Recurrent Deeply Invasive Basal Cell Carcinoma.

INTRODUCTION: Basal cell carcinoma (BCC) is the most frequent skin malignancy worldwide. The majority of BCCs grow slowly and have a low metastatic potential. However, they can be destructive to surrounding tissues since they are locally invasive. METHODS: This case report was conducted on a 78-year-old woman complaining of a solid lump on the left side of the neck and nonhealing lesion. Three years earlier, she had BCC on the same site. Clinical and radiographic examinations were made. The biopsy specimens revealed that it is a recurrent BCC. In operating room, during blunt tissue dissection, the arterial wall was damaged. Tumor was overgrown left internal carotid artery near the bifurcation. Infiltrated part of arteria wall was resected, and a synthetic arterial prosthesis was placed. RESULTS: Follow-up after 4 months showed that the wound was healing well. No complications regarding cardiovascular and other organ systems were seen.

Physical and mechanical changes on titanium base of three different types of hybrid abutment after cyclic loading.

PURPOSE: This study investigated the physical and mechanical changes in the titanium base of three different hybrid abutment materials after cyclic loading by estimating the post-load reverse torque value (RTV), compressive side fulcrum wear pattern of titanium base, and surface roughness. MATERIALS AND METHODS: A total of 24 dental implants were divided into three groups (n = 8 each): Group Z, LD, and P used zirconia, lithium disilicate, and polyetheretherketone, respectively, for hybrid abutment fabrication. RTV was evaluated after cyclic loading with 50 N for 1.2 × 106 chewing cycles. The compressive sides of the titanium bases were analyzed using a scanning electron microscope, and the roughness of the affected areas was measured using an optical profilometer after loading. Datasets were analyzed using Kruskal-Wallis test followed by Mann-Whitney tests with the Bonferroni correction (α = .05). RESULTS: Twenty-three samples passed the test; one LD sample fractured after 770,474 cycles. Post-load RTV varied significantly depending on the hybrid-abutment material (P = .020). Group P had a significantly higher median of post-load RTVs than group Z (16.5 and 14.3 Ncm, respectively). Groups LD and P showed minor signs of wear, and group Z showed a more pronounced wear pattern. While evaluating compressive side affected area roughness of titanium bases, lower medians were shown in group LD (Ra 0.16 and Rq 0.22 µm) and group P (Ra 0.16 and Rq 0.23 µm) than in group Z (Ra 0.26 and Rq 0.34 µm); significant differences were found only among the unaffected surface and group Z. CONCLUSION: The hybrid abutment material influences the post-load RTV. Group Z had a more pronounced wear pattern on the compressive side of titanium base; however, the surface roughness was not statistically different among the hybrid-abutment groups.

A comparative biomechanical study of original and compatible titanium bases: evaluation of screw loosening and 3D-crown displacement following cyclic loading analysis.

PURPOSE: This study evaluated screw loosening and 3D crown displacement after cyclic loading of implant-supported incisor crowns cemented with original titanium bases or with three compatible, nonoriginal components. MATERIALS AND METHODS: A total of 32 dental implants were divided into four groups (n = 8 each): Group 1 used original titanium bases, while Groups 2-4 used compatible components. The reverse torque value (RTV) was evaluated prior to and after cyclic loading (1,200,000 cycles). Samples (prior to and after cyclic loading) were scanned with a microcomputed tomography (micro-CT). Preload and postload files were superimposed by 3D inspection software, and 3D crown displacement analysis was performed using root-mean-square (RMS) values. All datasets were analyzed using one-way ANOVA and Tukey's post hoc analysis. RESULTS: Significant variations were observed in the postload RTV, depending on the titanium base brand (P < .001). The mean postload RTVs were significantly higher in Groups 1 and 2 than in the other study groups. While evaluating 3D crown displacement, the lowest mean RMS value was shown in the original Group 1, with the highest RMS value occurring in Group 4. CONCLUSION: Within the limitations of this in vitro study and under the implemented conditions, it was concluded that the manufacturer brand of the titanium base significantly influenced screw loosening following the fatigue test and influenced 3D crown displacement after cyclic loading.

Functional Rehabilitation after Mandibular Fracture - A Systematic Review.

Background: The objective of this study was to evaluate the efficiency of functional rehabilitation in terms of mouth opening, quality of life, healing process, occlusion and dysfunction, between different treatment methods, after condylar fractures, based on the current literature. Methods: Using the PRISMA guidelines in search of clinical trials published between 2011 and 2021, a literature analysis was performed. This search was conducted using the following Medical Subject Headings (MeSH) terms: rehabilitation OR mouth opening recovery OR function recovery AND mandibular fracture OR condylar fracture. Results: The literature search resulted in a total of 110 study articles, of which seven publications were used in the present review, according to a selection based on the pre-established eligibility criteria. The review showed that open reduction resulted in a better three-dimensional recovery of mandibular movements and revealed greater results regarding the absence of the symptoms after applied treatment. However, studies assessing closed reduction, especially performed with intermaxillary fixation screws (IMFS), revealed excellent results in terms of quality of life, mouth opening and occlusal parameters. Discussion: This systematic literature review showed that open reduction resulted in a better three-dimensional recovery of mandibular movements and showed greater results regarding the absence of symptoms. However, studies assessing CR, especially those performed with IMFS, revealed excellent results in terms of quality of life, mouth opening and occlusal parameters.

The Role of Facial Expression Analysis and Electrodermal Activity as an Objective Evaluation of Persistent Idiopathic Facial Pain.

ABSTRACT: Persistent idiopathic facial pain (PIFP) is an enigmatic condition presenting with variable features. Psychiatric comorbidities are speculated to influence PIFP.In this study, the authors evaluated patients with PIFP through the hospital anxiety and depression scale, facial expression analysis, and electrodermal activity.A total of 67 respondents enrolled as the experimental group and 28 participants as the control group. Pain scores were higher in the experimental group (5.24; SD 2.349) P < 0.001 depression (5.58 (SD 3.766) versus 3.07 (SD 2.418), P = 0.002) and anxiety scores (9.78 (SD 4.923) versus 6.75 (SD 4.097) P = 0.007) were higher in the experimental group. The experimental group expressed more negative episodes (P = 0.024); Electrodermal Activity data in terms of peaks/min (P = 0.872) and average peak amplitude (P = 0.168) were not significantly different between the groups.It may be concluded that pain levels may be influenced by psychiatric comorbidity as PIFP patients showed insignificant physiological response to pain.

Does persistent idiopathic facial pain relate to mood (affective) disorders.

OBJECTIVE: Persistent idiopathic facial pain (PIFP) is a condition in the absence of clear pathology. Pathogenesis is still enigmatic, although comorbidity with mood/affective disorders is observed. The aim of this study was to investigate the association between personality traits, mood and sleep disorders, and PIFP; and to compare them with posttraumatic chronic orofacial pain. METHOD AND MATERIALS: A cross-sectional, single-center study was designed to evaluate patients diagnosed with PIFP according to ICOP (International Classification of Orofacial Pain) diagnostic criteria through Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, Five Factor Model, and visual analog scale indexes. Data were analyzed and compared with patients suffering from organic pathology - unilateral chronic mandibular fracture pain. RESULTS: A total of 67 respondents enrolled as the experimental group and 28 participants as a control group. Pain scores were higher in the experimental group (P < .001) and had positive correlation with depression (r = .44, P < .001) and sleep index scores (r = .415, P < .001). Personality trait scores did not differ between the groups. However, neuroticism correlated with depression (r = .466, P < .01) and anxiety (r = .634, P < .01) scores in the experimental group. Depression (P = .002) and anxiety scores (P = .007) were higher in the experimental group, as well as sleep indexes (P = .038). Depression (r = .609, P < .001) and anxiety (r = .655, P < .001) scores had positive correlation with sleep index scores. Sleep scores in the experimental group positively correlated with neuroticism score (r = .442, P < .001). PIFP increases the chance of experiencing depression (OR 10.688; 95% CI 1.355-84.309, P = .006) as well as poor quality of sleep (OR 3.389; 95% CI 1.023-11.228, P = .006). CONCLUSIONS: The results suggest that personality traits (neuroticism), anxiety, depression, and sleep disorders are associated with PIFP.

Effects of Different Bone Substitutes on Reactive Oxygen Species Release in Leukocytes in Vitro: A Pilot Study.

PURPOSE: To evaluate the formation of reactive oxygen species in human leukocytes promoted by bone substitutes that are different in origin and morphology used for jawbone tissue regeneration. MATERIALS AND METHODS: This preclinical prospective randomized crossover study involved 10 subjects, from whom venous blood samples were taken. Leukocytes were separated and standardized. Sixty experimental samples consisted of leukocytes incubated with allogeneic, xenogeneic, or alloplastic bone substitutes at different bone weights (12.5 and 25 mg). The control samples consisted only of incubated leukocytes. Reactive oxygen species were quantitatively determined with the fluorimetric method. Statistical analysis was carried out using SPSS 23 software. RESULTS: The highest average reactive oxygen species values were obtained in the allogeneic bone substitute group (P < .05), while the xenogeneic bone substitute group and control group presented equal reactive oxygen species formation rates (P > .05). A proportional difference (P < .05) of reactive oxygen species emission was obtained between different masses of bone substitute in the samples. CONCLUSION: Allogeneic and alloplastic bone substitutes affect leukocytes and promote reactive oxygen species emission. Xenogeneic bone substitute presents no leukocyte stimulation and maintains anti-inflammatory conditions. Larger bone substitute mass provokes greater oxidative stress.

Three-dimensional analysis of dimensional changes after alveolar ridge preservation with bone substitutes or plasma rich in growth factors: Randomized and controlled clinical trial.

OBJECTIVES: To evaluate alveolar ridge dimensional changes of different alveolar ridge preservation techniques after 3 months of tooth extraction and to compare the efficacy of autologous plasma rich in growth factor (PRGF) to the bone substitutes in alveolar ridge preservation and sites left to heal spontaneously. MATERIALS AND METHODS: Forty patients requiring tooth extraction in the anterior maxilla were randomly allocated to the four following treatment modalities: spontaneous healing (control), natural bovine bone mineral covered with resorbable native collagen membrane (BBM/CM), freeze-dried bone allograft covered with resorbable native collagen membrane (FDBA/CM) and PRGF alone. Cone beam computed tomography (CBCT) scans were taken after surgery and 3 months later. The measurements of height and width (at 1, 3, and 5 mm below the crest) were performed after superimposing the 2 consecutive CBCT scans. RESULTS: The greatest horizontal alveolar bone resorption at 1 mm below bone crest was observed in the control group (-1.61 ± 1.76 mm, P = .037), whereas the least reduction in width was found in the BBM/CM group (-0.68 ± 0.67 mm, P = .037). The most pronounced alveolar height reduction was observed in the control group (-0.86 ± 0.43 mm), whereas alveolar ridge preservation with BBMC/CM (-0.26 ± 0.91 mm) and PRGF (-0.54 ± 0.86 mm) successfully reduced the alveolar height reduction as compared to the control group. CONCLUSIONS: Alveolar ridge preservation technique in the esthetic zone using BBM/CM or using PRGF is beneficial to reduce horizontal and vertical bone changes.

Maxillary epithelioid hemangioendothelioma: an especially rare malignant tumor mimicking periodontal disease.

BACKGROUND: Epithelioid hemangioendothelioma (EHE) is an especially rare, low-grade malignant vascular tumor that, according to WHO classification, is described as locally aggressive tumor with possible metastasis and makes up 1% of all vascular tumors. EHE is characterized by the accumulation of round, eosinophil-infiltrated endothelium cells; with vacuolation of their cytoplasm; frequent angiocentric inflammation; and myxohyaline stroma. This tumor is usually found in the liver, lungs, and bones and is especially rare in the mouth. CASE PRESENTATION: We present an 18-year-old Caucasian female whose oral cavity lesion had been misdiagnosed as marginal periodontitis. The patient was treated improperly for 2 years until she was referred to a maxillofacial surgeon. The patient complained only about gingival recession in the palatal area of her upper-right-side 13th, 14th, and 15th teeth. The lesion's clinical appearance was of locally ulcerated painless lesion that affect the underlying bone as seen in X-rays in the palatal side of the right canine and the first and second premolars. Patient underwent surgery for her present defect and reconstruction using allogenic bone transplant. The diagnosis of EHE was based on the bony destruction as seen in x-rays and in the accumulation of tumor cells that were 100% positive to CD31; CD34 and ERG to endothelial markers. During the 31-month follow-up period, the patient exhibited no clinical and radiographic complications. CONCLUSIONS: With this clinical case, we demonstrate that this rare tumor must be included in differential diagnoses of periodontal pathologies to perform histomorphological examination in a timely manner, which could lead to correct diagnosis and adequate treatment.

Plasma rich in growth factors injection effectiveness for myofascial pain treatment in masticatory muscles. Randomised controlled trial.

BACKGROUND: Myofascial pain in masticatory muscles is one of the most common temporomandibular disorder. Nowadays, the most usable treatment methods are based on the muscle taut band cell membrane disruption, which releases the taut band. Platelet-rich plasma, made with PRGF Endoret® method, gives an opportunity to use platelet-derived growth factors in treatment processes. It has been proven that platelet-derived growth factors can relief pain and activate muscle regeneration. OBJECTIVE: To test a hypothesis that PRGF injections can be effective for treating myofascial pain in masticatory muscles. METHODS: Fifty adult patients participated in the study. Participants were randomly divided into two groups. The first group received 1-mL lidocaine injections to trigger point in their masseter muscle. The second group of patients received 1-mL PRGF injections. The patients' pain was measured by using visual analogue scale (VAS). RESULT: Statistically significant difference in pain levels before the procedure and 4 weeks after it was found in both groups. There was no statistically significant difference between groups in pain levels before the procedure (P = .063) and 2 weeks after it (P = .123); however, statistically significant difference was noticed 4 weeks after the procedure (P < .001). Four weeks after the procedure, patients' average pain in lidocaine group was 3.4 on VAS, and it was 0.9 in PRGF group. CONCLUSIONS: PRGF injections in masseter muscle affected by myofascial pain syndrome are an effective treatment method. PRGF injections more effectively relief myofascial pain in masseter muscle than lidocaine injections.

Randomized and Controlled Clinical Trial of Bone Healing After Alveolar Ridge Preservation Using Xenografts and Allografts Versus Plasma Rich in Growth Factors.

The aim of this study was to compare bone regeneration in the anterior maxilla between bone substitutes and autologous platelet concentrate in alveolar ridge preservation. Forty patients requiring tooth extraction in the anterior maxilla were randomly allocated to the following 4 treatment modalities: spontaneous healing (control), natural bovine bone mineral covered with resorbable native collagen membrane (BBM/CM), freeze-dried bone allograft covered with resorbable native collagen membrane (FDBA/CM), and plasma rich in growth factors (PRGF) alone. Bone biopsies and histomorphometrical analysis were performed after 3 months of healing. The following parameters were assessed: newly formed mineralized tissue, newly formed nonmineralized tissue, and residual bone-grafting material (if applicable). Statistical analysis was performed to provide descriptive analysis and to compare the parameters of the bone regeneration between the study groups. Histomorphometrical analysis revealed the highest new mineralized tissue formation in the PRGF group. Statistically significant differences in new mineralized tissue formation were found between control/PRGF (46.4% ± 15.2% vs 75.5% ± 16.3%), control/(BBM/CM) (46.4% ± 15.2% vs 20.3% ± 21.9%), control/(FDBA/CM) (46.4% ± 15.2% vs 7.2% ± 8.6%), PRGF/(BBM/CM) (75.5% ± 16.3% vs 20.3% ± 21.9%), and PRGF/(FDBA/CM) (75.5% ± 16.3% vs 7.2% ± 8.6%) groups. The new mineralized tissue formation was in the following order: PRGF > control > BBM > FDBA. Alveolar ridge preservation in the esthetic zone with PRGF was the most effective for bone regeneration of the alveolar ridge.

Comparative Analysis of Blood Clot, Plasma Rich in Growth Factors and Platelet-Rich Fibrin Resistance to Bacteria-Induced Fibrinolysis.

Alveolar osteitis (AO) is a common, painful postoperative complication after tooth extraction. Fibrinolytic activity in the extraction socket is one etiological factor. Platelet concentrates are used to prevent and treat AO. The aim of this study was to find out whether the positive effect of platelet concentrates can be related to resistance to bacteria-induced fibrinolysis. Blood from 45 human volunteers was used to prepare four media: blood clot medium as control group; PRF and PRGF first fraction (PRGF I) and PRGF second fraction (PRGF II) as study groups. Additionally, collected blood was used for blood plasma preparation on which evaluation of initial value of d-dimer concentration was performed. A solution of five different microbes (Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumonia, Bacillus cereus, and Candida albicans) was adjusted to 0.5 McFarland (1 × 108 CFU/mL) and then diluted to 0.25 McFarland (0.5 × 108 CFU/mL). The d-dimer concentration was evaluated after one and three hours of bacteria exposure. The resistance to fibrinolysis was not statistically distinguished among any media groups at any time. S. pneumoniae was statistically active in PRF after three hours. C. albicans was statistically active in PRGF II after one hour and in PRF between the first and third hour and after three hours. S. aureus and B. cereus were statistically active in PRGF II after three hours. S. pyogenes was statistically active after one hour, between the first and third hour, and after the third hour in all groups. S. pyogenes was the most active bacterium. Different blood formulations were not distinguishable based on resistance to bacteria-induced fibrinolysis. Low fibrinolytic properties of the found major microbes suggests that bacteria-induced fibrinolysis is one of the leading causes of absence of a clot in a post-extraction socket to be clinically insignificant. The initial absence of a clot or its mechanical elimination during formation or the healing period are major causes of dry socket.

The Influence of Porphyromonas Gingivalis Bacterium Causing Periodontal Disease on the Pathogenesis of Rheumatoid Arthritis: Systematic Review of Literature.

Periodontal pathologies are highly widespread throughout the world. Epidemiological studies have shown that as much as 1% of the population is suffering from periodontal disease. In recent years, there has been a growing number of studies linking these diseases with autoimmune diseases, especially with rheumatoid arthritis. This literature review evaluates changes in the relationship between periodontal pathologies caused by the bacterium Porphyromonas gingivalis and rheumatoid arthritis. The systematic review of the literature was performed according to the PRISMA analysis protocol. The review was performed with articles from the PubMed database. Searched articles were not older than 5 years. Only full texts and research performed with people were selected. A total of 56 results were received. A review and analysis of their full texts have been carried out and 10 articles were selected according to the established criteria. They were analyzed and results were presented. The results obtained from the literature were based on the influence of Porphyromonas gingivalis on the pathogenesis of rheumatoid arthritis. In the literature, the activity of this bacterium is explained by the analysis of its enzyme peptidylarginine deiminase and its principle of action. Studies have also been found to prove the presence of Porphyromonas gingivalis not only in the oral cavity but its DNA is also found in synovial fluid and plasma. In the researched articles, direct links between Porphyromonas gingivalis and rheumatoid arthritis have led doctors to draw attention to patients' oral hygiene and the condition of parodentium, as this may be the cause of autoimmune lesions. Treatment of periodontal disease will not only help maintain a healthy oral cavity but prevent the spread of bacteria to the surrounding tissues.

Alveolar Ridge Preservation after Tooth Extraction Using Different Bone Graft Materials and Autologous Platelet Concentrates: a Systematic Review.

OBJECTIVES: To review and assess the efficiency of different post extraction socket preservation techniques. MATERIAL AND METHODS: An electronic literature search was performed on the MEDLINE and Embase databases. The review included human studies published between from January 1st, 2007 to January 1st, 2018, in English. Outcome measures included dimensional changes and/or histological evaluation of alveolar bone. RESULTS: Twenty-six full text articles were reviewed, 16 of which met the inclusion criteria and were selected for the study. Autogenous tooth graft prevented vertical resorption the most: -0.28 (SD 0.13) mm, observation period (OP): 4 months, while the least effective approach was beta tri-calcium phosphate (ß-TCP): -1.72 (SD 0.56) mm, OP: 4 months. Estimating horizontal resorption, the most effective technique was biphasic calcium sulphate (BCS) with ß-TCP and hydroxyapatite (HA) - BCS + TCP + HA: 0.03 (SD 2.32) mm, OP: 4 months, while ß-TCP was the least efficient: -1.45 (SD 0.4) mm, OP: 4 months. Evaluating residual graft particles (RG) and newly formed bone (NFB) ratio the best results were achieved with demineralized freeze-dried bone allograft: RG: 8.88%, NFB: 38.42%, OP: 5 months, whereas magnesium-enriched hydroxyapatite was least effective: RG: 40.82%, NFB: 31.85%, OP: 4 months. CONCLUSIONS: This review revealed that even though there are numerous types of biomaterials for socket preservation none of them can completely stop alveolar bone loss after tooth extraction. Furthermore, lack of information about qualitative evaluation of bone was noticed indicating that further studies regarding this topic are needed.

Regenerative bone potential after sinus floor elevation using various bone graft materials: a systematic review.

OBJECTIVES: The purpose of the present study was to review and evaluate the effectiveness of bone substitute materials used for maxillary sinus floor elevation and to propose the most effective bone graft material by assessing newly formed bone, remaining graft particles, and soft tissue ratio. METHOD AND MATERIALS: The search protocol used the electronic MEDLINE (PubMed) database for articles published between 1 January 2008 and 1 January 2019. The search was limited to English language only and included clinical studies on humans. Outcomes were the percentage of newly formed bone, remaining graft particles, and soft tissue. RESULTS: Eighteen studies fulfilled the inclusion criteria. Autologous bone and mineralized cancellous bone allograft showed the best results regarding the percentage of newly formed bone (41.74% and 35.41%, respectively). The worst bone formation was observed when Bio-Oss material was used alone (8.25%) and in combination with recombinant human bone morphogenetic protein-7 (rhBMP-7) (6.55%). During estimation of bone regeneration results when anorganic bovine bone (ABB) substitute was used alone and in combination with platelet-rich plasma (PRP), histomorphometric analysis revealed a higher amount of newly formed bone in sites treated with PRP + ABB (31%) compared to ABB alone (21.3%). CONCLUSIONS: The present systemic review demonstrated that autologous bone has the best regenerative potential for sinus floor elevation. Combining autologous bone with bone substitutes leads to more matured newly formed bone and better bone graft osseointegration. PRP/plasma rich in growth factors (PRGF) combined together with bone graft materials enhances bone formation and vascularization. It might also reduce inflammation and decrease the risk of complications.

Dental anxiety and self-perceived stress in Lithuanian University of Health sciences hospital patients. A cross-sectional study.

OBJECTIVES: Dental anxiety is a serious problem that influences both mental and physical patient's health. Earlier studies have associated it with avoidance of dental visits and poor oral health. The aim of this study was to evaluate the prevalence of dental anxiety in a Lithuanian population and investigate its association with perceived stress as well as demographic factors and dental-anxiety-inducing stimuli. MATERIAL AND METHODS: This study was based on a face-to-face questionnaire consisting of DAS (Dental Anxiety Scale), PSS (Perceived Stress Scale) and an author questionnaire about specific dental-anxiety-inducing stimuli. Based on the questionnaires, a fear score (FS) was calculated for each respondent. Bivariate logistic regression was used to determine associations between DAS, PSS, and FS. RESULTS: In total 431 patients took part in the study. The mean DAS score was 9.59. Higher perceived stress was associated with age, sex, marital status, income, and weekly hours of work. A positive correlation was found between PSS and DAS scores. A positive correlation was found between FS sum and PSS score. Women had a higher average FS sum than men. CONCLUSION: This study revealed that dental anxiety is still highly prevalent, as almost half of the study population had some level of dental anxiety. As this study shows that perceived stress plays a significant role in dental anxiety, dentists should take special care when working with patients that may be experiencing higher levels stress.

Associations between chronic pain and depressive symptoms in patients with trigeminal neuralgia.

UNLABELLED: Trigeminal neuralgia (TN) is a rare neuropathic disorder with an excruciating facial pain. The unpredictable pain attacks may result in anxiety and depression. The aim of this study was to determine and to evaluate the level of chronic facial pain and its association with the appearance of anxiety and depression. MATERIALS AND METHODS: A total of 30 patients with TN and chronic facial pain (group A, 25 women and 5 men; mean age, 64.2±3.2 years) and 30 with atypical facial pain (group B, 26 women and 4 men; mean age, 64.8±1.9 years) were examined. A standardized diagnostic protocol was applied to all of them, which consisted of the following: 1) demographic data and estimation of overall pain on a visual analog scale; and 2) evaluation of emotional status using the Sheehan Disability Scale, Covi's Anxiety Scale, and Beck Depression Inventory. RESULTS: The intensity of facial pain was much higher in the group A than the group B (89.7±2.5 versus 44.0±2.9, P<0.0001). Besides, the group A reported increased scores on the disability and anxiety symptom scales (17.4±1.3 and 9.7±0.3 vs. 6.4±0.7 and 3.6±0.1, respectively, P<0.0001). Severe (46.7%) or moderate (30%) levels of depression were documented in the majority of patients in the group A, while the group B did not show depressive symptoms (P<0.0001). CONCLUSIONS: Patients with TN and chronic facial pain had a significantly higher level of pain perception, and they presented the higher level for anxiety and depression than those with atypical facial pain. A multidisciplinary approach is needed for the additional assessment of emotional status of patients in order to improve the efficacy of treatment and patients' quality of life.