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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The postoperative mucocele of the maxillary sinus typically occurs after 11-15 years after the initial Caldwell-Luc operation with the complaints of swollen and painful cheek. Typical signs and symptoms will be divided into two groups, the one which is associated with expansive lesions and the other with pains along the various branches of the maxillary nerve. In the clinical set-ups, cases with the similar signs and symptoms, and yet lacking definite mucoceles, are often encountered. The present treatise will compare 86 definite cases and 27 simulating cases as to the history, signs and symptoms, various modalities of imaging (CT & MRI), and the possible causes leading to simulating cases. The age at onset, gender, affected side, and period after the initial sinus surgery all showed no differences between the two, i.e., definite and simulating cases. Among signs and symptoms, the definite case showed more of swelling-related matters whereas the simulating case more of pain-related except toothache. The past history of surgeries for the mucoceles on the similar sides to the present lesion is more often seen in the simulating case (64.3%) than in the definite case (18.3%). The findings by imagings in the simulating cases are as follows; obliterated sinus (25.0%), healthy, aerated postop. cavity (35.7%), postop. cavity with mucosal thickening (32.1%), and cyst-like aerated cavity (7.1%). The possible causes leading to the simulating cases are as follows; causes unknown (39.3%), recurrent infection in the postop. cavity (28.6%), dental origin (10.7%), atypical neuralgia (10.7%) and the case shortly after the proceeding sinus surgery (within 12 months, 10.7%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[On the postoperative mucocele of the maxillary sinus and its simulating cases. A clinical treatise]. 161 6

The authors challenge the general view that the analgesic effect of the nonsteroidal anti-inflammatory drugs (NSAIDs) can be universally attributed to their inhibitory effects on the synthesis of peripherally formed prostaglandins. Analgesic activity by some of these compounds in the reduction of physiological pain elicited by a single noxious stimulus, or the treatment of acute pain which results from sudden trauma to otherwise healthy tissue, is better described as an antinociceptive effect. Single-dose studies in the dental pain model that have been conducted in double-blind conditions and included a placebo control group have been reviewed; those NSAIDs which are significantly superior to the reference compound aspirin 650mg and those which could represent real alternatives to the use of narcotics in certain situations for the management of acute pain have been identified. Azapropazone, diflunisal, naproxen, oxaprozin and tolmetin are all weak inhibitors of prostaglandin synthesis, yet they have been shown to be more effective than aspirin. In a model of joint pain, azapropazone 600mg has been shown to be as effective as pethidine (meperidine) 100mg despite being the weakest inhibitor of prostaglandin synthesis. Whether the antinociceptive effect of azapropazone acts at a peripheral or a central level, or both, is not clear; evidence for the effects of NSAIDs on the central nervous system (CNS) is discussed. Historically, the antinociceptive character of some NSAIDs is apparent in several studies in both animals and humans. More recently, experimental algesimetry models designed to distinguish the antinociceptive effects of NSAIDs include the use in humans of photoplethysmography and computer-supported infrared thermographic imaging.
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PMID:Dissociation between the antinociceptive and anti-inflammatory effects of the nonsteroidal anti-inflammatory drugs. A survey of their analgesic efficacy. 171 58

Acetaminophen (APAP) 1000 mg, APAP 2000 mg, the combination of APAP 1000 mg plus codeine phosphate 60 mg (APAPCOD), and placebo (PBO) were compared in a 6-hour, randomized, single-dose, double-blind, parallel-group analgesic trial. All active treatments were statistically superior (p less than 0.05) to placebo for 4 hours after medication with respect to pain intensity (PI) and pain intensity difference (PID), and up to 3 hours regarding pain relief (PAR). The combination scored better than all other treatments on the summary analgesic efficacy measures sum PI (SUMPI), sum PID (SPID), and total PAR (TOTPAR). The combination was statistically superior to APAP 1000 mg on SUMPI, TOTPAR and maximum PAR (MAXPAR). Acetaminophen 2000 mg showed marginal numerical superiority over 1000 mg for SUMPI, but was not statistically superior for any summary efficacy measure. The 2000-mg dose was numerically inferior to APAPCOD for every summary efficacy measure and statistically inferior regarding SPID and MAXPAR. We concluded that codeine 60 mg added to acetaminophen 1000 mg offers analgesic advantages, and acetaminophen reaches an analgesic ceiling effect at 1000 mg using the dental pain model.
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PMID:Analgesic efficacy of acetaminophen 1000 mg, acetaminophen 2000 mg, and the combination of acetaminophen 1000 mg and codeine phosphate 60 mg versus placebo in acute postoperative pain. 174 22

Pain is a complex phenomenon which challenges healthcare providers to develop multidisciplinary diagnostic and treatment competencies. This paper reviews literature on idiopathic odontalgia and tooth hypersensitivity without apparent cause, and considers the role bioelectric mechanisms may play in the onset and treatment of these moderately common disorders. The hypothesis considers that such pain may be associated with health disturbances in areas remote from the teeth and periodontium. A multidisciplinary approach to preventive dental health is discussed along with factors which may impact the outcome in the treatment of dental pain.
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PMID:Multidisciplinary patient care in preventive dentistry: idiopathic dental pain reconsidered. 181 2

Toothache occurs as a result of pulpal and periodontal diseases. Due to the nature of their innervation pain is the only means for both pulp and dentine to react to all kinds of external stimuli. The actual mechanism of sensory transmission, however, has not been clarified, yet. In contrast to this, the innervation of the periodontium offers a wide range of mechano-sensitive receptors. Chronic dental pain is mainly the result of inflammatory reactions. Nerve sprouting, summation, convergence in the trigeminal system and regional inflammatory conditions modulate the local pain process, thus complicating diagnosis. The differential diagnostic clarification with regard to neuralgiform and ENT-diseases therefore requires special care with case history and status. Although there have been advances in pain research over the last few years, no fundamental development in dental diagnosis has been brought about, yet. Probing, sensitivity- and percussion testing as well as x-ray exposure are still the most important diagnostic tools for the dental practitioner.
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PMID:[Acute and chronic toothache]. 181

A six-month pilot emergency service for children was established at Glasgow Dental Hospital to provide care for patients in pain, offer preventive advice and ensure ongoing dental care. The service was staffed by experienced community dental officers. In the main study period 2965 patients were seen. The majority (54 per cent) were referred from general dental practitioners; however, 27 per cent came directly to the hospital without seeking dental advice in their locality. The most common problems were toothache (55 per cent), occasional pain (28 per cent) and swelling (14 per cent). Eighty per cent of the patients were directed to oral surgery for extractions under general anaesthesia and six per cent for extractions under local anaesthesia. Dental caries still causes pain and distress to a large number of Glasgow school children. Clearly water fluoridation would greatly improve dental health and in so doing reduce the proportion of children requiring extractions under a general anaesthetic. The emergency service is currently being reorganised so as to place more emphasis on following up those patients who do not have a dentist, or who presented for care without a referral letter.
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PMID:A report on the feasibility of establishing a paediatric emergency dental service at Glasgow Dental Hospital. 183 18

The purpose of this article is to inform the general dentist treating the temporomandibular joint complex about fibrositis (fibromyalgia syndrome). Patients may present with spasms in the muscles of mastication, which may mimic joint pain or cause joint dysfunction. Tooth pain, which may mimic endodontic pain, may also be referred from a trigger pain in a muscle.
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PMID:Fibrositis (fibromyalgia syndrome) and the dental clinician. 184 81

A case is presented in which posterior tooth mobility and pain, bilateral intraoral swelling of the mandible, and anterior open bite following an incident of facial trauma were the presenting symptoms of a 4-year-old, white American male with Burkitt-type malignant lymphoma. Radiographic examination revealed multiple osteolytic lesions in the body of the mandible, with loss of osseous trabecular architecture, and generalized loss of lamina dura in both maxillary and mandibular arches. The patient also had bone marrow involvement at the time of diagnosis. Following the initial course of chemotherapy, the patient experienced a significant resolution of the bilateral mandibular swelling, anterior open bite, tooth mobility, and dental pain. Relapse occurred shortly after remission was achieved, with tumor metastasis to the central nervous system and testes. The tumor remained resistant to further chemotherapeutic treatments and radiation strategems. Because of renal and metabolic complications, Burkitt's lymphoma constitutes an oncologic emergency. If untreated, this rapidly growing tumor is fatal. Early interception and referral of these cases by the examining dentist is crucial.
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PMID:North American Burkitt's lymphoma presenting with intraoral symptoms. 194 86

Phenylbutazone is a potent nonsteroidal, anti-inflammatory drug often used by veterinarians to treat racetrack animals. Its use in human beings is limited because of significant adverse effects and the availability of newer, safer drugs. We report the case of a 24-year-old man who ingested 17 g of equine phenylbutazone over a 24-hour period to treat the pain of a toothache. He developed grand mal seizures, coma, hypotension, respiratory and renal failure, and hepatic injury. Serum phenylbutazone concentration obtained approximately eight hours after presentation was 900 micrograms/mL. The patient recovered during six weeks of intensive supportive care and repeated hemodialysis.
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PMID:Poisoning with equine phenylbutazone in a racetrack worker. 199 8

Toothache of nonodontogenic origin may be better differentiated with the use of differential diagnostic blockade. Table 9 reviews the expected outcome of somatic block at the site of pain and when the nerve division or the site of nociception is blocked. Although there is considerable overlap, this technique together with a careful history and detailed physical examination will prevent many unnecessary irreversible treatments. If no sign of periapical pathology can be determined (radiography is normal) and the dental examination is nonrevealing, at least a 4-month period should be allowed to elapse before considering any irreversible dental procedure. During this time pharmacologic trials may be attempted, bearing in mind the clinical presentation. Patients should be informed that it may take at least 4 months for the dental pathology to manifest and in the hope of preventing irreversible damage, careful observation accompanied by the pharmacologic trials will be carried out. The practicing clinician is encouraged to maintain a broad perspective of the differential diagnosis of toothache when the pathology is not obvious.
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PMID:Headache problems that can present as toothache. 199 50


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