2012 Volume 55 Issue 6 Pages 424-431
Purpose: This case report illustrates the exploration, diagnosis and treatment plan for the simultaneous occurrence both of myofascial pain syndrome-induced non-odontogenic toothache in masticatory muscle and periapical inflammation and fenestration-induced odontogenic toothache. Case and result: At the first visit, the patient complained not only of pain at the maxillary lateral incisor on the left side but also irradiation pain on the ipsilateral orofacial region. After several assessments, the disease was diagnosed as myofascial pain syndrome in masticatory muscle in association with periapical inflammation and fenestration on the ipsilateral maxillary lateral incisor. After root canal therapy, cognitive-behavioral intervention and physical therapy, the patient showed a good prognosis. Discussion and conclusion: It is important that clinicians identify the symptom as odontogenic or non-odontogenic toothache at the initial visit, and then to perform priority treatment for effective and better healing. This case report indicates that proper examination, diagnosis and adequate treatment led to better prognosis.
