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Oral Surgery · single question

For mandibular deviation due to TMD, what is the best initial pharmacological management?

  1. Carbamazepine — sodium channel blocker
  2. Cyclobenzaprine — muscle relaxant
  3. Diclofenac (Voltaren) — NSAID
  4. Prednisone — systemic corticosteroid
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Correct answer: C. Diclofenac (Voltaren) — NSAID

  • A. Carbamazepine is used for trigeminal neuralgia, not TMD.
  • B. Cyclobenzaprine (muscle relaxant) may be used as adjunct therapy for muscular TMD but is not the primary first-line choice.
  • C. Correct. NSAIDs (e.g., diclofenac/Voltaren, ibuprofen, naproxen) are the first-line pharmacological treatment for TMD involving pain and limited opening, providing both analgesic and anti-inflammatory effects.
  • D. Systemic corticosteroids are reserved for severe inflammatory TMD or acute joint inflammation after other treatments fail.

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