title: Neuropathic pain in the orofacial region: The role of pain history. A retrospective study.
abstract: BACKGROUND
  Orofacial neuropathic pain is often difficult to treat, mostly because of still unclear underlying mechanisms. The occurrence of such neuropathic pain varies depending on different factors, of which preexisting preoperative pain seems to be of high importance. The aim of this study was thus to test the hypothesis that prior history of pain could indeed be considered a risk factor for the development of orofacial neuropathic pain in the same region.
  
  
  METHODS
  The study was performed in the dental department of the Groupe Hospitalier Pitié-Salpêtrière (GHPS) in Paris, France. We investigated the presence of prior inflammatory pain before development of orofacial neuropathic pain in 56 patients. For each patient file, the following items were collected: age, gender; medical history; diagnosis; description of the pain (at time of consultation); presence or absence of prior dental treatment; date and type of dental treatment received.
  
  
  RESULTS
  41 patients (73%) of orofacial neuropathic pain patients had a history of pain compatible with an inflammatory condition; 4% (n=2) did not report any prior pain and 23% (n=13) could not remember. Among the patients with documented history of pain prior to neuropathy, 88% (n=36) received surgical treatment; 61%, (n=25) endodontic treatment and 22%, (n=9) restorative treatment. All eventually received endodontic treatment or tooth extraction. These dental treatments are compatible with the hypothesis of prior inflammatory pain in these patients.
  
  
  CONCLUSIONS
  These results support the hypothesis that prior inflammatory pain could favor the development of orofacial neuropathic pain. Prevention and treatment of inflammatory trigeminal pain may therefore play a key role in preventing future neuropathic pain development.
authors.affiliation: UFR d'Odontologie, Université Paris Diderot, Hôpital Pitié Salpêtrière, Paris, France.
authors.forename: W
authors.initials: W
authors.lastname: Dieb
authors.affiliation: UFR d'Odontologie, Université Paris Descartes, Hôpital Bretonneau, Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Moreau
authors.affiliation: UFR d'Odontologie, Université Paris Diderot, Hôpital Pitié Salpêtrière, Paris, France.
authors.forename: I
authors.initials: I
authors.lastname: Chemla
authors.affiliation: UFR d'Odontologie, Université Paris Diderot, Hôpital Pitié Salpêtrière, Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Descroix
authors.affiliation: UFR d'Odontologie, Université Paris Diderot, Hôpital Pitié Salpêtrière, Paris, France. Electronic address: yves.boucher@univ-paris-diderot.fr.
authors.forename: Y
authors.initials: Y
authors.lastname: Boucher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005157:Facial Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D009437:Neuralgia / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D010147:Pain Measurement; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Endodontics; Inflammation; Neuropathic pain; Priming; Trigeminal