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Background: The evaluation of possible differences in the distribution or characteristics of palpation-induced
pain in the masticatory muscles could be valuable in terms of diagnostic assessment. The aim of this study was to
evaluate the impact of different combinations of anterior temporalis (AT) and masseter palpation-induced pain in
the diagnostic of temporomandibular disorder (TMD), primary headaches and bruxism.
Material and Methods: A total of 1200 dental records of orofacial pain adult patients were analyzed. The outcomes
were dichotomously classified (presence/absence) as following: a) AT and/or masseter palpation-induced pain; b)
myogenous TMD; c) temporomandibular joint (TMJ) arthralgia (arthrogenous TMD); d) migraine; e) tension-type
headache (TTH); f) self-reported bruxism. Binomial logistic regression model (α = 5%) was applied to the data
considering the palpation-induced muscle pain as the dependent variable.
Results: Mean age (SD) were 35.7 years (13.4) for 635 included dental records (83% females). Myogenous and
arthrogenous TMD, migraine, TTH and bruxism were mainly associated with, respectively, masseter palpationinduced
pain (p<0.001 - OR=5.77, 95%CI 3.86-8.62), AT or masseter palpation-induced pain (p<0.001 - OR=2.39,
95%CI 1.57-3.63), bilateral AT palpation-induced pain (p<0.001 - OR=2.67, 95%CI 1.64-4.32), masseter and AT
palpation-induced pain (p=0.009 - OR=1.62, 95%CI 1.12-2.33) and bilateral masseter palpation-induced pain
(p=0.01 - OR=1.74, 95%CI 1.13-2.69).
Conclusions: Palpation-induced pain in the masticatory muscles may play a role in the differential diagnosis among
painful TMD, primary headaches and bruxism
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