Hands OnPain relief
Section snippets
Background
Pharmacotherapy is used for temporomandibular disorders (TMDs) as a monotherapy or combined with physiotherapy, behavioral therapy, appliances, or surgery. The agents used most often are analgesics (non-steroidal anti-inflammatory drugs [NSAIDs] or opioids), myorelaxants, corticosteroids, antianxiety drugs, anticonvulsants, and tricyclic antidepressants. The efficacy and safety of these agents for TMD are not all well-established. The purposes and characteristics of the primary analgesics and
Analgesics
The analgesics used for pain relief include primary and secondary agents. Among the primary analgesics are non-narcotics such as salicylates, para-aminophenol derivatives, NSAIDs, and narcotics.
Non-narcotic agents produce analgesia by inhibiting cyclooxygenase enzyme (COX) and inhibiting the synthesis of proinflammatory prostaglandin. NSAIDs are associated with most of the complications with these agents, such as gastrointestinal disorders, although parenteral application can avoid many adverse
Myorelaxants
Myorelaxants partially suppress the tonic flow of nerve impulses transmitted to the voluntary muscles, resulting in centrally controlled muscle relaxation. Drugs that lower skeletal muscle tone reduce and prevent the increased masticatory muscle activity related to TMDs. NSAIDs plus myorelaxants can be significantly more effective than placebo. Cyclobenzaprine was more effective than placebo against myofascial pain in a single study, although the number of patients involved was too limited to
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Kucuk BB, Kaya ST, Motro PK, et al: Pharmacotherapeutic agents used in temporomandibular disorders. Oral Dis 20:740-743, 2014
Reprints available from BB Kucuk, Faculty of Dentistry, Dept of Prosthodontics, Yeditepe Univ, Bagdat Caddesi 238 Göztepe-Istanbul-Turkey; fax: 0090 216 3636211; e-mail: [email protected]