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At least 631 records · Page 35Linked to original sources
PubMed2006

Effect of local anesthesia on atypical odontalgia--a randomized controlled trial.

The aim of the study was to evaluate the analgesic effect of lidocaine in a double-blind, controlled multi-center study on patients with atypical odontalgia (AO)--a possible orofacial neuropathic pain condition. Thirty-five consecutive AO patients (range 31-81 years) with a mean pain duration of 7.2 years (range 1-30 years) were recruited from four different orofacial pain clinics in Sweden. In a randomized cross-over design, 1.5 ml local anesthesia (20mg/ml lidocaine and 12.5 microg/ml adrenaline) or 1.5 ml saline (9 mg/ml NaCl solution) (placebo) was injected to block the painful area. The VAS pain scores showed an overall effect of time (ANOVA: P<0.001) and treatment (ANOVA: P=0.018) with a significant interaction between the factors (ANOVA: P<0.001). Overall, VAS pain relief was significantly greater at 15-120 min following the lidocaine injections compared to the placebo injections (Tukey: P<0.05). All patients demonstrated significant disturbances in somatosensory function on the painful side compared to the non-painful side as revealed by quantitative sensory tests, however, only one significant inverse correlation was found between percentage pain relief and the magnitude of brush-evoked allodynia (Spearman: P<0.01). In conclusion, AO patients experienced significant, but not complete, pain relief from administration of local anesthetics compared with placebo. The findings indicate that the spontaneous pain in AO patients only to some extent is dependent on peripheral afferent inputs and that sensitization of higher order neurons may be involved in the pathophysiology of AO.

Adult↗
PubMed2006

Differential effect of intravenous S-ketamine and fentanyl on atypical odontalgia and capsaicin-evoked pain.

Atypical odontalgia (AO) is an intraoral pain condition of currently unknown mechanisms. In 10 AO patients and 10 matched healthy controls, we examined the effect of intravenous infusion of an N-methyl-D-aspartate (NMDA) receptor antagonist S-ketamine and a mu-opioid agonist fentanyl on spontaneous AO pain and on an acute intraoral nociceptive input evoked by topical application of capsaicin. The drugs were administered in a randomized, placebo-controlled, cross-over manner. Furthermore, measures of intraoral sensitivity to mechanical and thermal quantitative sensory testing (QST) including temporal summation were compared between groups and sides. Both drugs failed to produce an analgesic effect on spontaneous AO pain, but fentanyl effectively reduced capsaicin-evoked pain. AO patients showed increased sensitivity to capsaicin and heat pain, but no significant differences in cold and mechanical sensitivity compared with healthy controls. No side-to-side differences in QST measures were found in AO patients. The present study demonstrates that AO is unlikely to be primarily due to a persistent afferent barrage from the peripheral region. Furthermore, in contrast to studies on various neuropathic pain conditions, fentanyl and S-ketamine in the present doses failed to attenuate AO pain.

Adult↗
PubMed2006

Incidence of periapical lesions and clinical symptoms after pulpectomy--a clinical and radiographic evaluation of 1- versus 2-session treatment.

OBJECTIVE: Outcome of pulpectomy in 2 treatment sessions with calcium hydroxide as an intracanal dressing was compared to a procedure comprising instrumentation and root-filling in 1 session. STUDY DESIGN: Subjects with a vital pulp condition (N = 256) were recruited to a randomized clinical trial. Outcome parameters included radiographic signs of apical periodontitis and painful symptoms at clinical follow-ups 1 week and 1-3 years after treatment. RESULTS: Of 244 subjects available for final recall, 17 presented with periapical radiolucency. Lesions were evenly distributed among the 2 treatment groups. Postoperative pain recorded 1 week after permanent filling was significantly associated with overfilling (P = .001), with no difference between treatment groups. There was no association with presence of overfilling and radiographic lesion at end point of recall. CONCLUSIONS: Study confirms that pulpectomy may be carried out at a high rate of success if due attention is given to aseptic operating procedures, proper instrumentation and filling. Under these conditions an interappointment dressing with calcium hydroxide does not seem to influence outcome.

Adolescent↗
PubMed2006

Oral myiasis: a case report and literature review.

Myiasis is the infestation of tissues and organs of animals and humans by certain Dipteran fly larvae. This phenomenon is well documented in the skin, especially among animals and people in tropical and subtropical areas. Oral myiasis is a rare condition and can be caused by several species of Dipteran fly larvae and may be secondary to serious medical conditions. Upon removal of the larvae, the tissues seem to recover with no subsequent complications and with no need for further treatment. Here we describe a case of oral myiasis within the gingiva of a healthy young man caused by the larvae of Wohlfahrtia magnifica (Family Sarcophagidae), in which infection may have been due to ingestion of infested flesh. Reviewing the literature revealed that most cases of oral myiasis tend to be multiple and to occur in anterior segments of the jaws rather than in posterior segments as in the case we describe here.

Animals↗
PubMed1987

Orofacial pain of psychogenic origin: current concepts and classification.

A description and attempt to classify the newly revised DSM-III and IASP classification schemes and those persistent orofacial pain syndromes that are commonly considered to be significantly associated with psychological or psychosocial factors, either as primary causes or as factors contributing to the maintenance of the chronic pain state are presented. The classification schemes include the DSM-III-R of the American Psychiatric Association and the new IASP taxonomy system, are the two systems currently available for classifying chronic orofacial pain states that are often considered to represent psychogenic pain conditions.

Burning Mouth Syndrome↗
PubMed1989

Cranial arteritis mimicking odontogenic pain: report of case.

A 65-year-old patient treated for pain of apparent odontogenic origin did not respond to appropriate dental treatment. While the signs and symptoms mimicked a dental problem, further diagnostic evaluation determined the "culprit"--cranial arteritis. Proper treatment immediately after diagnosis is advised as the complications of cranial arteritis can include the rapid onset of blindness.

Aged↗
PubMed1997

Ibuprofen elevates immunoreactive beta-endorphin levels in humans during surgical stress.

Release of beta-endorphin is modulated by physiologic stress and a variety of hormonal and pharmacologic factors. Prostaglandin E2 inhibits release of beta-endorphin and corticotropin from pituitary corticotroph cells, suggesting that suppression of prostaglandin levels should increase beta-endorphin release. This hypothesis was tested by administration of 600 mg ibuprofen before surgical stress in humans in comparison to placebo and methylprednisolone. Plasma samples were analyzed for immunoreactive beta-endorphin with concurrent measurement of pain and apprehension. Levels of immunoreactive beta-endorphin increased during surgery in the placebo group but were significantly greater in the group of patients pretreated with ibuprofen. Methylprednisolone suppressed intraoperative immunoreactive beta-endorphin, compared with both placebo and ibuprofen. Parallel in vivo and in vitro studies indicate that nonsteroidal anti-inflammatory drug potentiation of endorphin release is mediated at the level of the pituitary corticotroph cell. These results show that ibuprofen enhances pituitary release of beta-endorphin by corticotroph cells in response to stress.

Adult↗
PubMed2002

Antibiotic therapy--managing odontogenic infections.

Several pharmaceuticals have been developed in the past 10 years that have made a significant impact on the health of the human race. There have been few advances, however, that have proved more efficacious than the pharmacotherapies we have had available for many decades for the treatment of odontogenic infections. Many new antibiotics/antimicrobials have been developed, but none have been determined to be of significant benefit to replace or supplant the use of penicillins for the management of orofacial infections caused by pathogens in and around the oral cavity. Judicious use of antibiotics in conjunction with surgical therapy is the most appropriate method to treat odontogenic infections. Using the antibiotic "du jour," many times promoted by pharmaceutical representatives, results in costly and unnecessary complexity of care. A return to the basics is indicated for the antibiotic management of odontogenic infections.

Abscess↗
PubMed1996

Clinical comparison of postoperative sensitivity for a glass ionomer and a zinc phosphate luting cement.

In 60 patients, 120 partial and full-coverage restorations were cemented on vital abutment teeth with either a glass ionomer or a zinc phosphate luting cement. A split-mouth design and a patient blind data acquisition protocol were used. During an average observation period of 17.3 months there were no differences between the two types of luting cements in regard to subjective and clinical parameters. A high incidence of postoperative hypersensitivity, which is often said to accompany the use of glass ionomer luting cements, was not observed. With the cementation method used in this study, the glass ionomer cement Ketac-Cem Maxicap was an acceptable alternative to conventional zinc phosphate cement. Capsule systems make the clinical handling of glass ionomer luting cements safe and easy and should be used routinely in dental practice.

Adult↗
PubMed2003

Pain from the oral cavity.

The head, face, mouth, and throat collectively is the most frequent site of pain in humans. Facial pain is a particularly distressing problem because identification and effective treatment of the underlying cause is often challenging and sometimes elusive. This article focuses on the more common causes of facial pain that originate in the oral cavity and associated structures and outlines a general approach to diagnosis and management of these problems.

Acute Disease↗
PubMed2005

[Orofacial pain and secondary headaches].

Recent studies have improved our knowledge of the mechanisms underlying orofacial pain. This review presents the most relevant aspects of such mechanisms according to the different clinical features of the various entities in orofacial pain: odontogenic pain, atypical facial pain and other idiopathic orofacial pain conditions and musculoskeletal pain characterized by pain in the temporomandibular joint and/or the associated muscles of mastication. The link between the muscular temporomandibular disorders and tension type headache is particularly considered in the light of the different possible mechanisms.

Facial Pain↗