Atypical Odontalgia (AO) is a persistent pain condition located in the teeth and jaws. It has been described as a persistent neuropathic pain that. A new patient visits a dentist with a six-month history of pain in the left mandibular posterior teeth that previous treatments by other dentists have failed to resolve. Abstract. Objective. Atypical odontalgia (AO), a subform of persistent idiopathic facial pain, is defined as a continuous toothache in which a.

Author: Nagar Basar
Country: Trinidad & Tobago
Language: English (Spanish)
Genre: Finance
Published (Last): 27 April 2016
Pages: 344
PDF File Size: 8.3 Mb
ePub File Size: 4.60 Mb
ISBN: 196-1-47882-423-8
Downloads: 74853
Price: Free* [*Free Regsitration Required]
Uploader: Gardatilar

The patient atypicl requested a prescription of 7. She had a history of dysautonomia, gastritis, pyloric ahypical, and stomach polyps. The pathology of PTN is thought to be the same as that of TN, because membrane-stabilizing medication has an effect on both entities.

A year-old female with the chief complaint of severe pain 8 based on Visual Analogue Scale VAS in the site of extracted tooth 3 since 2 months ago was referred to the Department of Oral Medicine.

Clinical features of atypical odontalgia; three cases and literature reviews

kdontalgia The Multidimensional Pain Inventory MPI [ 42 ] is a comprehensive instrument used odobtalgia assess a number of dimensions of the chronic pain experience, including pain intensity, emotional distress, cognitive and functional adaptation, and social support. The effect was usually achieved within weeks and the maximum effect was reached within weeks; the duration of the therapeutic effect was quite heterogeneous among studies, lasting months [ 19 ]. All facial pain subjects were screened before to be sent to the psychophysics pain laboratory located in the Pain Therapy Unit.

Merskey H, Bogduk N, editors.

Interestingly, BoNTA injections have shown to reduce not only pain intensity and pain frequency, but also the surface of the painful area in patients with TN [ 21 ]. In addition, BoNTA can decrease the translocation of the transient receptor potential vanilloid 1 TRPV1 to neuron cell membranes, thus reducing pain sensitivity.

Diagnostic challenges of neuropathic tooth pain. PTN is associated with constant pain, for which local anesthesia is occasionally effective, and it is difficult to differentiate PTN from odontogenic pain [ 378 ]. Aripiprazole might be effective not only for the pain sensation but also anticipatory anxiety or rumination about pain. International Headache Society criteria for migraine without aurea.


The sum of the presence of resentment and depression could very well be the two independent psychological variables that predispose an individual to atypical odontalgia via an amygdala-hypothalamus-PAG-trigeminal neurophysiological dysfunction. A statistical consideration of 65 cases. The mechanism by which BoNTA acts in nociception remains unclear. Our study compared AO patients with pain-free subjects and with other facial pain patients. On the basis of these results, we suggest that a biopsychosocial model can be used to predict AO.

Some patients with trigeminal neuralgia TN complain of pain that differs from that of classical TN, before the appearance of the pain that is typically associated with the disorder. Local injected anesthetics and corticosteroids or nerve blocks have been also essayed with inconsistent results [ 11 ].

Subjects with a history of migraine headaches were selected only if they did not experience auras and did not have comorbid head and facial pain. AO shows various features and responses to drugs. Low-dose Aripiprazole augmentation in Amitriptyline-resistant burning mouth syndrome: A change in the perception of pain induced by emotion has been reported in preview studies [ 5253 ].

His pain was also waking him at night. Two patients received two cycles of BoNTA, while the remaining patients received three and five cycles each, respectively. Depression and resentment were positively correlated in all pain subjects Spearman rho coefficient 0. View at Google Scholar A. Magnetic resonance imaging revealed neurovascular compression at the left trigeminal nerve root entry zone Figure 2.

A year-old female university teacher who was living with her husband was referred to our clinic after complaining of a heavy, splitting pain in the four maxillary front post-crown teeth, as if they were being pressed atypocal the side. Microvascular decompression surgery was performed in January and the pain resolved completely.

Time table of medicines prescription. There is no report of the efficacy of aripiprazole for AO; however, some reports on the treatment of burning mouth syndrome exist [ 1819 ]. Frequency of persistent tooth pain after root canal therapy: Moreover, all patients experienced a decrease of the extent of the painful area from the first administration, with the pain being thereafter limited to the tooth region where it was previously centered.


Atypcial and Aquaculture Journals Dr. These sensory modifications were located intraoral on the site of the treated tooth, suggesting a disturbance of the central processing or craniofacial information carried by the trigeminal nerve [ 9 ].

A systematic review and meta-analysis. Antidepressants, such as amitriptyline, are reported to atypiical effective in the treatment of AO; however, their efficacy varies depending on the case. The aim of the study is to explore the presence of specific abnormalities in facial pain patients that can be considered as psychophysical factors predisposing to AO.

Because BoNTA has proved to be effective in various neuropathic conditions, we postulated that it might be effective in patients with AO. In our study, we investigated certain dimensions of aggressive behavior and determined that there exists a relationship between the perception threshold of current stimuli and individuals with AO. Pre- Trigeminal Neuralgia ; TN: In case 3, although 7. Clinical characteristics and diagnosis of atypical odontalgia: Case Report Open Access.

It has also revealed itself as an advantageous treatment in a number of painful neuropathic conditions, such as trigeminal neuralgia TNpainful diabetic neuropathy, complex regional pain syndrome, and postherpetic neuralgia [ 14—21 ].

Availability of data and supporting materials Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

Biopsychosocial Aspects of Atypical Odontalgia

This condition has been designated in different ways in the literature, namely phantom tooth pain [ 5 ], idiopathic toothache [ 6 ], chronic continuous dentoalveolar pain [ 7 doontalgia, and persistent dentoalveolar pain disorder [ 8 ]. Moreover, a similar pattern of response in the overall patients supports a direct effect of BoNTA on the sensory system and pain.

It is hard to diagnose AO precisely and we need an atypkcal consensus about AO to prevent overtreatment.