Dolor Idiopático Dentoalveolar Persistente (DIDAP). Revisión de literatura y caso clínico tratado con aplicación intraoral de toxina Botulínica

Autores/as

  • Andrés R. Cervantes-Chavarría Máster en Ciencias Orales University of Minnesota, USA. Especialista en Dolor orofacial y DTM, University of Minnesota, USA. Especialista en Odontología General Avanzada UCR-SEP, Caja Costarricense del Seguro Social-UCR. Odontólogo Asistente, Departamento Cirugía Maxilofacial, Hospital San Juan de Dios, CCSS. Docente del Departamento de Ciencias Diagnósticas y Quirúrgicas. Facultad de Odontología. Universidad de Costa Rica, Costa Rica. Autor/a https://orcid.org/0000-0001-6756-8029

DOI:

https://doi.org/10.15517/ijds.2021.46105

Palabras clave:

Desorden de dolor dentoalveolar persistente; PDAP; Dolor neuropático intraoral; Toxina botulínica intraoral.

Resumen

l Dolor Idiopático Dentoalveolar Persistente (DIDAP), es un dolor neuropático orofacial, que puede resultar difícil de diagnosticar y generalmente se acompaña de creciente angustia tanto de parte del paciente como también del odontólogo tratante. Se presenta un caso de una paciente femenina de 38 años en  donde se demuestra  el proceso diagnóstico y abordaje terapéutico.  Se resalta el manejo interdisciplinario acompañado de varias lineas farmacológica: la toxina Botulínica se utilizó como tratamiento coadyuvante para disminuir la dosis de medicamentos administrados por vía sistémica y por ende sus posibles efectos secundarios.  Esta condición habitualmente abarca aspectos psicosociales del paciente y tiende a verse sumamente afectada su calidad de vida.  Es de suma relevancia antes de iniciar un tratamiento clínico invasivo, obtener un diagnóstico diferencial claro y valorar en algunos casos la presencia de dolor no ontogénico, como el DIDAP.

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Referencias

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. DOI: https://doi.org/10.1016/0030-4220(82)90285-7

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 DOI: https://doi.org/10.1016/0007-117X(79)90027-1

Baad-Hansen L. Atypical odontalgia- Pathophysiology and clinical management. J Oral Rehabil. 2008; 35 (1): 1-11. DOI: https://doi.org/10.1111/j.1365-2842.2007.01813.x

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. DOI: https://doi.org/10.1111/j.1365-2842.2011.02247.x

Nixdorf D.R., Moana-Filho E.J. Nonodontogenic pain after root canal therapy. Dent Abstr. 2011; 56 (1): 40-1. DOI: https://doi.org/10.1016/j.denabs.2010.10.032

Orofacial T., Classification P. International Classification of Orofacial Pain, 1st edition (ICOP). Cephalalgia. 2020; 40 (2): 129-221. DOI: https://doi.org/10.1177/0333102419893823

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. DOI: https://doi.org/10.1046/j.1526-4610.2003.03207.x

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. DOI: https://doi.org/10.11607/jop.1033

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. DOI: https://doi.org/10.1111/iej.12263

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. DOI: https://doi.org/10.1179/crn.2011.031

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. DOI: https://doi.org/10.1111/joor.12256

Ram S., Teruel A., Satish K.S., Clark G. Clinical characteristics and diagnosis of Atypical Odontalgia: Implications for Dentists. Jada. 2009; 140: 222-8. DOI: https://doi.org/10.14219/jada.archive.2009.0136

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 DOI: https://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 DOI: https://doi.org/10.11607/jop.1022

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. DOI: https://doi.org/10.1016/j.joen.2014.12.012

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 DOI: https://doi.org/10.1016/j.joen.2010.06.020

Marbach J.J. Phantom Tooth Pain. J Endod. 1978; 4 (12): 362-72. DOI: https://doi.org/10.1016/S0099-2399(78)80211-8

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/ DOI: https://doi.org/10.1155/2013/413515

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. DOI: https://doi.org/10.1177/204946371100500404

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. DOI: https://doi.org/10.11607/ofph.1463

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 DOI: https://doi.org/10.1186/1471-2202-11-142

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 DOI: https://doi.org/10.1016/j.pain.2013.04.005

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. DOI: https://doi.org/10.1080/19424396.2006.12222229

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 DOI: https://doi.org/10.5005/jcdp-8-3-81

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. DOI: https://doi.org/10.1097/WNF.0b013e3181cb5793

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 DOI: https://doi.org/10.1097/WNF.0b013e31827453fa

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 DOI: https://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 DOI: https://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. DOI: https://doi.org/10.1016/j.cden.2006.09.003

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 DOI: https://doi.org/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 DOI: https://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.

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Publicado

2026-06-15

Número

Vol. 23 Núm. 3 (2021): Odovtos-International Journal of Dental Sciences

Sección

Artículo de Revisión de Literatura

Licencia

Derechos de autor 2021 Andrés R. Cervantes-Chavarría (Author)

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