articulation in human type.Dent. Cosmos 60: 505.
Ramfjord, S. P., and Ash, M. M., Jr. (1966).Occlusion, W. B. Saunders, Philadelphia.
Reading, A., and Raw, M. (1976). The treatment of mandibular dysfunction: Possible application of psychological methods.Br. Dent. J. 140: 201–205.
Rothwell, P. S. (1972). Personality and temporomandibular joint dysfunction.Oral Surg. 34: 734–742.
Rothwell, P. S. (1973). Personality and response to treatment of the temporomandibular joint pain dysfunction syndrome.Oral Surg. 36: 331–335.
Rugh, J. D., and Solberg, W. K. (1976). Psychological implications in temporomandibular pain and dysfunction.Oral Sci. Rev. 7: 3–30.
Schwartz, R. A., Greene, C. S., and Laskin, D. M. (1979). Personality characteristics of patients with myofascial pain-dysfunction (MPD) syndrome unresponsive to conventional therapy.J. Dent. Res. 58: 1435–1439.
Scott, D. S., and Lundeen, T. F. (1980). Myofascial pain involving the masticatory muscles: An experimental model.Pain 2: 207–215.
Shipman, W. G., Greene, C. S., and Laskin, D. M. (1974). Correlation of placebo responses and personality characteristics in myofascial pain-dysfunction (MPD) patients.J. Psychosom. Res. 18: 475–483.
Siirila, H. S., and Laine, P. (1963). The tactile sensibility of the parodontium to slight axial loadings of the teeth.Acta Odontol. Scand. 21: 415–429.
Small, E. W. (1974). Correlation of psychological findings and treatment results in temporomandibular joint pain-dysfunction syndrome.J. Oral Surg. 32: 589–592.
Smith, T. (1925). Review of literature on eustachian tube with data indicating a relation to dental occlusion.J. Am. Dent. Assoc. 12: 671.
Solberg, W. K., Flint, R. T., and Brantner, J. P. (1972). Temporomandibular joint pain and dysfunction: A clinical study of emotional and occlusal components.J. Prosthet. Dent. 28: 412–422.
Solberg, W. K., Woo M. W., and Houston, J. B. (1979). Prevalence of mandibular dysfunction in young adults.J. Am. Dent. Assoc. 98: 25–34.
Stenn, P. G., Mothersill, K. J., and Brooke, R. I. (1979). Biofeedback and a cognitive behavioral approach to treatment of myofascial pain dysfunction syndrome.Behav. Ther. 10: 29–36.
Thomas, L. J., Tiber, N., and Schireson, S. (1973). The effect of anxiety and frustration on muscular tension related to the temporomandibular joint syndrome.Oral Surg. 36: 763–768.
Yemm, R. (1969). Temporomandibular dysfunction and masseter muscle response to experimental stress.Br. Dent. J. 127: 508–510.
Yemm, R. (1971). Comparison of the activity of left and right masseter muscles of normal individuals and patients with mandibular dysfunction during experimental stress.J. Dent. Res. 50: 1320–1323.
Yeem, R. (1976). Neurophysiologic studies of temporomandibular joint dysfunction.Oral Sci. Rev. 1: 31–53.
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Portions of this research were funded at the University of North Carolina at Chapel Hill by National Institute of Dental Research Grant DE 07018.
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Scott, D.S. Myofascial pain-dysfunction syndrome: A psychobiological perspective. J Behav Med 4, 451–465 (1981). https://doi.org/10.1007/BF00846153
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DOI: https://doi.org/10.1007/BF00846153