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The most common form of headache is tension headache. Painful indurations are found in the masticatory muscles of such patients, in the thickness of which there are areas of hypersensitivity – muscle-fascial trigger points. When examining adult patients with occlusion pathology at an orthodontist’s consultation appointment, complaints of headaches were revealed. These headaches are very common and make up the most numerous outpatient visits of patients with headache complaints. The purpose. To study the manifestations of headache in patients with occlusion disorders. Material and methods. The study covered 171 adult patients with occlusion anomalies and deformities of the dentition aged 18 to 63 years. All the patients were asked to answer the questionnaire. The data obtained were processed by standard parametric methods using the Student’s paired criterion. The Microsoft Excel application software package was used to calculate the correlation coefficient. Results. The study showed regular dependence of headache localization on the type of occlusion pathology. Headache in the region of the longitudinal suture very little depends on the type of occlusion pathology. The connection between pain in the frontal region and the pathology of occlusion is also weak. Pain in the temporal, occipital and parietal regions of the head shows a fairly high correlation with the corresponding pathologies of occlusion. Conclusions. It was found that the manifestation of headache in patients with occlusion pathology has a linear statistically significant correlation in the temporal and parietal lobes of the head. Pain in the occipital lobe has a rather high correlation with the types of occlusion pathology. Manifestations of headache in patients with occlusion pathology are poorly expressed in the frontal lobe of the head and very poorly expressed in the area of the longitudinal suture.
Relevance. Common physiological human suffering is headache. The prevalence of headache ranks third after back pain and joint pain in the structure of muscle-fascial pain syndromes. However, headaches and facial pains associated with muscle-fascial trigger points are much more common than headaches and facial pains caused by other causes. An extremely irritated area of skeletal muscle associated with an oversensitive palpable node located in a compacted bundle is the muscle–fascial trigger points. In the pathogenesis of headaches, a major role belongs to dysfunction or disease of the temporomandibular joint, age-related changes in the masticatory muscles, jaws and teeth and all elements of the TMJ occuring during a person’s life. In some cases, minor changes in the occlusion of teeth and jaws, as well as a stressful situation, lead to a painful spasm of the masticatory muscles. Goal. To analyze the clinical characteristics of tension headache in patients with occlusive disorders (OD) and physiological occlusion (PO). Material and methods. The study covered 210 patients with occlusion disorders and 92 patients with the signs of physiological occlusion. 141 patients from the first group and 32 patients from the second group complained of a headache. Occlusal relationships of teeth were analyzed in the position of central and dynamic occlusion. The destruction of the hard tissues of the teeth and partial adentia, as well as anomalies and deformities of the dentition were determined as the disorder of occlusion. The study of the muscles of the maxillofacial region and neck was carried out using the techniques described in the book by Travell J.G., Simons D.G. (2005). A visual-analogue pain assessment scale and a Russified McGill’s questionnaire on the nature of pain were used to identify the nature of the pain syndrome, the severity of pain. The assessment was carried out at a consultative appointment, the localization, nature, duration and intensity of pain, as well as the specificities of the pain syndrome being taken into account. When examining muscles, to quantify the data obtained the muscle syndrome index (IMS) was evaluated. The analysis of the research results was carried out using nonparametric criteria. Results. According to the severity of the pain syndrome, the use of a visual analogue scale (VAS) of pain allowed us to divide all patients into 3 groups: with mild pain, with moderate and with severe pain. According to the international classification of headaches, episodic and chronic headaches were distinguished. In patients with OD, the headache becomes chronic more often and is felt more intense than in patients with PO. Among the patients complaining of a headache, in patients with OD the IMS is higher than the IMS of the muscles of the masticatory complex, and in patients with PO the IMS is higher than the IMS of the neck muscles. Conclusions. Female patients with OD and PO suffer from tension headache more often than male patients. In patients with OD, musculo-fascial headaches are twice as common, have a more pronounced character and become chronic more often than in patients with PO. The severity of the IMS of the masticatory muscles in patients with OD is 2.5 times higher than in patients with PO.
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