비정형성 치통으로 여겨진 환자의 분석

Abstract

The purpose of this study is to looks into the clinical features of AO(Atypical odontalgia) patients. to find out relationship between AO and previous dental treatments. and to gain helpful information about the diagnosis and treatment of AO patients. The subjects chosen for this study were 42 patients who had visited the Department of Oral Medicine at Yonsei University Dental Hospital and diagnosed as AO. Previous clinical records review. questionnaires review. and diagnosis and treatment investigation were done for this study. The following results were obtained: 1. AO occurs more often to the femald(69%) than to the mald(31%). The average age is 45.2 years and the average pain duration is 40 months. 2. There were 40.5% without medical history.35.7% with GI troubles and 7.1 % with psychological diseases. And only few of them have smoking and drinking habits(7.1% each). 3. The most common site of AO is Molar area(83.3%). when the patients have more than two pain sites, unilateral case(70.8%) is more frequently shown than bilateral one. 4. Considering the departments referring to the department of oral medicine. treatment related to AO. previous dental treatment history, and visiting dental departments. AO is very closely related to the Endodontic treatments. 5. 90.5% of patients have visited more than 3 dental practitioners. 6. The number of patients who have referred pain and no referred pain were similar. 59.5% of patients have spontaneous pain. And the number of patients who have severe pain and who have moderate and light pain were similar. The average period of treatment was 7.2 months. 7. The main method of diagnosis was diagnostic anesthesia(57.1%), And it was diagnosed mainly as myofascial pain and chronic peripheral trigeminal neuropathy(28.6% each), 8. The used drugs were mainly anticonvulsants(69.0%) and antidepressants (59.5%), And the effectiveness of anticonvulsants(72.4%) is better than that of antidepressants(52%). Especially, one of the anticonvulsants, Gabapentin was used very frequently(64.3%), And topical Capsaicin has a limited effect. As a result. AO can be diagnosed from the detailed reviews of the clinical records and questionnaires when there's no abnormality in the clinical or radiographic examination but the patients appeal chronic pain which is not alleviated by dental treatments. And when the patients are considered to have AO. it's better to do a conservative treatments such as anticonvulsants or antidepressants therapy than to do an irreversible treatments like an Endodontic treatments or extractions