title: Can palpation-induced muscle pain pattern contribute to the differential diagnosis among temporomandibular disorders, primary headaches phenotypes and possible bruxism?
abstract: 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.
  
  
  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 palpation-induced 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.
authors.affiliation: Section of Orofacial Pain and Jaw Function, Department of Dentistry, Aarhus University, Vennelyst Boulevard, 9, 8000 Aarhus C, Aarhus, Denmark, yurimartinscosta@yahoo.com.br.
authors.forename: Yuri-Martins
authors.initials: YM
authors.lastname: Costa
authors.forename: André-Luís
authors.initials: AL
authors.lastname: Porporatti
authors.forename: Patrícia-dos-Santos
authors.initials: PD
authors.lastname: Calderon
authors.forename: Paulo-César-Rodrigues
authors.initials: PC
authors.lastname: Conti
authors.forename: Leonardo-Rigoldi
authors.initials: LR
authors.lastname: Bonjardim
mesh_terms: D000328:Adult; D002012:Bruxism / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005157:Facial Pain; D005260:Female; D006261:Headache / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008297:Male; D063806:Myalgia / Q000209:etiology; D010173:Palpation; D010641:Phenotype; D012189:Retrospective Studies; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis*