口腔颌面部病变患者SARS-COV-2感染所致咀嚼肌筋膜疼痛综合征1例(临床一例)

Volodymyr Lychko, Svitlana Lychko, Igor Zhivotovsky, Mykola Burtyka
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摘要

摘要肌筋膜疼痛综合征(MFPS)是一种慢性疼痛症状,其特征是肌肉中出现肌筋膜触发点(MTP)。该病可由多种因素引起,可通过临床检查和触诊诊断。最近的研究表明,像SARS-CoV-2这样的感染可以导致MFPS以及其他症状。牙医经常在颞下颌关节功能障碍的患者中遇到MFPS的问题,但它也可以在关节功能正常的患者中发展。症状包括疼痛、敏感和下颌骨活动能力异常。在这篇文章中,在SARS-CoV-2诊断后出现口腔面部病理的患者中出现MFPS的病例。研究材料和方法。描述由于咀嚼牙齿的缺失、破坏和处置导致咀嚼肌肉紊乱而导致咬伤不稳定的人。患者在新冠肺炎后出现MFPS症状。使用搜索词“冠状病毒、SARS-COV-2和肌筋膜疼痛综合征”对2020年1月至2023年10月期间发表的文章进行了系统的在线搜索。结果。该患者于2021年10月被诊断出患有SARS-CoV-2,并住院10天。出院后,她去看牙医,主诉咀嚼肌区头痛和僵硬,侧牙缺失和破坏,咀嚼食物困难,个别牙齿活动和移位,牙龈周期性出血,以及审美障碍。客观检查发现继发性部分牙体缺失,导致咬合不稳定,咀嚼牙硬组织缺损,额牙组病理性磨损,外伤性咬合现象。触诊时,在咀嚼肌和颞肌区域发现了触发点。患者在其咀嚼肌中进行了一系列的10次触发点注射(干针),约有30%的即时缓解。结论。MFPS可由多种因素引起,包括SARS-CoV-2等感染。诊断基于临床检查和触诊mtp,治疗可包括触发点注射、物理治疗和非侵入性治疗方法。在本病例中,患者有部分牙齿缺失,导致在诊断为SARS-CoV-2后咬伤不稳定和MFPS症状。及时诊断和治疗MFPS对于提高患者的生活质量是必要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Masticatory myofascial pain syndrome provoked by SARS-COV-2 infection in a patient with orofacial pathology (clinical case)
Abstract. Myofascial pain syndrome (MFPS) is a chronic pain condition characterised by the appearance of myofascial trigger points (MTP) in muscles. The condition can be caused by various factors and is diagnosed through clinical examination and palpation of MTPs. Recent studies have shown that infections like SARS-CoV-2 can cause MFPS, along with other symptoms. Dentists often encounter the problem of MFPS in patients with temporomandibular joint dysfunction, but it can also develop in patients with a normally functioning joint. Symptoms include pain, sensitivity, and abnormalities in mandible mobility. In this article, the case of MFPS in a person with orofacial pathology after SARS-CoV-2 diagnosis is presented. Materials and methods of research. Describes a person who has the instability of the bite caused by the absence, destruction and disposition of the chewing teeth led to disorders of the chewing muscles. The patient was found to have appearing MFPS symptoms after COVID-19. The systematic online search of articles utilising the search terms «Coronavirus, SARS-COV-2 and Myofascial pain syndrome», published between January 2020 and October 2023, was performed. Results. The patient was diagnosed with SARS-CoV-2 in October 2021 and was hospitalised for 10 days. After discharge, she went to the dentist with complaints of headache and stiffness in the area of masticatory muscles, absence and destruction of lateral teeth, difficulty in chewing food, mobility and displacement of individual teeth, periodic bleeding gums, as well as aesthetic disorders. During the objective examination, secondary partial adentia was revealed, which led to instability of the bite, defects of the hard tissues of the chewing teeth, pathological wear of the frontal group, and traumatic occlusion phenomena. During palpation, trigger points were found in the area of the masticatory and temporal muscles. The patient underwent a series of ten trigger point injections (dry needling) in her chewing muscles, with about 30 % immediate relief. Conclusion. MFPS can be caused by various factors, including infections like SARS-CoV-2. The diagnosis is based on clinical examination and palpation of MTPs, and treatment may include trigger point injections, physical therapy, and non-invasive therapy methods. In the presented case, the patient had partial adentia, leading to instability of the bite and MFPS symptoms after SARS-CoV-2 diagnosis. Prompt diagnosis and management of MFPS are necessary to improve the patient’s quality of life.
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