Browsing by Author "Casassus, Rodrigo"
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Item Effect of lidocaine patches on upper trapezius EMG activity and pain intensity in patients with myofascial trigger points: a randomized clinical study(Norstedts Förlag, 2015) Firmani, Monica; Miralles, Rodolfo; Casassus, RodrigoOBJECTIVE: To compare the effects of 5% lidocaine patches and placebo patches on pain intensity and electromyographic (EMG) activity of an active myofascial trigger point (MTrP) of the upper trapezius muscle. MATERIALS AND METHODS: Thirty-six patients with a MTrP in the upper trapezius muscle were randomly divided into two groups: 20 patients received lidocaine patches (lidocaine group) and 16 patients received placebo patches (placebo group). They used the patches for 12 h each day, for 2 weeks. The patch was applied to the skin over the upper trapezius MTrP. Spontaneous pain, pressure pain thresholds, pain provoked by a 4-kg pressure applied to the MTrP and trapezius EMG activity were measured before and after treatment. RESULTS: Baseline spontaneous pain values were similar in both groups and significantly lower in the lidocaine group than the placebo group after treatment. The baseline pressure pain threshold was significantly lower in the lidocaine group, but after treatment it was significantly higher in this group. Baseline and final values of the pain provoked by a 4-kg pressure showed no significant difference between the groups. Baseline EMG activity at rest and during swallowing of saliva was significantly higher in the lidocaine group, but no significant difference was observed after treatment. Baseline EMG activity during maximum voluntary clenching was similar in both groups, but significantly higher in the lidocaine group after treatment. CONCLUSIONS: These clinical and EMG results support the use of 5% lidocaine patches for treating patients with MTrP of the upper trapezius muscle.Item Fenómenos fisiopatológicos sistémicos asociados al bruxismo de sueño(2014) Iturriaga, V.; Bornhardt, T.; Casassus, Rodrigo; Alveal, C.; Medina, H.; Reuque, C.El bruxismo de sueño (BS) se define como un trastorno del movimiento estereotipado que se presenta durante el sueño, caracterizado por rechinamiento y/o apretamiento dentario. Se encuentra dentro de la clasificación internacional de desórdenes de sueño como un trastorno del movimiento asociado a una exagerada actividad muscular masticatoria rítmica. Se reporta una incidencia del 15% al 22% en la población general. Antiguamente se creía que la etiología del BS estaba relacionada con alteraciones oclusales; sin embargo actualmente se piensa que la causa principal está más bien relacionada con alteraciones de sueño, enfermedades del sistema nervioso central, drogas, dolor crónico, alteraciones emocionales, entre otros factores que participarían en su origen. Se ha identificado la presencia de diversos fenómenos fisiopatológicos sistémicos que acontecen durante un episodio de BS, entre los cuales encontramos los microdespertares corticales, alteraciones en el ritmo cardíaco, el tono simpático, la presión arterial, entre otros, sobre los cuales trata esta revisión.Publication Management of chronic pain associated with temporomandibular disorders: a clinical practice guideline(2023) Busse, Jason; Casassus, Rodrigo; Carrasco, Alonso; Durham, Justin; Mock, David; Zakrzewska, Joanna; Palmer, Carolyn; Samer, Caroline; Coen, Matteo; Guevremont, Bruno; Hoppe, Thomas; Guyatt, Gordon; Crandon, Holly; Yao, Liang; Sadeghirad, Behnam; Vandvik, Per; Siemieniuk, Reed; Lytvyn, Lyuba; Hunskaar, Birk; Agoritsas, ThomasClinical question: What is the comparative effectiveness of available therapies for chronic pain associated with temporomandibular disorders (TMD)? Current practice: TMD are the second most common musculoskeletal chronic pain disorder after low back pain, affecting 6-9% of adults globally. TMD are associated with pain affecting the jaw and associated structures and may present with headaches, earache, clicking, popping, or crackling sounds in the temporomandibular joint, and impaired mandibular function. Current clinical practice guidelines are largely consensus-based and provide inconsistent recommendations. Recommendations: For patients living with chronic pain (≥3 months) associated with TMD, and compared with placebo or sham procedures, the guideline panel issued: (1) strong recommendations in favour of cognitive behavioural therapy (CBT) with or without biofeedback or relaxation therapy, therapist-assisted mobilisation, manual trigger point therapy, supervised postural exercise, supervised jaw exercise and stretching with or without manual trigger point therapy, and usual care (such as home exercises, stretching, reassurance, and education); (2) conditional recommendations in favour of manipulation, supervised jaw exercise with mobilisation, CBT with non-steroidal anti-inflammatory drugs (NSAIDS), manipulation with postural exercise, and acupuncture; (3) conditional recommendations against reversible occlusal splints (alone or in combination with other interventions), arthrocentesis (alone or in combination with other interventions), cartilage supplement with or without hyaluronic acid injection, low level laser therapy (alone or in combination with other interventions), transcutaneous electrical nerve stimulation, gabapentin, botulinum toxin injection, hyaluronic acid injection, relaxation therapy, trigger point injection, acetaminophen (with or without muscle relaxants or NSAIDS), topical capsaicin, biofeedback, corticosteroid injection (with or without NSAIDS), benzodiazepines, and β blockers; and (4) strong recommendations against irreversible oral splints, discectomy, and NSAIDS with opioids. How this guideline was created: An international guideline development panel including patients, clinicians with content expertise, and methodologists produced these recommendations in adherence with standards for trustworthy guidelines using the GRADE approach. The MAGIC Evidence Ecosystem Foundation (MAGIC) provided methodological support. The panel approached the formulation of recommendations from the perspective of patients, rather than a population or health system perspective. The evidence: Recommendations are informed by a linked systematic review and network meta-analysis summarising the current body of evidence for benefits and harms of conservative, pharmacologic, and invasive interventions for chronic pain secondary to TMD. Understanding the recommendation: These recommendations apply to patients living with chronic pain (≥3 months duration) associated with TMD as a group of conditions, and do not apply to the management of acute TMD pain. When considering management options, clinicians and patients should first consider strongly recommended interventions, then those conditionally recommended in favour, then conditionally against. In doing so, shared decision making is essential to ensure patients make choices that reflect their values and preference, availability of interventions, and what they may have already tried. Further research is warranted and may alter recommendations in the futureItem Pediatric patients' reasons for visiting dentists in all WHO regions(2021) Bekes, Katrin; John, Mike T.; Rener-Sitar, Ksenija; Al-Harthy, Mohammad H.; Michelotti, Ambra; Reissmann, Daniel R.; Nikolovska, Julijana; Sanivarapu, Sahityaveera; Lawal, Folake B.; List, Thomas; Peršić Kiršić, Sanja; Strajnić, Ljiljana; Casassus, Rodrigo; Baba, Kazuyoshi; Schimmel, Martin; Amuasi, Ama; Jayasinghe, Ruwan D.; Strujić-Porović, Sanela; Peck, Christopher C.; Xie, Han; Haugaard Bendixen, Karina; Simancas-Pallares, Miguel Angel; Perez-Franco, Eka; Naghibi Sistan, Mohammad Mehdi; Valerio, Patricia; Letunova, Natalia; Nurelhuda, Nazik; Bartlett, David W.; Oluwafemi, Ikeoluwa A.; Dghoughi, Saloua; Ferreira, Joao N A R; Chantaracherd, Pathamas; Sekulić, StellaBackground: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the four oral health-related quality of life (OHRQoL) dimensions (4D) or areas in which oral disorders impact pediatric patients. Using their dentists' assessment, the study aimed to evaluate whether pediatric dental patients' oral health concerns fit into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. Methods: Dentists who treat children from 32 countries and all WHO regions were selected from a web-based survey of 1580 international dentists. Dentists were asked if their pediatric patients with current or future oral health concerns fit into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. Proportions of all pediatric patients' oral health problems and prevention needs were computed. Findings: Data from 101 dentists treating children only and 523 dentists treating children and adults were included. For 90% of pediatric patients, their current oral health problems fit well in the four OHRQoL dimensions. For 91% of oral health problems they intended to prevent in the future were related to these dimensions as well. Both numbers increased to at least 96% when experts analyzed dentists´ explanations of why some oral health problems would not fit these four categories. Conclusions: The study revealed the four fundamental components of dental patients, i.e., the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact) are also applicable for pediatric patients, regardless of whether they have current or future oral health concerns, and should be considered when measuring OHRQoL in the pediatric dental patient population.