IDIOPATHIC ORO-FACIAL PAIN: PRELIMINARY EPIDEMIOLOGICAL AND AETIOLOGICAL DATA

Idiopathic orofacial pain (IOFP) has been defined as a persistent idiopathic facial pain that has not the classic features of neuralgias and that is not attributed to another disorder or to another biological or clinical cause.1 Idiopathic orofacial pain often occurs without any recognizable etiology or trigger factor. Nevertheless, minor oral surgical procedures, trauma and major maxillofacial surgeries have been reported in literature as possible causes of long standing orofacial pain disorders.2,3,4 Actually, the diagnosis of IOFP is reached after the following conditions have been excluded: TMJ related pain and disorders, headaches and migraines, typical neuralgias, ENT disorders and ophthalmic disorders5. As a direct consequence of the over mentioned differential diagnosis process, the group of patients diagnosed for IOFP includes different kind of pain with different etiologies and clinical features. The IOFP often presents as pain in the face, present daily and persisting for all or most of the day. At onset the pain is confined to a limited area on one side of the face, is deep and poorly localized and it is not associated with sensory loss or other physical signs. Investigations including x-ray of face and jaws should not demonstrate any relevant abnormality1. Here is presented preliminary epidemiological and etiological data collected in the last 24 months at the Policlinic G.B. Rossi, University of Verona, by a multidisciplinary group involving maxillofacial surgeons and anesthesiologists. A population of 33 patients has been studied. In the studied population the females were 25 (75,8%) and the males were 8 (24,2%); the mean age was 54 (52 for women and 58 for men). The etiology was minor oral surgical procedures (MOSP) in 19 cases, major oncologic surgery in 2 cases and no etiology was recorded in 12 cases. For females the etiology were MOSP in 60% of cases (15) and no etiology in 40% (10); for males were MOSP in 50% of cases (4), major oncologic surgery in 2 patients (25%) and no etiology in another 2 patients (25%). Patients were also tested for oral and extraoral sensory disorders. An extraoral sensory disorder was present in the 66,7% of MOSP and no etiology patients, while it was present in the 100% of major surgery patients. In the no etiology patients were an intraoral sensory disorder in the 66,7% of cases, while in MOSP patients only the 37,5% had some kind of disorders. In major surgery patients a sensory disorder was always present. Furthermore the specific features of pain for each etiology were different.