CASE REPORT
Introdução: A causa mais frequente de dor orofacial é a de origem dentária que pode apresentar-se com características nociceptivas e/ou neuropáticas, confundindo muitas vezes o profissional de saúde no correto diagnóstico, tornando-se um desafio até mesmo para o clínico mais experiente. Objetivos: Enfatizar a importância da presença do especialista em Disfunção Temporomandibular e Dor Orofacial no corpo clínico hospitalar com o intuito de realizar o diagnóstico diferencial de odontalgias em pacientes com hipótese clínica de neuralgia trigeminal. Relato de caso: Baseado numa série de cinco casos é ilustrado como a dor odontogênica pode mimetizar uma neuralgia trigeminal, capaz de gerar um diagnóstico equivocado e, tantas vezes, um tratamento irreversível. Os autores estabeleceram um guia para uma correta avaliação diagnóstica das dores de origem dental. Conclusão: Uma equipe multidisciplinar é imprescindível na abordagem de pacientes com sintomas sugestiveis de neuralgia trigeminal para minimizar os riscos de um diagnóstico errôneo. Uma vez estabelecido o correto diagnóstico, o tratamento se concentrará na resolução de suas causas.
Introduction: The most frequent cause of orofacial pain is from dental origin, which can present either with nociceptive and/or neuropathic features, often confounding the health professional in the correct diagnosis, becoming a challenge even to the more experienced clinician. Objectives: To emphasize the importance of a specialist in Temporomandibular Joint Disorders and Orofacial Pain in the hospital facility, in order to perform differential diagnosis of dental pain in patients with clinical hypothesis of trigeminal neuralgia. Case Presentation: The authors propose a guide for the correct evaluation of dental pain based on a series of five cases illustrating how odontogenic pain can mimick a trigeminal neuralgia, often generating misdiagnosis and, several times, irreversible treatments. Conclusion: Multidisciplinary approach is mandatory in many patients with symptoms suggesting trigeminal neuralgia, minimizing the risks of misdiagnosis. Once the correct diagnosis is established, the treatment will focus on the resolution of its causes.
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(1) DDS, MSc, PhD, Neurological Institute of Curitiba, Center of Temporomandibular Joint Diagnosis and Treatment, Tuiuti University of Paraná, Curitiba (PR), Brazil.
(2) DDS, Center of Temporomandibular Joint Diagnosis and Treatment, Tuiuti University of Paraná, Curitiba (PR), Brazil.
(3) MD, MSc, Neurosurgeon, Neurological Institute of Curitiba, Curitiba (PR), Brazil.
(4) MD, PhD, Chairman of Neurosurgery Department, Neurological Institute of Curitiba, Curitiba (PR), Brazil.
(5) DDS, PhD, Endodontic Department, Federal University of Paraná - UFPR, Curitiba (PR), Brazil.
Received Feb 3, 2022
Corrected Mar 9, 2022
Accepted Mar 27, 2022
