Original scientific paper

Orofacial pain caused by trigeminal neuralgia and/or temporomandibular joint disorder

TOMISLAV BADEL ; Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
IVANA SAVIĆ PAVIČIN ; Department of Dental Anthropology, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
VANJA BAŠIĆ KES ; Department of Neurology, Clinical Hospital, Centre “Sisters of Charity”University of Zagreb, Vinogradska cesta 29, 10000 Zagreb, Croatia
IRIS ZAVOREO ; Department of Neurology, Clinical Hospital, Centre “Sisters of Charity”University of Zagreb, Vinogradska cesta 29, 10000 Zagreb, Croatia
DIJANA ZADRAVEC ; Department of Diagnostic and Interventional Radiology, Clinical Hospital Centre, “Sisters of Charity”, University of Zagreb, Vinogradska cesta 29, 10000 Zagreb, Croatia
JOSIPA KERN ; Department of Medical Statistics Epidemiology and Medical Informatics, School of Public Health “Andrija Štampar”, School of Medicine, University of Zagreb, Rockefellerova 4, 10000 Zagreb, Croatia

Abstract

Background and Purpose: The purpose was to evaluate an accurate
method of differentiating between temporomandibular joint (TMJ) disorder and trigeminal neuralgia (TN) in the sample of patients from a
subspecialist dental practice.

Patients and Methods: Patients (n=239, mean age 39.3 years, 83.3%
female) were examined for clinical symptoms and signs of orofacial pain of non-dental origin. The study included 12 female patients (groupG-1;mean age 60.3 years)with determined co-morbidity of TMJ disorder and TN, and 17 patients (group G-2; mean age 53.8 years, 64.7% female) with only TN confirmed and the TMJ disorder ruled out. The TMJ diagnosis by means of magnetic resonance imaging (MRI) was confirmed. Pain intensity was rated on a visual-analogue scale (VAS with range 0–10) and maximal mouth opening capacity (mm) measured by gauge.

Results: TMJ pain on the VAS scale for G-1 patients amounted to 6.91.
TN related pain symptoms on the VAS scale for G-1 patients amounted to 9.0±1.6 and for G-2 patients 8.1±2.7. There was a statistically significant difference in the intensity of TMJ and TN related pain (p=0.0074) within the G-1 patients group. Pain in the TMJ area (p=0.0012), noise in the TMJs (p=0.0345) as well as ear pain (p<0.001) were more frequent in G-1 patients with TMJ disorder. Maximal mouth opening was statistically significant (p=0.0037) between G-1 (38.9±9.2 mm) and G-2 patients (48.9±5.2 mm).

Conclusion: A thorough clinical evaluation of symptoms as well as MRI
as the gold standard for TMJ diagnostics also includes a neurological
examination in cases of uncommon orofacial pain conditions.

Keywords

orofacial pain; trigeminal neuralgia; temporomandibular joint; magnetic resonance imaging

Hrčak ID:

105972

URI

https://hrcak.srce.hr/105972

Publication date:

1.6.2013.

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