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Tu TTH, Watanabe M, Nayanar GK, Umezaki Y, Motomura H, Sato Y, Toyofuku A. Phantom bite syndrome: Revelation from clinically focused review. World J Psychiatry 2021; 11:1053-1064. [PMID: 34888173 PMCID: PMC8613755 DOI: 10.5498/wjp.v11.i11.1053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/10/2021] [Accepted: 08/30/2021] [Indexed: 02/06/2023] Open
Abstract
Phantom bite syndrome (PBS), also called occlusal dysesthesia, is characterized by persistent non-verifiable occlusal discrepancies. Such erroneous and unshakable belief of a “wrong bite” might impel patients to visit multiple dental clinics to meet their requirements to their satisfaction. Subsequently, it takes a toll on their quality of life causing, career disruption, financial loss and suicidal thoughts. In general, patients with PBS are quite rare but distinguishable if ever encountered. Since Marbach reported the first two cases in 1976, there have been dozens of published cases regarding this phenomenon, but only a few original studies were conducted. Despite the lack of official classification and guidelines, many authors agreed on the existence of a PBS “consistent pattern” that clinicians should be made aware. Nevertheless, the treatment approach has been solely based on incomplete knowledge of etiology, in which none of the proposed theories are fully explained in all the available cases. In this review, we have discussed the critical role of enhancing dental professionals’ awareness of this phenomenon and suggested a comprehensive approach for PBS, provided by a multidisciplinary team of dentists, psychiatrists and exclusive psychotherapists.
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Affiliation(s)
- Trang Thi Huyen Tu
- Department of Basic Dental Sciences, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh 72714, Viet Nam
- Department of Psychosomatic Dentistry, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Motoko Watanabe
- Department of Psychosomatic Dentistry, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | | | - Yojiro Umezaki
- Department of General Dentistry, Fukuoka Dental College, Fukuoka 814-0193, Japan
| | - Haruhiko Motomura
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Yusuke Sato
- Gerodontology and Oral Rehabilitation, Tokyo Medical and Dental University (TMDU), Tokyo 113-8510, Japan
| | - Akira Toyofuku
- Department of Psychosomatic Dentistry, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
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FLOX (5-fluorouracil + leucovorin + oxaliplatin) chemotherapy for colorectal cancer leads to long-term orofacial neurotoxicity: a STROBE-guided longitudinal prospective study. Int J Clin Oncol 2020; 25:2066-2074. [PMID: 32761281 DOI: 10.1007/s10147-020-01757-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 07/20/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Colorectal carcinoma (CRC) is widely treated by chemotherapy based on an intensely neurotoxic drug: oxaliplatin (OXL). We objective to evaluate prospectively the orofacial neurotoxicity during FLOX (fluorouracil + leucovorin + OXL) chemotherapy. METHODS So, 46 patients with CRC were prospectively evaluated during FLOX chemotherapy by 3 cycles (C) of 6 weeks (W) each. We weekly applied the orofacial section of the Acute and Chronic Neuropathy Questionnaire of Common Toxicity Criteria for Adverse Events of the National Cancer Institute of the United States of America (Oxaliplatin-specific neurotoxicity scale). Patients were asked the following concerning the severity (scores 0-5) of orofacial symptoms: jaw pain, eyelids drooping, throat discomfort, ear pain, tingling in mouth, difficulty with speech, burning or discomfort of the eyes, loss of any vision, feeling shock/pain down back and problems breathing. We summed the scores (0-50) and evaluated the clinicopathological data. Friedman/Dunn, Chi square and multinomial regression logistic tests were used (SPSS 20.0, p < 0.05). RESULTS There was a significant increase in sum of orofacial neurotoxicity from baseline to C1.W3, C2.W1 and C3.W5 (p < 0.001) due increase in scores of jaw pain (p < 0.001), eyelids drooping (p = 0.034), throat discomfort (p < 0.001), ear pain (p = 0.034), tingling in mouth (p = 0.015), burning/discomfort of your eyes (p < 0.001), loss of any vision (p < 0.001), feeling shock/pain down back (p < 0.001), problems with breathing (p = 0.045), but not difficulty with speech (p = 0.087). Women (p = 0.021) and young patients (p = 0.027) had significant higher prevalence of orofacial neurotoxicity. CONCLUSIONS FLOX-related orofacial neurotoxicity begins acutely and remains long term with increased incidence in women and younger patients.
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Imhoff B, Ahlers MO, Hugger A, Lange M, Schmitter M, Ottl P, Wolowski A, Türp JC. Occlusal dysesthesia-A clinical guideline. J Oral Rehabil 2020; 47:651-658. [PMID: 32080883 PMCID: PMC7317831 DOI: 10.1111/joor.12950] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 02/03/2020] [Accepted: 02/09/2020] [Indexed: 12/29/2022]
Abstract
Background The diagnosis and management of patients suffering from occlusal dysesthesia (OD) remain a major challenge for dental practitioners and affected patients. Objectives To present the results of a literature‐based expert consensus intended to promote better understanding of OD and to facilitate the identification and management of affected patients. Methods In 2018, electronic literature searches were carried out in PubMed, Cochrane Library and Google Scholar as well as in the archives of relevant journals not listed in these databases. This approach was complemented by a careful assessment of the reference lists of the identified relevant papers. The articles were weighted by evidence level, followed by an evaluation of their contents and a discussion. The result represents an expert consensus. Results Based on the contents of the 77 articles identified in the search, the current knowledge about clinical characteristics, epidemiology, aetiology, diagnostic process, differential diagnosis and management of OD is summarised. Conclusions Occlusal dysesthesia exists independently of the occlusion. Instead, it is the result of maladaptive signal processing. The focus should be on patient education, counselling, defocusing, cognitive behavioural therapy, supportive drug therapy and certain non‐specific measures. Irreversible, specifically an exclusively dental treatment approach must be avoided.
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Affiliation(s)
| | - M Oliver Ahlers
- Department of Prosthetic Dentistry School of Dental Medicine, University Medical Centre Hamburg-Eppendorf, and CMD-Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alfons Hugger
- Department for Prosthodontics, School of Dentistry, Heinrich Heine University, Düsseldorf, Germany
| | | | - Marc Schmitter
- Department of Prosthodontics, University of Würzburg, Würzburg, Germany
| | - Peter Ottl
- Department of Prosthodontics and Materials Science, University Medical Center Rostock, Rostock, Germany
| | - Anne Wolowski
- Department for Prosthodontics and Biomaterials, University Hospital Münster, Münster, Germany
| | - Jens Christoph Türp
- Department of Oral Health & Medicine, University Center of Dental Medicine Basel, University of Basel, Basel, Switzerland
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Abstract
Patients are living longer and the rate of edentulism is decreasing. Endodontic treatment is an essential part of maintaining the health and well-being of the elderly. Retention of natural teeth improves the quality of life and the overall health and longevity of ageing patients. Also, teeth that might be otherwise extracted may be strategically valuable to retain a prosthesis, and elderly patients are more likely to have medical complications that may prevent dental extractions from being safely performed. The technical goals of endodontic treatment in the elderly are the same as those for younger patients. However, the pulpo-dentinal complex undergoes calcific changes over time, which may pose challenges for the clinician. The purposes of this review are to discuss age changes in the pulp and the challenges posed by diagnosing, treatment planning and treating the elderly endodontic patient.
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Affiliation(s)
- M Johnstone
- Melbourne Dental School, The University of Melbourne, Victoria, Australia
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Melis M, Zawawi KH. Occlusal dysesthesia: a topical narrative review. J Oral Rehabil 2015; 42:779-85. [DOI: 10.1111/joor.12309] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2015] [Indexed: 12/14/2022]
Affiliation(s)
- M. Melis
- Private Practice; Cagliari Italy
- Craniofacial Pain and Headache Center; School of Dental Medicine; Tufts University; Boston MA USA
| | - K. H. Zawawi
- Department of Orthodontics; Faculty of Dentistry; King Abdulaziz University; Jeddah Saudi Arabia
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De Rui M, Marini I, Bartolucci ML, Inelmen EM, Bortolotti F, Manzato E, Gatto MRA, Checchi L, Sergi G. Pressure pain threshold of the cervico-facial muscles in healthy elderly people: the role of gender, age and dominance. Gerodontology 2014; 32:274-80. [PMID: 26780382 DOI: 10.1111/ger.12117] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2014] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim of this study was to assess the impact of age on pressure pain threshold (PPT) of cervico-facial muscles in healthy geriatric subjects and to investigate the role of gender and dominance on nociception. BACKGROUND Musculo-skeletal pain is common in the elderly, but being subjective, it risks to be underdiagnosed and undertreated. A useful method for assessment of local pain is determining PPT through pressure algometry. Ageing process seems to increase PPTs, but reference values for the assessment of pain in geriatric subjects are lacking. METHODS In this study, PPTs in temporal muscle, masseter, sternocleidomastoid, occipital and splenius capitis of 97 healthy elderly subjects were measured using Fischer algometer. Participants were divided by age in four classes (years 65-69; 70-74; 75-79; ≥80). RESULTS Women had lower PPTs in all muscles compared with men. Comparing PPTs obtained from the right and the left side, no significant differences were recorded neither in men nor in women. When dividing subjects by age class and education, in both genders no significant differences were observed in PPTs among the groups, neither in the right nor in the left sides. CONCLUSION In conclusion, the present study reports reference PPT values for the cervico-facial muscles that can be applied to a population of healthy elderly subjects. After 65 years of age, further ageing does not influence PPTs in cervico-facial muscles whereas female gender has lower PPTs.
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Affiliation(s)
- Marina De Rui
- Department of Medicine - DIMED, Geriatrics Division, University of Padova, Padova, Italy
| | - Ida Marini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Orthodontics and Gnathology Division, "Alma Mater Studiorum" University of Bologna, Bologna, Italy
| | - Maria Lavinia Bartolucci
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Orthodontics and Gnathology Division, "Alma Mater Studiorum" University of Bologna, Bologna, Italy
| | - Emine Meral Inelmen
- Department of Medicine - DIMED, Geriatrics Division, University of Padova, Padova, Italy
| | - Francesco Bortolotti
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Orthodontics and Gnathology Division, "Alma Mater Studiorum" University of Bologna, Bologna, Italy
| | - Enzo Manzato
- Department of Medicine - DIMED, Geriatrics Division, University of Padova, Padova, Italy
| | - Maria Rosaria Antonella Gatto
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Orthodontics and Gnathology Division, "Alma Mater Studiorum" University of Bologna, Bologna, Italy
| | - Luigi Checchi
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Orthodontics and Gnathology Division, "Alma Mater Studiorum" University of Bologna, Bologna, Italy
| | - Giuseppe Sergi
- Department of Medicine - DIMED, Geriatrics Division, University of Padova, Padova, Italy
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de Siqueira SRDT, Vilela TT, Florindo AA. Prevalence of headache and orofacial pain in adults and elders in a Brazilian community: an epidemiological study. Gerodontology 2013; 32:123-31. [DOI: 10.1111/ger.12063] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2013] [Indexed: 12/01/2022]
Affiliation(s)
| | - Talissa Tavares Vilela
- Gerontology; School of Arts, Science and Humanities; University of Sao Paulo; Sao Paulo Brazil
| | - Alex Antonio Florindo
- Physical Activity; School of Arts, Science and Humanities; University of Sao Paulo; Sao Paulo Brazil
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Hara ES, Matsuka Y, Minakuchi H, Clark GT, Kuboki T. Occlusal dysesthesia: a qualitative systematic review of the epidemiology, aetiology and management. J Oral Rehabil 2012; 39:630-8. [PMID: 22506934 DOI: 10.1111/j.1365-2842.2012.02300.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Occlusal dysesthesia refers to a persistent complaint of uncomfortable bite sensation with no obvious occlusal discrepancy. This systematic review aimed to draw a picture of such patients, to present an agreement of previously reported diagnostic criteria and to analyse the evidence level of the recommended management approaches. An electronic search for all relevant reports on occlusal dysesthesia was thoroughly performed based on previous nomenclatures (e.g. phantom bite, occlusal hyperawareness) in PubMed and The Cochrane Library in July, 2011. A total of 84 reports were matched, among which only 11 studies were included after a two-step (abstract and detailed full-text revision) screening process. Additionally, a thorough manual review of reference lists of the included reports enabled the inclusion of two additional studies. Data analysis revealed that 37 occlusal dysesthesia patients presented a mean age of 51.7 ± 10.6 years and were predominantly women (male/female: 1/5.1) with symptom duration of more than 6 years (average: 6.3 ± 7.5 years) and with concomitant psychological disturbances (e.g. mood disorders, somatoform disorders, personality disorders). Only four authors presented diagnostic criteria for occlusal dysesthesia, which served as the basis for an agreement in the diagnostic criteria. Treatment approaches included psychotherapy, cognitive/behaviour therapy, splint therapy and prescription of anti-depressants or anti-anxiety drugs. Classification of evidence level of management approaches, however, revealed that most of them were expert opinions with single- or multiple-case report(s). Future studies are necessary for a deeper understanding of the mechanisms behind the occlusal dysesthesia symptoms, and consequently, for improvements in evidence-based management approaches.
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Affiliation(s)
- E S Hara
- Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Minor JS, Epstein JB. Burning mouth syndrome and secondary oral burning. Otolaryngol Clin North Am 2011; 44:205-19, vii. [PMID: 21093630 DOI: 10.1016/j.otc.2010.09.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Burning mouth syndrome is a complex disorder of unclear etiology that is most prevalent in perimenopausal women. It is often accompanied by dysguesia and subjective xerostomia. Recent evidence implicates both central and peripheral neuropathies, possibly representing a phantom pain syndrome in some patients. Ensuring that the patient's oral burning is not secondary to some other local or systemic factor is central to appropriate management. Current standard therapies include clonazepam, paroxetine, and cognitive behavioral therapy, and several promising new alternatives are described.
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Affiliation(s)
- Jacob S Minor
- Department of Otolaryngology, University of Colorado at Denver, Denver, CO 80045, USA.
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