The craniofacial pain center
Among oro-facial pains, the most common pain with a tendency to become chronic is that caused by temporomandibular joint disorder. This pain rarely occurs in adolescence but peaks between the ages of 20 and 40.
Temporomandibular joint disorder manifests with the following symptoms: oro-facial pain, pain in the masticatory muscles, impaired joint mobility, joint and muscle tenderness, headache and neck pain, ear pain and sounds.
The treatment of oro-facial pain is carried out by a multidisciplinary team consisting of a dentist, oral or maxillofacial surgeon, physiotherapist, psychologist. Additionally, the expertise of a neurologist and an ENT specialist is often required.
Our Team
The pain center operating within our clinic benefits from the professional experience of several specialists, including:
Prof. Dr. Horațiu Rotar
Primary specialist in oral and maxillofacial surgery, he has been involved in the diagnosis and treatment of patients with oral and craniofacial pain, alongside Prof. Dr. Alexandru Rotar, since the late '90s. Clinical experience includes conservative and surgical treatment of myofascial pain, essential trigeminal neuralgia, as well as secondary neuralgic pain.
Dr. Daniel Talmăceanu
Medic specialist in dento-alveolar surgery and dental prosthetics, with a primary interest in oro-facial pain. They pursued doctoral studies on this topic and have been treating patients with oro-facial pain and temporomandibular dysfunction, as well as patients with bruxism and dental wear, for over 10 years.
"Oro-facial pain is an ongoing challenge for me, with each patient being unique. The response to treatment varies greatly, which is why it's important for therapy to be carefully tailored based on each patient's symptoms. The most powerful tool in treating patients with oro-facial pain is the doctor's ability to make an accurate diagnosis."
Emanuela Broscățan
A physiotherapist with nearly 9 years of private clinical experience in rehabilitating spinal conditions, knee issues, and managing muscular and joint pains at the temporomandibular joint in all stages.
The stages of analyzing a patient with temporomandibular joint disorder are:
First Consultation
It involves a detailed discussion where we try to determine exactly where the pain originates, its nature, situations when it subsides or becomes more pronounced, and many other relevant details.
The next step is the clinical consultation. We will examine the cervicofacial musculature, the temporomandibular joint, and the oral cavity.
The last stage of the initial consultation involves recommending other complementary examinations (CBCT - available in our clinic, MRI, ultrasound, etc.).
At the end of the initial consultation, subsequent appointments will be scheduled as needed - for treatment or further investigations.
The second consultation
It involves taking impressions of the dental arches and capturing the correct position of the mandible relative to the skull base.
The diagnosis
It is done by combining clinical examinations with occlusion examination and imaging tests.
The treatment plan
It's individualized. The presence of common symptoms in temporomandibular joint disorders doesn't imply a single, uniform treatment plan. Therefore, it may involve a multidisciplinary approach, incorporating procedures from orthodontics, minimally invasive and invasive surgery, and physiotherapy.
The stages of analyzing a patient with temporomandibular pathology
Physiotherapy procedures
Physiotherapy procedures aim to reduce pain, decrease inflammation, improve joint mobility, and restore optimal muscle elasticity. Low-Level Laser Therapy (LLLT) procedures can also be used to reduce joint pain and inflammation.
Last but not least, one of the physiotherapist's most important roles is to educate the patient by explaining the diagnosis, treatment plan, and encouraging them to perform specific exercises at home.
Subcutaneous/intramuscular injection of botulinum toxin
This treatment is not aimed at aesthetics but rather at achieving muscular reset, together with physiotherapy, to achieve two major goals: pain relief and muscle re-education for optimal functionality. At the same time, it prepares the ground for achieving the most precise bite balance.
Arthrocentesis
In local anesthesia, the joint is lavaged, removing the inflammatory factors from the temporomandibular joint and the pain caused by them. At the end of the lavage, i-PRF or hyaluronic acid is introduced to restore the intra-articular environment. For the best results, this procedure is followed by physiotherapy sessions.
Equipment
Although the most important element in approaching and treating patients with facial pain is the doctor's ability to make the correct diagnosis, sometimes complementary examinations are also needed, such as imaging or recordings of mandibular dynamics. The pain center is equipped with state-of-the-art radiological equipment (Planmeca) and tools for analyzing mandibular dynamics, both traditional (SAM articulator) and digital (the innovative Modjaw system).
