Among neurodental diseases, atypical facial pain accounts for an average of 6.4%

Аннотация

Among neurodental diseases, atypical facial pain accounts for an average of 6.4%. Atypical facial pain can also be caused by pulp pathology, which is most often manifested by chronic pulpitis. It is known that the pain of pulpitis is one of the most severe and causes the patient suffering. Often it does not allow you to sleep, chew food properly, makes a person irritable and irascible. However, fear of treatment at the dentist or other reasons make you endure this pain for a long time, use all sorts of means of independent struggle with it, which most often turn out to be temporary and ineffective. Despite the long study of odontogenic facial pain, the clinical and pathophysiologic features of atypical facial pain in pulpitis have not yet been elucidated. Such a study would allow dentists to consider pulpitis pain not only as a symptom of dental disease, but also as a systemic syndrome that affects the nervous system, the patient's psyche, his ability to work and quality of life. The aim of the study was to investigate the complex of clinical and immunologic parameters in patients with pulpitis. Materials and methods of the study. 107 patients with facial pain caused by dental pulp inflammation aged from 18 to 64 years were examined. The average age was 36±1,2 years. The bulk of the examined patients (87.9%) were aged from 20 to 49 years, fewer patients were aged under 20 years (3.7%) and after 50 years (8.4%). The ratio of men and women was 48 (44,9%) to 59 (55,1%). During immunologic researches” we compared the results obtained with similar results obtained from practically healthy volunteers. Such a comparison group consisted of 20 people with sanitized oral cavity, without acute and chronic somatic and psychoneurological pathology. Among them there were 8 men and 12 women. Their age, almost as in the main group, varied from 18 to 62 years. The average age was 34,2±3,1 years The methods of immunologic research included determination of the level of antibodies to myeloperoxidase (MPO) and antibodies to myelin basic protein (MBP) in blood serum by means of immunofemoral analysis (ELISA). The obtained data were subjected to statistical processing on a computer with a Pentium-IV processor using Microsoft Office Excel-2003 software package, including the use of built-in functions of statistical processing. Results and their discussion. Facial pain was often detected on the right 82 ACADEMIC RESEARCH IN MODERN SCIENCE International scientific-online conference side - in 60.7% of cases. Bilateral pain was detected only in 1 case. All 107 patients with pain symptom examined by us needed oral cavity sanation. The hygienic state of the oral cavity was evaluated in all examined patients using the Fedorov-Volodkina hygienic index. Painful paroxysms occurred with varying frequency from 3 - 4 times a day to 5 - 7 attacks per hour. Pain localization corresponded to the affected dental plexus. Pain was most often localized in molars (61.1%) and premolars (36.1%), less often in canines (0.9%) and incisors (1.9%). During the attack, the pain irradiated along the alveolar plexus and also spread to the hard palate, cheek and temple area. The duration of the pain symptom in the patients ranged from 3 days to 7 months as revealed during the examination. Detailed neurological examination of patients with pulpitis pain allowed us to identify symptoms of nervous system damage. The most frequent symptoms were tinnitus and ringing in the ears, hearing loss, systemic and non-systemic dizziness, headache, unsteadiness in walking, nausea and vomiting. The examined patients complained of general weakness, decreased efficiency, rapid fatigability, sweating (especially at night), increased body temperature (37.1°- 37.7°C), decreased body weight. In some patients with prolonged pain symptom we noted (both subjectively and objectively) salivation disorders. In a number of cases hyposalivation was revealed, in which patients complained of dry mouth. However, on the contrary, the majority of such patients noted increased salivation, especially during an attack of pain. Pain during eyeball movement was observed in 11.2% of patients. Violation of innervation of the facial nerve was manifested in 45.8% of patients by unilateral smoothing of the nasolabial fold, indicating a central character of the lesion. Tongue deviation was observed in 17.8% of patients. The syndrome of diffuse cerebral microsymptomatology was detected in 37.4% of patients, and in 28.0% of patients the I degree of dental neuralgia was diagnosed, and in 34.6% of patients - the II degree of dental neuralgia. This syndrome is characterized by the presence of subjective neurological symptoms and focal microsymptoms in the form of insufficient convergence of eyeballs, decreased corneal reflexes, smoothing of the nasolabial fold, tongue deviation, oral automatism reflexes. Immunologic studies revealed a reliable increase of parameters in patients with atypical facial pain in comp