Trismus: Spasmodic contraction of the masseter muscle resulting in forceful jaw closure. This may be seen with a variety of diseases, including TETANUS, as a complication of radiation therapy, trauma, or in association with neoplastic conditions.Molar, Third: The aftermost permanent tooth on each side in the maxilla and mandible.Tooth Extraction: The surgical removal of a tooth. (Dorland, 28th ed)Tooth, Impacted: A tooth that is prevented from erupting by a physical barrier, usually other teeth. Impaction may also result from orientation of the tooth in an other than vertical position in the periodontal structures.Peritonsillar Abscess: An accumulation of purulent material in the area between the PALATINE TONSIL and its capsule.Myofunctional Therapy: Training or retraining of the buccal, facial, labial, and lingual musculature in toothless conditions; DEGLUTITION DISORDERS; TEMPOROMANDIBULAR JOINT DISORDERS; MALOCCLUSION; and ARTICULATION DISORDERS.Dry Socket: A condition sometimes occurring after tooth extraction, particularly after traumatic extraction, resulting in a dry appearance of the exposed bone in the socket, due to disintegration or loss of the blood clot. It is basically a focal osteomyelitis without suppuration and is accompanied by severe pain (alveolalgia) and foul odor. (Dorland, 28th ed)Piroxicam: A cyclooxygenase inhibiting, non-steroidal anti-inflammatory agent (NSAID) that is well established in treating rheumatoid arthritis and osteoarthritis and used for musculoskeletal disorders, dysmenorrhea, and postoperative pain. Its long half-life enables it to be administered once daily.AxisCervical Atlas: The first cervical vertebra.Mandible: The largest and strongest bone of the FACE constituting the lower jaw. It supports the lower teeth.Tetanus: A disease caused by tetanospasmin, a powerful protein toxin produced by CLOSTRIDIUM TETANI. Tetanus usually occurs after an acute injury, such as a puncture wound or laceration. Generalized tetanus, the most common form, is characterized by tetanic muscular contractions and hyperreflexia. Localized tetanus presents itself as a mild condition with manifestations restricted to muscles near the wound. It may progress to the generalized form.Encyclopedias as Topic: Works containing information articles on subjects in every field of knowledge, usually arranged in alphabetical order, or a similar work limited to a special field or subject. (From The ALA Glossary of Library and Information Science, 1983)Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve SKELETAL MUSCLE or SMOOTH MUSCLE.Mastication: The act and process of chewing and grinding food in the mouth.Trigeminal Nerve: The 5th and largest cranial nerve. The trigeminal nerve is a mixed motor and sensory nerve. The larger sensory part forms the ophthalmic, mandibular, and maxillary nerves which carry afferents sensitive to external or internal stimuli from the skin, muscles, and joints of the face and mouth and from the teeth. Most of these fibers originate from cells of the TRIGEMINAL GANGLION and project to the TRIGEMINAL NUCLEUS of the brain stem. The smaller motor part arises from the brain stem trigeminal motor nucleus and innervates the muscles of mastication.Electronic Mail: Messages between computer users via COMPUTER COMMUNICATION NETWORKS. This feature duplicates most of the features of paper mail, such as forwarding, multiple copies, and attachments of images and other file types, but with a speed advantage. The term also refers to an individual message sent in this way.Food Dispensers, Automatic: Mechanical food dispensing machines.Editorial Policies: The guidelines and policy statements set forth by the editor(s) or editorial board of a publication.Authorship: The profession of writing. Also the identity of the writer as the creator of a literary production.Periodicals as Topic: A publication issued at stated, more or less regular, intervals.Postal Service: The functions and activities carried out by the U.S. Postal Service, foreign postal services, and private postal services such as Federal Express.Internet: A loose confederation of computer communication networks around the world. The networks that make up the Internet are connected through several backbone networks. The Internet grew out of the US Government ARPAnet project and was designed to facilitate information exchange.Masseter Muscle: A masticatory muscle whose action is closing the jaws.Ankylosis: Fixation and immobility of a joint.Apgar Score: A method, developed by Dr. Virginia Apgar, to evaluate a newborn's adjustment to extrauterine life. Five items - heart rate, respiratory effort, muscle tone, reflex irritability, and color - are evaluated 60 seconds after birth and again five minutes later on a scale from 0-2, 0 being the lowest, 2 being normal. The five numbers are added for the Apgar score. A score of 0-3 represents severe distress, 4-7 indicates moderate distress, and a score of 7-10 predicts an absence of difficulty in adjusting to extrauterine life.Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Delivery, Obstetric: Delivery of the FETUS and PLACENTA under the care of an obstetrician or a health worker. Obstetric deliveries may involve physical, psychological, medical, or surgical interventions.Head and Neck Neoplasms: Soft tissue tumors or cancer arising from the mucosal surfaces of the LIP; oral cavity; PHARYNX; LARYNX; and cervical esophagus. Other sites included are the NOSE and PARANASAL SINUSES; SALIVARY GLANDS; THYROID GLAND and PARATHYROID GLANDS; and MELANOMA and non-melanoma skin cancers of the head and neck. (from Holland et al., Cancer Medicine, 4th ed, p1651)Burning Mouth Syndrome: A group of painful oral symptoms associated with a burning or similar sensation. There is usually a significant organic component with a degree of functional overlay; it is not limited to the psychophysiologic group of disorders.Calcaneus: The largest of the TARSAL BONES which is situated at the lower and back part of the FOOT, forming the HEEL.Pruritus Vulvae: Intense itching of the external female genitals.Heel: The back (or posterior) of the FOOT in PRIMATES, found behind the ANKLE and distal to the TOES.Diagnostic Errors: Incorrect diagnoses after clinical examination or technical diagnostic procedures.Sensation: The process in which specialized SENSORY RECEPTOR CELLS transduce peripheral stimuli (physical or chemical) into NERVE IMPULSES which are then transmitted to the various sensory centers in the CENTRAL NERVOUS SYSTEM.Zygoma: Either of a pair of bones that form the prominent part of the CHEEK and contribute to the ORBIT on each side of the SKULL.Mandibular Nerve: A branch of the trigeminal (5th cranial) nerve. The mandibular nerve carries motor fibers to the muscles of mastication and sensory fibers to the teeth and gingivae, the face in the region of the mandible, and parts of the dura.Jaw: Bony structure of the mouth that holds the teeth. It consists of the MANDIBLE and the MAXILLA.Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982).Oral Surgical Procedures: Surgical procedures used to treat disease, injuries, and defects of the oral and maxillofacial region.Dental Care for Chronically Ill: Dental care for patients with chronic diseases. These diseases include chronic cardiovascular, endocrinologic, hematologic, immunologic, neoplastic, and renal diseases. The concept does not include dental care for the mentally or physically disabled which is DENTAL CARE FOR DISABLED.Islam: A monotheistic religion promulgated by the Prophet Mohammed with Allah as the deity.Interdisciplinary Studies: Programs of study which span the traditional boundaries of academic scholarship.Musculoskeletal Diseases: Diseases of the muscles and their associated ligaments and other connective tissue and of the bones and cartilage viewed collectively.Syndrome: A characteristic symptom complex.Muscle Contraction: A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments.Molecular Sequence Data: Descriptions of specific amino acid, carbohydrate, or nucleotide sequences which have appeared in the published literature and/or are deposited in and maintained by databanks such as GENBANK, European Molecular Biology Laboratory (EMBL), National Biomedical Research Foundation (NBRF), or other sequence repositories.Laser Therapy, Low-Level: Treatment using irradiation with LASER light of low power intensity so that the effects are not due to heat, as they are in LASER THERAPY.Lasers, Semiconductor: Lasers with a semiconductor diode as the active medium. Diode lasers transform electric energy to light using the same principle as a light-emitting diode (LED), but with internal reflection capability, thus forming a resonator where a stimulated light can reflect back and forth, allowing only a certain wavelength to be emitted. The emission of a given device is determined by the active compound used (e.g., gallium arsenide crystals doped with aluminum or indium). Typical wavelengths are 810, 1,060 and 1,300 nm. (From UMDNS, 2005)Laser Therapy: The use of photothermal effects of LASERS to coagulate, incise, vaporize, resect, dissect, or resurface tissue.Temporomandibular Joint: An articulation between the condyle of the mandible and the articular tubercle of the temporal bone.Lasers: An optical source that emits photons in a coherent beam. Light Amplification by Stimulated Emission of Radiation (LASER) is brought about using devices that transform light of varying frequencies into a single intense, nearly nondivergent beam of monochromatic radiation. Lasers operate in the infrared, visible, ultraviolet, or X-ray regions of the spectrum.Pain Measurement: Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies.

Anesthetic efficacy of a combination of hyaluronidase and lidocaine with epinephrine in inferior alveolar nerve blocks. (1/53)

The purpose of this prospective, randomized, double-blind study was to determine the anesthetic efficacy of a buffered lidocaine with epinephrine solution compared to a combination buffered lidocaine with epinephrine plus hyaluronidase solution in inferior alveolar nerve blocks. Thirty subjects randomly received an inferior alveolar nerve block using 1 of the 2 solutions at 2 separate appointments using a repeated-measures design. Mandibular anterior and posterior teeth were blindly pulp tested at 4-minute cycles for 60 minutes postinjection. No response from the subject to the maximum output (80 reading) of the pulp tester was used as the criterion for pulpal anesthesia. Anesthesia was considered successful when 2 consecutive readings of 80 were obtained. A postoperative survey was used to measure pain and trismus. The results demonstrated 100% of the subjects had profound lip numbness with both solutions for inferior alveolar nerve blocks. The anesthetic success rates for individual teeth ranged from 20 to 80%. There were no significant differences (P > .05) between the 2 solutions. However, the combination lidocaine/hyaluronidase solution resulted in a significant increase in postoperative pain and trismus. It was concluded that adding hyaluronidase to a buffered lidocaine solution with epinephrine did not statistically increase the incidence of pulpal anesthesia in inferior alveolar nerve blocks and, because of its potential tissue damaging effect, it should not be added to local anesthetic solutions for inferior alveolar nerve blocks.  (+info)

Reduction of jaw opening (trismus) in giant cell arteritis. (2/53)

OBJECTIVE: To study the prevalence and the clinical characterisation of jaw problems in patients with giant cell arteritis (GCA). METHODS: the prevalence of such symptoms in patients with GCA was evaluated by performing a retrospective analysis of all patients with GCA and polymyalgia rheumatica who were diagnosed during admission to Hadassah University Hospital. Ten patients reported previously in the literature were also evaluated. RESULTS: Six patients out of 88 (6.8%) had complaints of reduction in jaw opening. These six patients seemed to have a much more abrupt onset of disease with shorter duration until diagnosis, higher prevalence of eye involvement (50% v 27%), and a higher rate of positive pathology (100%). CONCLUSIONS: Reduction in jaw opening in the appropriate setting may indicate the presence of GCA. This sign should not be overlooked in the presence of the claudication sign as it seems to reflect more severe GCA disease.  (+info)

Prevention and treatment of the consequences of head and neck radiotherapy. (3/53)

The location of the primary tumor or lymph node metastases dictates the inclusion of the oral cavity, salivary glands, and jaws in the radiation treatment portals for patients who have head and neck cancer. The clinical sequelae of the radiation treatment include mucositis, hyposalivation, loss of taste, osteoradionecrosis, radiation caries, and trismus. These sequelae may be dose-limiting and have a tremendous effect on the patient's quality of life. Most treatment protocols to prevent these sequelae are still based on clinical experience, but alternatives based on fundamental basic and clinical research are becoming more and more available. Many of these alternatives either need further study before they can be incorporated into the protocols commonly used to prevent and treat the radiation-related oral sequelae or await implementation of these protocols. In this review, the various possibilities for prevention and/or treatment of radiation-induced changes in healthy oral tissues and their consequences are discussed.  (+info)

Osteoma of the condyle as the cause of limited-mouth opening: a case report. (4/53)

Osteoma is a benign tumour consisting of mature bone tissue. It is an uncommon lesion that occurs mainly in the bones of the craniofacial complex. Only a few cases involving the condylar process have been reported. An osteoma of the left condyle causing limited mouth-opening in a 32-year-old Malaysian Chinese female is reported here to alert the practitioner to consider this lesion as a diagnostic possibility in instances of trismus or limited-mouth opening.  (+info)

Mutation of perinatal myosin heavy chain associated with a Carney complex variant. (5/53)

BACKGROUND: Familial cardiac myxomas occur in the hereditary syndrome Carney complex. Although PRKAR1A mutations can cause the Carney complex, the disorder is genetically heterogeneous. To identify the cause of a Carney complex variant associated with distal arthrogryposis (the trismus-pseudocamptodactyly syndrome), we performed clinical and genetic studies. METHODS: A large family with familial cardiac myxomas and the trismus-pseudocamptodactyly syndrome (Family 1) was identified and clinically evaluated along with two families with trismus and pseudocamptodactyly. Genetic linkage analyses were performed with the use of microsatellite polymorphisms to determine a locus for this Carney complex variant. Positional cloning and mutational analyses of candidate genes were performed to identify the genetic cause of disease in the family with the Carney complex as well as in the families with the trismus-pseudocamptodactyly syndrome. RESULTS: Clinical evaluations demonstrated that the Carney complex cosegregated with the trismus-pseudocamptodactyly syndrome in Family 1, and genetic analyses demonstrated linkage of the disease to chromosome 17p12-p13.1 (maximum multipoint lod score, 4.39). Sequence analysis revealed a missense mutation (Arg674Gln) in the perinatal myosin heavy-chain gene (MYH8). The same mutation was also found in the two families with the trismus-pseudocamptodactyly syndrome. Arg674 is highly conserved evolutionarily, localizes to the actin-binding domain of the perinatal myosin head, and is close to the ATP-binding site. We identified nonsynonymous MYH8 polymorphisms in patients with cardiac myxoma syndromes but without arthrogryposis. CONCLUSIONS: We describe a novel heart-hand syndrome involving familial cardiac myxomas and distal arthrogryposis and demonstrate that these disorders are caused by a founder mutation in the MYH8 gene. Our findings demonstrate novel roles for perinatal myosin in both the development of skeletal muscle and cardiac tumorigenesis.  (+info)

Tiagabine may reduce bruxism and associated temporomandibular joint pain. (6/53)

Tiagabine is an anticonvulsant gamma-aminobutyric acid reuptake inhibitor commonly used as an add-on treatment of refractory partial seizures in persons over 12 years old. Four of the 5 cases reported here indicate that tiagabine might also be remarkably effective in suppressing nocturnal bruxism, trismus, and consequent morning pain in the teeth, masticatory musculature, jaw, and temporomandibular joint areas. Tiagabine has a benign adverse-effect profile, is easily tolerated, and retains effectiveness over time. Bed partners of these patients report that grinding noises have stopped; therefore, the tiagabine effect is probably not simply antinociceptive. The doses used to suppress nocturnal bruxism at bedtime (4-8 mg) are lower than those used to treat seizures.  (+info)

Effects of co-administered dexamethasone and diclofenac potassium on pain, swelling and trismus following third molar surgery. (7/53)

BACKGROUND: The apparent interactions between the mechanisms of action of non-steroidal anti-inflammatory drugs (NSAIDS) and steroids suggest that co-therapy may provide beneficial inflammatory and pain relief in the absence of side effects. The aim of the study was to compare the effect of co-administered dexamethasone and diclofenac potassium (diclofenac K) with diclofenac K alone on the postoperative pain, swelling and trismus after surgical removal of third molars. PATIENTS AND METHODS: A prospective randomized double-blind study was conducted at the Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Nigeria. A total of 100 patients were randomly allocated to two treatment groups of dexamethasone (prophylactic 8 mg and postoperative 4 mg IV) and diclofenac K (50 mg Oral before and after surgery), and diclofenac K alone (as with first group). The overall analgesic efficacy of the drug combinations was assessed postoperatively by determination of pain intensity using a category rating scale. Facial swelling was measured using a tape measure placed from tragus to gonion to tragus, while interincisal mouth-opening of patients was measured using a vernier calibrated caliper pre-operatively and post-operatively. RESULTS: Co-administration of dexamethasone and diclofenac K was significantly superior to diclofenac alone for the relief of pain (P < 0.05), and facial swelling up to post-operative 48 hour (P < 0.05). However, there was no significant difference for trismus relief between the two medication protocols (P > 0.05). CONCLUSION: This study illustrates enhanced effects of co-administered dexamethasone and diclofenac K on short-term post-operative pain and swelling, compared to diclofenac potassium alone in third molar surgery.  (+info)

Influence of smoking upon the postoperative course of lower third molar surgery. (8/53)

OBJECTIVES: To determine whether smoking influences the postoperative course (pain and trismus) of lower third molar surgery, with a clinical evaluation of surgical wound condition and analysis of the possible differences between smokers and nonsmokers. DESIGN: The study subjects were randomly distributed into two groups (smokers and nonsmokers) and subjected to lower third molar extraction in the Unit of Oral and Maxillofacial Surgery (Madrid Complutense University, Spain). The study variables were trismus after 7 days, the intensity of pain and the need for rescue medication during a period of one week. The surgical wound was also assessed (color, presence of plaque, etc). RESULTS: Two cases of postoperative infection were documented among the smokers, and postoperative trismus was found to be greater among the latter (p=0.05). CONCLUSIONS: There were no statistically significant differences between the two groups in terms of pain, though trismus was greater among the smokers. Smoking did not influence wound condition (color, marginal inflammation, appositioning of the margins, ulceration, etc).  (+info)

  • In the present study, an analysis of the factors associated with the occurrence and development of trismus is also included, as well as appropriate management strategies in order to provide an effective treatment method for affected patients and for the prevention of trismus in the future. (
  • Barbing of needles at the time of injection followed by tissue damage on withdrawal of the barbed needle causes post-injection persistent paresthesia, trismus and paresis. (
  • This review aimed at reviewing the etiopathogenesis of trismus in patients with head and neck cancer. (
  • One recent study , "Impact of Exercise with TheraBite device on trismus and health-related quality of life: A prospective study" (1.25.17), looks at the significant positive impact the TheraBite Jaw Motion Rehabilitation System had on patients experiencing trismus. (
  • Seventeen patients (77.3%) experienced different degrees of trismus during the two-year follow-up period. (
  • At the optimum cut-off points of 0.38 for the propensity score, the sensitivity was 100% and the specificity was 93% for predicting the prognosis of the trismus patients. (
  • Trismus is defined as difficulty in opening the mouth due to a muscle spasm resulting from a disturbance in the trigeminal nerve, however it can also refer to limited mouth opening of any cause. (
  • a grinding, rasping or gnashing" Traditionally causes of trismus are divided into intra-articular (factors within the temporomandibular joint [TMJ]) and extra-articular (factors outside the joint, see table). (
  • Trismus refers to a person's inability to normally open his or her mouth. (
  • This review highlights the possible involvement of infratemporal fossa as a predetermining factor for developing trismus related to tumor extension. (
  • Prevention: primary immunization (DPT) Dental trismus is characterized by a difficulty in opening the jaw. (
  • Dental trismus results from some sort of insult to the muscles of mastication, such as opening the jaw for a period of time or having a needle pass through a muscle. (
  • Radiation-induced trismus is also a relatively common oral complication. (
  • Acute closed locked conditions - displaced meniscus Rarely, trismus is a symptom of nasopharyngeal or infratemporal tumors/ fibrosis of temporalis tendon, when patient has limited mouth opening, always premalignant conditions like oral submucous fibrosis (OSMF) should also be considered in differential diagnosis. (
  • It is used primarily to prevent and treat trismus and scarring or fibrosis from radiation therapy, surgery, and trauma. (
  • Bounded anteriorly by the last erupted molar, posteriorly by the ramus of the mandible, superiorly by the maxillary tuberosity, and inferiorly by the retromolar trigone, the retromolar space has been used for flexible fiberoptic oral intubation in patients with severe trismus in whom the reduced interincisor distance does not allow for placement of a rigid laryngoscope or a tracheal tube between the teeth . (
  • Reduced mobility of the mandible known as trismus is a phenomenon frequently seen in head and neck (H&N) cancer patients and patients with temporomandibular disorders [1- (
  • Temporary trismus occurs much more frequently than permanent trismus. (
  • Most commonly trismus is temporary, and typically resolves in less than 2 weeks, but permanent trismus may also occur. (
  • In some instances, trismus presents with altered facial appearance. (
  • The objective of the present study is to evaluate the efficacy of photobiomodulation with light emitting diode (LED) in the control of pain, facial edema, trismus, and quality of life resulting from the extraction of retained lower third molars. (
  • What is the cause of trismus in people with facial palsy? (
  • This symptom is also called trismus and results in a facial expression called risus sardonicus , which is a Latin phrase meaning "sardonic smile. (
  • Dexamethasone resulted in significantly less trismus than controls on day 2 postoperatively, but there was no significant difference among the groups at 7thday. (
  • We describe a patient with a locked-in syndrome due to a vascular malformation of the basilar artery-megadolichobasilar artery (fusiform aneurysm, vertebrobasilar dolichoectasia) with bilateral masticatory spasms and persistent trismus. (
  • Trismus is often followed by stiffness of the neck and other muscles throughout the body as well as uncontrollable spasms. (
  • Although unilateral restriction may occur, by definition, trismus is a bilateral process that results from increased tone mediated by the efferent portion of the reflex arch of the trigeminal nerve. (
  • Unilateral trismus caused by vertebrobasilar dolichoectasia with truncal irritation of the motor root of the trigeminal nerve is a rare disease that has been described only once . (
  • In contrast to an irritation of the trigeminal nerve in this patient, we presume that rather an irritation of the trigeminal nuclear area was the cause of trismus in our patient, because MRI could not demonstrate a contact of the magadolichobasilaris to both trigeminal roots. (
  • Edema and trismus presented lower values during the administration of the two treatments. (
  • Dental trismus results from some sort of insult to the muscles of mastication, such as opening the jaw for a period of time or having a needle pass through a muscle. (
  • This article discusses an interesting case report of circumscribed myositis ossificans of the masseter muscle causing trismus with a review of literature on the subject. (
  • Strong dose-volume correlations support the hypothesis that limiting dose to the ipsilateral masseter muscle and, in particular, the medial pterygoid muscle may reduce the likelihood of trismus. (
  • Trismus, from the Greek "trismus" ("gnashing," as in teeth) refers to restriction of the range of motion of the jaws. (