Papers by Wesley E Shankland
PubMed, 1995
Undiagnosed pain in the face, head and neck is very frustrating to all parties involved: the pati... more Undiagnosed pain in the face, head and neck is very frustrating to all parties involved: the patient, the family of the patient, and the clinician. Simple pains may be treated with ease; however, chronic pain is a different matter. Often, patients consult numerous doctors, clinics, and hospitals in their search of pain relief. The patient may then undergo extensive and at times, unnecessary invasive treatment with the hope that the relentless agony of their suffering will be relieved. The purpose of this article is primarily one of education. Physicians and dentists alike encounter these unfortunate sufferers and yet, are confounded by the multitude of symptoms and complaints. Therefore, it was felt that an article such as this was needed. Many concepts presented within are either new or revised. It will be interesting to the reader just how similar many of these pain syndromes appear. Yet, when a systematic diagnostic approach is attempted, it will become clear just how different these syndromes are as well.
PubMed, 1994
The modal or most common position of the mental foramen in the human mandible with respect to tee... more The modal or most common position of the mental foramen in the human mandible with respect to teeth appears to be below the second premolar regardless of race or age. The position of this structure was investigated in a sample of Asian Indians of unknown age or sex. In this study, 75.36% of 138 mandibular sides exhibited the position of the mental foramen to be located directly below the second premolar. In addition, 6.62% of the mandibles possessed accessory mental foramina. The results of this study do not support those reported in some commonly used textbooks on anatomy, anesthesia, and anthropology concerning the position of the mental foramen in the human mandible.
Cranio-the Journal of Craniomandibular Practice, Apr 1, 1996
Gross anatomical structures of the human body have been known and taught to students for centurie... more Gross anatomical structures of the human body have been known and taught to students for centuries. However, at times, anomalies or even previously undescribed structures are discovered and subsequently reported. This preliminary report discusses the discovery of either a previously undescribed belly of the temporalis muscle, a previously undescribed muscle of mastication, or simply an anomaly of the temporalis. The somatosensory innervation of this structure was identified and will be presented. Preliminary measurements of this structure will also be provided. Finally, clinical implications of these findings, which may aid in the diagnosis and treatment of temporal and facial pain, will be discussed.
Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology, Sep 1, 2015
Cranio-the Journal of Craniomandibular Practice, Jul 1, 1996
Pain originating from the throat may emanate from many different structures. The stylohyoid and s... more Pain originating from the throat may emanate from many different structures. The stylohyoid and stylomandibular ligaments are known as structures, that when injured, produce most of the throat pain which also may be referred to the face, ears, and temporomandibular joints. Another structure which may produce similar pain complaints, the synovial bursa of the tensor veli palatini muscle, has been isolated and described in this study. The histology and pertinent anatomy of the general area and this bursa specifically will be described.
Cranio-the Journal of Craniomandibular Practice, Oct 1, 2002
Ischemic jawbone lesions were first discussed in the dental literature more than a century ago, b... more Ischemic jawbone lesions were first discussed in the dental literature more than a century ago, but then seemingly forgotten. In recent years, there has been considerable resurgence in interest in this unique pathological condition. Controversy surrounds the subject. Some proclaim these lesions to be mere fabrications of the imaginations of non-traditional or alternative dental surgeons. Others attribute all human maladies to these maxillofacial lesions. Aside from these philosophical and metaphysical arguments, are there common diagnoses of jawbone pathologies that produce pain? This present investigation reviews the clinicopathologic features of 500 consecutive jawbone surgeries with pathological confirmation in patients with idiopathic facial pain. Four hundred seventy-six (476) of the 500 lesions (95.2%) were directly attributed to impaired blood flow in the jawbone, tooth, or both, according to histopathological analysis and confirming Cavitat (bone ultrasound) examination. Statistical data concerning the location, frequency, and pathological diagnoses of these bony lesions are presented, as are brief methods of diagnosis, and treatment is also discussed.
Cranio-the Journal of Craniomandibular Practice, Oct 1, 1996
ln the first part of this series of two papers, the bursa of the tendon of the tensor veli palati... more ln the first part of this series of two papers, the bursa of the tendon of the tensor veli palatini muscle was demonstrated and described histologically. ln Part Il, the symptoms and the process of diagnosis of bursitis of the hamular process is presentee!. Additionally, recommended treatment options will be discussed. The article presents three case reports.
Cranio-the Journal of Craniomandibular Practice, Apr 1, 1993
The horrible disorder of trigeminal neuralgia has been reviewed in the medical literature for cen... more The horrible disorder of trigeminal neuralgia has been reviewed in the medical literature for centuries. Various methods of diagnosis and treatment have been offered and yet, it has only been in the last few decades that two similar but different types of trigeminal neuralgias have been recognized. Typical trigeminal neuralgia, or tic douloureux, is by far the most recognized type, although atypical trigeminal neuralgia has recently appeared in the literature as well. It is of the utmost importance that these two neuralgias of the trigeminal nerve be accurately diagnosed as their forms of treatment are quite different. This short treatise will compare and contrast the two different types of trigeminal neuralgias, typical and atypical, and offer methods for treatment of both.
Cranio-the Journal of Craniomandibular Practice, Apr 1, 2011
Emotions can and do affect the way one perceives pain, both acute and chronic. Many factors uncon... more Emotions can and do affect the way one perceives pain, both acute and chronic. Many factors unconsciously alter the intensity in which pain is perceived even though human beings all have the same anatomical structures to convey nociception to the central nervous system. Pain cannot be measured, only observed by one's behavior to pain. Those who diagnose and treat craniofacial pain quickly realize that many factors in addition to pathological conditions affect patients differently and oftentimes, unpredictably. We, as those who attempt to treat these patients, need to recognize these factors and how they can influence our treatment and a patient's recovery. In this short article, factors that affect pain behavior are described.
Cranio-the Journal of Craniomandibular Practice, Oct 1, 1998
The signs and symptoms of osteoarthritis are common complaints seen in patients suffering with ch... more The signs and symptoms of osteoarthritis are common complaints seen in patients suffering with chronic temporomandibular disorders (TMD), specifically, internal derangements with a diagnosis of osteoarthritis. With or without the complaints of pain and swelling, joint noises are bothersome and annoying to both the patient and at times, to those seated close to the patient during mealtime. In fact, many patients are driven to seek care by family members because of his or her TMJ noises. For years in veterinarian medicine, glucosamine and chondroitin sulfates have been used to treat symptoms of osteoarthritis. Recently, the use of these two supplements has been recommended for human beings as well. Reports of decreased joint noises, pain and swelling after the administration of therapeutic doses of these supplements have sparked an interest in their possible use in the treatment of osteoarthritis.
Cranio-the Journal of Craniomandibular Practice, 2001
The ophthalmic, or first division (V1) of the trigeminal nerve, is the smallest of the three divi... more The ophthalmic, or first division (V1) of the trigeminal nerve, is the smallest of the three divisions and is purely sensory or afferent in function. It supplies sensory branches to the ciliary body, the cornea, and the iris; to the lacrimal gland and conjunctiva; to portions of the mucous membrane of the nasal cavity, sphenoidal sinus, and frontal sinus; to the skin of the eyebrow, eyelids, forehead, and nose; and to the tentorium cerebelli, dura mater, and the posterior area of the falx cerebri. At first glance, one might not expect one interested in the diagnosis and treatment of orofacial pain and temporomandibular joint disorders to have a need to be concerned with the ophthalmic division. Although much of this division's influence is dedicated to structures within the orbit, nose, and cranium, still, the ophthalmic division may be afflicted with a lesion or structural disorder which can cause all sorts of orofacial pain. Ignorance of this or any portion of the trigeminal nerve will lead to diagnostic and therapeutic failures. In this, the second of four (4) articles concerning the trigeminal nerve, the first division of this vast cranial nerve will be described in detail.
Cranio-the Journal of Craniomandibular Practice, Oct 1, 2000
The trigeminal nerve is the largest and most complex of twelve cranial nerves. lts vast size and ... more The trigeminal nerve is the largest and most complex of twelve cranial nerves. lts vast size and influence are greatly appreciated when one attempts to diagnose and treat patients suffering from orofacial pain and temporomandibular joint disorders. Without a thorough knowledge of the trigeminal nerve, the efficacy of diagnostic and therapeutic procedures will be very disappointing. This is the first of a four-part series of articles about the trigeminal nerve, a basic overview of both the gross and neuroanatomical structures is presented. Dr. Wesley E. Shankland, II graduated from the Ohio State University with a B.S. degree, majoring in biochemistry and zoo/ogy. He continued his education at Ohio State and graduatedfrom the Co/lege of Dentistry in 1978. He eamed an M.S. degree in /993 and a Ph.D. in 1997, both in anatomy. He maintains a practice in Columbus, Ohio, that is limited to the diagnosis and treatment of craniofacial and temporomandibular joint disorders. Dr. Shankland is the author of over fifty-five scientific publications, a manual of head and neck anatomy, chapters in three textbooks and has also written two books. He is the recent Past President of the American Academy of Head, Neck and Facial Pain, and he is a member of the American Academy of Orofacial Pain, the American Headache Society, the International Headache Association, the Christian Medical and Dental Society, the American Association of Clinicat Anatomists, the American Association for the Advancement of Science, and the Christian Medical and Dental Society. He has lectured throughout the world conceming head and neck anatomy, craniofacial pain, the differentiai diagnosis of headache pain, and temporomandibular disorders. He is on the editorial boards of four scientific journals and
Cranio-the Journal of Craniomandibular Practice, 1986
AbstractThe clinical practitioner is faced daily with myriad pain complaints. Headache is a most ... more AbstractThe clinical practitioner is faced daily with myriad pain complaints. Headache is a most common complaint, with pain arising from odontogenic, neurologic, and myogenic sources. The practitioner needs to be familiar with various headache symptoms in order to make an accurate diagnosis of each patient's problems.This article presents three categories that represent the most common types of headache pain. The most common symptoms for each type are discussed, and suggestions for treatment are offered.
Cranio-the Journal of Craniomandibular Practice, 2009
Any division or branch of the trigeminal nerve can exhibit signs and symptoms of neuralgia. Those... more Any division or branch of the trigeminal nerve can exhibit signs and symptoms of neuralgia. Those who treat patients suffering with craniofacial pain are frequently charged with determining the cause of illusive pain complaints and if objective signs are not discovered, the patient may not be treated and may be forced to seek help elsewhere. Trigeminal neuralgia-like pain is often seen in the mental nerve region of the mandible, but frequently, there is no radiographic evidence for the source of such pain. In the current case report, it was discovered that the patient's mental nerve pain was cause by an irregular surface of the anterior portion of the mental foramen. Successful treatment was provided by surgically recontouring the edge or lip of the mental foramen without injury to the mental nerve.
Cranio-the Journal of Craniomandibular Practice, Apr 1, 2009
The use of herbal supplements in North America is steadily growing and raises concerns about safe... more The use of herbal supplements in North America is steadily growing and raises concerns about safety, efficacy, and how they affect safe patient care. The most notable and direct health risks associated with herbal supplements include hypertension, prolonged bleeding, and the potential for drug-herb interactions, which is of particular concern for patients undergoing anesthesia, both general and local anesthesia. In this article, four of the most commonly used herbs today in North America will be discussed: garlic, gingko, ginseng, and ginger. The pharmacology, benefits, and possible side effects of these herbs will be presented. Awareness of the rising use of herbs is important to prevent, recognize, and treat potential problems that can arise from herbal preparations taken alone or in conjunction with prescription medications.
Cranio-the Journal of Craniomandibular Practice, Jul 1, 2001
The mandibular or third division of the trigeminal nerve is the largest of the three divisions. l... more The mandibular or third division of the trigeminal nerve is the largest of the three divisions. lt is considered a mixed nerve. That is, like the ophthalmic and maxillary divisions, the mandibular conveys afferent fibers. But unlike the tonner two divisions, the mandibular also contains motor or efferent fibers to the muscles of mastication, the mylohyoid and anterior digastric muscles, and the tensor veli palatini and tensor tympani muscles. So intimately associated with dentistry, the mandibular nerve has also been tenned the dental nerve by anatomists in the past. This extensive and complicated division of the trigeminal nerve can cause confusion to both patient and doctor. Pain is often referred within its branches and even into other trigeminal divisions, chiefly the maxillary. This fourth and last article about the trigeminal nerve will present in detail the mandibular division.
Cranio-the Journal of Craniomandibular Practice, Jul 1, 1993
The disorder tenned osteocavitation lesion has been described in the literature since at least 19... more The disorder tenned osteocavitation lesion has been described in the literature since at least 1976. This disorder has often been misdiagnosed as trigeminal neuralgia or atypical facial pain, and, unfortunately, patients have either continued to suffer or inappropriate treatment or treatments have been prescribed in an attempt to rid the patient of this terrible pain disorder. These symptoms, which can be misinterpreted as trigeminal neuralgia, include a history of undiagnosed facial pain, a history of tooth extraction, the presence of trigger areas and nonnal radiographic findings. A confinned diagnosis of osteocavitation lesion can be treated only with surgery. Dr. Wesley Shankland ll received his D.D.S. degree from the Ohio State University College of Dentistry in 1978. He maintains a practice limited to the diagnosis and treatment of craniofacial and temporomandibular disorders (TMD) in Columbus, Ohio. Dr. Shankland is presently a graduate student in the depanment of Cell Biology Neurobiology and Anatomy at Ohio State University, pursuing his Ph.D. in anatomy. He is a Fellow of the American Academy of Head, Neck, Facial Pain &: TMJ Onhopedics, a member of the American Academy of Orofacial Pain, a Diplomate of the American Academy of Pain Management and a member of the Christian Medical and Dental Society.
Cranio-the Journal of Craniomandibular Practice, Apr 1, 2001
The maxillary nerve gives sensory innervation to ali structures in and around the maxillary bone ... more The maxillary nerve gives sensory innervation to ali structures in and around the maxillary bone and the midfacial region including the skin of the midfacial regions, the lower eyelid, side of nose, and upper lip; the mucous membrane of the nasopharynx, maxillary sinus, soft palate, palatine tonsil, roof of the mouth, the maxillary gingivae, and maxillary teeth. This vast and complex division of the trigeminal nerve is intimately associated with many sources of orofacial pain, often mimicking maxillary sinus and/or temporomandibular joint involvement. For those who choose to treat patients suffering with orofacial pain and temporomandibular disorders, knowledge of this nerve must be second nature. Just providing the difficult services of a general dental practice should be stimulus enough to understand this trigeminal division, but if one hopes to correctly diagnose and treat orofacial pain disorders, dedication to understanding this nerve cannot be overstated. ln this, the third of a four part series of articles conceming the trigeminal nerve, the second or maxillary division will be described and discussed in detail.
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Papers by Wesley E Shankland