インプラント除去を余儀なくされた非定型歯痛の１例

抄録

We often witness pain without pathological change in the dental office. If patients have such pain, their quality of life deteriorates. We encountered a patient who suffered from intractable atypical odontalgia. The patient was a 56-year-old woman, with the main complaint of mobility of dental implants. We removed the compromised dental implant and placed dental implants again. The pain appeared in the site of the dental implants when she occluded. The patient requested that the dental implants be removed because her pain had continued for a long time, so we removed the dental implants again and the pain was temporarily relieved. However, the pain then began to spread to other teeth and other sites of the mandible, and worsened in spite of surgical treatment. Since we suspected it was neuropathic or psychogenic pain, we treat it by administering intravenous lidocaine, stellate ganglion block and peroral tricyclic antidepressant. The pain improved, but the patient requested tooth extraction because she believed that the pain was odontogenic. The pain increased again after dental treatment or tooth extraction by another clinician. From her clinical characteristics, we considered that an appropriate diagnosis was atypical odontalgia. The mechanisms of atypical odontalgia are far from clear, and its treatment is often difficult. We conclude that it is necessary to cooperate with each clinician in different clinical sections to treat cases of atypical odontalgia.