A new adjunctive tool to aid in the diagnosis of myogenous temporomandibular disorder pain originating from the masseter and temporalis muscles: Twin-block technique

Samuel Y P Quek, Mythili Kalladka, Veena Kanti, Gayathri Subramanian, Samuel Y P Quek, Mythili Kalladka, Veena Kanti, Gayathri Subramanian

Abstract

Myogenous temporomandibular disorder (TMD) is the most common type of nonodontogenic pain. The diagnosis is often elusive since diagnosing such conditions often requires a more comprehensive patient assessment. At present, there is no simple one-step diagnostic test to help render a definitive diagnosis of myogenous TMD pain. The twin-block injection can serve as a diagnostic aid to facilitate diagnosis of such myogenous TMD. The twin-block injection blocks the innervation to both the temporalis and masseter muscles, the two most common sources of referred pain to the teeth. This article reviews the twin-block technique along with a case report illustrating its potential role in the diagnosis and management of myogenous TMD pain of masseteric and temporalis origin.

Keywords: Masseter; myogenous temporomandibular disorders; temporalis; twin-block technique.

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Relationship between the masseteric nerve and the deep temporal nerves to the twin-block injection needle as V3 exits foramen ovale
Figure 2
Figure 2
Photograph depicting the needle insertion during twin-block technique
Figure 3
Figure 3
Twin block in the diagnosis of myogenous pain of temporalis/masseteric origin

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