Clinical Statistics for Odontogenic Disease in Patients Referred for Unknown Causes

Abstract: To examine the characteristics of cases of patients referred to the Nihon University School of Dentistry at Matsudo Hospital for unknown causes who were ultimately diagnosed with odontogenic disease as the underlying disease, particularly among those clinically diagnosed with pulpitis. Met...

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Published inJapanese Journal of Orofacial Pain Vol. 12; no. 1; pp. 11 - 17
Main Authors Kamiyama, Hirona, Makiyama, Yasuhide, Masuda, Manabu, Shimosaka, Michiharu, Sakaki, Mika, Nishimura, Hitoshi, Wake, Hiroyuki, Okubo, Masakazu, Uchida, Takashi, Iida, Takashi, Nishimori, Hideta, Komiyama, Osamu, Ishii, Tomohiro, Koide, Yasuyo
Format Journal Article
LanguageJapanese
Published Japanese Society of Orofacial Pain 2019
日本口腔顔面痛学会
Subjects
Online AccessGet full text
ISSN1883-308X
1882-9333
DOI10.11264/jjop.12.11

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Abstract Abstract: To examine the characteristics of cases of patients referred to the Nihon University School of Dentistry at Matsudo Hospital for unknown causes who were ultimately diagnosed with odontogenic disease as the underlying disease, particularly among those clinically diagnosed with pulpitis. Methods: The study subjects were patients referred to us for unknown causes during the three-year period between January 2016 and December 2018(“patients of unknown causes”). Results: Of 13,152 patients who visited us during the study period, 2,147 were referred from another hospital. Of these 2,147 patients, 287 were patients of unknown causes. The chief complaint in 76.3% of these patients of unknown causes was orofacial pain. The percentage of women among the patients of unknown causes was significantly greater than that among the overall patients and referral patients. No characteristic age distribution was identified. Odontogenic disease was diagnosed as the underlying disease in 107 cases of the patients of unknown causes, of whom 32 cases had pulpitis, the most common disease. Diagnoses that had been made instead of pulpitis included the following: 7 cases of caries under inlay(5 cases) or in prosthesis(2 cases); 6 cases of pulpitis after treatment for deep caries; and 5 cases of tooth crown crack or fracture. In addition, a diagnosis of non-odontogenic disease was made for 131 cases; the most common disease was TMD in 29 cases, followed by BMS in 25 cases and neuropathic pain in 10 cases. Conclusions: Odontogenic disease was diagnosed in 40% or more of the patients referred for unknown causes. If orofacial pain is caused by odontogenic disease, the pain tends to be readily treatable. These results demonstrate the significance of correctly differentiating odontogenic disease from non-odontogenic disease when diagnosing the cause of orofacial pain.
AbstractList Abstract: To examine the characteristics of cases of patients referred to the Nihon University School of Dentistry at Matsudo Hospital for unknown causes who were ultimately diagnosed with odontogenic disease as the underlying disease, particularly among those clinically diagnosed with pulpitis. Methods: The study subjects were patients referred to us for unknown causes during the three-year period between January 2016 and December 2018(“patients of unknown causes”). Results: Of 13,152 patients who visited us during the study period, 2,147 were referred from another hospital. Of these 2,147 patients, 287 were patients of unknown causes. The chief complaint in 76.3% of these patients of unknown causes was orofacial pain. The percentage of women among the patients of unknown causes was significantly greater than that among the overall patients and referral patients. No characteristic age distribution was identified. Odontogenic disease was diagnosed as the underlying disease in 107 cases of the patients of unknown causes, of whom 32 cases had pulpitis, the most common disease. Diagnoses that had been made instead of pulpitis included the following: 7 cases of caries under inlay(5 cases) or in prosthesis(2 cases); 6 cases of pulpitis after treatment for deep caries; and 5 cases of tooth crown crack or fracture. In addition, a diagnosis of non-odontogenic disease was made for 131 cases; the most common disease was TMD in 29 cases, followed by BMS in 25 cases and neuropathic pain in 10 cases. Conclusions: Odontogenic disease was diagnosed in 40% or more of the patients referred for unknown causes. If orofacial pain is caused by odontogenic disease, the pain tends to be readily treatable. These results demonstrate the significance of correctly differentiating odontogenic disease from non-odontogenic disease when diagnosing the cause of orofacial pain.
Abstract: To examine the characteristics of cases of patients referred to the Nihon University School of Dentistry at Matsudo Hospital for unknown causes who were ultimately diagnosed with odontogenic disease as the underlying disease, particularly among those clinically diagnosed with pulpitis.Methods: The study subjects were patients referred to us for unknown causes during the three-year period between January 2016 and December 2018(“patients of unknown causes”).Results: Of 13,152 patients who visited us during the study period, 2,147 were referred from another hospital. Of these 2,147 patients, 287 were patients of unknown causes. The chief complaint in 76.3% of these patients of unknown causes was orofacial pain. The percentage of women among the patients of unknown causes was significantly greater than that among the overall patients and referral patients. No characteristic age distribution was identified. Odontogenic disease was diagnosed as the underlying disease in 107 cases of the patients of unknown causes, of whom 32 cases had pulpitis, the most common disease. Diagnoses that had been made instead of pulpitis included the following: 7 cases of caries under inlay(5 cases) or in prosthesis(2 cases); 6 cases of pulpitis after treatment for deep caries; and 5 cases of tooth crown crack or fracture. In addition, a diagnosis of non-odontogenic disease was made for 131 cases; the most common disease was TMD in 29 cases, followed by BMS in 25 cases and neuropathic pain in 10 cases.Conclusions: Odontogenic disease was diagnosed in 40% or more of the patients referred for unknown causes. If orofacial pain is caused by odontogenic disease, the pain tends to be readily treatable. These results demonstrate the significance of correctly differentiating odontogenic disease from non-odontogenic disease when diagnosing the cause of orofacial pain. 目的:日本大学松戸歯学部付属病院を紹介にて受診した患者の中で,紹介元で原因不明とされたが,実際の診断が歯原性疾患であった症例(特に臨床診断が歯髄炎)について検討を行った.方法:2016年1月〜2018年12月までの3年間,紹介内容が「原因不明」であった患者(原因不明患者)を調査対象とした.結果:調査期間中に受診した患者は13,152名,紹介患者数2,147名で,そのうち原因不明患者は287名であり,原因不明患者の主訴は76.3%が口腔顔面痛であった.原因不明患者は総患者,紹介患者に比べ有意に女性が多かったが,年齢分布に特徴は認めなかった.原因不明患者のうち原疾患が,歯原性疾患と診断された症例は107例で,歯髄炎が32例で最も多かった.歯髄炎の診断に至らなかった原因として,歯冠修復物直下(5例)もしくは補綴物内部(2例)のう蝕が7例,深在う蝕の処置後の歯髄炎が6例,歯根破折が5例などであった.また非歯原性疾患と診断されたのは131例で,最も多かったのが顎関節症29例,次いで舌痛症25例,神経障害性疼痛10例であった.結論:原因不明で紹介された患者の40%以上が歯原性疾患であった.痛みの原因が歯原性疾患であれば苦痛を早期に除去できる可能性が高く,口腔顔面痛の診断においては,まず歯原性疾患を確実に鑑別することの重要性が再確認された.
Author Kamiyama, Hirona
Sakaki, Mika
Komiyama, Osamu
Makiyama, Yasuhide
Ishii, Tomohiro
Nishimura, Hitoshi
Nishimori, Hideta
Okubo, Masakazu
Iida, Takashi
Koide, Yasuyo
Masuda, Manabu
Shimosaka, Michiharu
Uchida, Takashi
Wake, Hiroyuki
Author_FL 増田 学
牧山 康秀
大久保 昌和
Shimosaka Michiharu
小見山 道
西森 秀太
Iida Takashi
榊 実加
Uchida Takashi
和気 裕之
神山 裕名
西村 均
石井 智浩
小出 恭代
Author_FL_xml – sequence: 1
  fullname: Uchida Takashi
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  fullname: Iida Takashi
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  fullname: 西村 均
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  fullname: 石井 智浩
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  fullname: Shimosaka Michiharu
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  fullname: 榊 実加
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  fullname: 西森 秀太
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  fullname: 牧山 康秀
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  organization: Orofacial and Head Pain Clinic, Nihon University Hospital at Matsudo
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  fullname: Makiyama, Yasuhide
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  fullname: Masuda, Manabu
  organization: Orofacial and Head Pain Clinic, Nihon University Hospital at Matsudo
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  organization: Orofacial and Head Pain Clinic, Nihon University Hospital at Matsudo
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  organization: Orofacial and Head Pain Clinic, Nihon University Hospital at Matsudo
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  fullname: Nishimori, Hideta
  organization: Orofacial and Head Pain Clinic, Nihon University Hospital at Matsudo
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  fullname: Komiyama, Osamu
  organization: Orofacial and Head Pain Clinic, Nihon University Hospital at Matsudo
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  fullname: Ishii, Tomohiro
  organization: Orofacial and Head Pain Clinic, Nihon University Hospital at Matsudo
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  fullname: Koide, Yasuyo
  organization: Orofacial and Head Pain Clinic, Nihon University Hospital at Matsudo
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References_xml – reference: 25.須田英明:歯根破折について.日外傷歯会誌 5:1-9,2009.
– reference: 7.小嶋郁穂,飯久保正弘,金田直人,阪本真弥,佐々城 真,熊坂 晃,鈴木宏尚,伊藤あゆみ,山村宗正,佐藤恭子,酒井 梓,佐藤しづ子,菅原由美子,古内 壽,庄司憲明,笹野高嗣.歯科受診患者の主訴に関する診断学的研究 過去30年間の主訴の変遷と社会的背景について.日口腔診断会誌 24(3):320-325,2011.
– reference: 12.日本歯科保存学会.う蝕治療ガイドライン,2版 113-118,京都:永松書店,2015.
– reference: 19.Kim SY, Kim SH, Cho SB, Lee GO, Yang SE. Different treatment protocols for different pulpal and periapical diagnoses of 72 cracked teeth. J Endod 39(4):449-452, 2013.
– reference: 22.Seo DG, Yi YA, Shin SJ, Park JW. Analysis of factors associated with cracked teeth. J Endod 2012 38(3):288-292, 2012.
– reference: 21.Kang SH, Kim BS, Kim Y. Cracked teeth: distribution, characteristics, and survival after root canal treatment. J Endod 42(4):557-562, 2016.
– reference: 13.Schwendicke F, Stangvaltaite L, Holmgren C, Maltz M, Finet M, Elhennawy K, Eriksen I, Kuzmiszyn TC, Kerosuo E, Doméjean S. Dentists’ attitudes and behaviour regarding deep carious lesion management: a multi-national survey. Clin Oral Investig 21(1):191-198, 2017.
– reference: 10.松尾敬志,中西 正.深在性う蝕への対応と歯髄の免疫応答.日歯保誌 62(1):1-7,2019.
– reference: 1.Okeson JP. Bell’s Orofacial Pains: the Clinical Management of Orofacial Pain, 6th ed 259-286, Illinois: Quintessence Publishing, 2005.
– reference: 5.小見山 道.難治性の歯痛 なかなか歯の痛みが治らない時に考えること.日歯医師会誌 69(1):19-26,2016.
– reference: 26.Hilton TJ, Funkhouser E, Ferracane JL, Gordan VV, Huff KD, Barna J, Mungia R, Marker T, Gilbert GH. National Dental PBRN Collaborative Group. Associations of types of pain with crack-level, tooth-level and patient-level characteristics in posterior teeth with visible cracks: Findings from the National Dental Practice-Based Research Network. J Dent 70:67-73, 2018.
– reference: 3.森村美奈,廣橋一裕,石河 修.女性の性差を考慮した慢性疼痛性障害の症状と治療の検討.心身医 46(10):922-923,2006.
– reference: 15.高橋雄介,吉岡靖介,朝日陽子,永山智崇,野杁由一郎,林 美加子.う蝕象牙質除去後の残存細菌にEr:YAGレーザーが与える影響.日歯保誌 56(1):1-8,2013.
– reference: 6.小見山 道,牧山康秀,平山晃康,川良美佐雄.歯痛,歯周組織の痛み.ペインクリニック 28(6):801-809,2007.
– reference: 14.Oen KT, Thompson VP, Vena D, Caufield PW, Curro F, Dasanayake A, Ship JA, Lindblad A. Attitudes and expectations of treating deep caries: a PEARL Network survey. Gen Dent 55(3):197-203, 2007.
– reference: 11.Al-Hiyasat AS, Barrieshi-Nusair KM, Al-Omari MA. The adiographic outcomes of direct pulp-apping procedures performed by dental students: a retrospective study. J Am Dent Assoc 137(12):1699-1705, 2006.
– reference: 17.Noma N, Shimizu K, Watanabe K, Young A, Imamura Y, Khan J. Cracked tooth syndrome mimicking trigeminal autonomic cephalalgia: A report of four cases. Quintessence Int 48(4):329-337, 2017.
– reference: 16.田上順次,千田 彰,奈良陽一郎,桃井保子.保存修復学21第3版第2刷 75-87,京都:永松書店,2008.
– reference: 4.遠藤友樹,西須大徳,村岡 渡,佐藤 仁,臼田 頌,中川種昭,和嶋浩一.口腔顔面痛外来における口腔内疼痛患者の臨床統計.日本口腔顔面痛学会雑誌 8(1):1-6,2015.
– reference: 20.Mamoun JS, Napoletano D. Cracked tooth diagnosis and treatment: An alternative paradigm. Eur J Dent 9(2):293-303, 2015.
– reference: 18.神山卓久.レプリカ計測からみた亀裂歯と破折歯の境界に関する臨床的検討.日外傷歯会誌 14(1):53-60,2018.
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Snippet Abstract: To examine the characteristics of cases of patients referred to the Nihon University School of Dentistry at Matsudo Hospital for unknown causes who...
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StartPage 11
SubjectTerms non-odontogenic diseases
odontogenic diseases
referred patient
unknown causes
原因不明
歯原性疾患
紹介患者
非歯原性疾患
Title Clinical Statistics for Odontogenic Disease in Patients Referred for Unknown Causes
URI https://www.jstage.jst.go.jp/article/jjop/12/1/12_11/_article/-char/en
https://cir.nii.ac.jp/crid/1390283659834186112
Volume 12
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