Maxillofacial Pain Research Articles

P1.47: Consultation frequency of medical and dental doctors by patients suffering from chronic maxillofacial pain disease

P1.47: Consultation frequency of medical and dental doctors by patients suffering from chronic maxillofacial pain disease

とう痛を制御し得た三叉神経領域の帯状ほう疹の１例

An 85-year-old man came to our hospital 2 days after the onset of left maxillofacial pain and vesicle formation on the face. Herpes zoster of the 2nd branch of the trigeminal nerve was diagnosed. The patient was treated with an intravenous infusion of acyclovir for 8 days, followed by oral acyclovir for 7 days. He also received linear polarized light irradiation applied by a SUPER LIZER around the stellate ganglion starting on his 2nd day for 23 days. The duration of irradiation was 7 minutes, with a cycle of 1 second on and 4 seconds off. On the 23rd day, most left facial and oral lesions had disappeared, and pain had significantly improved. Herpetic pain was evaluated before and after the treatment according to a visual analogue scale (VAS). The VAS score decreased from 6 to 1. Postherpetic neuralgia has not developed 6 months after the onset of disease. The combination of linear polarized light irradiation near the stellate ganglion and the intravenous infusion of acyclovir is an effective, noninvasive method for the treatment of elderly patients with trigeminal herpes zoster.

直線偏光型近赤外線治療器ＳＵＰＥＲ ＬＩＺＥＲ ＨＡ‐５５０の口腔・顎・顔面領域への応用 第１報 頚部郭清術後の患者について

Four cases of oral and maxillofacial pain resulted from neck dissection or postoperative radiotherapy for the oral cancers were treated with SUPER LIZER HA-550 (R). SUPER LIZER HA-550 (R) is the linear polarized light type near infrared ray therapy equipment; the range of wavelength is 600-1600nm, and the best output power is 1800mW. The lesions accompanied with pain were treated with SUPER LIZER HA 550 (R) once a day for continuous five days a week. The therapeutic effect were evaluated with the Visual Analogue Scale. As a result of this therapy, one case showed complete recovery and three cases showed improvent clinically.

Cefaclor advanced formulation 750 mg twice daily versus clarithromycin 500 mg twice daily in the treatment of acute maxillary sinusitis

This multicenter, open-label, randomized, parallel-treatment, outpatient study compared the therapeutic equivalence and safety of cefaclor advanced formulation (AT) with those of clarithromycin in the treatment of acute maxillary sinusitis. Eligible patients were randomly allocated to receive cefaclor AT 750 mg twice daily for 10 days (n = 64) or clarithromycin 500 mg twice daily for 10 days (n = 65). A medical history was recorded, a physical examination was performed, and sinusitis diagnostic criteria (maxillofacial pain or tenderness, purulent rhinorrhea, headache, and fever) were assessed ≤24 hours before administration of the first dose of study medication (pretherapy). Assessments of symptomatic response, clinical response, and adverse events were performed 3 to 5 days after the end of therapy or at the time of early discontinuation (post therapy) and 10 to 14 days after the end of therapy (follow-up). Symptomatic responses of maxillofacial pain or tenderness, purulent rhinorrhea, and headache were scored on a 4-point scale (0 = absent, 1 = mild, 2 = moderate, and 3 = severe); clinical response was defined as cure, improvement, relapse, failure, or indeterminate. Treatment with cefaclor AF or clarithromycin almost eliminated maxillofacial pain and tenderness, purulent rhinorrhea, and headache. Mean symptom scores post therapy and at follow-up ranged from 0.1 to 0.3 in the cefaclor AF group and from 0.0 to 0.2 in the clarithromycin group. The incidence of treatment success was identical in the 2 treatment groups: 58 patients (91%) in the cefaclor AF group and 59 patients (91%) in the clarithromycin group were cured or improved post therapy. Twenty patients (31%) in the cefaclor AF group and 19 patients (29%) in the clarithromycin group experienced adverse events, none of which were serious. Discontinuations because of adverse events occurred in 4 patients in the clarithromycin group (gastrointestinal, 3; rash, 1) and 1 patient in the cefaclor AF group (rash); these differences were not statistically significant. In terms of clinical response and symptom score, cefaclor AF and clarithromycin were equally effective in the treatment of this group of patients with acute maxillary sinusitis.

Oral and maxillofacial cancer pain.

SUMMARYPain resulting from oral and maxillofacial cancer is a major problem that requires the attention of all members of the health care team. This attention is important because of the large number of people affected and because the treatment of cancer pain is too frequently inadequate. An understanding of acute and chronic pain, the underlying malignant disease, the complications of cancer treatment, and currently available treatments for pain must form the basis of pain management. A review of the problem of oral and maxillofacial pain in the patient with cancer is presented.

Aspirin-intolerance syndrome: Report of a case

Maxillofacial pain is often managed by the use of mild analgesics, such as acetylsalicylic acid and nonsteroidal anti-inflammatory agents. The following is a review of an idiosyncratic phenomenon that could prove life-threatening following ingestion of these pharmaceuticals. A thorough review of the patient's past medical history with an understanding of this syndrome may alleviate such a danger.

Computerized tomography and Trotter's syndrome in the diagnosis of maxillofacial pain

Trotter's syndrome is a clinical triad of unilateral deafness, neuralgia affecting branches of the trigeminal nerve, and defective mobility of the soft palate, which is caused by malignant tumors involving the lateral pharyngeal recess (Rosenmu¨ller's fossa). It is an ominous presentation, which can masquerade as dental or masticatory pain. Computerized tomography (CT) can be used not only to explain the anatomic basis of Trotter's syndrome but also to determine the extent and distribution of the malignant tumor involved. The advantages of CT over conventional radiography are illustrated by a case of adenoid cystic carcinoma that presented as Trotter's syndrome. Perineural invasion by tumor is shown on the gross level for the first time with CT, and important diagnostic considerations, which may aid in the early diagnosis of future cases, are discussed.

いわゆる顎関節症の臨床的研究

One hundred and twenty one patients with mandibular dysfunction complaining of maxillofacial pain were clinically observed.Since no organic change was detected at the temporomandibular joints in any, it was surmised that the dysfunction was due to functional imbalance.The dysfunction was symptomatically divided into three types: arthrogenic, myogenic and mixed.The incidence was highest in the arthrogenic type (57%) mainly comprising arthromotoralgia, followed by the myogenic type (39%) mainly comprising contraction of the masticatory muscles.Usually dental and drug combination therapies were given and favorable results were obtained.

The induction of trigeminal neuralgia-like symptoms by pulp-periapical pathosis

The etiology of trigeminal neuralgia is poorly understood. Many patients develop neuralgiform types of pain from oral and dental pathoses. This is a report of a case of a 30-yr-old patient with a diagnosis of trigeminal neuralgia, who was treated with carbamazepine by a neurologist without alleviation of symptoms. The patient was then seen in the Maxillofacial Pain Control Center. After a complete oral and dental examination, a diagnosis of necrosis of the dental pulp of a lower molar was made. Endodontic treatment was instituted and the symptoms gradually disappeared. After two months, the pain was completely eliminated.

Pain relief by dietary manipulation and tryptophan supplements

Ninety-six patients with chronic maxillofacial pain were treated with a therapeutic diet consisting of approximately 80% carbohydrate, 10% protein, and 10% fat content, plus 3 g of supplementary tryptophan daily. Reports' concerning pain status were reviewed at intervals ranging from 1 wk to 18 months. Overall, the treatment was 62% effective, as measured by either elimination of pain or at least a 50% reduction in pain intensity. Pain reduction, as measured by mean pain rating scales, increased linearly with the passage of time. The results appear to confirm that dietary manipulations are capable of altering central pain states. However, the systemic effects of long-term therapy remain to be investigated. Ninety-six patients with chronic maxillofacial pain were treated with a therapeutic diet consisting of approximately 80% carbohydrate, 10% protein, and 10% fat content, plus 3 g of supplementary tryptophan daily. Reports' concerning pain status were reviewed at intervals ranging from 1 wk to 18 months. Overall, the treatment was 62% effective, as measured by either elimination of pain or at least a 50% reduction in pain intensity. Pain reduction, as measured by mean pain rating scales, increased linearly with the passage of time. The results appear to confirm that dietary manipulations are capable of altering central pain states. However, the systemic effects of long-term therapy remain to be investigated. Noventa-seis pacientes con dolor maxilo facial crónico fueron tratados con una dieta terapéutica conteniendo aproximadamente 80% hiaratos de carbono, 10% proteínas y 10% de grasas más 3 g de suplemento de triptofano diarios. Comunicacions al respecto del estado del dolor fueron revisadas en intervalos que varía de una semana a 18 meses. En términos generales el tratamiento fue efectivo en el 62% de los casos evalvados, ya sea por eliminación del dolor o disminución de un 50% en su intensidad. La reducción del dolor, medida por una escala de puntos, aumentó linealmente con el transcurso del tiempo. Estos resultados parecen confirmar que las manipulaciones de la dieta son capaces de alterar el estado de dolor central. Sin embargo los efectos sistemicos de la terapia a largo plazo deben ser investigadas. Noventa-seis pacientes con dolor maxilo facial crónico fueron tratados con una dieta terapéutica conteniendo aproximadamente 80% hiaratos de carbono, 10% proteínas y 10% de grasas más 3 g de suplemento de triptofano diarios. Comunicacions al respecto del estado del dolor fueron revisadas en intervalos que varía de una semana a 18 meses. En términos generales el tratamiento fue efectivo en el 62% de los casos evalvados, ya sea por eliminación del dolor o disminución de un 50% en su intensidad. La reducción del dolor, medida por una escala de puntos, aumentó linealmente con el transcurso del tiempo. Estos resultados parecen confirmar que las manipulaciones de la dieta son capaces de alterar el estado de dolor central. Sin embargo los efectos sistemicos de la terapia a largo plazo deben ser investigadas.

Dietary control of chronic maxillofacial pain.

Abstract Chronic maxillofacial pain has been treated with a therapeutic diet consisting of approximately 80% carbohydrate, 10% protein and 10%, fat content, plus 3 g supplementary tryptophan daily. Overall, the treatment has been found to be 62% effective, as measured by either elimination of pain or at least a 50%, reduction in pain intensity. Pain reduction as measured by mean pain rating scales, increased linearly with the passage of time.

Psychiatry The effects of dietary tryptophan on chronic maxillofacial pain and experimental paintolerance: J. psychiat. Res., 17 (1982/83) 181–186

Psychiatry The effects of dietary tryptophan on chronic maxillofacial pain and experimental paintolerance: J. psychiat. Res., 17 (1982/83) 181–186

Stress: a common denominator for nonorganic TMJ pain-dysfunction.

S tress and its relationship to temporomandibular joint (TMJ) dysfunction-pain syndrome has been the subject of much research and controversy in recent years. Various TMJ disorders involve many identical symptoms, such as crepitation, masticator-y muscles tender to palpation, preauricular pain, and bruxism. These symptoms have received numerous labels, for example, maxillofacial pain, myofascial pain-dysfunction (MPD) syndrome, orofacial pain, TMJ dysfunction-pain syndrome, and TMJ pain and dysfunction. According to Weinberg,’ the etiology of TM J disorders can be divided into four classifications: stress, occlusion, condylar displacement within the fossae, and anterior displacement of the disk. As TMJ etiology is multicausal, individual study is prevented and only trends can be recognized. Stress, however, deserves emphasis as a significant underlying cause of TMJ dysfunction in patients where no obvious alteration or physical change has occurred, that is, recent placement of individual restorations or prostheses, trauma, degenerative joint diseases, or chronic partial and total subluxations. Medical dictionaries place different emphasis on the definition of stress.‘, s Commonly shared by each definition is the reference to “nonspecific” and “various abnormal states,” allowing significant latitude to the definition of stress. The Random House Dictionary defines stress simply as physical, mental, or emotional strain or tension.4 Devoid of specificity, this permits the acceptance of stress as a trend.

The effects of dietary tryptophan on chronic maxillofacial pain and experimental pain tolerance

This study investigated the effects of daily administration of three grams of tryptophan in conjunction with a high carbohydrate, low fat, low protein diet on chronic maxillofacial pain, experimental pain thresholds, and anxiety and depression. In a double-blind study, 30 chronic pain patients were randomly assigned to a tryptophan or placebo group. At the initial appointment and 4 weeks later, the patients' subjective ratings of their pain were recorded, electrical tooth pulp stimulation was used to measure pain thresholds, and psychological tests of depression and anxiety were administered. Over the 4 weeks of the study, there was a greater reduction in reported clinical pain and a greater increase in pain tolerance threshold in the tryptophan group than in the placebo group. The group did not differ in anxiety and depression—for all subjects there was lowered depression and anxiety over the 4 weeks of study.

The diagnosis of chronic maxillofacial pain

The diagnosis of chronic maxillofacial pain

Evaluation of Patients with Maxillofacial Pain

Usually the vast majority of patients who have maxillofacial pain will not pose a diagnostic problem if the basic fundamentals of diagnosis are used in conjunction with a sound knowledge of disease. The problem almost certainly will be that of successful treatment. Every effort must be made to establish a diagnosis and rule out the possibility of serious disease. When confronted with a diagnostic or therapeutic problem that cannot be resolved, consultation must be sought from specialists in areas such as oral surgery, neurology, neurosurgery, and psychiatry. These individuals can provide a broad base of experience to help resolve the difficult problems.

Diagnosis of Acute Maxillofacial Pain

Diagnosis of Acute Maxillofacial Pain

Psychiatric considerations in maxillofacial pain

Psychiatric considerations in maxillofacial pain