Iontophoresis: An Effective Modality for the Treatment of Inflammatory Disorders of the Temporomandibular Joint and Myofascial Pain

Abstract

The use of the iontophoresis modality for driving medications through the skin for treatment of certain TM dysfunction and myofascial pain dysfunction syndrome was first suggested by Gangarosa and Mahan in 1982. This paper introduces the iontophoresis technique for treatment of inflammatory and myofascial disorders of the craniomandibular system. The historical aspects of iontophoresis in medicine and dentistry is reviewed. As an aid to understanding the clinical applications of this method, a review of diagnostic classification of temporomandibular disorders and an in-depth review of the role of the inflammatory process are provided. The effect of inflammation on the synovial/ lymphatic system is detailed. Reference is made to the advantages of iontophoresis over hypodermic injection. The basic materials and methods of use of the modality are shown along with a protocol for patient treatment. Several case studies are discussed with clinical observations given.

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Notes on contributors

Matthew R. Lark

Dr. Matthew R. Lark is a graduate of the University of Detroit School of Dentistry and received specialized studies in craniomandibular disorders at the L.D. Pankey Institute, Case Western Reserve University, and at the Medical College of Ohio. He is on the faculty of the Medical College of Ohio where he instructs postgraduate students in diagnosis and management of the craniofacial pain patient. Dr. Lark has a general dentistry practice that has an emphasis on TMJ and restorative dentistry. He has lectured extensively throughout the United States and presently conducts a two-day participation course for dentists and physical therapists. Dr. Lark is a member of the L.D. Pankey Alumni Association and the American Equilibration Society, and he lectures actively with the Detroit Dental Clinic Club's occlusion and crown and bridge sections.

Louis P. Gangarosa

Dr. Louis P. Gangarosa, Sr. received a B.S. with High Distinction from the University of Rochester in 1952 and a D.D.S. from the University of Buffalo in 1955. He spent three years as a general dentist in the United States Air Force and four years in private practice. In 1961, Dr. Gangarosa received an M.S. in Pharmacology from the University of Rochester. He then became a full-time fellow in dental research and obtained a Ph.D. in Pharmacology in 1965. Dr. Gangarosa was appointed assistant professor of Dental Research at Rochester. New York, in 1965. He moved to Georgia in 1968 as associate professor and coordinator of Pharmacology for Dentistry at the Medical College of Georgia where he was promoted to professor in 1972. Dr. Gangarosa is currently conducting research on local drug delivery using iontophoresis. He has been awarded numerous grants from National Institutes of Health and industries. He has 178 publications.