The existence of a pathophysiological link between tonic muscle activity and chronic muscle pain is still being debated. The purpose of this retrospective, controlled study was to evaluate the electromyographic (EMG) activity of masticatory muscles in subjects with different orofacial pain conditions. The temporal and masseter EMG activity at rest and the masseteric reflex were recorded in two groups of patients with either myofascial pain (n=33) or neuropathic pain (n=20), one group of non-pain patients with disc derangement disorders (n=27) and one control group of healthy, asymptomatic subjects (n=32). The EMG activities of both muscles at rest were significantly higher in the pain patient groups compared to the asymptomatic control group. There was no significant difference between the disc derangement disorder group and the control group. The masseteric reflex amplitude was reduced in all patient groups when compared with the control group. In pain patient groups, the increased EMG activity at rest and the reduction of the masseteric reflex amplitude were equally distributed in the pain and non-pain sides. In addition, subjects presenting with bilateral pain showed higher EMG activity at rest than those with unilateral pain. These results suggested that the modulation of muscle activity was not the direct consequence of a peripheral nociceptive mechanism and seemed to indicate that a central mechanism was at work. The contrast between the increased EMG activity at rest and the reduction of the masseteric reflex amplitude may reflect modulations of motoneurones that differed in tonic versus phasic conditions in chronic pain patients.

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Introduction The aim of the study was to assess the frequency, features and management of dental emergencies at sea in France. Methods A descriptive study was carried out by retrospectively examining medical records of patients who were assisted by the French maritime TeleMedical Assistance Service (TMAS) from 2012 to 2016. Data were ranked in different categories: socio-demographic data, diagnosis, prescription, and monitoring or treatment prescribed. Results The TMAS recorded 9122 medical files for all medical emergencies. Among these medical records 135 concerned oral diseases. The main causes for dental emergencies are dental abscess (51.8%), tooth decay (33.3%), and dental fracture (8.9%). Even where teledentistry is validated for remote screening and oral lesion diagnosis, management of dental emergencies mostly requires a dental procedure. On board, without special equipment and/or specifically trained healthcare workers, this management often results in the prescription of medication. Discussion The International Medical Guide for Ships published by the World Health Organization could be updated to suit the latest recommendations of dental emergency management. This could facilitate the addition of a medical act to dental management, resulting in more effective treatment. Furthermore, simple and specific equipment could be added to the medical supplies.

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