engleski

Trigeminal neuralgia and temporomandibular joint disorder – differential diagnostics in a sample of patients with orofacial pain

The aim of this study was to evaluate accurate differentiating between temporomandibular joint (TMJ) disorder and trigeminal neuralgia (TN) in the sample of patients from subspecialist dental practice. The study included 32 patients (group G-1) with TMJ disorder who were previously neurologically examined due to unconfirmed suspicions of a neurological origin of orofacial pain, 12 female patients (group G-2) with determined co-morbidity of TMJ disorder and TN, and 13 patients (group G-3) with only TN confirmed and the TMJ disorder ruled out. Clinical characteristics, pain intensity (in groups 1 and 2 to TMJs at mouth opening, in groups 2 and 3 pain related to TN) rated on a visual- analogue scale (VAS with range 0-10) and maximal mouth opening capacity (in mm) measured by gauge of all three groups were compared. The level of anxiety was evaluated by State-Trait Anxiety Inventory (STAI). Data were analyzed by t-test, chi-squared test, and correlation analysis. TMJ pain on the VAS scale for G-1 patients was 6.96 and for G-2 patients 6.91 (p=0.9325). TN related pain symptoms on the VAS scale were for G-2 patients 9.0 and for G-3 patients 7.98 (p=0.2921). However, there was a statistically significant difference in the intensity of TMJ and TN related pain (p<0.001). Burning sensation in the mouth (p<0.0007) as well as toothache (p<0.002) were dominant symptoms in patients with TN (G-2 and G-3 patients). Maximal mouth opening was statistically significant (p=0.002) between G-1/G-2 groups and G-3 patients: 39.34/39.77 and 49.50 mm. A positive correlation (p<0.05) existed between STAI 1 and STAI 2 scores independently within each group of patients. Correct diagnosis is the key to managing facial pain of non-dental origin, which includes participation of several experts from the fields of dentistry, neurology and radiology.

trigeminal neuralgia; temporomandibular disorders; orofacial pain; magnetic resonance imaging

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