Masakazu Okubo

Characteristics of middle-aged and older patients with temporomandibular disorders and burning mouth syndrome

The aim of this study was to evaluate the relationship between pain intensities and psychosocial characteristics in middle-aged and older patients with temporomandibular disorders (TMDs) and burning mouth syndrome (BMS). Subjects were selected according to the Research Diagnostic Criteria for TMD (n = 705) and International Association for the Study of Pain criteria for BMS (n = 175). Patients were then divided into two age groups: 45-64 years (middle-aged, Group A) and 65-84 years (older, Group B). Pain intensity and depression and somatization scores were evaluated in both groups. In BMS patients, present and worst pain intensities were significantly higher in Group B than in Group A {4.6 [95% confidence interval (CI) = 4.0-5.2] vs. 3.5 [95% CI = 3.1-3.9] and 5.9 [95% CI = 5.2-6.4] vs. 5.0 [95% CI = 4.5-5.6], respectively; P < 0.05}, with no difference observed in TMD patients. The depression and somatization scores were significantly higher in Group A than in Group B among BMS patients [0.57 (95% CI = 0.45-0.69) vs. 0.46 (95% CI = 0.34-0.59) and 0.537 (95% CI = 0.45-0.63) vs. 0.45 (95% CI = 0.34-0.55); P < 0.05], with no difference observed in TMD patients. The results of the present study indicate that pain intensities and psychosocial characteristics in BMS appear to differ between middle-aged and older patients.

Comparison of masticatory muscle myofascial pain in patients with and without a chief complaint of headache.

Abstract Objectives: Headaches are a common complaint in temporomandibular disorder (TMD) patients. However, few studies have compared the symptom characteristics between TMD patients with and without a complaint of headache. The aim of this study was to compare subjective symptoms and treatment outcomes between myofascial TMD patients who had a chief complaint of headache and those who did not. Methods: One hundred sixty one patients underwent comprehensive examinations and scored their pre- and post-treatment symptoms on a form (4 items assessing pain intensity and 1 assessing sleeping difficulty). On the basis of the primary diagnosis, patients were divided into two groups: myofascial pain with and without a chief complaint of headache (MPH and MP). Results: Before treatment, patients in the MPH group scored significantly higher with respect to pain intensity and level of sleeping difficulty than did patients in the MP group (jaw/face pain, P  =  0·015; headache, P < 0·001; neck pain, P < 0·001, and difficulty in sleeping, P  =  0·005; Mann-Whitney U-test). Patients in the two groups demonstrated similar treatment outcomes, except for neck pain. Conclusion: Significant differences in symptom characteristics and outcomes were observed between primarily myofascial TMD patients with and without a chief complaint of headache.

Measurement reliability of current perception threshold and pain threshold in parallel with blood sampling

The irritation and pain associated with oral blood sampling necessary to monitor glycemic control can alter oral sensation, but no studies have measured the reliability of oral sensation testing when performed concurrently with blood sampling. The primary and secondary aims of this study were to verify the measurement reliability of current perception threshold (CPT) and pain threshold (PT) tests performed before and after blood sampling and to investigate the differences in CPTs/PTs obtained from the oral cavity, hand, and foot, respectively. CPT/PT measurements were obtained from the oral mucosa and the tips of fingers and toes of 18 volunteers (10 males and 8 females, average age = 26.3 years) using electrical stimulation at frequencies of 5, 250, and 2,000 Hz. Participants also provided blood samples by pricking their own index fingers with a small needle. All subjects completed the following 3 conditions at once‐weekly intervals as follows: (a) sensory measurements followed by blood sampling (SB block); (b) blood sampling followed by sensory measurements (BS block); (c) sensory measurements without blood sampling (CO control block). Cronbachs α coefficients were over 0.78 for the SB, BS, and CO blocks, and are considered to be acceptable for assuring measurement reliability. The oral cavity had significantly lower CPT/PTs than both hands and feet, such that the threshold increased in the order oral cavity < hand < foot. CPT and PT measurements performed concurrently with blood sampling are both reliable and region specific, and for which the oral cavity is the most sensitive testing region.