IADR Abstract Archives

MRI Findings in Patients With Atypical Odontalgia (AO)

Objective: Atypical odontalgia (AO) is a severe chronic pain condition in the teeth and jaws. AO is suggested to be of neuropathic origin; differential diagnosis from inflammatory pain conditions like symptomatic apical periodontitis (SAP) is challenging. In a previous study we found that Cone-Beam Computed Tomography (CBCT) can improve the diagnostic certainty, but the relationship between CBCT findings and periapical disease is unclear. This clinical study aimed to examine the occurrence of Magnetic Resonance Imaging (MRI) findings indicating inflammation in the pain regions of patients with AO, and the correlation to CBCT findings.   

Methods:  20 patients (mean age 52 years, range 34–65) diagnosed with AO in the Orofacial Pain Unit, Faculty of Odontology at Malmö University, participated. Inclusion criteria were: chronic pain (>6 months) located in a region where a tooth had been endodontically or surgically treated, with no clear pathological cause detectable clinically or radiographically. The assessments included (i) clinical examination, (ii) self-report questionnaire, (iii) CBCT examination, and (iv) MRI examination. MRI signs of bone marrow oedema in the pain region were recorded. Spearman’s rho correlated MRI findings to CBCT periapical bone destruction. Two neuroradiologists assessed the MRIs, and kappa calculated the observer agreement.   

Results: Average pain intensity was 5.6 (±1.8) on a 0–10 numerical rating scale and pain duration 4.3 (±5.2) years. 6/20 patients with AO (30%) had MRI signs of inflammation in the pain region. The correlation to CBCT periapical bone destruction was 0.526 (P=0.003). Of the six teeth with MRI signs of inflammation, three showed periapical bone destruction in CBCT. Two findings were recorded at extraction sites. Observer agreement was excellent at kappa 0.89. 

Conclusion: MRI examination found no inflammation in the pain region in a majority of patients with AO. MRI signs of inflammation correlated significantly to CBCT findings.

IADR/LAR General Session
2012 IADR/LAR General Session (Iguaçu Falls, Brazil)
Iguaçu Falls, Brazil
  • Pigg, Maria  ( Malmo University, Malmo, N/A, Sweden )
  • List, Thomas  ( Malmo University, Malmoe, N/A, Sweden )
  • Abul-kasim, Kasim  ( Skåne University Hospital, Malmö, N/A, Sweden )
  • Maly, Pavel  ( Skåne University Hospital, Malmö, N/A, Sweden )
  • Petersson, Arne  ( Malmo University, Malmo, N/A, Sweden )
  • Oral Session
    Dental Pain and Atypical Odontalgia