Mythili Kalladka

Review Article Musculoskeletal disorders and orofacial pain: a narrative review Mythili Kalladka, Sowmya Ananthan, Archana Viswanath, Davis Thomas, Andrew Young, Shilpa Singh, Junad Khan

Temporomandibular disorders, neuropathic and idiopathic orofacial pain, and headaches: a literature review Andrew Young, Ladan Sahabi, Noboru Noma, Mythili Kalladka, Zhimin Yan

This case report describes the rare occurrence of an epidermoid tumor compressing the ipsilateral trigeminal nerve resulting in secondary trigeminal neuralgia. MRI is the imaging modality of choice for the diagnosis of secondary trigeminal neuralgia. The epidermoid tumor was discovered by an orofacial pain specialist after reassessing the MRI study, previously reported as normal. Clinicians encounter a diagnostic dilemma when the clinical picture is not consistent with the MRI reports, clinical presentation, and expected results of treatment. The reassessment of the MRI and discovery of the epidermoid tumor resulted in a prompt referral to a neurosurgeon with a successful treatment outcome.

Review Article Nerve blocks in the management of acute temporomandibular disorder emergencies—a narrative review Mythili Kalladka, Shilpa Padar Shastry, Muralidhar Thondebhavi, Samuel Y. P. Quek, Shilpa Singh, Junad Khan

The pain of occipital neuralgia (ON) is thought to be secondary to trauma or injury to the occipital nerve at any point along the course of the nerve. ON may also be caused by an infectious process (herpes zoster) or compression of the nerve. The patient, in this case, presented to our clinic with complaints of occipital pain and rash and swelling of the right lower jaw. One week before presenting to our clinic, the patient developed severe pain in the first division of the trigeminal region with erythema and vesicles. A blood test showed a remarkably high antibody titer for varicella–zoster virus (VZV). The patient was prescribed oral valacyclovir (Valtrex^®) (3000 mg/day), which resulted in the complete remission of the rash and blisters in the occipital region. This highlights the importance of considering neuroanatomy of the trigeminal region and cervical nerve.

Objective: The term temporomandibular disorders (TMDs) en-compasses a variety of disorders of the temporomandibular joint (TMJD) and the associated musculature (MMD). Occlusion and its role in the genesis of TMDs is one of the most controver-sial topics in this arena. The objective of the narrative review was to summarize the implications of TMDs and its relationship to dental occlusion in two scenarios: 1) TMD as an etiologic fac-tor in dental occlusal changes; 2) The role of dental occlusion as a causative factor in the genesis of TMDs. Data Sources: In-dexed databases were searched from January 1951 to August 2021 using the terms TMJ, TMD, temporomandibular disorders, temporomandibular joint, and dental occlusion. Conclusion:There is lack of good primary research evaluating true associ-ation and showing the cause-and-effect relationship between dental occlusion and TMD. Systematic reviews suggest that the role of occlusion as a primary factor in the genesis of TMDs is low to very low. However, a variety of TMDs can lead to second-ary changes in dental occlusion. Distinction between the two is paramount for successful management. (Quintessence Int 2022;53: 450-459; doi: 10.3290/j.qi.b2793201)