Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
Centre for Advanced Dental Research and Care, Department of Dentistry, Mount Sinai Hospital, Toronto, Ontario, Canada.
J Endod. 2022 Jan;48(1):55-69. doi: 10.1016/j.joen.2021.10.004. Epub 2021 Oct 25.
Masticatory myofascial pain syndrome can present similarly to other dental conditions in odontogenetic structures. Endodontists should be familiar with the symptomology and pathophysiology of masticatory myofascial pain syndrome to avoid misdiagnosis, incorrect treatment, and medicolegal repercussions. The aim of this review was to provide a foundational summary for endodontists to identify and correctly manage masticatory myofascial pain syndrome.
A narrative review of the literature was performed through a MEDLINE search and a hand search of the major myofascial pain textbooks.
Masticatory myofascial pain syndrome is a musculoligamentous syndrome that can present similarly to odontogenic pain or refer pain to the eyebrows, ears, temporomandibular joints, maxillary sinus, tongue, and hard palate. Currently, the most comprehensive pathophysiology theory describing masticatory myofascial pain syndrome is the expanded integrated hypothesis. The most widely accepted diagnostic guidelines for masticatory myofascial pain syndrome are the Diagnostic Criteria for Temporomandibular Disorders; however, their diagnostic capability is limited. There is no hierarchy of treatment methods because each patient requires a tailored and multidisciplinary management aimed at regaining the muscle's range of motion, deactivating the myofascial trigger points, and maintaining pain relief.
The pain patterns for masticatory myofascial pain syndrome are well-known; however, there is a lack of consensus on the most proper method of trigger point diagnosis or pain quantification. The diagnostic strategies for masticatory myofascial pain syndrome vary, and the diagnostic aids are not well developed.
咀嚼肌筋膜疼痛综合征在牙源性结构中可能表现类似其他牙齿疾病。牙髓病医生应熟悉咀嚼肌筋膜疼痛综合征的症状和病理生理学，以避免误诊、治疗不当和医疗法律后果。本综述的目的是为牙髓病医生提供一个基础总结，以识别和正确管理咀嚼肌筋膜疼痛综合征。
通过 MEDLINE 搜索和主要肌筋膜疼痛教科书的手工搜索进行文献综述。
咀嚼肌筋膜疼痛综合征是一种肌肉韧带综合征，可能表现类似牙源性疼痛或向眉毛、耳朵、颞下颌关节、上颌窦、舌头和硬腭放射疼痛。目前，描述咀嚼肌筋膜疼痛综合征最全面的病理生理学理论是扩展综合假说。最广泛接受的咀嚼肌筋膜疼痛综合征诊断标准是颞下颌关节紊乱诊断标准；然而，其诊断能力有限。没有治疗方法的等级制度，因为每个患者都需要量身定制和多学科管理，旨在恢复肌肉的运动范围，使肌筋膜触发点失活，并保持疼痛缓解。
咀嚼肌筋膜疼痛综合征的疼痛模式是众所周知的；然而，对于触发点诊断或疼痛量化最恰当的方法缺乏共识。咀嚼肌筋膜疼痛综合征的诊断策略各不相同，诊断辅助手段也不完善。
