{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:18:56Z","timestamp":1788952736609,"version":"build-2803163510"},"reference-count":33,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2016,1,12]],"date-time":"2016-01-12T00:00:00Z","timestamp":1452556800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Dent Res"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:p>The role of masticatory muscle activation on pain in temporomandibular muscle and joint disorders (TMJD) is controversial. This single-group, prospective panel study examined the relationships among masticatory muscle tension, emotional distress, and TMJD pain in a sample of 7,023 observations obtained from 171 individuals using longitudinal multilevel modeling. Three main hypotheses were tested. The first posited that emotional distress and muscle tension directly influenced pain (hypothesis 1a: Distress \u2192 TMJD Pain; hypothesis 1b: Muscle Tension \u2192 TMJD Pain). The second posited that emotional distress directly influenced muscle tension (Distress \u2192 Muscle Tension), and the third posited that the effect of emotional distress on pain was mediated by muscle tension (Distress \u2192 Muscle Tension \u2192 TMJD pain). We also examined the fit of the data to possible alternative models. All the data used in this study were collected via an experience sampling methodology. The fit of the preferred models was better than that of the alternative models, with the preferred models explaining large proportions of the data, especially for level 2 variance (hypothesis 1a = 41% variance; hypothesis 1b = 69% variance; hypothesis 2 = 48% variance). In the mediation model, the addition of muscle tension to the model reduced the impact of emotional distress. The findings support a causal role for masticatory muscle tension in TMJD pain. Clinically, the results suggest that addressing tension and other oral parafunctions in those diagnosed with TMJDs should be an important part of the conservative, noninvasive care of individuals diagnosed with the myofascial pain or arthralgia of TMJD.<\/jats:p>","DOI":"10.1177\/0022034515625216","type":"journal-article","created":{"date-parts":[[2016,1,13]],"date-time":"2016-01-13T04:27:32Z","timestamp":1452659252000},"page":"416-422","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":54,"title":["Longitudinal Multilevel Modeling of Facial Pain, Muscle Tension, and Stress"],"prefix":"10.1177","volume":"95","author":[{"given":"A.G.","family":"Glaros","sequence":"first","affiliation":[{"name":"Department of Dental Public Health and Behavioral Science, University of Missouri\u2013Kansas City, School of Dentistry, Kansas City, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.M.","family":"Marszalek","sequence":"additional","affiliation":[{"name":"Department of Counseling and Educational Psychology, University of Missouri\u2013Kansas City, School of Education, Kansas City, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.B.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Biomedical &amp; Health Informatics, University of Missouri\u2013Kansas City, School of Medicine, Kansas City, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,1,12]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2007.01.012"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1037\/1082-989X.11.2.142"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0049124104268644"},{"issue":"4","key":"e_1_3_2_5_1","first-page":"350","article-title":"Interstitial glutamate concentration is elevated in the masseter muscle of myofascial temporomandibular disorder patients","volume":"24","author":"Castrillon EE","year":"2010","unstructured":"Castrillon EE, Ernberg M, Cairns BE, Wang K, Sessle BJ, Arendt-Nielsen L, Svensson P. 2010. 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