García-Sáez Rafael, Gutiérrez-Viedma Álvaro, González-García Nuria, Gómez-Mayordomo Víctor, Porta-Etessam Jesús, Cuadrado María-Luz
Headache Unit, Department of Neurology, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain,
Department of Medicine, School of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain,
J Pain Res. 2018 Aug 23;11:1583-1588. doi: 10.2147/JPR.S169701. eCollection 2018.
Atypical odontalgia (AO) manifests as continuous pain in the region of one or several teeth, in the absence of signs of dental pathology. Currently, there is insufficient evidence to establish treatment guidelines for AO. The aim of this study was to describe the effectiveness and safety of treatment with OnabotulinumtoxinA (OnabotA) on a series of patients with AO.
Nine patients with AO (four males and five females, aged between 31 and 77 years) received injections of OnabotA in the region of pain. The dosage used in each procedure ranged between 10 and 30 U, spread between 4 and 12 injection sites along the gums (n=9), the lips (n=3), and the hard palate (n=1). The median follow-up time was 27 months (interquartile range, IQR 20-40) and the median number of injection sessions per patient was seven (IQR 4.5-9). The assessment variables included the change in the maximal intensity of pain on a 0-10 numerical rating scale (NRS), the response latency, and the duration of the effect.
All patients experienced a significant improvement, with ≥50% of reduction in the intensity of the maximal pain. The median of reduction of maximal pain after treatment was six points on the NRS (IQR 5-8.5). The response latency was 2-15 days and the duration of the effect was 2-6 months. No significant adverse reactions were registered.
OnabotA may be a safe and effective option for the treatment of AO.
非典型牙痛（AO）表现为一颗或多颗牙齿区域的持续性疼痛，且无牙科病理学迹象。目前，尚无足够证据制定AO的治疗指南。本研究的目的是描述用A型肉毒毒素（OnabotA）治疗一系列AO患者的有效性和安全性。
9例AO患者（4例男性，5例女性，年龄31至77岁）在疼痛区域接受OnabotA注射。每次注射的剂量在10至30单位之间，沿牙龈（n = 9）、嘴唇（n = 3）和硬腭（n = 1）的4至12个注射部位分布。中位随访时间为27个月（四分位间距，IQR 20 - 40），每位患者注射次数的中位数为7次（IQR 4.5 - 9）。评估变量包括0至10数字评分量表（NRS）上最大疼痛强度的变化、反应潜伏期和效果持续时间。
所有患者均有显著改善，最大疼痛强度降低≥50%。治疗后最大疼痛降低的中位数在NRS上为6分（IQR 5 - 8.5）。反应潜伏期为2 - 15天，效果持续时间为2 - 6个月。未记录到显著不良反应。
OnabotA可能是治疗AO的一种安全有效的选择。
