Evaluation of the treatment and prognosis of the patients with orofacial pain of unknown cause

Abstract

The aim of this study was to evaluate the symptoms, diagnoses, clinical treatment and prognoses of patients with orofacial pain of unknown origin. The study included 61 patients (13 males, 48 females, mean age 60.8 years) who experienced orofacial pain of unknown etiology, except for those with definite causes including dental pain, infection, osteomyelitis, and temporomandibular joint disease. Clinical examinations included patients’ clinical signs, radiological examinations (radiographs, CT, MRI, bone scan), blood tests, thermography, electric pulp tests, electrophysiological examinations, and anesthesia for diagnostic purposes. The treatment methods included medication, physiotherapy, dental treatment, periodontal treatment, surgical operation, and consultation, taking into consideration the precise diagnosis and symptoms for each patient. We retrospectively reviewed the medical records and evaluated the treatment duration and prognosis for each diagnosis. There were more female patients than male patients (78.7% female) and the mean age for all participants was 60.8 years. The mean duration of treatment for orofacial pain was 32 months; the traumatic neuropathy group had the shortest duration, 29.1 months, and the trigeminal neuralgia group had the longest duration, 52.9 months. Atypical odontalgia was the most favorable prognosis, followed by psychological pain, trigeminal neuralgia, traumatic neuropathy, and atypical facial pain. In all cases of oral facial pain, a significant relief of symptoms was observed after treatment. The outcome of current medications and physical therapies for patients with unexplained orofacial pain is generally good.