持続性特発性顔面痛

抄録

　Persistent idiopathic facial pain (PIFP) is a chronic facial pain disorder that cannot be adequately explained by structural abnormalities and has recently been reclassified as a form of chronic primary pain involving nociplastic pain mechanisms. This article reviews the classification, pathophysiology, clinical features, diagnosis, and treatment of PIFP and persistent idiopathic dentoalveolar pain (PIDAP) .
　PIDAP is regarded as a dentoalveolar subtype of PIFP, and in many patients the pain initially presents as toothache and subsequently spreads to the facial region. The pathophysiology of these disorders is considered to involve altered central pain processing. The mainstay of treatment consists of patient education and centrally acting therapies, and antidepressants, particularly tricyclic antidepressants, have been shown to be effective.
　To avoid repeated unnecessary dental procedures and diagnostic investigations and to provide appropriate management, clinicians should recognize these disorders as important differential diagnoses in patients with chronic facial pain or toothache. Close collaboration between medical and dental professionals is essential for accurate diagnosis and optimal patient care.