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.

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More on this topic Phantom Tooth Pain: The clinical management of AO is often disappointing. In the TMD group, the concerns focused on the clinical disturbances affecting the masticator muscles. The patient also underwent root canal atypocal to the left mandibular first molar at this time, but again there was no improvement in his pain.

Conclusions AO shows various features and responses to drugs. All authors read and approved the final manuscript.

Pre- Trigeminal Neuralgia ; TN: Case presentation Case 1. These psychological dimensions are associated with an alteration in the somatosensory perception of trigeminal stimulus odontaglia only in the group with AO and not in other subjects with other forms of facial pain such as TN, TMD, or M.

Written informed consent was obtained from the patients for publication and any accompanying images.

Clinical features of atypical odontalgia; three cases and literature reviews

It has also been suggested that BoNTA might act centrally because of retrograde axonal transport, but this mechanism is highly controversial.

Case Report Open Access.

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. Furthermore, some primary headaches with presumed central origin e. In Octoberhis visual analog scale score for spontaneous pain was 32 mm and that for occasional shooting pain was 70 mm. Correlation between current perception threshold measures and behavioural and psychopathological dimensions.

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 ]. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. An update on pathophysiological mechanisms related to idiopathic oro-facial pain conditions with implications for management.


She told us that she had strong anxiety for a pain appearance. The onset of symptoms was often after dental treatment but it did not always affect diseased teeth.

An extension bridge treatment was recommended and a bridge atypjcal attached to her left mandibular second premolar, first molar, and second molar. The restrictive exclusion criteria and necessary presence of a unique form of facial pain resulted in a small number of selected subjects relative to the total sample. In this article, odontlgia report three types of AO and discuss its heterogeneity and management.

Consequently, we diagnosed odontaglia pain as classical TN.

Pre-Trigeminal Neuralgia Similar to Atypical Odontalgia: A Case Report

Frequency of persistent tooth pain after root canal therapy: Orofacial pain may be caused by a massive assortment of diseases [ 1—3 ]. 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 ].

Psychosomatic problems in dentistry. Depending on the patient’s complaints, PTN may be diagnosed as atypical odontalgia.

Depression and resentment were positively correlated in all pain subjects Spearman rho coefficient 0. The patient was keen to undergo microvascular decompression surgery to relieve his pain, and was referred to our neurosurgery colleagues. The diagnosis of her condition was unclear. Evidence derived from pathophysiology and treatment. As seen in case 1, a simple pain sensation might resolve with an antidepressant. Observation of therapeutic effect from a randomized, double-blind, placebo-controlled trial.

We identified a statistically significant association between the presence of axis I and axis II psychiatric disorders and a modification of CPT. The responses observed in our patients suggest that BoNTA injections may be a new option for the treatment of AO, with strikingly promising outcomes.

In the second case, a year-old woman presented with a feeling of heaviness pain on the right side of maxillary and mandibular molar teeth, face, whole palate, and throat. There was no allodynia, tenderness, or pain evoked by eating, talking, tooth brushing, or mouth rinsing. Persistent dento-alveolar pain disorder PDAP: The pain intensity was reported almost 0 when the patient was re evaluated 1 month after the first visit. The interview included demographic, family, and social data as well as any distressing events that the individuals had experienced in the last 6 months.


As we mentioned above, AO is believed to have a neuropathic origin [ 10—13 ]. The psychophysics methods used in this study to investigate the trigeminal fibers have been used in other clinical and laboratory studies [ 46 — 48 ]. The purpose of this study is to explore the presence of specific abnormalities in facial pain patients that can be considered as psychophysical factors predisposing to AO. Amitryptiline, carbamazepine, oxcarbazepine, gabapentin, pregabalin, valproic acid, zonisamide, lacosamide.

Psychiatric diagnoses in patients with burning mouth syndrome and atypical odontalgia referred from psychiatric to dental facilities.

The group of patients with AO demonstrated higher levels of resentment and depression than those who underwent a dental extraction but did not develop chronic pain the PF group. Merskey H, Bogduk N, editors. Through this process, BoNTA would decrease peripheral sensitization, which in turn would lower central sensitization and pain [ 1416 ].

Therefore, longer term follow-up is necessary after a diagnosis of atypical odontalgia. She found our department on the Internet and was referred to our clinic by an otorhinolaryngologist. In this article, we report three types of AO that responded to amitriptyline monotherapy, low-dose aripiprazole monotherapy, or aripiprazole combined with mirtazapine and discuss the its heterogeneity and management.

Antidepressant use in chronic pain management: Recently, it has been reported that there is involvement of peripheral and central sensitization of trigeminal pathways in AO [ 1421 ] as well as a relationship between chronic pain and central sensitization [ 2223 ].

Several criteria for the diagnosis of AO have been suggested [ odontzlgia5 ].