Treatment of Painful Post-traumatic Peripheral Neuropathy with Capsaicin in an Edentulous Patient with Extreme Resorption in the Mental Region: A Case Report

Abstract

The aim of this report is to present a clinical case of extensive alveolar resorption in the mental region of the mandible of a complete denture wearer for which capsaicin was used for alleviation and remission of post-traumatic painful peripheral neuropathy. Resorption of the residual ridge occurs in a chronic and progressive manner, altering the configuration of the ridge and the mucosa covering it and subsequently compromising the stability of the complete denture prosthesis. Individual variability associated with such factors as gender, age, edentulous period, nutrition, excessive load and compression on the ridge, parafunctional habits, occlusal instability, and maladaptation of the prosthesis may have a role in the rate and manner of bone loss. A 62-year-old woman, edentulous at the age of 30, presented with complaints of pain and spontaneous "electrical shocks" in the mucosa under her mandibular complete denture. The pain increased while chewing approximately two years ago due to the pressure of this denture on her supporting tissues. The patient indicated the level of pain corresponded to a score of ten out of ten on the Visual Analogical Scale (VAS). Treatment included denture replacement and topical application of capsaicin gel using a custom tray technique. The review of the literature and the results obtained from the management of this case have served to emphasize how much neuropathic pain research has demonstrated the complexity of its neurophysiologic mechanism due to the lack of association with any somatic manifestation. During the fabrication of a new lower denture the topical application of capsaicin was shown to be effective in the relief and remission of the painful symptoms of the neuropathy as of this writing.