Evaluation of patients with atypical odontalgia through quantitative sensory testing (QST) and conditioned pain modulation test (CPM): a case-control study.

Abstract

Atypical Odontalgia (AO) (phantom pain or deafferentation pain) is a chronic orofacial pain condition, often difficult to diagnose because it is associated with no clinical and radiographic evaluation. The patient complains a toothache or a pain in alveolar region and there is no sign of local dental, oral, facial, sinusal or neuropathic disease. It is considered a moderate to severe intensity pain, which occurs in structures and in dentoalveolar mucosa, which may last from months to even years. The painful condition is still misunderstood by physiological aspects, and often the patient is subjected to numerous and repeated dental procedures in order to reduce pain. The pain is continuous and accompanied by hyperalgesia and/or allodynia and sensory abnormalities, moreover, the mechanisms of transmission, perception and modulation of pain are poorly understood in the literature. The aim of this study is to evaluate patients with atypical odontalgia at some characteristics, such as intensity, duration, onset, quality, factors of worsening, improvement, accompanying symptoms and treatments they had made and also assessing the relationship with the control group, verifying the psychophysical mechanism of wind-up, the ability to modulate pain, and to verify some sensory abnormalities. The study will lead with 25 research subjects, Brazilian adults of both sexes, with AO diagnosed (group 01) and 25 healthy research subjects (control - group 02), previously screened in Faculty of Dentistry of Bauru clinical (FOB-USP). The research subjects will undergo two measurements tests: quantitative sensory testing (QST) and control pain modulation test (CPM), expanding the available knowledge about the mechanisms of the maintenance or perpetuation of pain. Statistical analysis will be through the paired "t" test and "t" test considering a significance level of 5%.