INTRODUCTION/BACKGROUND Persistent idiopathic craniofacial pain (PIFP) is a heterogeneous group of pain syndromes whose main characteristic is the daily presence of persistent pain for at least 3 months. The pathophysiology of PIFP is still not entirely known and probably related to biological and psychological factors. Although PIFP has been attributed to the central neuron activity, the importance of masticatory muscles as a possible pathogenic mechanism was recently demonstrated. The main purpose of our paper was to identify the physiological rest position of the mandible with minimal tonus of both the elevator and depressor muscles and the neuromuscular trajectory of mouth closing obtained by transcutaneous electrical stimulation (TENS) and maintained with the use of an occlusal device, known as orthotic. MATERIALS AND METHODS The VAS scale for facial pain and the migraine disability assessment score (MIDAS) index for patient quality of life were evaluated at the beginning of the study for the 38 subjects that came to our attention. Our research included two phases. The first phase consisted of kinesiographic and electromyographic (EMG) examinations of the masticatory muscles and a 45-min application of TENS in order to deprogram the muscular activity. Kinesio-electromyographic examinations were repeated in the second phase. The main evaluated parameter was jaw deflection or deviation on the sagittal and frontal planes before and after TENS during patient tooth occlusion. Patients that showed a significant modification of this parameter were treated with orthotics for 12 months. RESULTS The results of a 12-month follow-up show a sharp reduction of the VAS (pre-orthotic 9.05, range 8-10, SD 0.8; post-orthotic 5.87, range 1-5, SD 0.7) and an improvement in the quality of life (MIDAS). CONCLUSIONS Our study demonstrated the usefulness of TENS as a screening method for the application of orthotics. This non-invasive and/or non-painful procedure could be a useful complementary treatment in this patient population. The results of the study also confirm the role of masticatory muscle dynamics as a possible pathogenic mechanism in patients with PIFP.

中文翻译：

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颌骨检查技术在治疗持续性特发性面部疼痛（PIFP）中的预测作用。

引言/背景持续性特发性颅面部疼痛（PIFP）是一组不同种类的疼痛综合征，其主要特征是每天持续存在持续性疼痛至少3个月。PIFP的病理生理学仍不完全清楚，可能与生物学和心理因素有关。尽管PIFP已被归因于中枢神经元活动，但最近已证明咀嚼肌作为一种可能的致病机制的重要性。本文的主要目的是通过经皮电刺激（TENS）获得并通过使用咬合装置保持闭合状态的下颌骨的生理静止位置，以使升降肌和降压肌的肌张力最小，并闭口的神经肌肉轨迹，称为矫形器。材料和方法在研究开始时，我们针对38位引起我们注意的受试者，评估了面部疼痛的VAS量表和患者生活质量的偏头痛残疾评估评分（MIDAS）指数。我们的研究包括两个阶段。第一阶段包括咀嚼肌的肌电图和肌电图（EMG）检查以及TENS的45分钟应用，以使肌肉活动失调。在第二阶段重复进行运动肌电图检查。评估的主要参数是在患者牙合期间，TENS前后，在矢状面和额面上的颌骨偏斜或偏离。表现出明显改变该参数的患者接受矫形器治疗12个月。结果为期12个月的随访结果显示，VAS显着降低（矫形前9.05，范围8-10，SD 0.8；矫形后5.87，范围1-5，SD 0.7），并且VAS有所改善。生活质量（MIDAS）。结论我们的研究证明了TENS作为矫形器应用筛查方法的有用性。这种无创和/或非痛苦的过程可能是该患者人群中有用的补充治疗。该研究结果还证实咀嚼肌动力学作为PIFP患者可能的致病机制的作用。这种无创和/或非痛苦的过程可能是该患者人群中有用的补充治疗。该研究结果还证实咀嚼肌动力学作为PIFP患者可能的致病机制的作用。这种无创和/或非痛苦的过程可能是该患者人群中有用的补充治疗。该研究结果还证实咀嚼肌动力学作为PIFP患者可能的致病机制的作用。