Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA.
Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
Oral Dis. 2022 Apr;28(3):805-812. doi: 10.1111/odi.13824. Epub 2021 Mar 9.
Neuropathic orofacial pain disorders are frequently managed with topical or systemic medications that carry a risk of dangerous side effects such as drowsiness, disorientation, and/or physical addiction. The aim of this paper is to report the use of neurosensory oral appliances as a safe means of providing symptomatic relief for neuropathic orofacial pain.
This is a retrospective chart review of patients with diagnoses of persistent idiopathic facial pain (PIFP), painful post-traumatic trigeminal neuropathy (PTTN), or an oral dysesthesia, who utilized neurosensory appliances with or without the use of topical anesthetic gel.
Eleven patients were identified. Eight patients (62.5%) found benefit with the neurosensory appliance alone, and three patients (37.5%) found relief with the addition of lidocaine 2% gel. All patients reported >50% resolution of their symptoms, with three (37.5%) reporting complete resolution. Seven patients maintained follow-up ≥3 months, with efficacy lasting for a range of at least 3-8 months.
Oral neurosensory appliances, whether used alone as a physical barrier or as a vehicle to deliver topical anesthetic, represent a safe and effective modality for the management of neuropathic orofacial pain disorders. Additional studies are needed to assess long-term efficacy.
神经病理性口面疼痛障碍常采用局部或全身药物治疗，但这些药物存在危险的副作用风险，如嗜睡、定向障碍和/或身体依赖。本文旨在报告使用神经感觉性口腔器具作为一种安全的方法，为神经病理性口面疼痛提供症状缓解。
这是一项对持续性特发性面部疼痛（PIFP）、创伤后三叉神经痛（PTTN）或口腔感觉异常诊断患者的回顾性图表审查，这些患者使用或不使用局部麻醉凝胶来使用神经感觉性器具。
共确定了 11 名患者。8 名患者（62.5%）单独使用神经感觉性器具获益，3 名患者（37.5%）在添加 2%利多卡因凝胶后缓解。所有患者报告症状缓解>50%，3 名患者（37.5%）报告完全缓解。7 名患者的随访时间≥3 个月，疗效持续至少 3-8 个月。
口腔神经感觉性器具，无论是单独用作物理屏障还是作为传递局部麻醉剂的载体，都是管理神经病理性口面疼痛障碍的安全有效方法。需要进一步的研究来评估长期疗效。
