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STUDY OF THE CLINICAL AND IMMUNOLOGIC ASPECT OF PAIN
SYNDROME IN PATIENTS WITH NEURODENTAL PATHOLOGY
Buriyeva Nafosat Askarali qizi
https://doi.org/10.5281/zenodo.13831920
Annotation
. Among neurodental diseases, atypical facial pain accounts
for an average of 6.4%. Atypical facial pain can also be caused by pulp pathology,
which is most often manifested by chronic pulpitis. It is known that the pain of
pulpitis is one of the most severe and causes the patient suffering. Often it does
not allow you to sleep, chew food properly, makes a person irritable and
irascible. However, fear of treatment at the dentist or other reasons make you
endure this pain for a long time, use all sorts of means of independent struggle
with it, which most often turn out to be temporary and ineffective.
Despite the long study of odontogenic facial pain, the clinical and
pathophysiologic features of atypical facial pain in pulpitis have not yet been
elucidated. Such a study would allow dentists to consider pulpitis pain not only
as a symptom of dental disease, but also as a systemic syndrome that affects the
nervous system, the patient's psyche, his ability to work and quality of life.
The aim of the study
was to investigate the complex of clinical and
immunologic parameters in patients with pulpitis.
Materials and methods of the study.
107 patients with facial pain caused by dental pulp inflammation aged
from 18 to 64 years were examined. The average age was 36±1,2 years. The bulk
of the examined patients (87.9%) were aged from 20 to 49 years, fewer patients
were aged under 20 years (3.7%) and after 50 years (8.4%). The ratio of men
and women was 48 (44,9%) to 59 (55,1%). During immunologic researches” we
compared the results obtained with similar results obtained from practically
healthy volunteers. Such a comparison group consisted of 20 people with
sanitized oral cavity, without acute and chronic somatic and psychoneurological
pathology. Among them there were 8 men and 12 women. Their age, almost as in
the main group, varied from 18 to 62 years. The average age was 34,2±3,1 years
The methods of immunologic research included determination of the level of
antibodies to myeloperoxidase (MPO) and antibodies to myelin basic protein
(MBP) in blood serum by means of immunofemoral analysis (ELISA). The
obtained data were subjected to statistical processing on a computer with a
Pentium-IV processor using Microsoft Office Excel-2003 software package,
including the use of built-in functions of statistical processing.
Results and their discussion.
Facial pain was often detected on the right
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side - in 60.7% of cases. Bilateral pain was detected only in 1 case. All 107
patients with pain symptom examined by us needed oral cavity sanation. The
hygienic state of the oral cavity was evaluated in all examined patients using the
Fedorov-Volodkina hygienic index. Painful paroxysms occurred with varying
frequency from 3 - 4 times a day to 5 - 7 attacks per hour. Pain localization
corresponded to the affected dental plexus. Pain was most often localized in
molars (61.1%) and premolars (36.1%), less often in canines (0.9%) and
incisors (1.9%). During the attack, the pain irradiated along the alveolar plexus
and also spread to the hard palate, cheek and temple area. The duration of the
pain symptom in the patients ranged from 3 days to 7 months as revealed during
the examination.
Detailed neurological examination of patients with pulpitis pain allowed us
to identify symptoms of nervous system damage. The most frequent symptoms
were tinnitus and ringing in the ears, hearing loss, systemic and non-systemic
dizziness, headache, unsteadiness in walking, nausea and vomiting. The
examined patients complained of general weakness, decreased efficiency, rapid
fatigability, sweating (especially at night), increased div temperature (37.1°-
37.7°C), decreased div weight. In some patients with prolonged pain symptom
we noted (both subjectively and objectively) salivation disorders. In a number of
cases hyposalivation was revealed, in which patients complained of dry mouth.
However, on the contrary, the majority of such patients noted increased
salivation, especially during an attack of pain. Pain during eyeball movement
was observed in 11.2% of patients. Violation of innervation of the facial nerve
was manifested in 45.8% of patients by unilateral smoothing of the nasolabial
fold, indicating a central character of the lesion. Tongue deviation was observed
in 17.8% of patients. The syndrome of diffuse cerebral microsymptomatology
was detected in 37.4% of patients, and in 28.0% of patients the I degree of
dental neuralgia was diagnosed, and in 34.6% of patients - the II degree of dental
neuralgia. This syndrome is characterized by the presence of subjective
neurological symptoms and focal microsymptoms in the form of insufficient
convergence of eyeballs, decreased corneal reflexes, smoothing of the nasolabial
fold, tongue deviation, oral automatism reflexes. Immunologic studies revealed a
reliable increase of parameters in patients with atypical facial pain in
comparison with the data of the comparison group. The difference amounted to
6.2 times. The established increase in titers of antibodies to myeloperoxidase in
patients with dental neuralgia indicates the presence of systemic vasculitis in
them, as these antibodies are one of the markers of inflammatory damage of
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small vessels. Thus, dental neuralgia was the result of systemic vascular process
of vasculitis type, caused by allergization to infectious-allergic factors.
Determination of the level of antibodies to the total myelin protein also
revealed its significant increase in the group of patients with dental neuropathy
compared to similar indicators of the comparison group. In the venous blood of
patients with pulpitis pain symptom the amount of antibodies to
myeloperoxidase is 6.2 times higher than in healthy patients, which indicates a
direct connection of inflammatory and autoimmune processes in atypical facial
pain with the pathology of the terminal branches of the trigeminal nerve. The
studied immunologic indices have a direct statistically significant dependence
on the duration and phase of the disease, the size of the dental plexus. Patients
with pulpitis and pronounced pain symptom should be referred to the risk
group of dental diseases, in connection with which in 100% of cases they require
oral cavity sanation. The obtained results of the study are recommended to be
used in the activity of dental therapists to prevent the development of pain
symptom and prevent the development of neurological picture of the process.
Conclusions:
1.Inflammation in the pulp of teeth in the examined patients is accompanied not
only by pain symptom, the features of which are due to a number of
pathophysiological processes, but also by disorders of the immune, nervous
system, manifested in 42.1% of patients with the syndrome of vegeto-vascular
dystonia, 24.3% - focal lesions of the brain, combined with dental plexopathy.
2.In venous blood of patients with pulpitis pain symptom the amount of
antibodies to myeloperoxidase is 6.2 times, and to total myelin protein - 3 times
higher than in healthy patients, which indicates a direct connection of
inflammatory and autoimmune processes in atypical facial pain with the
pathology of the terminal branches of the trigeminal nerve.
List of used literature:
1. Akbarov, G.R. Dibazol and euphyllin SMT-phoresis in the treatment of facial
neuritis at cranial - cerebral trauma [Text] / G.R. Akbarov I Climatic preformed
physical factors in the prevention and rehabilitation of patients with
bronchopulmonary and cardiovascular diseases. - M., 2021 P. 69- 70.
2.
Grechko, V.E. Emergency care in neurostomatology. Izd. 2 [ M.: Medicine,
2020 - 256 p.
3.
Diagnostic possibilities of magnetic stimulation in facial nerve lesions
[Text] / A.A. Skoromets [et al] // Neurological Journal. - Moscow: Medicine,
1997. - № 5. - С. 29 - 31.
4.
Erokhina, L.G. Facial pains M.: Medicina. - 2013
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5.
Zavalishin, I:A. Facial neuropathy // Russian Dental Journal. - М., 2001. -
NO. G. - P. 21 -25.
