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Pharmacotherapeutic outcomes in atypical odontalgia: determinants of pain relief

OBJECTIVES: There has been considerable research which has focused on clarifying the origin of pain in patients with atypical odontalgia (AO), also known as “idiopathic toothache”, and on identifying effective treatment, but there has been limited success so far. In this study, we assessed the outco...

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Autores principales: Tu, Trang T H, Miura, Anna, Shinohara, Yukiko, Mikuzuki, Lou, Kawasaki, Kaoru, Sugawara, Shiori, Suga, Takayuki, Watanabe, Takeshi, Aota, Yuma, Umezaki, Yojiro, Takenoshita, Miho, Toyofuku, Akira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398971/
https://www.ncbi.nlm.nih.gov/pubmed/30881094
http://dx.doi.org/10.2147/JPR.S188362
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author Tu, Trang T H
Miura, Anna
Shinohara, Yukiko
Mikuzuki, Lou
Kawasaki, Kaoru
Sugawara, Shiori
Suga, Takayuki
Watanabe, Takeshi
Aota, Yuma
Umezaki, Yojiro
Takenoshita, Miho
Toyofuku, Akira
author_facet Tu, Trang T H
Miura, Anna
Shinohara, Yukiko
Mikuzuki, Lou
Kawasaki, Kaoru
Sugawara, Shiori
Suga, Takayuki
Watanabe, Takeshi
Aota, Yuma
Umezaki, Yojiro
Takenoshita, Miho
Toyofuku, Akira
author_sort Tu, Trang T H
collection PubMed
description OBJECTIVES: There has been considerable research which has focused on clarifying the origin of pain in patients with atypical odontalgia (AO), also known as “idiopathic toothache”, and on identifying effective treatment, but there has been limited success so far. In this study, we assessed the outcomes of treatment and attempted to identify factors that could account for pain remission in patients with AO. PATIENTS AND METHODS: Data for 165 patients diagnosed with AO from June 2015 to August 2017 were retrospectively reviewed. The patients’ sex, age, duration of pain, and psychiatric history were collected, along with information on pain intensity, depressive status, and catastrophizing scores. Responses at 4 and 16 weeks from the start of treatment were observed. The associations between potentially associated factors and outcome were investigated using Bayesian model averaging. RESULTS: A 30% reduction in pain was reported by 38 patients (46.3%) at 4 weeks and by 54 patients (65.9%) at 16 weeks. The pain intensity decreased as the depression and catastrophizing score improved; all of the changes were statistically significant (P<0.001). Four elements, that is, patient sex, depression score at baseline, pain score at 4 weeks, and change in the catastrophizing score, explained 52.5% of the variation in final outcome between individual patients. CONCLUSION: Our findings confirm the efficacy of tricyclic antidepressants (TCAs) as a treatment for AO and indicate that other medications, especially aripiprazole used in combination with a TCA, may be useful. A considerable number of patients, especially women, those with lower levels of depression at baseline, and those who responded to 4 weeks of treatment, achieved pain relief.
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spelling pubmed-63989712019-03-16 Pharmacotherapeutic outcomes in atypical odontalgia: determinants of pain relief Tu, Trang T H Miura, Anna Shinohara, Yukiko Mikuzuki, Lou Kawasaki, Kaoru Sugawara, Shiori Suga, Takayuki Watanabe, Takeshi Aota, Yuma Umezaki, Yojiro Takenoshita, Miho Toyofuku, Akira J Pain Res Original Research OBJECTIVES: There has been considerable research which has focused on clarifying the origin of pain in patients with atypical odontalgia (AO), also known as “idiopathic toothache”, and on identifying effective treatment, but there has been limited success so far. In this study, we assessed the outcomes of treatment and attempted to identify factors that could account for pain remission in patients with AO. PATIENTS AND METHODS: Data for 165 patients diagnosed with AO from June 2015 to August 2017 were retrospectively reviewed. The patients’ sex, age, duration of pain, and psychiatric history were collected, along with information on pain intensity, depressive status, and catastrophizing scores. Responses at 4 and 16 weeks from the start of treatment were observed. The associations between potentially associated factors and outcome were investigated using Bayesian model averaging. RESULTS: A 30% reduction in pain was reported by 38 patients (46.3%) at 4 weeks and by 54 patients (65.9%) at 16 weeks. The pain intensity decreased as the depression and catastrophizing score improved; all of the changes were statistically significant (P<0.001). Four elements, that is, patient sex, depression score at baseline, pain score at 4 weeks, and change in the catastrophizing score, explained 52.5% of the variation in final outcome between individual patients. CONCLUSION: Our findings confirm the efficacy of tricyclic antidepressants (TCAs) as a treatment for AO and indicate that other medications, especially aripiprazole used in combination with a TCA, may be useful. A considerable number of patients, especially women, those with lower levels of depression at baseline, and those who responded to 4 weeks of treatment, achieved pain relief. Dove Medical Press 2019-02-27 /pmc/articles/PMC6398971/ /pubmed/30881094 http://dx.doi.org/10.2147/JPR.S188362 Text en © 2019 Tu et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Tu, Trang T H
Miura, Anna
Shinohara, Yukiko
Mikuzuki, Lou
Kawasaki, Kaoru
Sugawara, Shiori
Suga, Takayuki
Watanabe, Takeshi
Aota, Yuma
Umezaki, Yojiro
Takenoshita, Miho
Toyofuku, Akira
Pharmacotherapeutic outcomes in atypical odontalgia: determinants of pain relief
title Pharmacotherapeutic outcomes in atypical odontalgia: determinants of pain relief
title_full Pharmacotherapeutic outcomes in atypical odontalgia: determinants of pain relief
title_fullStr Pharmacotherapeutic outcomes in atypical odontalgia: determinants of pain relief
title_full_unstemmed Pharmacotherapeutic outcomes in atypical odontalgia: determinants of pain relief
title_short Pharmacotherapeutic outcomes in atypical odontalgia: determinants of pain relief
title_sort pharmacotherapeutic outcomes in atypical odontalgia: determinants of pain relief
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398971/
https://www.ncbi.nlm.nih.gov/pubmed/30881094
http://dx.doi.org/10.2147/JPR.S188362
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