We do not have enough data to draw definitive conclusions on the etiology and pathophysiology of AO, but our opinion is that neuropathic mechanisms are involved primarily, perhaps not necessarily induced by trauma, since not all the patients report such an event, and psychological disturbances are probably more the consequence than the cause of chronic pain.
In light of the information extrapolated from cases of AO reported in the literature, the major issue in the treatment and prevention of the pain is establishing a correct diagnosis. Even though not all the cases of AO seem to originate from trauma due to dental procedures, almost all the patients underwent several dental treatments without obtaining any relief from the pain. Attention should be paid to any toothache in absence of evident signs of dental pathology in order to avoid unnecessary treatments that could originate or perpetuate the problem. Misdiagnosis can lead sometimes to frustrating outcomes. Significant is a panoramic radiograph showed by Marbach in several articles where ALL THE TEETH of a 22-year-old woman were treated by root canal treatment and apicoectomy![3,24,25,26]
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Appreciation is expressed to Dr. Simona Secci for support and encouragement during preparation of the manuscript.Reprint Address
Address all correspondence to Dr. Marcello Melis, Via Grosseto 1, 09125 Cagliari, Italy.
Headache. 2003;43(10) © 2003 Blackwell Publishing
Cite this: Atypical Odontalgia: A Review of the Literature - Medscape - Nov 01, 2003.