Brotman Facial Pain Clinic, School of Dentistry, University of Maryland, 650 W. Baltimore St, 1st Floor, Baltimore, MD, 21201, USA.
Department of Pain and Neural Sciences, School of Dentistry, University of Maryland, 650 W. Baltimore St, 8th Floor, Baltimore, MD, 21201, USA.
Drugs. 2023 Sep;83(14):1269-1292. doi: 10.1007/s40265-023-01927-z. Epub 2023 Aug 26.
Orofacial pain is a category of complex disorders, including musculoskeletal, neuropathic and neurovascular disorders, that greatly affect the quality of life of the patient. These disorders are within the fields of dentistry and medicine and management can be challenging, requiring a referral to an orofacial pain specialist, essential for adequate evaluation, diagnosis, and care. Management is specific to the diagnosis and a treatment plan is developed with diverse pharmacological and non-pharmacological modalities. The pharmacological management of orofacial pain encompasses a vast array of medication classes and approaches. This includes anti-inflammatory drugs, muscle relaxants, anticonvulsants, antidepressants, and anesthetics. In addition, as adjunct therapy, different injections can be integrated into the management plan depending on the diagnosis and needs. These include trigger point injections, temporomandibular joint (TMJ) injections, and neurotoxin injections with botulinum toxin and nerve blocks. Multidisciplinary management is key for optimal care. New and safer therapeutic targets exclusively for the management of orofacial pain disorders are needed to offer better care for this patient population.
口腔颌面部疼痛是一类复杂的疾病，包括肌肉骨骼、神经病理性和神经血管性疾病，极大地影响了患者的生活质量。这些疾病属于口腔医学和医学领域，管理具有挑战性，需要转诊到口腔颌面部疼痛专家，这对于充分的评估、诊断和护理是必要的。管理是根据诊断而定的，并且会制定一个包含各种药物和非药物治疗方法的治疗计划。口腔颌面部疼痛的药物治疗涵盖了广泛的药物类别和方法。这包括抗炎药、肌肉松弛剂、抗惊厥药、抗抑郁药和麻醉剂。此外，作为辅助治疗，可以根据诊断和需求将不同的注射剂纳入管理计划。这些包括扳机点注射、颞下颌关节（TMJ）注射和肉毒毒素神经毒素注射以及神经阻滞。多学科管理是获得最佳护理的关键。需要为口腔颌面部疼痛疾病的管理专门开发新的、更安全的治疗靶点，以提供更好的护理。
