***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES The aim of this study was to compare the effectiveness of using Ping On ointment and using petroleum jelly in the treatment of temporom and ibular joint ( TMJ ) and masticatory muscle pain , in order to establish the true efficacy of Ping On ointment . METHODS In this r and omized , double-blinded , placebo-controlled trial , 55 subjects with TMJ and /or masticatory pain ( Group I patients according to the Research Diagnostic Criteria for Temporom and ibular Disorder ( RDC/TMD ) received Ping On ointment for 4 weeks , or placebo for 4 weeks . Subjects were evaluated with st and ard measures of efficacy : pain intensity measured by visual analogue scale and maximal comfortable m and ibular opening , at baseline and again after 4 weeks of treatment . RESULTS Ping On ointment significantly reduced the symptoms of painful TMJs and /or masticatory muscles . Maximal comfortable m and ibular opening also improved in the Ping On ointment group compared with the placebo , but was not clinical ly significant . CONCLUSIONS This preliminary study suggests that topical application of Ping On ointment may be considered for further investigation as a potential first-line treatment modality , before prescribing analgesics , for the management of TMDs . It is topically applied , safe , reversible , and effective in managing TMDs and masticatory muscle pain A study of the effectiveness of physical therapy for patients with myofacial pain dysfunction syndrome was performed . Clinical evaluation of 120 patients revealed marked male preponderance , distribution according to age showed a great prevalence of the third decade , and most common chief complaints were pain and muscle tenderness . Patients were classified r and omly into three equal groups treated by muscle relaxant drugs , shortwave diathermy , and ultrasonic therapy , respectively . Regular follow-up was carried out for 6 to 12 months to assess patients ' responses to different forms of treatment . Evaluation revealed marked relief of symptoms by the use of physical therapy , and the best results were obtained by the use of ultrasonic therapy & NA ; Burning mouth syndrome ( stomatodynia ) is associated with changes of a neuropathic nature the main location of which , peripheral or central , remains unknown . A r and omised , double‐blind crossover design was used to investigate the effects of lingual nerve block on spontaneous burning pain and a possible correlation with the effects of topical clonazepam , the patient 's response to a psychological question naire , and the taste and heat thresholds . The spontaneous burning was measured with a visual analogue scale ( VAS ) just before and 15 min after injection . The decreases in VAS score after lidocaine or saline injection were not significantly different ( 2.7 ± 3.9 and 2.0 ± 2.6 , respectively ; n = 20 ) . However , two groups of patients could be identified : in a “ peripheral group ” ( n = 10 ) the VAS decrease due to lingual nerve injection was 4.3 ± 3.1 cm after lidocaine and 0.9 ± 0.3 cm after saline ( p = 0.02 ) . In a “ central group ” ( n = 7 ) , there were an increase in pain intensity score ( −0.8 ± 2.6 cm ) after lidocaine and a decrease ( 1.5 ± 3.0 cm ) after saline ( p = 0.15 ) . An increase in the hospital anxiety and depression ( HAD ) score and a decreased taste sensitivity and heat pain threshold of painful oral area were seen in patients compared with age‐ and ‐sex‐matched controls ( p < 0.05 ) . Topical clonazepam treatment tended to be more effective ( p = 0.07 ) and HAD score lower ( p < 0.03 ) in the peripheral than in the central group . These results suggest that the neuropathic disorder associated with stomatodynia may be predominantly peripheral , central or mixed depending on the individual . Topical application of clonazepam and HAD may serve as indicators of which mechanism is dominating Purpose Arthrocentesis ( AC ) is an acceptable treatment modality in the treatment of internal derangement ( ID ) pain .  This study evaluated outcomes of AC on pain relief of ID pain with or without corticosteroids . Material s and Methods This single-blind clinical trial was conducted on 60 patients with ID pain who were r and omly assigned to 2 groups ( 30 in each group ) for AC . The AC of the upper joint space was then performed by using Ringer lactate under local anesthesia in both groups . In the second group , the procedure was followed by the administration of a single-dose intra-articular dexamethasone ( 8 mg ) . Assessment s were made at baseline ( T0 ) , 1 month ( T1 ) , and 6 months ( T6 ) after AC ; pain , maximum mouth opening , and joint sounds before and after treatment up to 6 months were evaluated . Pain severity was documented according to Visual Analogue Scale . Age , sex , and skeletal maxillom and ibular relationship were considered as variable factors , and irrigation with or without corticosteroids was a predictive factor of the study . Pain , click , and maximum mouth opening were other assessment outcomes of the study . Results Comparison of age , sex , and skeletal relationship did not show any significant differences between the 2 groups . Results did not demonstrate any difference for click between the 2 groups . Comparison of pain severity in T0 , T1 , and T2 between the 2 groups did not show any significant differences ( P < 0.05 ) . The repeat measure test revealed a significant change in T0 , T1 , and T2 for both groups ( P < 0.001 ) . MMO significantly changed between T0 and T1 and T0 and T6 in the 2 groups without any significant differences between them . Conclusions The AC is an effective procedure for a short-term reduction of pain in temporom and ibular disorder cases . It seems that AC using Ringer solution with or without corticosteroids may have the same effect on pain relief OBJECTIVES In a preliminary pilot study of 30 treatments in 26 patients with osteonecrosis of the jaws and chronic disabling facial pain , our specific aim was to determine whether , to what degree , and how safely therapy of hypofibrinolysis and thrombophilia would ameliorate the chronic pain associated with osteonecrosis of the m and ible and maxilla . STUDY DESIGN Thrombophilia was treated with Coumadin ( DuPont ) in 10 patients ; hypofibrinolysis was treated with Winstrol ( Sanofi-Winthrop ) in 20 patients , including 4 who had mixed thrombophilia and hypofibrinolysis and had previously been treated with Coumadin .  The initial treatment period was targeted to be 4 months . Each patient was asked to keep a daily written pain-relief numeric rating score and side-effects diary and to provide a summary pain-relief numeric rating score and side effects compilation for the total treatment period . RESULTS There were 4 men and 22 women in the study group ; their mean age was 49 + /- 11 years . The mean onset of their osteonecrosis pain was at age 45 + /- 12 years , and the mean duration of their facial pain prior to therapy was 4.5 + /- 4.2 years . Ten patients had one or more thrombophilic traits ( there were two patients with protein C deficiency , five with resistance to activated protein C and /or the mutant Factor V Leiden gene , and four with high anticardiolipin antibodies ) . The 10 patients who were thrombophilic were treated with Coumadin ( the international normalized ratio was targeted to 2.5 - 3.0 ) for 22 + /- 9 weeks . By self-reported pain-relief numeric rating scores , 6 of the 10 patients with thrombophilia ( 60 % ) had > or = 40 % pain relief , 2 ( 20 % ) had no change , and 2 ( 20 % ) had increased pain ( 30 % and 80 % worse ) . Nine of the 10 patients with thrombophilia ( 90 % ) had no Coumadin-related side effects ; 1 patient ( 10 % ) stopped Coumadin therapy ( after 28 weeks ) because of nosebleeds .  Winstrol ( 6 mg per day ) was used for 16 + /- 9 weeks in 20 patients with hypofibrinolysis , some of whom had one or more hypofibrinolytic traits ( 10 had high levels of plasminogen activator/inhibitor activity , usually accompanied by low stimulated tissue plasminogen activator activity ; 13 had high Lp[a ] lipoprotein ) . Of these 20 patients with hypofibrinolysis , 9 patients ( 45 % ) had > or = 40 % pain relief , 3 patients ( 15 % ) had 20 % to 30 % relief , 5 patients ( 25 % ) had no improvement , and 3 patients ( 15 % ) had increased pain ( 30 % worse , 60 % worse , and 70 % worse ) . Six of the 20 patients with hypofibrinolysis ( 30 % ) had no Winstrol-related side effects , while 14 ( 70 % ) had side effects that could be attributed to Winstrol , including weight gain , peripheral edema , increased facial and body hair , and acne -- all of which were reversed within 6 weeks of stopping Winstrol therapy . CONCLUSIONS We postulate that thrombophilia and hypofibrinolysis lead to impaired venous circulation and venous hypertension of the m and ible/maxilla with subsequent development of osteonecrosis and chronic facial pain . In many patients , facial pain can be ameliorated by treating the pathogenetic coagulation defects with Coumadin or Winstrol . Large , double-blind , placebo-controlled crossover studies will be required in the future to vali date these preliminary results and to determine whether pain relief with Coumadin or Winstrol justifies the risks and side effects associated with these medications , especially for long-term use , in osteonecrosis of the jaws INTRODUCTION Although a significant amount of evidence indicates the efficacy of some antidepressants in treating psychogenic pain and somatoform disorder , very few studies have investigated their possible therapeutic action in burning mouth syndrome ( BMS ) . The purpose of this 8-week , single-blind study was to provide preliminary data on the efficacy and tolerability of amisulpride and the selective serotonin reuptake inhibitors ( SSRIs ) paroxetine and sertraline for patients with BMS . METHOD Seventy-six patients with BMS ( diagnosed according to the criteria in the literature and integrating the Diagnostic Interview Schedule-Revised for a complete psychiatric assessment ) , with no possible local or systemic causes and without concurrent major depression , were r and omly assigned to receive amisulpride ( 50 mg/day ) , paroxetine ( 20 mg/day ) , or sertraline ( 50 mg/day ) . Efficacy assessment s included a visual analogue scale ( VAS ) for pain intensity , the Hamilton Rating Scale for Depression ( HAM-D ) , the Hamilton Rating Scale for Anxiety ( HAM-A ) , and the Clinical Global Impressions scale ( CGI ) . RESULTS All 3 treatment regimens result ed in a significant improvement from baseline in burning mouth symptoms at week 8 as demonstrated by the quantitative ( mean reduction in VAS , HAM-D , and HAM-A scores ) and qualitative ( percentage of responders ) analyses . Amisulpride showed a shorter response latency than the SSRIs . No serious adverse events were reported , and the incidence of side effects did not differ among the 3 groups . None of the patients who received amisulpride withdrew from the trial , whereas withdrawal from the trial occurred within the first week of treatment in 11.5 % of patients ( N = 3 ) treated with paroxetine and in 21.7 % of patients ( N = 5 ) treated with sertraline . CONCLUSION The data suggest that amisulpride and SSRIs may be effective treatments for BMS ; they are equally effective and equally well tolerated in the short-term treatment of BMS . Amisulpride is associated with better compliance within the first week of treatment and with a shorter response latency in comparison with SSRIs . This finding may indicate that amisulpride is especially useful at the beginning of drug therapy of BMS . Double-blind , placebo-controlled trials are needed to further document the efficacy of amisulpride and SSRIs in the treatment of BMS In a double-blind study , diclofenac sodium ( Voltaren ) , 50 mg two or three times a day , was compared with placebo in 32 patients with pain localized to the temporom and ibular joint ( TMJ ) . The patients were allocated into two equally large groups . A visual analog scale was used to estimate the pretreatment degree of pain . The treatment effect was assessed as the frequency of joint and muscle pain and by the patients ' own evaluation of improvement . The change in the clinical condition was assessed by tenderness to palpation of the TMJ and masticatory muscles and by m and ibular mobility . The frequency of TMJ pain showed a greater reduction in the diclofenac group than in the placebo group , and there was a significant reduction of daily TMJ pain in the diclofenac group . The diclofenac group also showed a significant decrease in tenderness to palpation of the masticatory muscles in comparison with the placebo group . The patients with short duration of pain showed the best response to diclofenac . There was no evidence in this study to prove that diclofenac should be used as a primary treatment of TMJ pain , but it could be used as a complement to other treatments of acute TMJ pain OBJECTIVE The purpose of this study was to evaluate the efficacy of the topical use of benzydamine hydrochloride 0.15 % 
    Output:
    
The narrative synthesis suggests that NSAIDs as well as corticosteroid and hyaluronate injections are effective treatments for TMD-joint pain .
The network meta- analysis showed that clonazepam and capsaicin reduced pain intensity in BMS , and the muscle relaxant cyclobenzaprine , for the TMD-muscle group .
In conclusion , based on a limited number of studies , evidence provided with network meta- analysis showed that clonazepam and capsaicin are effective in treatment of BMS and that the muscle relaxant cyclobenzaprine have a positive treatment effect for TMD-muscle pain .