A Patient with Refractory Trigeminal Neuralgia was Referred for Suspected Odontogenic Pain.

Chronic pain of the face with a sudden, unilateral, and electric shock-like pain in the distribution of the trigeminal nerve is known as Trigeminal neuralgia (TN). This case report presents a patient with TN symptoms, along with concomitant tooth pain. The diagnostic process and management of the patient are discussed, emphasizing the importance of interdisciplinary collaboration for optimal patient care.

Clinicians' experience with topical benzydamine and morphine for the management of oral mucositis: adverse effects and barriers.

INTRODUCTION: Among the evidence-based agents outlined in the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) mucositis guidelines, benzydamine and morphine are advised for the management of oral mucositis (OM) in certain cancer patients. This study is aimed to collect information from a group of highly experienced healthcare professionals in the field of oral mucositis about their clinical experience with these agents. METHODS: A survey questionnaire about the clinical experience with topical benzydamine and morphine to manage oral mucositis and their related adverse effects (AEs) was electronically distributed to the members of the Mucositis Study Group of MASCC/ISOO. RESULTS: Eighty-eight entries were recorded (response rate 25%), and 54 entries submitted complete questionnaires about the drug-related AE (completion rate 65%) and were used for the data analysis. Of the respondents, 44% and 27.7% prescribed benzydamine and morphine to manage their patients' oral mucositis, respectively. Lack of availability in the respondent's country was the common reason for not prescribing benzydamine and morphine (18.9% and 5.4%, respectively); however, a large portion of the respondents indicated that 'another reason' stopped them from prescribing these agents (51.3% and 73%, respectively). AEs to benzydamine or morphine were observed by 25.9% and 12.9% of respondents, respectively, with mild numbness and tingling as the most common drug-related AE for both agents. CONCLUSION: The use of topical benzydamine and morphine for the management of OM varies between countries. While relatively common, the AEs related to these agents are mild. Mitigating the barriers for prescribing them may increase their use.

Efficacy of topical interventions for temporomandibular disorders compared to placebo or control therapy: a systematic review with meta-analysis.

This systematic review focused on the efficacy of topical products in reducing temporomandibular joint disorder (TMD)-associated pain, in comparison to placebo or control interventions. The EMBASE, Web of Science, Cochrane Library, and MEDLINE via PubMed databases were searched for randomized controlled trials (RCTs) using topical interventions in adults diagnosed with TMD. The pain intensity was the primary outcome, and other clinical findings were the secondary outcomes. The risk of bias was evaluated according to the Cochrane's handbook. The search up to February 7, 2020 identified a total of 496 unduplicated references. Nine RCTs with 355 adult patients diagnosed with TMD were included. The meta-analysis did not show a significant reduction in baseline pain intensity in the nonsteroidal anti-inflammatory drug (NSAIDs) group, when compared to the placebo group (P = 0.288). One study demonstrated a statistically significant pain score decrease for Theraflex-TMJ compared to placebo after 10 d of treatment (P = 0.003) and follow-up, 5 d after the last application (P = 0.027). Ping On reduced pain at 4 weeks of application (P < 0.001) but not after 7 d of application (P = 0.136). In one study, cannabidiol (CBD) significantly improved the pain intensity compared to placebo (P < 0.001). However, no differences were found with capsaicin in the two studies (P = 0.465). Evidence was of low quality because the studies were considered as having an unclear or a high risk of bias and a small number of studies were analyzed. The evidence is not sufficient to support the use of topical NSAIDs and capsaicin, and limited evidence was found for Threraflex-TMJ, bee venom, Ping On, and CBD, with only one study reporting for each. Additional studies are recommended to validate these results.

Dental Treatment Planning for the Patient with Oral Cancer.

Oral cancer therapy is associated with a multitude of head and neck sequelae that includes, but is not limited to, hyposalivation, increased risk for dental caries, osteoradionecrosis of the jaw, radiation fibrosis syndrome, mucositis, chemotherapy-induced neuropathy, dysgeusia, dysphagia, mucosal lesions, trismus, and infections. Preparing a comprehensive treatment plan for patients undergoing cancer therapy is essential to help minimize their risks for developing these oral and dental complications. In addition, dentists must take into account a patient's ongoing oncologic therapy for those patients who present to the dentist while concurrently receiving cancer treatment.

Osteonecrosis of the jaw in patients treated with denosumab for metastatic tumors to the bone: A series of thirteen patients.

This case series describes the course of osteonecrosis of the jaw (ONJ) in thirteen patients with metastatic bone tumors treated solely with denosumab. Patients on denosumab may be more prone to developing ONJ even without a risk/precipitating factor and they may develop ONJ early in their denosumab therapy. The outcomes of ONJ in ten patients following a period of denosumab discontinuation after the onset of ONJ were: 3 had complete resolution of symptoms, 4 patients' ONJ progressed, 2 patients' ONJ was unchanged and in 1 patient there was partial ONJ resolution. The role of drug discontinuation prior to an invasive dental procedure or after the onset of ONJ still remains debatable.

Allergic reactions associated with metal alloys in porcelain-fused-to-metal fixed prosthodontic devices-A systematic review.

OBJECTIVE: To systematically review the allergic reactions associated with metal alloys in porcelain-fused-to-metal (PFM) fixed prosthetic devices. METHOD AND MATERIALS: After reviewing the titles and abstracts of the articles as well as removing duplicates, 22 articles were considered relevant. PubMed, Web of Science, ScienceDirect, and Google Scholar from 1970 to 2012 were evaluated, and randomized studies, review articles, case reports, cross-sectional surveys, and abstracts were included. Conference papers and posters were excluded. RESULTS: Although reported, allergic reactions to metallic alloys in the context of PFM devices are not well documented. Allergic reactions to high noble and noble metal alloy cores of palladium and gold and to base metal alloys nickel and cobalt in the context of PFM fixed partial dentures (FPDs) are reported. Each type of metal is associated with a different rate of allergic reactions, which may be attributed to the extent of corrosion of the alloy, population exposure, and the biologic environment. Because few studies document allergic reactions to metals that comprise PFM crowns and partial dentures, further research in this field is necessary to determine the frequency and type of reactions elicited. CONCLUSION: Though allergic reactions to metal alloys used in dentistry are well documented, only few articles focus on the correlation between FPDs and metal allergies. Thus, this paper surveys case reports of hypersensitivity reactions linked to FPDs and reviews the current literature on allergic reactions to the metallic elements comprising those devices.