Myofascial Pain Dysfunction Syndrome – an Etiopathologic Study

CONTEXT: Next to dental caries, Myofascial Pain Dysfunction Syndrome (MPDS) is probably the most common cause of chronic facial pain that a dentist treats. However, the combination of multicausality, unknown factors and lack of scientific clinical judgment has produced confusion and controversy. AIMS: The purpose of this study was to evaluate the rate of incidence, predisposing / etiological factors, clinical features and response to various treatment modalities in patients of MPDS. MATERIAL AND METHODS: The present study was conducted amongst 115 patients, selected on clinical basis, having MPDS with or without TMJ involvement (joint sounds and hypermobility). After completing all the procedures of diagnosis, all patients were given treatment in four different phases starting from conservative treatment to ultrasound therapy and follow-up was done weekly for 12 weeks. RESULTS: The common predisposing / etiological factors found were various occlusal disharmonies, psychophysiologic diseases, recent stressful life events, adverse chewing habits. Almost all patients had tenderness in one or more muscles of mastication, the most commonly tender being lateral ptetygoid muscle, followed by masseter, medial pterygoid and temporalis muscles. The MPDS of longer duration, which was usually complicated by TMJ involvement, required more extensive treatment procedures. CONCLUSION: MPDS, although originating as a functional problem, ultimately can lead to organic disease of TMJ or muscles, necessitating its early detection and intervention.