The aims of this project are: (1) to replicate and extend the results we found using a tricyclic antidepressant combined with psychophysiological therapy in the treatment of myofascial pain dysfunction (MPD) syndrome; (2) to evaluate the potential use of a tricyclic antidepressant as a therapeutic intervention for bruxism and to attempt to understand how this medication may effectively aid in the treatment of myofascial pain disorders; (3) to evaluate tonic, resting electromyographic values and mandibular posture in patients who receive splints or who receive psychophysiological therapy in order to better understand the potential etiological components of this disorder; and (4) continue our long-term follow-ups of patients treated during our previous grant periods in order to evaluate the natural course of treatment effects for both successfully treated patients. Three major studies will be completed during he proposed gant period. In the first study, we will attempt to extend the results we found using a tricyclic antidepressant with depressed patients to nondepressed patients to improve the rapidity and effectiveness of psychophysiological therapy for MPD. The second study will attempt to evaluate the effectiveness and minimal dose necessary of a tricyclic antidepressant for the treatment of nocturnal bruxism and the potential relationship of this treatment for the noted improvement in therapy of MPD patients. The third study will evaluate tonic, resting electromyographic values and mandibular posture in MPD patients and compare these two values to an appropriately matched control group. In addition, changes associated with splint therapy and psychophysiological therapy will be evaluated. This is in order to gain a better understanding of the potential etiological factors as well as the relationship of these therapies to successful outcome. It is obvious that the information gained in studying MPD can be generalized to other myofascial problems where behavioral techniques are to be used as well as the potential etiological factors associated with these disorders.

Agency
National Institute of Health (NIH)
Institute
National Institute of Dental & Craniofacial Research (NIDCR)
Type
Research Project (R01)
Project #
2R01DE004358-13A1
Application #
3219045
Study Section
Behavioral Medicine Study Section (BEM)
Project Start
1979-05-01
Project End
1992-06-30
Budget Start
1989-07-01
Budget End
1990-06-30
Support Year
13
Fiscal Year
1989
Total Cost
Indirect Cost
Name
State University of New York at Buffalo
Department
Type
Schools of Dentistry/Oral Hygn
DUNS #
038633251
City
Buffalo
State
NY
Country
United States
Zip Code
14260
Ohrbach, R; Blascovich, J; Gale, E N et al. (1998) Psychophysiological assessment of stress in chronic pain: comparisons of stressful stimuli and of response systems. J Dent Res 77:1840-50
Pierce, C J; Chrisman, K; Bennett, M E et al. (1995) Stress, anticipatory stress, and psychologic measures related to sleep bruxism. J Orofac Pain 9:51-6
Bowley, J F; Stockstill, J W; Pierce, C J (1993) Reliability and validity of instrumentation used to record nocturnal clenching and/or grinding. J Orofac Pain 7:378-85
Rivera-Morales, W C; Mohl, N D (1991) Variability of closest speaking space compared with interocclusal distance in dentulous subjects. J Prosthet Dent 65:228-32
Rivera-Morales, W C; Mohl, N D (1991) Relationship of occlusal vertical dimension to the health of the masticatory system. J Prosthet Dent 65:547-53
Rivera-Morales, W C; Mohl, N D (1990) Anteroposterior and mediolateral variability of the closest speaking space. Int J Prosthodont 3:179-84
Burdette, B H; Gale, E N (1990) Reliability of surface electromyography of the masseteric and anterior temporal areas. Arch Oral Biol 35:747-51
Bastien, R; Gale, E N; Mohl, N D (1990) An exploratory study on increases in masseteric muscle activity induced by caffeine. J Can Dent Assoc 56:943-7
Pierce, C J; Gale, E N (1989) Methodological considerations concerning the use of Bruxcore Plates to evaluate nocturnal bruxism. J Dent Res 68:1110-4
Gale, E N; Dixon, D C (1989) A simplified psychologic questionnaire as a treatment planning aid for patients with temporomandibular joint disorders. J Prosthet Dent 61:235-8

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