IADR Abstract Archives
Clinical Findings in Atypical Odontalgia – Reliability of Dental Examination
Objectives: To examine the frequency of clinical pain parameters in patients diagnosed with atypical odontalgia (AO), and to determine the reliability on repeated testing.
Methods: 21 adult patients (18 women, 3 men; mean age 56±14 years) diagnosed with atypical odontalgia in an extensive clinical and radiographic examination were recruited from the Orofacial Pain clinics of the Universities in Aarhus (Denmark), and Malmö (Sweden). The inclusion criterion was persistent pain in a tooth or a region where a tooth was extracted, with no signs of relevant pathology. Exclusion criteria were presence of odontogenic pain, primary headaches, or medical, psychiatric or personality disorders. In the sample, the average pain intensity was NRS 4.0 (0–10 scale), and average pain duration 87 months.75% reported continuous pain.
At the painful tooth, pain on tooth percussion, apical palpation, periodontal probing, and selective cusp loading were recorded. Presence of caries, periodontal pockets >3mm, furcation involvement, and bleeding on periodontal probing were noted. After approximately one week, the same examiner repeated the tests. Frequency and 95% confidence interval (CI) was calculated for each listed provocation. Kappa statistics calculated the test-retest reliability.
Results: The patients with AO reported pain on tooth percussion in 23.5% (4/17; 95% CI:5.37–41.63%), pain on apical palpation in 30% (6/20; 95% CI:9.92–50.08%), pain on probing in 23.8% (5/21; 95% CI:5.59–42.01%), and pain on cusp loading in 4.8% (1/21; 95% CI:-4.34–13.94%). Test-retest Kappa for percussion was 0.61, for apical palpation 0.87.
No caries, pockets >3mm, or furcation involvement was recorded. 2 patients displayed bleeding on periodontal probing.
Conclusions: One-fourth to one-third of patients with AO experienced pain on various dental and periodontal provocations, in absence of clinical signs of local inflammation. Test-retest reliability for pain perceived on tooth percussion and apical palpation was good to excellent.
Methods: 21 adult patients (18 women, 3 men; mean age 56±14 years) diagnosed with atypical odontalgia in an extensive clinical and radiographic examination were recruited from the Orofacial Pain clinics of the Universities in Aarhus (Denmark), and Malmö (Sweden). The inclusion criterion was persistent pain in a tooth or a region where a tooth was extracted, with no signs of relevant pathology. Exclusion criteria were presence of odontogenic pain, primary headaches, or medical, psychiatric or personality disorders. In the sample, the average pain intensity was NRS 4.0 (0–10 scale), and average pain duration 87 months.75% reported continuous pain.
At the painful tooth, pain on tooth percussion, apical palpation, periodontal probing, and selective cusp loading were recorded. Presence of caries, periodontal pockets >3mm, furcation involvement, and bleeding on periodontal probing were noted. After approximately one week, the same examiner repeated the tests. Frequency and 95% confidence interval (CI) was calculated for each listed provocation. Kappa statistics calculated the test-retest reliability.
Results: The patients with AO reported pain on tooth percussion in 23.5% (4/17; 95% CI:5.37–41.63%), pain on apical palpation in 30% (6/20; 95% CI:9.92–50.08%), pain on probing in 23.8% (5/21; 95% CI:5.59–42.01%), and pain on cusp loading in 4.8% (1/21; 95% CI:-4.34–13.94%). Test-retest Kappa for percussion was 0.61, for apical palpation 0.87.
No caries, pockets >3mm, or furcation involvement was recorded. 2 patients displayed bleeding on periodontal probing.
Conclusions: One-fourth to one-third of patients with AO experienced pain on various dental and periodontal provocations, in absence of clinical signs of local inflammation. Test-retest reliability for pain perceived on tooth percussion and apical palpation was good to excellent.