Journal of The Korean Dental Society of Anesthesiology (대한치과마취과학회지)

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
권호 표지

A Neuropathic Atypical Odontalgia Recognized after the Apicoectomy under Local Anesthesia on the Maxillary Lateral Incisor -A Case Report-

국소마취하 상악 측절치 치근단 절제술 후 인식된 신경병성 비정형 치통 1예 -증례 보고-

  • Mo, Dong-Yub (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University (Wonju Christian Hospital)) ;
  • Yoo, Jae-Ha (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University (Wonju Christian Hospital)) ;
  • Choi, Byung-Ho (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University (Wonju Christian Hospital)) ;
  • Kim, Ha-Rang (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University (Wonju Christian Hospital)) ;
  • Lee, Chun-Ui (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University (Wonju Christian Hospital)) ;
  • Kim, Jong-Bae (Department of Dentistry (Oral and Maxillofacial Surgery), Dongsan Medical Center, College of Medicine, Keimyung University)
  • 모동엽 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 유재하 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 최병호 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 김하랑 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 이천의 (연세대학교 치과대학 구강악안면외과학교실(원주기독병원)) ;
  • 김종배 (계명대학교 의과대학 동산의료원 치과학교실(구강악안면외과))
  • Received : 2010.03.29
  • Accepted : 2010.06.20
  • Published : 2010.06.27
Download PDF
⟨ Previous Next ⟩

Abstract

This type of neuropathic pain(atypical odontalgia) is seen most often in middle-aged women or men after dentoalveolar operation. Atypical odontalgia probably is caused by deafferentation leading to intraneural changes in the medullary dorsal horn. Treatment of this problem is difficult, but some success has been reported in uncontrolled, open-labeled studies using high doses of tricyclic antidepressants. This is the management report of a patient case, that had a neuropathic atypical odontalgia recognized with the right maxillary lateral incisor. The patient was consulted to the Department of Pain Clinics, ENT & Neurology and diagnosed the adenoid cystic carcinoma on left cerebellum and right paranasal sinus with extension to the cavernous sinus. In spite of the osteoplastic craniotomy, neurosurgical mass removal and radiation therapy were done with chemotherapy, atypical odontalgia was continued. In addition to the consultation to Psychology, stress management and antidepressant medication were done and improved slowly.

Keywords

References

  1. 김경욱, 김명진, 김여갑, 김종렬, 박영욱, 박형식 등: 최신 구강악안면외과학, 제3판. 서울, 나래 출판사. 1999, pp 696-710.
  2. 최재갑, 홍정표, 서봉직, 고홍섭: 스트레스와 구강질환. 대한치과의사협회지 1998; 36(11): 740-59.
  3. Bell WE: Orofacial pain. classification, diagnosis and management. 4th edition. Chicago, Year Book Medical Publishers. 1989, pp 337-414.
  4. Bricker SL, Langlais RP, Miller CS: Oral diagnosis, oral medicine and treatment planning, second edition. Philadelphia, Lea & Febiger. 1994, pp 733-7.
  5. Coderre TJ, Katz J, Vaccarino AL, Melzack R: Contribution of central neuroplasticity to pathologic pain : review of clinical and experimental evidence. Pain 1993; 52: 259-64. https://doi.org/10.1016/0304-3959(93)90161-H
  6. Ekbom K, Olivarius BF: Chronic migrainous neuralgiadiagnostic and therapeutic aspects. Headache 1971; 11: 97-102. https://doi.org/10.1111/j.1526-4610.1971.hed1103097.x
  7. Falace DA: Emergency dental care, diagnosis and management of urgent dental problem. Baltimore, Williams and Wilkins. 1995, pp 10-24.
  8. Fay T: Atypical neuralgia. Arch Neurol Psychiat 1927; 18: 309-14.
  9. Gaylord JJ: The aetiology of atypical facial pain and its relation to prognosis and treatment. Br J Oral Surg 1970; 7: 202-7.
  10. Gessel AH: Electromyographic biofeedback and tricyclic antidepressants in myofascial pain dysfunction syndrome: psychological predictors of outcome. J Am Dent Assoc 1975; 91: 1049-54.
  11. Graff-Radford SB and Solberg WK: Atypical odontalgia. J Craniomand Disord Facial Oral Pain 1992; 6: 260-5.
  12. Haynes SN, Cuevas J and Gannon LR: The psychophysilogical etiology of muscle-contraction headache. Headache 1982; 22: 122-7. https://doi.org/10.1111/j.1526-4610.1982.hed2203122.x
  13. Kerr FWL: Atypical facial pain. Pain Analg 1979; 6: 1-6. https://doi.org/10.1016/0304-3959(79)90135-0
  14. Kruger GO: Textbook of oral and maxillofacial surgery. 6th ed. Saint Louis, CV Mosby Co.. 1984, pp 700-7.
  15. Mumford JM: Orofacial pain, aetiology, diagnosis and treatment, 3rd edition. Edinburg, Churchill Livingstone. 1982, pp 379-96.
  16. Rushton JG, Gibilisco JA, Goldstein NP: Atypical facial pain. JAMA 1959; 171: 545-50. https://doi.org/10.1001/jama.1959.03010230043010
  17. Scott DS, Gregg JM: Myofascial pain of the temporomandibular joint: a review of the behavioral-relaxation therapies. Pain 1980; 9: 231-6. https://doi.org/10.1016/0304-3959(80)90010-X
  18. Seltzer S: Pain control in dentistry. Pholadelphia, J.J. Lippincott Co.. 1978, pp 64-77.
  19. Sessle BJ, Hu JW, Amano N, Zhong G: Convertgence of cutaneous, tooth pulp, visceral, neck and muscle afferents onto nociceptive and non-nociceptive neurons in trigeminal subnucleus caudalis(medullary dorsal horn)and its implications for referred pain. Pain 1986; 27: 219-24. https://doi.org/10.1016/0304-3959(86)90213-7
  20. Sicuteri F, Anselmi B, Fanciullaci M: The serotonin (5HT) theory of migraine. Adv Neurol 1974; 4: 383-8.