Viscuso Domenico, Storari Marco, Casu Cinzia, Scano Alessandra, Aru Eleonora, Orrù Germano, Garau Valentino
Department of Surgical Science, College of Dentistry, University of Cagliari, 09124 Cagliari, Italy.
Department of Surgical Science, Oral Biotechnology Lab (OBL), University of Cagliari, 09124 Cagliari, Italy.
J Oral Facial Pain Headache. 2025 Mar;39(1):103-111. doi: 10.22514/jofph.2025.009. Epub 2025 Mar 12.
Post-traumatic trigeminal neuropathic pain represents neuropathic pain in the distribution of the trigeminal nerve caused by trauma to the trigeminal nerve. Dental traumatic interventions, such as root-canal therapy and extractions, are reported to precede, in some cases, the onset of the disease. The current study aims to investigate how much dentists are trained to recognize, treat or properly address patients suffering from Post-traumatic trigeminal neuropathic pain.
Data were collected from a large sample of Italian dentists in 2021. The setting of this study relates to an epidemiological survey conducted on the web. Google Forms, a product of Google Inc., was used as the operating system. An online questionnaire was sent to each participant, and the degree of knowledge of the disease along with the direct experience of having encountered it was investigated through specific multiple-choice questions.
634 dentists participated in the survey. 29% of participants declared to be unaware of the existence of Post-traumatic trigeminal neuropathic pain. 70% of dentists reported to have had patients suspicious of such pain in their clinical activity, following endodontic treatment (60%), tooth extraction (43%), spontaneously (37%) or other dental therapies (21%). When encountered, only in one out of three cases were patients sent to a pain specialist, and in most cases dentists performed irreversible therapies the site of the pain.
This study evidences a major public health problem, such as the incapability of clinicians to perform a correct diagnosis and management of Post-traumatic trigeminal neuropathic pain. Such a lack of knowledge costs the patients mistaken and irreversible surgical therapies in many cases, and resulting delays in receiving proper diagnosis and management that could affect the success of the treatment. Furthermore, the unawareness had high socioeconomic costs for both the healthcare system and the patients due to the disability.
NP/2021/5460, Institutional Review Boards of the University of Cagliari, Italy.
创伤后三叉神经痛性疼痛是指由三叉神经创伤引起的三叉神经分布区域的神经性疼痛。据报道，在某些情况下，牙科创伤性干预措施，如根管治疗和拔牙，会先于该疾病的发作。本研究旨在调查牙医在识别、治疗或妥善处理创伤后三叉神经痛性疼痛患者方面接受了多少培训。
2021年从大量意大利牙医样本中收集数据。本研究的背景是在网络上进行的一项流行病学调查。使用谷歌公司的产品谷歌表单作为操作系统。向每位参与者发送一份在线问卷，并通过特定的多项选择题调查对该疾病的了解程度以及遇到该疾病的直接经验。
634名牙医参与了调查。29%的参与者表示不知道创伤后三叉神经痛性疼痛的存在。70%的牙医报告称，在他们的临床活动中，有患者在接受牙髓治疗（60%）、拔牙（43%）、自发出现（37%）或其他牙科治疗（21%）后疑似患有这种疼痛。当遇到这种情况时，只有三分之一的患者被转介给疼痛专科医生，而且在大多数情况下，牙医在疼痛部位进行了不可逆的治疗。
本研究证明了一个重大的公共卫生问题，即临床医生无法对创伤后三叉神经痛性疼痛进行正确的诊断和管理。这种知识的缺乏在许多情况下使患者接受了错误且不可逆的手术治疗，并导致接受正确诊断和管理的延迟，这可能会影响治疗的成功率。此外，由于残疾，这种无知对医疗系统和患者都造成了高昂的社会经济成本。
NP/2021/5460，意大利卡利亚里大学机构审查委员会。
