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Marques de Mattos de Araujo B, Jesus Freitas PF, Deliga Schroder AG, Küchler EC, Baratto-Filho F, Ditzel Westphalen VP, Carneiro E, Xavier da Silva-Neto U, Miranda de Araujo C. PAINe - An Artificial Intelligence Based Virtual Assistant to Aid in the Differentiation of Pain of Odontogenic versus Temporomandibular Origin. J Endod 2024:S0099-2399(24)00524-7. [PMID: 39342988 DOI: 10.1016/j.joen.2024.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 09/23/2024] [Accepted: 09/23/2024] [Indexed: 10/01/2024]
Abstract
INTRODUCTION Pain associated with temporomandibular dysfunction (TMD) is often confused with odontogenic pain, which is a challenge in endodontic diagnosis. Validated screening questionnaires can aid the identification and differentiation of the source of pain. Therefore, this study aimed to develop a virtual assistant based on artificial intelligence, using natural language processing techniques to automate the initial screening of patients with tooth pain. METHODS The PAINe chatbot was developed in Python language, using the PyCharm environment and the 'openai' library to integrate the ChatGPT 4 API, and the 'streamlit' library for interface construction. The validated TMD Pain Screener questionnaire and one question about the current pain intensity was integrated into the chatbot to perform the differential diagnosis of TMD in patients with tooth pain. The responses' accuracy was evaluated in 50 random scenarios to compare the chatbot with the validated questionnaire. The Kappa coefficient was calculated to assess the agreement level between the chatbot responses and the validated questionnaire. RESULTS The chatbot achieved an accuracy rate of 86% and a substantial level of agreement (Kappa = 0.70). Most responses were clear and provided adequate information about the diagnosis. CONCLUSIONS The implementation of a virtual assistant using natural language processing, based on large language models, for initial differential diagnosis screening of patients with tooth pain, demonstrated substantial agreement between validated questionnaires and the chatbot. This approach emerges as a practical and efficient option for screening these patients.
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Affiliation(s)
| | | | | | - Erika Calvano Küchler
- Department of Orthodontics, University Hospital Bonn, Medical Faculty, Welschnonnenstr. 17, 53111, Bonn, Germany
| | - Flares Baratto-Filho
- School of Dentistry, Department of Endodontics, Tuiuti University of Paraná, Curitiba, PR, Brazil
| | | | - Everdan Carneiro
- School of Dentistry, Department of Endodontics, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Ulisses Xavier da Silva-Neto
- School of Dentistry, Department of Endodontics, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
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McCloy K, Herrero Babiloni A, Sessle BJ. Sleep disorders and orofacial pain: insights for dental practice. Aust Dent J 2024. [PMID: 39304335 DOI: 10.1111/adj.13037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2024] [Indexed: 09/22/2024]
Abstract
In dental sleep medicine several sleep disorders commonly coexist with pain, contributing to complex clinical presentations which might affect the provision of appropriate and timely treatment. There are associations between sleep disorders and pain in general, as well as with specific orofacial pain conditions. As many as five of six patients with orofacial pain can present with sleep problems. The comorbidity of orofacial pain and sleep disorders overlays a complex web of altered neurobiological mechanisms that predispose to the chronification of orofacial pain. This review discusses the relationship between orofacial pain and sleep disorders and highlights their interactions and the neurobiological mechanisms underlying those relationships.
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Affiliation(s)
- K McCloy
- Pain Management and Research Institute Sydney University, Sydney, New South Wales, Australia
| | - A Herrero Babiloni
- Faculty of Medicine, Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
| | - B J Sessle
- Faculty of Dentistry, Faculty of Medicine Department of Physiology, and Centre for the Study of Pain, University of Toronto, Toronto, Canada
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Yilmaz M, Kale E, Ozge A. The link between cutaneous allodynia and pain/sensitivity in teeth and gums during migraine episodes. BMC Oral Health 2024; 24:1043. [PMID: 39232738 PMCID: PMC11375880 DOI: 10.1186/s12903-024-04705-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 08/05/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Migraine is one of the most common primary headaches worldwide, while toothache is the most common pain in the orofacial region. The association of migraine pain, and oral pain is unknown. This study aims to investigate the association between migraine and dental and gingival pain with the presence of allodynia. METHODS A questionnaire comprising demographic data with the ID-Migraine (IDM) tool, an Allodynia Symptom Checklist (ASC), and inquiries about pain and sensitivity in the teeth and gums during migraine attacks was administered to the participants and 762 responded the survey. The study classified participants based on the ASC, and the relationship between allodynia and pain/sensitivity in the teeth and/or gums during migraine attacks was analyzed. The statistical analyses utilized Chi-square tests and the Fisher-Exact test. RESULTS Among 762 migraine patients, 430 (56.44%) were classified as allodynia (+), while 332 (43.56%) were classified as allodynia (-) (p < 0.001). Additionally, 285 participants (37.5%) reported experiencing pain and sensitivity in the teeth and gums during migraine attacks, with a significant relationship observed between allodynia and pain/sensitivity in the teeth and/or gums during migraine attacks (p < 0.001). CONCLUSION The findings of this study have important clinical implications. For migraine patients who are non-allodynic, the presence of pain and sensitivity in their teeth and gums during migraine attacks may indicate underlying dental diseases or the need for dental treatment especially root canal treatment. However, for allodynic patients, such symptoms may not necessarily indicate the presence of dental diseases or the need for dental treatment especially root canal treatment. These results underscore the significance of considering the presence of allodynia in the assessment and management of oral symptoms during migraine attacks.
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Affiliation(s)
- Melis Yilmaz
- Faculty of Dentistry, Department of Endodontics, Mersin University, Private Practice, Mersin, Turkey
| | - Ediz Kale
- Faculty of Dentistry, Department of Prosthodontics, Mersin University, Mersin, Turkey.
| | - Aynur Ozge
- Faculty of Medicine, Department of Neurology, Mersin University, Mersin, Turkey
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Shimizu K, Yasukawa T, Ohara K, Noma N, Hayashi M, Takeichi O. Mirogabalin as a Therapeutic Option for Neuropathic Pain Emerging Post-endodontic Treatment: A Two-Case Report. J Endod 2024; 50:1351-1356. [PMID: 38901645 DOI: 10.1016/j.joen.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 06/22/2024]
Abstract
INTRODUCTION Occlusal and percussion pain may manifest occasionally following endodontic treatment, influencing retreatment decisions. Two cases of periapical neuropathic pain, classified as post-traumatic trigeminal neuropathic pain according to the International Classification of Orofacial Pain, are presented. Although mirogabalin is effective in managing neuropathic pain, there is a lack of clinical reports on its use for occasional post-traumatic trigeminal neuropathic pain after endodontic treatment. These cases highlight clinical symptoms and successful treatment with mirogabalin for post-traumatic trigeminal neuropathic pain after endodontic treatment, providing clinicians a "take-away" lesson for improving patient condition. METHODS The patients, referred by their primary dentist due to postendodontic abnormal pain, found no relief with antibiotics or nonsteroidal anti-inflammatory drugs. Although no findings including swelling or periapical radiolucency were observed around the tooth, they experienced occlusal and percussion pain. Local anesthetic testing showed that the pain originated from the peripheral area around the tooth rather than from central sensitization. Dental radiography and cone-beam computed tomography revealed no abnormal findings. Root canal retreatment was performed by a specialist in endodontic treatment. Although endodontic retreatment drastically decreased visual analog scale pain score, pain persisted. Based on the International Classification of Orofacial Pain criteria, diseases other than post-traumatic trigeminal neuropathic pain were excluded. Mirogabalin (10 mg/d) was prescribed once daily before bedtime. RESULTS Visual analog scale scores gradually and drastically decreased 2 weeks after mirogabalin therapy. Several months later, no recurrence of postendodontic pain was observed after tapering off and discontinuing mirogabalin. CONCLUSIONS These findings suggest the possibility of a new treatment method for post-traumatic trigeminal neuropathic pain after endodontic treatment.
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Affiliation(s)
- Kohei Shimizu
- Department of Endodontics, Nihon University School of Dentistry, Tokyo, Japan; Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan.
| | - Takuya Yasukawa
- Department of Endodontics, Nihon University School of Dentistry, Tokyo, Japan; Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Kinuyo Ohara
- Department of Endodontics, Nihon University School of Dentistry, Tokyo, Japan; Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Noboru Noma
- Department of Oral Medicine, Nihon University School of Dentistry, Tokyo, Japan; Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Makoto Hayashi
- Department of Endodontics, Nihon University School of Dentistry, Tokyo, Japan; Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | - Osamu Takeichi
- Department of Endodontics, Nihon University School of Dentistry, Tokyo, Japan; Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
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Anita H, Asnely Putri F, Maulina T. The Association Between Orofacial Pain and Depression: A Systematic Review. J Pain Res 2024; 17:785-796. [PMID: 38440413 PMCID: PMC10910975 DOI: 10.2147/jpr.s435219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 02/16/2024] [Indexed: 03/06/2024] Open
Abstract
Background The occurrence of orofacial pain is often accompanied by comorbid conditions such as depression. Even though previous studies suggested a bidirectional correlation between orofacial pain and psychological factors, some studies still provided contradictory results. Objective This systematic review aimed at providing scientific evidence regarding the association between orofacial pain and depression in published literature. Methods The current study is a systematic literature review (PROSPERO registration no. CRD42023438596) that was conducted by reviewing cross-sectional studies that investigated the association between orofacial pain and depression. Article selection was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Articles searching was performed by using three databases, namely PubMed, ScienceDirect, and Scopus using the Boolean operator method. Article screening was carried out by applying the inclusion and exclusion criteria, as well as duplication checking, suitability checking, and compatibility checking. Reviewed articles went through the risk of bias evaluation form from the Joanna Briggs Institute (JBI). Extracted data were analyzed in a qualitative method. Results Twelve studies that were conducted on 5557 participants were included in the final review. After all articles were analyzed, the correlation between orofacial pain and depression was revealed. Most articles revealed a positive correlation between orofacial pain and depression, and the rest showed how orofacial pain patients showed significantly higher depression scores compared to those individuals without orofacial pain. Conclusion The results of this systematic review suggested a correlation between orofacial pain and depression with varying degrees. Incorporating potential depressive symptoms' treatment, when treating orofacial pain patients, should be part of the treatment plan.
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Affiliation(s)
- Hadia Anita
- Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Farah Asnely Putri
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Tantry Maulina
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
- Dentistry Department, Faculty of Medical Sciences, Radboud University, Nijmegen, the Netherlands
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Sharma D, Kumar S, Garg Y, Chopra S, Bhatia A. Nanotechnology in Orthodontics: Unveiling Pain Mechanisms, Innovations, and Future Prospects of Nanomaterials in Drug Delivery. Curr Pharm Des 2024; 30:1490-1506. [PMID: 38644722 DOI: 10.2174/0113816128298451240404084605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/28/2024] [Accepted: 03/21/2024] [Indexed: 04/23/2024]
Abstract
Orthodontic pain is characterized by sensations of tingling, tooth discomfort, and intolerance. According to the oral health report, over forty percent of children and adolescents have undergone orthodontic treatment. The efficacy of orthodontic treatment involving braces can be compromised by the diverse levels of discomfort and suffering experienced by patients, leading to suboptimal treatment outcomes and reduced patient adherence. Nanotechnology has entered all areas of science and technology. This review provides an overview of nanoscience, its application in orthodontics, the underlying processes of orthodontic pain, effective treatment options, and a summary of recent research in Nano-dentistry. The uses of this technology in healthcare span a wide range, including enhanced diagnostics, biosensors, and targeted drug delivery. The reason for this is that nanomaterials possess distinct qualities that depend on their size, which can greatly enhance human well-being and contribute to better health when effectively utilized. The field of dentistry has also experienced significant advancements, particularly in the past decade, especially in the utilization of nanomaterials and technology. Over time, there has been an increase in the availability of dental nanomaterials, and a diverse array of these materials have been extensively studied for both commercial and therapeutic purposes.
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Affiliation(s)
- Divya Sharma
- Department of Pharmaceutical Sciences and Technology, Maharaja Ranjit Singh Punjab Technical University (MRSPTU), Bathinda 151001, Punjab, India
- Faculty of Pharmaceutical Sciences, The ICFAI University, Baddi, Himachal Pradesh 174103, India
| | - Shiv Kumar
- Department of Pharmaceutical Sciences and Technology, Maharaja Ranjit Singh Punjab Technical University (MRSPTU), Bathinda 151001, Punjab, India
| | - Yogesh Garg
- Department of Pharmaceutical Sciences and Technology, Maharaja Ranjit Singh Punjab Technical University (MRSPTU), Bathinda 151001, Punjab, India
| | - Shruti Chopra
- Department of Pharmaceutical Sciences and Technology, Maharaja Ranjit Singh Punjab Technical University (MRSPTU), Bathinda 151001, Punjab, India
| | - Amit Bhatia
- Department of Pharmaceutical Sciences and Technology, Maharaja Ranjit Singh Punjab Technical University (MRSPTU), Bathinda 151001, Punjab, India
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Luiz MD, Coelho LAS, Vivan RR, Duarte MAH, Alcalde MP, Conti PCR, Costa YM, Bonjardim LR. Divergence between confidence and knowledge of endodontists regarding non-odontogenic pain. J Appl Oral Sci 2023; 31:e20230222. [PMID: 37820183 PMCID: PMC10561960 DOI: 10.1590/1678-7757-2023-0222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/09/2023] [Accepted: 08/16/2023] [Indexed: 10/13/2023] Open
Abstract
INTRODUCTION This study aimed to assess the self-reported levels of confidence and knowledge related to non-odontogenic pain among a group of Brazilian endodontists. METHODOLOGY A total of one hundred and forty-six endodontists affiliated with the Brazilian Society of Endodontics participated in the survey. The questionnaire, distributed via email or WhatsApp, contained inquiries designed to gauge self-perceived confidence and knowledge concerning non-odontogenic pain. The practitioners were categorized into four groups based on their self-reported familiarity with various orofacial pain types, classified as either sufficient or insufficient, and on their engagement in ongoing educational programs related to orofacial pain. Data were analyzed by Chi-Square Test and Fischer's exact test (p<0.05). RESULTS Overall, self-reported confidence about non-odontogenic pain was high, especially for endodontists who considered their knowledge about orofacial pain sufficient, regardless of whether they had (71.1% - 97.8%) or not (35.7% - 96.4%) been continuously involved in education courses on orofacial pain. In general, self-reported knowledge about non-odontogenic pain was insufficient (0% - 42%), except in the question about how they would act in cases of pain that persists beyond the normal healing time after an endodontic procedure (70.6% - 81.9%). In general, endodontists are confident in their diagnosis and treatment of non-odontogenic pain. Nonetheless, this confidence did not correlate with a commensurate knowledge depth of. Thus, specialization courses in endodontics should highly consider training and qualifying these professionals in the diagnosis of non-odontogenic pain.
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Affiliation(s)
- Marcos Dezotti Luiz
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, Brasil
| | - Letycia Accioly Simões Coelho
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, Brasil
| | - Rodrigo Ricci Vivan
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, Brasil
| | - Marco Antônio Hungaro Duarte
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, Brasil
| | - Murilo Priori Alcalde
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, Brasil
| | - Paulo César Rodrigues Conti
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, Brasil
| | - Yuri Martins Costa
- Universidade de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Biociências, Piracicaba, Brasil
| | - Leonardo Rigoldi Bonjardim
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, Brasil
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Labanca M, Gianò M, Franco C, Rezzani R. Orofacial Pain and Dentistry Management: Guidelines for a More Comprehensive Evidence-Based Approach. Diagnostics (Basel) 2023; 13:2854. [PMID: 37685392 PMCID: PMC10486623 DOI: 10.3390/diagnostics13172854] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/24/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
Orofacial pain represents one of the most common health problems that negatively affects the activities of daily living. However, the mechanisms underlying these conditions are still unclear, and their comprehensive management is often lacking. Moreover, even if pain is a common symptom in dentistry, differential diagnostic procedures are needed to exclude other pain origins. Misinterpretation of the pain origin, in fact, can lead to misdiagnosis and to subsequent mismanagement. Pain in the orofacial area is the most common reason for patients to visit the dentist, but this area is complex, and the pain could be associated with the hard and soft tissues of the head, face, oral cavity, or to a dysfunction of the nervous system. Considering that the origins of orofacial pain can be many and varied, a thorough assessment of the situation is necessary to enable the most appropriate diagnostic pathway to be followed to achieve optimal clinical and therapeutic management.
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Affiliation(s)
- Mauro Labanca
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (M.G.); (C.F.); (R.R.)
- Italian Society for the Study of Orofacial Pain (Società Italiana Studio Dolore Orofacciale—SISDO), 25123 Brescia, Italy
| | - Marzia Gianò
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (M.G.); (C.F.); (R.R.)
| | - Caterina Franco
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (M.G.); (C.F.); (R.R.)
| | - Rita Rezzani
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (M.G.); (C.F.); (R.R.)
- Italian Society for the Study of Orofacial Pain (Società Italiana Studio Dolore Orofacciale—SISDO), 25123 Brescia, Italy
- Interdipartimental University Center of Research “Adaption and Regeneration of Tissues and Organs (ARTO)”, University of Brescia, 25123 Brescia, Italy
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Gianò M, Franco C, Castrezzati S, Rezzani R. Involvement of Oxidative Stress and Nutrition in the Anatomy of Orofacial Pain. Int J Mol Sci 2023; 24:13128. [PMID: 37685933 PMCID: PMC10487620 DOI: 10.3390/ijms241713128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/13/2023] [Accepted: 08/17/2023] [Indexed: 09/10/2023] Open
Abstract
Pain is a very important problem of our existence, and the attempt to understand it is one the oldest challenges in the history of medicine. In this review, we summarize what has been known about pain, its pathophysiology, and neuronal transmission. We focus on orofacial pain and its classification and features, knowing that is sometimes purely subjective and not well defined. We consider the physiology of orofacial pain, evaluating the findings on the main neurotransmitters; in particular, we describe the roles of glutamate as approximately 30-80% of total peripheric neurons associated with the trigeminal ganglia are glutamatergic. Moreover, we describe the important role of oxidative stress and its association with inflammation in the etiogenesis and modulation of pain in orofacial regions. We also explore the warning and protective function of orofacial pain and the possible action of antioxidant molecules, such as melatonin, and the potential influence of nutrition and diet on its pathophysiology. Hopefully, this will provide a solid background for future studies that would allow better treatment of noxious stimuli and for opening new avenues in the management of pain.
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Affiliation(s)
- Marzia Gianò
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (M.G.); (C.F.); (S.C.)
| | - Caterina Franco
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (M.G.); (C.F.); (S.C.)
| | - Stefania Castrezzati
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (M.G.); (C.F.); (S.C.)
| | - Rita Rezzani
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (M.G.); (C.F.); (S.C.)
- Interdipartimental University Center of Research “Adaption and Regeneration of Tissues and Organs (ARTO)”, University of Brescia, 25123 Brescia, Italy
- Italian Society for the Study of Orofacial Pain (Società Italiana Studio Dolore Orofacciale—SISDO), 25123 Brescia, Italy
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Garcia R, Chen Q, Posadas E, Tran J, Kwon A, Qian X. Continuous Ketamine Infusion as a Treatment for Refractory Facial Pain. Cureus 2023; 15:e35638. [PMID: 37009385 PMCID: PMC10064815 DOI: 10.7759/cureus.35638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2023] [Indexed: 03/05/2023] Open
Abstract
Complex orofacial pain disorders, such as trigeminal neuralgia (TN) and atypical facial pain (AFP), can be excruciating and debilitating during attacks. Ketamine, an N-methyl-D-aspartate (NMDA) antagonist, is a powerful analgesic that has been used to treat various chronic pain conditions, but its role in treating complex facial pain has only been recently explored. In this retrospective case series, we reviewed the efficacy of continuous ketamine infusion for 12 patients with facial pain refractory to medical treatment. Patients who presented with a diagnosis of TN were more likely to have significant and sustained pain relief after receiving ketamine infusion. By contrast, those who did not respond to the treatment were more likely to have a diagnosis of AFP. The current report suggests a fundamental difference between these two facial pain disorders in their respective underlying pathophysiology and supports the use of continuous ketamine infusion for refractory TN, but not AFP.
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Assessment of internal derangement of the temporomandibular joint according to the concentration of salivary cytokines in patients with spondyloarthritis. Med Hypotheses 2022. [DOI: 10.1016/j.mehy.2022.111000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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A Review on Autophagy in Orofacial Neuropathic Pain. Cells 2022; 11:cells11233842. [PMID: 36497100 PMCID: PMC9735968 DOI: 10.3390/cells11233842] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/02/2022] Open
Abstract
Orofacial neuropathic pain indicates pain caused by a lesion or diseases of the somatosensory nervous system. It is challenging for the clinician to diagnose and manage orofacial neuropathic pain conditions due to the considerable variability between individual clinical presentations and a lack of understanding of the mechanisms underlying the etiology and pathogenesis. In the last few decades, researchers have developed diagnostic criteria, questionnaires, and clinical assessment methods for the diagnosis of orofacial neuropathic pain. Recently, researchers have observed the role of autophagy in neuronal dysfunction as well as in the modulation of neuropathic pain. On this basis, in the present review, we highlight the characteristics, classification, and clinical assessment of orofacial neuropathic pain. Additionally, we introduce autophagy and its potential role in the modulation of orofacial neuropathic pain, along with a brief overview of the pathogenesis, which in future may reveal new possible targets for treating this condition.
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Muacevic A, Adler JR, Al Mazyad B, Al Yousef S, Hatab Alanazi S. The Association Between Post-Traumatic Stress Disorder and Temporomandibular Disorders: A Systematic Review. Cureus 2022; 14:e31896. [PMID: 36579250 PMCID: PMC9792336 DOI: 10.7759/cureus.31896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022] Open
Abstract
The purpose of this systematic study was to discover a connection between temporomandibular joint disorders and post-traumatic stress disorder. A systematic review of observational studies on post-traumatic stress disorder and the incidence of temporomandibular joint disorders (TMD) was conducted. Electronic searches of PubMed, the Saudi Digital Library, Science Direct, the Virtual Health Library (VHL), Scopus, Web of Science, Sage, EBSCO Information Services, and Ovid were performed. There was a consensus among the reviewing examiners. Only studies with the following Medical Subject Headings (MeSH) terms were included: "Posttraumatic stress disorder" combined with "temporomandibular joint disorder," "myofascial pain," "orofacial pain," "internal derangement," "disc displacement with reduction," or "disc displacement without reduction." Only full-text studies in the English language published between 2010 and June 2020 were considered. Of a total of 381 articles meeting the initial screening criteria, only eight were included in the qualitative analysis. Overall, pain is exacerbated in patients with PTSD; that is, their TMD is heightened in all aspects of pain, chronicity, decreased response to conventional therapies, and the need for more potent treatment options as compared with patients with just TMD. The evidence, albeit weak, obtained from the studies included in this review suggests a relationship between PTSD and TMDs.
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Vital Pulp Therapy of Permanent Teeth with Reversible or Irreversible Pulpitis: An Overview of the Literature. J Clin Med 2022; 11:jcm11144016. [PMID: 35887779 PMCID: PMC9321233 DOI: 10.3390/jcm11144016] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/08/2022] [Accepted: 07/10/2022] [Indexed: 12/10/2022] Open
Abstract
Vital pulp therapy (VPT) has been recently proposed as an alternative approach even in symptomatic mature permanent teeth with deep caries’ lesions, aiming to maintain the pulp vitality over time and/or to avoid non-surgical root canal therapy (NSRCT). However, to date, the diagnosis of reversible or irreversible pulpitis is only based on clinical pain quantity and quality, without precisely reflecting the pulp inflammation status. Therefore, the aim of the present study was to provide an overview based on the current scientific literature to demonstrate the clinical effectiveness of VPT on mature permanent teeth, validating the use of hydraulic calcium silicate-based cements and their role in pain management. VPT may be successfully applied not only in mature permanent teeth diagnosed with reversible pulpitis, but also in permanent dental elements with signs and symptoms of irreversible pulpitis. Hydraulic cements showed favorable outcomes in terms of decrease of pro-inflammatory mediators and of post-operative pain. Pain plays a central role in the chance to perform VPT in mature permanent teeth, since it may be considered as a pre-operative diagnostic criterion as well as a treatment success parameter. In addition, proper assessment of pulp inflammation and choice of appropriate materials are key factors in enhancing VPT success.
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15
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Arısan V, Bedeloğlu E, Pişkin B. Prevalence and predictors of bruxism in two university clinic patient populations with dental implants: A cross-sectional analysis. Cranio 2022:1-12. [PMID: 35522040 DOI: 10.1080/08869634.2022.2071794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To analyze the prevalence, predictors, and prosthetic complications of bruxing patients with dental implants in two tertiary clinics in Istanbul, Turkey. METHODS Patients with at least one dental implant and with a fixed prosthesis were examined for the evidence of probable bruxism. Factors that could be related to bruxism were analyzed in relation to patient-specific variables. Technical and mechanical complications were investigated. RESULTS A total of 1688 patients were analyzed. The overall rate of probable bruxism was 19.72%. Besides self-reported bruxism (p < 0.022), antidepressant use (p < 0.002), frequent headaches (p < 0.014), and observation of linea alba (p < 0.028) were the predictors for probable bruxism. Technical and mechanical complications were frequent in the probable bruxers (p < 0.05). CONCLUSION Overall prevalence of bruxism was 19.72%, and bruxism was associated with general and gender-specific predictors.
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Affiliation(s)
- Volkan Arısan
- Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Capa-Beyazıt, Turkey
| | - Elçin Bedeloğlu
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Istanbul Aydın University, Florya, Turkey
| | - Bülent Pişkin
- Department of Prosthodontics, Faculty of Dentistry, Kapadokya University, Nevşehir, Turkey
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16
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Mustafa NS, Kashmoola MA, Al-Ahmad BEM, Fansuri MABH, Jurimi NHM, Kashmoola S. A Retrospective Study on the Etiological Factors of Orofacial Pain in a Malaysian Sample. Eur J Dent 2022; 16:302-306. [PMID: 34753187 PMCID: PMC9339946 DOI: 10.1055/s-0041-1735443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
OBJECTIVE This study aimed to examine the etiological factors of orofacial pain for patients attending dental clinic at Faculty of Dentistry, International Islamic University Malaysia (IIUM). MATERIALS AND METHODS This retrospective study examined the data of 248 patients who have attended dental clinic at Faculty of Dentistry IIUM and suffering from different types of orofacial pain. The data were collected from January 2010 to November 2018. The etiologies of pain were classified according to International Classification of Orofacial Pain, 1st edition (2020). STATISTICAL ANALYSIS The association of age and gender with orofacial pain was evaluated by using the Chi-square test, and the significance level was set to 0.05. RESULTS Collected data showed that orofacial pain has different etiologies among the patients attending the dental clinic at Faculty of Dentistry IIUM. Moreover, a statistically significant relation was observed between orofacial pain toward gender and different age group. CONCLUSION The findings proposed that the orofacial pain has a variety of etiological factors with the highest percentage of orofacial pain attributed to disorders of dentoalveolar and anatomically related structures among patients attending dental clinic at Faculty of Dentistry IIUM.
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Affiliation(s)
- Nazih Shaban Mustafa
- Department of Oral Maxillofacial Surgery and Oral Diagnosis, Faculty of Dentistry, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Muhannad Ali Kashmoola
- Department of Oral Maxillofacial Surgery and Oral Diagnosis, Faculty of Dentistry, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Basma Ezzat Mustafa Al-Ahmad
- Department of Fundamental Dental and Medical Sciences, Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | | | | | - Sayfaldeen Kashmoola
- Department of Prosthodontics, Faculty of Dentistry, Lincoln University College, Petaling Jaya, Selangor, Malaysia
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17
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Di Spirito F, Scelza G, Fornara R, Giordano F, Rosa D, Amato A. Post-Operative Endodontic Pain Management: An Overview of Systematic Reviews on Post-Operatively Administered Oral Medications and Integrated Evidence-Based Clinical Recommendations. Healthcare (Basel) 2022; 10:healthcare10050760. [PMID: 35627897 PMCID: PMC9141195 DOI: 10.3390/healthcare10050760] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 01/08/2023] Open
Abstract
Endodontic treatment comprises the overall management of pre-, intra- and post-operative symptoms, including post-operative endodontic pain, considered as a complication susceptible of chronicization. Post-operative pain is very common and highly unpreventable and has a multi-factorial etiology and a potential pathogenic link to the acute inflammation of the periapical area, secondary to localized chemical, mechanical, host and/or microbial damage occurring during endodontic treatment. Considering the multitude of heterogeneous technical and pharmacological approaches proposed to control post-operative endodontic pain, the present study primarily comprised an overview of systematic reviews of systematic reviews of randomized clinical trials, summarizing findings on post-operatively administered oral medications for post-operative endodontic pain control, in order to note the most effective type and dosage of such drugs. Secondarily, a narrative review of the current evidence on technical solutions to be observed during endodontic treatment procedures, to control post-operative pain, was conducted to provide integrated evidence-based clinical recommendations for optimal post-operative endodontic pain management.
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Affiliation(s)
- Federica Di Spirito
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (G.S.); (F.G.); (D.R.); (A.A.)
- Correspondence: or
| | - Giuseppe Scelza
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (G.S.); (F.G.); (D.R.); (A.A.)
| | | | - Francesco Giordano
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (G.S.); (F.G.); (D.R.); (A.A.)
| | - Donato Rosa
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (G.S.); (F.G.); (D.R.); (A.A.)
| | - Alessandra Amato
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (G.S.); (F.G.); (D.R.); (A.A.)
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18
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Duncan HF. Present status and future directions - Vital pulp treatment and pulp preservation strategies. Int Endod J 2022; 55 Suppl 3:497-511. [PMID: 35080024 PMCID: PMC9306596 DOI: 10.1111/iej.13688] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 11/29/2022]
Abstract
Therapeutic strategies focussed on the pulp preservation, are important when managing vital teeth with deep caries and an exposed pulp. These vital pulp treatments (VPTs); however, are not new, with indirect and direct pulp capping procedures being described as a therapy for carious teeth for over a century. As a result of unpredictable outcomes, the traditional indications for VPT particularly when the pulp was exposed were limited to the treatment of immature teeth with incomplete root formation. Over the last 20 years, the advent of regenerative endodontics and the promotion of biologically based therapies aimed at reducing intervention have reinvigorated VPT with new waves of basic science and clinical research indicating a role for VPT not only in mature cariously affected teeth, but also in teeth with signs and symptoms indicative of irreversible pulpitis. Driven by new materials such as hydraulic calcium silicate cements, a better understanding of pulpal immunity and biology as well and improved tissue handling, VPT has been at the forefront of treatment recommendations made by global Cariology and Endodontic organizations. Care must be exercised, however, as key gaps in scientific knowledge remain alongside severe limitations in educational dissemination amongst dentists. Although research has highlighted that carious injury to the dentine–pulp complex stimulates a wide range of responses and that the interaction between infection, inflammation and repair will eventually impact on the outcome of pulpitis, our ability to accurately and objectively diagnose the true inflammatory state of the pulp remains poor. An overreliance on symptoms leaves clinicians with subjective, crude diagnostic tools by which to inform treatment planning and decision‐making, which results in large variations in the treatments offered to patients. Not only is there an urgent need to develop preoperative and intraoperative diagnostic tools, but there is also a paucity of the high‐quality comparative evidence required to answer the most important questions and justify treatment options. The aim of this review was to consider the current status of VPT and to discuss the principle problems that are hindering clinical acceptance of these techniques. Potential solutions and opportunities are offered to suggest ways that VPT may become a more consistently prescribed evidenced‐based treatment in dental practice.
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Affiliation(s)
- Henry F Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Lincoln Place, Dublin 2, Ireland
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19
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Supportive Home Remedies for Orofacial Pain during the Coronavirus Disease 2019 Pandemic: Their Value and Limitations. Int J Dent 2022; 2022:2005935. [PMID: 35069740 PMCID: PMC8771145 DOI: 10.1155/2022/2005935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/06/2022] [Indexed: 12/03/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has impeded access to timely dental care, and there is an urgent need for adjuvant therapies that can reduce orofacial pain in emergencies. Aims To provide information on the benefits and limitations of eight representative home remedies as palliative care for orofacial pain during the coronavirus disease 2019 (COVID-19) pandemic. Methods PubMed and Medline were electronically searched for eight home remedies for orofacial pain that can be used in COVID-19. Papers published in English in the past 30 years were considered. Among the published studies suitable for the research purpose, those in which the abstract and body text were confirmed were targeted, and duplicate studies were excluded. Finally, 86 studies were included. Results There is extensive and high-level scientific evidence for the application of tooth brushing and flossing, mouth rinsing with chlorhexidine, use of over-the-counter pain medication, and application of cryotherapy in emergencies. Gargling with salt water, brushing with bamboo salt, gargling with garlic juice, and oil pulling are traditional methods used for centuries. The use of natural products for orofacial pain has a significant empirical effect but has weak scientific evidence. Conclusions Knowing the correct application method, effects, and side effects is desirable to use these methods appropriately in emergencies. However, scientific evidence is unclear and generally lacking for home remedies to be the main treatment strategy, and there are clear limitations to their use as a single main treatment.
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Zehnder M, Belibasakis GN. A critical analysis of research methods to study clinical molecular biomarkers in Endodontic research. Int Endod J 2021; 55 Suppl 1:37-45. [PMID: 34655496 PMCID: PMC9298367 DOI: 10.1111/iej.13647] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/14/2021] [Indexed: 12/22/2022]
Abstract
The authors of this narrative review aimed to address various experimental methods and make recommendations for how research should move forward in the context of studying biomarkers in clinical Endodontic research. The approach adopted is exemplified using two prominent clinical problems, namely (a) the ‘reversible’ versus ‘irreversible’ pulpitis conundrum and (b) persistent idiopathic dentoalveolar pain (PIDAP). Pulpitis under deep caries or dentinal cracks is understood from a histological perspective, but clinical assessment tools to indicate irreversibly inflamed aspects of the dental pulp are elusive. PIDAP, on the other hand, is a diagnosis of exclusion; its pathophysiology is complex and not understood sufficiently to avoid unnecessary dental treatments. This review addresses how diagnostic biomarkers could further our understanding of those and other clinical problems, and how issues can be tackled from a methodological point of view. Hence, different methodological approaches to identify suitable diagnostic biomarker(s) or use known biomarkers are presented. The importance of asking a relevant research question, collecting the most suitable fluid and using the ideal collection vehicle for the research question under investigation is discussed based on the defined clinical problems.
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Affiliation(s)
- Matthias Zehnder
- Clinic of Conservative and Preventive Dentistry, University of Zürich Center of Dental Medicine, Zürich, Switzerland
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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21
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Erdogan O, Ramsey A, Uyanik JM, Gibbs JL, Burns LE. Outcomes of referrals from endodontic to orofacial pain specialists: A retrospective cohort study. Clin Exp Dent Res 2021; 8:457-463. [PMID: 34623771 PMCID: PMC8874062 DOI: 10.1002/cre2.497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/11/2021] [Accepted: 08/25/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Diagnosis and treatment of non-odontogenic pain is challenging for endodontists. The purpose of the study was to investigate the outcomes of referrals to orofacial pain specialists made for patients with suspected non-odontogenic pain, after evaluation and/or treatment by an endodontist. MATERIALS AND METHODS A retrospective review of dental records was conducted for 60 patients referred from a postgraduate endodontic clinic to an orofacial pain clinic. Patient demographics, pain history, endodontic, and orofacial pain diagnoses were collected. Number of visits, length of treatment, and treatments prescribed were recorded. For analysis of outcomes, data pertinent to resolution/persistence of symptoms and patient compliance were analyzed. RESULTS Thirty-five patients were included in the study. The most frequent pulpal and periapical diagnoses were previously treated (62%) and symptomatic apical periodontitis (72%), respectively. The most common orofacial pain diagnosis was temporomandibular disorder. The average time spent to diagnose and treat the pain was 17 months. Pain reduction varied and was documented for 51% of patients. Indications of non-compliance with orofacial pain appointments and treatments were documented for 66% of patients. CONCLUSIONS Non-odontogenic pain diagnosis and treatment are challenging. Patients may have an increased predilection for developing persistent pain after endodontic treatment and/or have an undiagnosed, chronic orofacial pain condition as a true source of their chief complaint. It may be helpful for endodontists to set expectations of typical treatment times/plans when referring patients for evaluation and treatment of non-odontogenic pain.
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Affiliation(s)
- Ozge Erdogan
- Department of Endodontics, College of DentistryNew York UniversityNew YorkNew YorkUSA
- Division of Endodontics in Restorative Dentistry and Biomaterials SciencesHarvard School of Dental MedicineBostonMassachusettsUSA
| | - Austin Ramsey
- Department of Endodontics, College of DentistryNew York UniversityNew YorkNew YorkUSA
| | - James M. Uyanik
- Department of Oral and Maxillofacial Pathology, Radiology and MedicineCollege of Dentistry, New York UniversityNew YorkNew YorkUSA
| | - Jennifer L. Gibbs
- Division of Endodontics in Restorative Dentistry and Biomaterials SciencesHarvard School of Dental MedicineBostonMassachusettsUSA
| | - Lorel E. Burns
- Department of Endodontics, College of DentistryNew York UniversityNew YorkNew YorkUSA
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22
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Bogusławska-Kapała A, Kochańska B, Rusyan E, Basak GW, Strużycka I. Late Post-Operative Occurrence of Dentin Hypersensitivity in Adult Patients Following Allogeneic Hematopoietic Stem Cell Transplantation-A Preliminary Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168761. [PMID: 34444506 PMCID: PMC8391522 DOI: 10.3390/ijerph18168761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 11/16/2022]
Abstract
Allogeneic hematopoietic stem cell transplantation (alloHSCT) is one of the most commonly performed transplantation procedures nowadays. Despite the significant progress made in the treatment, alloHSCT is still associated with numerous complications also affecting the oral cavity. One of them is dentin hypersensitivity (DH)-a sharp, short-term pain that occurs when stimuli act on exposed dentin. Various authors point out that DH may result in a significantly lower quality of life, among other things by impeding the consumption of food as well as causing difficulties in daily oral hygiene. The aim of the study was a preliminary analysis of the incidence rate and severity of DH pain in adult patients during late period after alloHSCT. The impact of chronic graft-versus-host disease (cGvHD) and time after alloHCT were also considered. A total of 80 patients were examined. cGvHD was identified in 52 participants. The incidence rate and severity of DH pain was assessed on the basis of a questionnaire and a clinical examination. DH pain appeared a serious problem in late period after alloHSCT regardless of post-transplant time. DH primarily affected cGvHD patients. The prevention-treatment protocol for DH should be developed for this group.
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Affiliation(s)
| | - Barbara Kochańska
- Department of Conservative Dentistry, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
| | - Ewa Rusyan
- Department of Conservative Dentistry, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Grzegorz Władysław Basak
- Department of Hematology, Oncology and Internal Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Izabela Strużycka
- Department of Comprehensive Dental Care, Medical University of Warsaw, 02-091 Warsaw, Poland;
- Correspondence:
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23
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A comprehensive review on biomarkers associated with painful temporomandibular disorders. Int J Oral Sci 2021; 13:23. [PMID: 34326304 PMCID: PMC8322104 DOI: 10.1038/s41368-021-00129-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/05/2021] [Accepted: 06/11/2021] [Indexed: 02/07/2023] Open
Abstract
Pain of the orofacial region is the primary complaint for which patients seek treatment. Of all the orofacial pain conditions, one condition that possess a significant global health problem is temporomandibular disorder (TMD). Patients with TMD typically frequently complaints of pain as a symptom. TMD can occur due to complex interplay between peripheral and central sensitization, endogenous modulatory pathways, and cortical processing. For diagnosis of TMD pain a descriptive history, clinical assessment, and imaging is needed. However, due to the complex nature of pain an additional step is needed to render a definitive TMD diagnosis. In this review we explicate the role of different biomarkers involved in painful TMD. In painful TMD conditions, the role of biomarkers is still elusive. We believe that the identification of biomarkers associated with painful TMD may stimulate researchers and clinician to understand the mechanism underlying the pathogenesis of TMD and help them in developing newer methods for the diagnosis and management of TMD. Therefore, to understand the potential relationship of biomarkers, and painful TMD we categorize the biomarkers as molecular biomarkers, neuroimaging biomarkers and sensory biomarkers. In addition, we will briefly discuss pain genetics and the role of potential microRNA (miRNA) involved in TMD pain.
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