Quantitative methods for somatosensory evaluation in atypical odontalgia

Abstract

A systematic review was conducted to identify reliable somatosensory evaluation methods for atypical odontalgia (AO) patients. The computerized search included the main databases (MEDLINE, EMBASE, and Cochrane Library). The studies included used the following quantitative sensory testing (QST) methods: mechanical detection threshold (MDT), mechanical pain threshold (MPT) (pinprick), pressure pain threshold (PPT), dynamic mechanical allodynia with a cotton swab (DMA1) or a brush (DMA2), warm detection threshold (WDT), cold detection threshold (CDT), heat pain threshold (HPT), cold pain detection (CPT), and/or wind-up ratio (WUR). The publications meeting the inclusion criteria revealed that only mechanical allodynia tests (DMA1, DMA2, and WUR) were significantly higher and pain threshold tests to heat stimulation (HPT) were significantly lower in the affected side, compared with the contralateral side, in AO patients; however, for MDT, MPT, PPT, CDT, and WDT, the results were not significant. These data support the presence of central sensitization features, such as allodynia and temporal summation. In contrast, considerable inconsistencies between studies were found when AO patients were compared with healthy subjects. In clinical settings, the most reliable evaluation method for AO in patients with persistent idiopathic facial pain would be intraindividual assessments using HPT or mechanical allodynia tests.

Patient phenotyping in clinical trials of chronic pain treatments: IMMPACT recommendations

“…Temporal summation of pain can be reduced by a variety of analgesic treatments, from ketamine [3] to spinal cord stimulation [87] to acupuncture [271] to exercise [235]. Recent studies of post-operative pain have highlighted the potential prognostic value of temporal summation for predicting the development of persistent post-operative pain [189] and for profiling patients with various chronic pain syndromes including osteoarthritis and atypical odontalgia [86;197]. However, no Phase 2 or 3 studies to date have evaluated the prospective predictive effects of temporal summation phenotypes on treatment outcomes.…”

Perspectives on next steps in classification of oro‐facial pain – part 2: role of psychosocial factors

“…This framework was then used to develop an ontology‐based taxonomy for disorders that manifest themselves through the symptom of chronic OFP and are commonly seen in clinical practice and difficult to manage . The diagnostic criteria proposed using this methodology were then used to conduct a systematic review to identify reliable somatosensory evaluation methods for atypical odontalgia patients .…”

Pressure pain threshold and pain perception in temporomandibular disorder patients: is there any correlation?

“…The common concepts in QST methods are that the assessment of normal and non-normal responses to various stimuli provides information about the functioning of the peripheral and central nervous system. These responses can be quantified by the amount of physical stimuli required to evoke specific levels of sensory perception 2 . QST battery assembles a list of short form tests representing measurements of all relevant factors of the somatosensory system 1 .…”