Keywords
Desorden de dolor dentoalveolar persistente; PDAP; Dolor neuropático intraoral; Toxina botulínica intraoral.
How to Cite
Abstract
Persistent Idiopathic Dentoalveolar Pain (PIDAP) is an orofacial neuropathic pain, which can be difficult to diagnose and is usually accompanied by increasing anxiety from both the patient and the treating dentist. A case of a 38-year-old female patient is presented, and it is shown the diagnostic process and therapeutic approach. The interdisciplinary management accompanied by several pharmacological lines is highlighted: Botulinum toxin was used as an adjunctive treatment allowing it to decrease systemically administered medications dosing and therefore its possible side effects. This condition usually affects psychosocial aspects of the patient and has a major impact on his quality of life. It is very important before initiating an invasive clinical treatment, obtaining a clear differential diagnosis and assessing in some cases the presence of non-odontogenic pain, such as PIDAP.
References
Marbach J.J., Hulbrock J., Hohn C., Segal A.G. Incidence of phantom tooth pain: An atypical facial neuralgia. Oral Surgery, Oral Med Oral Pathol. 1982; 53 (2): 190-3.
Rees R.T., Harris M. Atypical odontalgia. Br J Oral Surg [Internet]. 1979; 16 (3): 212-8. Available from: http://dx.doi.org/10.14219/jada.archive.2011.0323
Baad-Hansen L. Atypical odontalgia- Pathophysiology and clinical management. J Oral Rehabil. 2008; 35 (1): 1-11.
Nixdorf D.R., Drangsholt M.T., Ettlin D.A., Gaul C., De Leeuw R., Svensson P., et al. Classifying orofacial pains: A new proposal of taxonomy based on ontology. J Oral Rehabil. 2012; 39 (3):161-9.
Nixdorf D.R., Moana-Filho E.J. Nonodontogenic pain after root canal therapy. Dent Abstr. 2011; 56 (1): 40-1.
Orofacial T., Classification P. International Classification of Orofacial Pain, 1st edition (ICOP). Cephalalgia. 2020; 40 (2): 129-221.
Melis M., Lobo Lobo S., Ceneviz C., Zawawi K., Al-Badawi E., Maloney G., et al. Views and Perspectives Atypical Odontalgia: A Review of the Literature. Headache. 2003; 43:1060-74.
Pigg M., Svensson P., Drangsholt M., List T. 7 year follow up of patients Diagnosed with Atypical Odontalgia: A prospective Study. J Orofac Pain. 2013; 27 (27): 151-64.
Durham J., Nixdorf DR. Healthcare pathway and biopsychosocial impact of persistent dentoalveolar pain disorder: a qualitative study. Int Endod J. 2014;47 (12):1151-9.
M. B-A, E. V-D, Gay-Escoda C. Atypical odontalgia: A Systematic Review Following the Evidence-Based Principles of Dentistry. Cranio J Craniomandib Pract. 2011; 29 (2): 219-26.
Forssell H., Jääskeläinen S., List T., Svensson P., Baad-Hansen L. An update on pathophysiological mechanisms related to idiopathic oro-facial pain conditions with implications for management. J Oral Rehabil. 2015; 42 (4): 300-22.
Ram S., Teruel A., Satish K.S., Clark G. Clinical characteristics and diagnosis of Atypical Odontalgia: Implications for Dentists. Jada. 2009; 140: 222-8.
Shueb S.S., Nixdorf D.R., John M.T., Alonso B.F., Durham J. ScienceDirect What is the impact of acute and chronic orofacial pain on quality of life ? J Dent [Internet]. 2015; 43 (10): 1203-10. Available from: http://dx.doi.org/10.1016/j.jdent.2015.06.001
Durham J., Exley C., John M.T., Nixdorf D.R. Persistent dentoalveolar pain: The patient’s experience. J Orofac Pain [Internet]. 2013; 27 (1): 6-13. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23424715
Nixdorf D.R., Law A.S., John M.T., Sobieh R.M., Kohli R., Nguyen R.H.N. Differential Diagnoses for Persistent Pain after Root Canal Treatment : A Study in the National Dental Practice-based Research Network. 2015; 41 (4): 457-63.
Nixdorf D.R., Moana-Filho E.J., Law A.S., McGuire L.A., Hodges J.S., John M.T. Frequency of nonodontogenic pain after endodontic therapy: A systematic review and meta-analysis. J Endod [Internet]. 2010; 36 (9): 1494-8. Available from: http://dx.doi.org/10.1016/j.joen.2010.06.020
Marbach J.J. Phantom Tooth Pain. J Endod. 1978; 4 (12): 362-72.
Ciaramella A., ., Paroli M., Lonia L., Bosco M., Poli P. Biopsychosocial Aspects of Atypical Odontalgia. ISRN Neurosci [Internet]. 2013; 2013: 1-10. Available from:http://www.hindawi.com/isrn/neuroscience/2013/413515/
Marbach J.J. Phantom tooth pain: deafferentation pain. Pa Dent J (Harrisb). 1984; 51 (6): 32-3.
Nixdorf D., Ms D.D.S. Persistent dento-alveolar pain disorder (PDAP): Working towards a better understanding. 2011; (december): 18-25.
Moana-Filho E.J., Bereiter D.A., Nixdorf D.R. Amplified Brain Processing of Dentoalveolar Pressure Stimulus in Persistent Dentoalveolar Pain Disorder Patients. J oral facial pain headache. 2015; 29 (4): 349-62.
Moana-Filho E.J., Nixdorf D.R., Bereiter D.A., John M.T., Harel N. Evaluation of a magnetic resonance-compatible dentoalveolar tactile stimulus device. BMC Neurosci [Internet]. 2010;11(1):142. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21029454
Baad-Hansen L., List T., Jensen T., Svensson P. Increased pain sensitivity to intraoral capsaicin in patients with atypical odontalgia. J Orofac Pain [Internet]. 2006; 20 (2): 107-14. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16708828
Ivanovic M., Faris H., List T., Baad-hansen L., Pigg M., El S., et al. Intraoral somatosensory abnormalities in patients with atypical odontalgia-a controlled multicenter quantitative sensory testing study. 2013; 154: 1287-94.
Baad-Hansen L., Pigg M., Ivanovic S.E., Faris H., List T., Drangsholt M., et al. Intraoral somatosensory abnormalities in patients with atypical odontalgia--a controlled multicenter quantitative sensory testing study. Pain [Internet]. 2013; 154 (8):1287-94. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23725780
Pigg M. Chronic intraoral pain--assessment of diagnostic methods and prognosis. [Internet]. Swedish dental journal. Supplement. 2011. 7-91 p. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22338784
Clark G.T. Pain and Pain Control Persistent neuropathic pain. Calif Dent Assoc J. 2006; 34 (4): 599-600.
Graff-Radford S.B., Solberg W.K. Atypical Odontalgia. J Craniomandib Disord Oral Facial Pain. 1992; 6: 260-6.
Melis M., Secci S. Diagnosis and treatment of atypical odontalgia: a review of the literature and two case reports. J Contemp Dent Pract [Internet]. 2007; 8 (3): 81-9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17351685
Ito M., Kimura H., Yoshida K., Kimura Y., Ozaki N., Kurita K. Effectiveness of milnacipran for the treatment of chronic pain in the orofacial region. Clin Neuropharmacol. 2010; 33 (2): 79-83.
Nagashima W., Kimura H., Ito M., Tokura T., Arao M., Aleksic B., et al. Effectiveness of Duloxetine for the Treatment of Chronic Nonorganic Orofacial Pain. Clin Neuropharmacol [Internet]. 2012; 35 (6): 1-5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23123692
Zagury J.G., Eliav E., Heir G.M., Nasri-Heir C., Ananthan S., Pertes R., et al. Prolonged gingival cold allodynia: A novel finding in patients with atypical odontalgia. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology [Internet]. 2011; 111 (3): 312-9. Available from: http://dx.doi.org/10.1016/j.tripleo.2010.10.008
Babiloni A.H., Kapos F.P., Nixdorf D.R. Intraoral administration of botulinum toxin for trigeminal neuropathic pain. Oral Surgery, Oral Med Oral Pathol Oral Radiol [Internet]. 2016; 121 (6): e148-53. Available from: http://dx.doi.org/10.1016/j.oooo.2016.03.013
Clark G.T., Stiles A., Lockerman L.Z., Gross S.G. A Critical Review of the Use of Botulinum Toxin in Orofacial Pain Disorders. Dent Clin North Am. 2007; 51 (1): 245-61.
Cuadrado M-L, García-Moreno H., Arias J-A, Pareja JA. Botulinum Neurotoxin Type-A for the Treatment of Atypical Odontalgia. Pain Med [Internet]. 2016;pnw040. Available from: http://painmedicine.oxfordjournals.org/lookup/doi/10.1093/pm/pnw040
Baad-Hansen L. Comparison of Clinical findings and Psychosocial factors in patients with Atypical Odontalgia and Temporomandibular Disorders. J Oral Rehabil. 2008; 22: 7-14.
Hals E.K.B., Stubhaug A. Mental and somatic co-morbidities in chronic orofacial pain conditions: Pain patients in need of multiprofessional team approach. Scand J Pain [Internet]. 2011; 2 (4): 153-4. Available from: http://dx.doi.org/10.1016/j.sjpain.2011.08.003
List T., Leijon G., Helkimo M., Oster A., Dworkin S.F., Svensson P. Clinical findings and psychosocial factors in patients with atypical odontalgia: a case-control study. J Orofac Pain [Internet]. 2007; 21 (2): 89-98. Available from: 17547120.