Dentaltown September 2024 - 45

The challenge continues online!
Find more cases on Dentaltown
In the digital version of this article,
Dr. Seena Patel describes two more
cases in which patients complain of
pain caused by nondental sources.
Can you correctly diagnose the
diff erent sources?
Visit dentaltown.com/painquiz.
C
ases of pain aff ecting the dentition and periodontium usually
involve straightforward diagnoses because they often present with
a clear source of pathology and positive fi ndings on diagnostic tests.
However, how do you approach the patient who presents with pain
in the tooth with no signs of dental, pulpal or periodontal pathology?
Nondental sources of tooth pain can lead to misdiagnoses, inappropriate
and unnecessary dental procedures and a potential for pain exacerbation.
Th erefore, you as the dentist must be aware of such diagnoses to provide
patients with the right treatment. Let's see if you can correctly identify
what kind of non-odontogenic pains each of these cases present with.
CASE
1
A 35-year-old female presented to the dental clinic with a
chief complaint of pain on #10. Th e pain had been present
for many years, and previous treatments included
two root canal therapies and an extraction followed by
implant placement. Th e pain persisted and was described
as a " severe pressure " type of pain that became constant
and daily, rated at 9/10 on a pain severity scale. Bruxism
increased the pain, and the patient reported both day and
night parafunction.
Th e #10 implant site did not show any periimplant
abnormalities or pathology in the gingival or alveolar bone
regions. A musculoskeletal exam was performed, which showed severe
pain on palpation of the temporomandibular joints (TMJs), superfi cial
masseters, anterior temporalis, sternocleidomastoid and upper trapezius
muscles. Interestingly, when the patient's left anterior temporalis was
palpated, the pain referred down her head and toward her anterior teeth,
on the left side.
SEPTEMBER 2024 | 45 | DENTALTOWN.COM

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Dentaltown September 2024

Table of Contents for the Digital Edition of Dentaltown September 2024

Dentaltown September 2024 - Intro
Dentaltown September 2024 - Cover1
Dentaltown September 2024 - Cover2
Dentaltown September 2024 - 1
Dentaltown September 2024 - 2
Dentaltown September 2024 - 3
Dentaltown September 2024 - 4
Dentaltown September 2024 - 5
Dentaltown September 2024 - 6
Dentaltown September 2024 - 7
Dentaltown September 2024 - 8
Dentaltown September 2024 - 9
Dentaltown September 2024 - 10
Dentaltown September 2024 - 11
Dentaltown September 2024 - 12
Dentaltown September 2024 - 13
Dentaltown September 2024 - 14
Dentaltown September 2024 - 15
Dentaltown September 2024 - 16
Dentaltown September 2024 - 17
Dentaltown September 2024 - 18
Dentaltown September 2024 - 19
Dentaltown September 2024 - 20
Dentaltown September 2024 - 21
Dentaltown September 2024 - 22
Dentaltown September 2024 - 23
Dentaltown September 2024 - 24
Dentaltown September 2024 - 25
Dentaltown September 2024 - 26
Dentaltown September 2024 - 27
Dentaltown September 2024 - 28
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Dentaltown September 2024 - 30
Dentaltown September 2024 - 31
Dentaltown September 2024 - 32
Dentaltown September 2024 - 33
Dentaltown September 2024 - 34
Dentaltown September 2024 - 35
Dentaltown September 2024 - 36
Dentaltown September 2024 - 37
Dentaltown September 2024 - 38
Dentaltown September 2024 - 39
Dentaltown September 2024 - 40
Dentaltown September 2024 - 41
Dentaltown September 2024 - 42
Dentaltown September 2024 - 43
Dentaltown September 2024 - 44
Dentaltown September 2024 - 45
Dentaltown September 2024 - 46
Dentaltown September 2024 - 47
Dentaltown September 2024 - 48
Dentaltown September 2024 - 49
Dentaltown September 2024 - 50
Dentaltown September 2024 - 51
Dentaltown September 2024 - 52
Dentaltown September 2024 - 53
Dentaltown September 2024 - 54
Dentaltown September 2024 - 55
Dentaltown September 2024 - 56
Dentaltown September 2024 - Cover3
Dentaltown September 2024 - Cover4
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