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sources and the throbbing pain may not respond to TMD therapy. In this situation, the practitioner may desire to perform an occlusal appliance therapy trial and, if it is not effective, consider a referral to the patient s physician or neurologist for a probable migraine. Studies suggest some migraines respond to TMD therapy, but characteristics for identifying which migraines respond are not well established.5 For other patients, the throbbing pain may be referred pain from an oral problem (most commonly a tooth). Sometimes the perceived painful site (e.g., masseter muscle and/or TMJ) appears as the source to the patient, whereas the actual source (e.g., a tooth) has minimal symptoms. This is similar to how a patient suffering from a heart attack may perceive pain only in the left arm, whereas the pain s source is the heart. Treatment for the pain must be directed toward the source, not the site where it is felt.

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Also Known As: Simple Data Model, Data at the Nodes Most Frequent Scale: Application, system Refactorings: Plan for Scaling, Choose the Right Data Architecture Refactored Solution Type: Process, role, architecture Root Causes: Haste, feature creep Unbalanced Forces: Time to market, individual/role responsibilities, unplanned features Anecdotal Evidence: We have too many copies of the data. I need the data from this bean in that bean.

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A notable characteristic of the spectrum shown in Figure 4.15 is its simplicity. The C H stretching bands con rm that no unsaturation is present, since there are no bands above 3000 cm 1 . The band at 1467 cm 1 is the scissoring frequency of CH2 groups, while that at 1378 cm 1 is the symmetrical bending mode of a CH3 group. The absence of bands between 1300 and 750 cm 1 suggests a straight-chain structure, while the band at 782 cm 1 tells us that there are four or more CH2 groups in the chain. The compound is, in fact, n-decane.

The referred pain from the masticatory structures can be veri ed by palpating the masticatory structures and observing whether this reproduces the patient s tooth pain The referred pain is often not limited to the tooth, but also causes pain to be perceived in the gingiva and alveolar process, even in edentulous areas The nervous system shares the neurological circuitry between pulpal pain and musculoskeletal pain Similar to how central sensitization and central convergence can cause tooth pulpal pain to be perceived as masticatory musculoskeletal pain (Figure 11), masticatory musculoskeletal pain can be perceived as tooth pulpal pain (Figure 328) In Figure 314, the map for Maxillary Dentition has areas of the temporalis muscle, TMJ, and masseter muscle marked on the head, in addition to the lateral pterygoid area and medial pterygoid muscle annotated below (These are intraoral muscles that could not be drawn on the head.

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An electron microscope set in the diffraction mode (rather than in the usual imaging mode) allows a diffraction pattern to be projected on the electron microscope s screen. Crystallite dimensions, degree of crystallinity, and other morphological information can be obtained by analyzing the observed pattern. Advantages include higher intensities, small sample size, and the fact that both

) The masseter muscle is the location marked with the color designated as the more common source, so intensely palpating the designated area of the masseter muscle is most likely to generate referred pain to the maxillary dentition This also helps the patient to realize the source of the pain is not from the tooth, but from the masseter muscle Patients with these symptoms may not nd practitioners who understand this concept and able to demonstrate the true source of the pain Occasionally these patients are able to convince their dentists to treat their tooth pain with endodontic therapy, which does not provide improvement, and for various reasons the pain may then be perceived as from another tooth (Figure 329).

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Another way to demonstrate this to the patient is to anesthetize the tooth with a ligamentary injection and show the patient that the tooth is numb, but the pain is still present Conversely, if you anesthetize a tooth to treat it for a pain, be sure the anesthesia eliminated the pain prior to treating the tooth..

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else s pain. So what we can share is the mental experience of the pain, not its physical aspect. These brain areas also become active when you anticipate pain, if you know that 5 seconds after hearing a tone you will be touched by the hot rod. If you can anticipate the pain that you will feel, is it so dif cult to anticipate the pain that someone else will feel Of course we can t experience the physical sensations that impinge on others. But we can construct the mental models based on these stimuli. It is because we make mental models of the physical world that we can share our experiences in the mental world.

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