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At least 1,171 records · Page 65Linked to original sources
PubMed2002

Hemicrania continua.

Unilateral throbbing headaches may present similar signs and symptoms as dental pathology and are a diagnostic challenge for dental practitioners. Cases may be seen with a primary complaint of unilateral pain or referred by medical colleagues for exclusion of dental causes. In the present article the authors add a new case of hemicrania continua (HC), which is one such unilateral headache, and review the previously published cases. HC is relatively easy to treat since it responds completely to treatment with indomethacin. However, as is presented in this case, HC may masquerade as dental pain. Cases secondary to trauma, systemic disease, and nervous system pathology have been described in the literature, and the clinician must exclude these possible causes. A thorough knowledge of this entity is therefore essential.

Adult↗
PubMed2002

[Acute and chronic facial pain due to injured neural plexus of the upper teeth].

The general causes of upper dental plexus injury are tooth disturbances and the periodontal tissues diseases, the pathology of maxillary sinus, various traumatically manipulations in the area of tooth and maxilla as well. The main symptom of upper tooth neural plexus injury is acute and chronic pain in the alveolar sprout of maxilla, gums or in the area of singly tooth, which rarely spreads into neighboring maxillofacial areas. The authors recommend that the acute pain syndrome would be called the inflammation of upper tooth plexus, and the chronic pain syndrome--plexopathia of upper tooth. Study presents the differential diagnosis according to character of facial pain syndrome and the data of sensority disorders research and investigation of pain thresholds as well. The recommendations for treatment tactic and methods of analyzed indispositions are suggested.

Acute Disease↗
PubMed2001

[The role of Fos protein in modulation of dental pain in central nerve system].

OBJECTIVE: The aims of this study were to reveal the relationship between Fos protein expression, the transcription of preproenkephalin (PENK) mRNA, and the change of enkephalin (ENK) level initiated by experimental dental pain, and to understand the central modulation mechanism of dental pain. METHODS: The techniques of Immunohistochemistry in situ hybridization and radioimmunoassay were applied respectively to detect the expression of Fos, the transcription of PENK mRNA, and the change of ENK level in the experimental nucleus of the spinal tract of the trigeminal nerve, caudal part (sp5c) of rats. RESULTS: It was found that Fos protein expression was in a time-dependent manner. Fos appeared half hour after the pain stimulation, and its peak occurred two hours after the pain stimulation, but disappeared slowly four hours later. The transcription of PENK mRNA was seen two hours after the pain stimulation, its peak appeared four hours later and it disappeared eight hours later. The level of ENK increased significantly (P < 0.01) in the caudal part of the spinal tract of the trigeminal nerve four hours after pain stimulation. CONCLUSION: Fos protein may take a part in the central modulation of dental pain by initiating PENK mRNA transcription which led to the increment of ENK.

Animals↗
PubMedDate not supplied

Reference fields in phantom tooth pain as a marker for remapping in the facial territory.

Six patients with chronic phantom tooth pain were studied for the presence of reference fields for their phantom sensation. In five of them, pain or dysesthesia in the affected oral structures was elicited by thermal or mechanical stimulation of areas that were well separate from these structures. However, a relation of topographical proximity between the stimulated areas and the areas of reference could be traced in the sensory maps. Therefore, denervation of small structures with coarse sensitivity can yield the plastic changes that have previously been described for larger deafferentations of areas endowed with finer discriminative capacity.

Adult↗
PubMedDate not supplied

Hereditary angioedema: a case report and literature review.

Hereditary angioedema is an autosomal dominant condition with a typical presentation of diffuse edematous, painless, and nonpitting swelling of the soft tissues. The disease manifests itself primarily in the extremities, face, airway, and abdominal viscera. Proper diagnosis and treatment are essential as this condition has the capacity of becoming life-threatening due to potential airway embarrassment. This case report demonstrates the complexity of diagnosing and treating hereditary angioedema. Hereditary angioedema often is overlooked on a differential diagnosis of patients suffering from diffuse swelling and/or abdominal discomfort. Nonetheless, the diagnosis of hereditary angioedema should be included when assessing patients who display the proper symptomology and familial history of the condition.

Adult↗
PubMed2003

Emergency management of acute apical periodontitis in the permanent dentition: a systematic review of the literature.

OBJECTIVE: To perform a systematic literature review and meta-analysis on the effectiveness of interventions used in the emergency management of acute apical periodontitis in the permanent dentition. METHODS: Electronic databases were searched from their inception to 2001. These searches, combined with manual searching, yielded 1,097 citations, of which 92 were relevant. Independent application of inclusion criteria by 2 teams of reviewers yielded 15 eligible randomized controlled trials. Data on population, interventions, outcomes (pain relief or change in intensity of pain as reported by patients or clinicians) and methodological quality were determined by independent duplicate review. Disagreements were resolved by consensus. RESULTS: Meta-analysis showed that pre-emptive analgesics (nonsteroidal anti-inflammatory drugs [NSAIDs]) in conjunction with pulpectomy provided a significant benefit (weighted mean difference -11.70, 95% confidence interval -22.84 to -0.56). Three interventions did not show significant benefit: systemic antibiotics, intracanal treatment with a steroid-antibiotic combination, and trephination through attached gingiva. CONCLUSIONS: In the management of pain associated with acute apical periodontitis, there is strong evidence to support the use of systemic NSAIDs in conjunction with nonsurgical endodontics. The use of antibiotics is not recommended.

Analgesics↗
PubMed2002

[Who would suffer this child in the cold? History and diagnosis during a Socratic dialogue].

This article gives an account of the experiences of 12 dentists (11 general practitioners and one periodontist) during a one-day Socratic dialogue, which took place at the International Conference for Dentists in Bruges 2001. The key question was: "When must I (or mustn't I) comply with the patient's wish?" The participants tackled an example from Edgar, general practitioner. His story went like this: on Christmas Eve, dinnertime, one of his patients--duly instructed beforehand--arrived just like that, and said: "I'm in pain". When the central question was applied to this example, uncertainty arose about the exact nature of "the patient's wish". In this article you read how the participants dealt with the "pain", with the uncertainty.

Communication↗
PubMed2003

Local anesthetics: special considerations in endodontics.

Local anesthetics are essential for successful endodontic treatment, and their pharmacologic characteristics have special implications for the treatment of painful, chronically-inflamed or necrotic teeth. Their dosages must be limited to prevent toxicity, which may be enhanced by the coadministration of sedative agents or drugs which affect hepatic drug metabolism. Endodontic patients with established central and peripheral sensitization represent special challenges for pain control, since morphogenetic changes resulting from neurogenic inflammation can render pain fibers more resistant to local anesthesia. The use of vasconstrictors with conventional and alternative injection techniques, e.g., intraosseous injections, are necessary to prolong the duration of action of local anesthesia but can place patients with cardiovascular disease at some risk. An appreciation of all of these aspects of local anesthesia in endodontics will better prepare the operator for predictably safe and effective patient care.

Amides↗
PubMed2003

Gender difference in symptoms related to temporomandibular disorders in a population of 50-year-old subjects.

AIMS: To investigate, by means of a mail questionnaire, the prevalence of symptoms related to temporomandibular disorders (TMD) in 50-year-old subjects living in the counties of Orebro and Ostergötland, Sweden. METHODS: The total population comprised 8,888 individuals, and the overall response rate was 71%. A clinical evaluation of the masticatory system was performed in subgroups to validate the responses to the questionnaire. There was satisfactory correspondence between self-reports and well-defined clinical conditions. RESULTS: Women reported, more often than men, pain from the temporomandibular joints (TMJs), TMJ sounds, bruxism, sensitive teeth, and burning mouth symptoms. The prevalences of difficulties in jaw opening, loss of anterior teeth due to trauma, and masticatory problems were greater in men than in women. No gender difference was found in the number of remaining teeth. Logistic regression analysis with pain from the TMJ as the dependent variable identified bruxism, impaired chewing efficiency, and gender (women) as the most significant risk factors. With reduced chewing ability as the dependent variable, several missing teeth constituted the highest risk, followed by pain from the TMJ, bruxism, gender (men), and loss of anterior teeth due to trauma. CONCLUSION: There were significant gender differences in reported TMD-related symptoms in 50-year-old Swedes. Bruxism was a significant risk factor for pain from the TMJ. Reduced number of teeth and pain from the TMJ were significant risk factors for impaired chewing ability.

Bruxism↗