research

Odontogena bol

Abstract

Pain has the function of a warning to tissue damage and activation of defensive mechanisms, with the aim of prevention of further damage. The stimulus which damages or threatens to damage a tissue activates the nociceptors which in turn carry the information by a system of neurons to cortex, where it is processed and recognized as pain. Most somatosensory information from the area of orofacial system is transported via n. trigeminus. In order to remove pain, it is necessary to recognize and properly diagnose the caus of pain. This is not always easy, due to numerous variations within the clinical findings, and the latent possibility that pain has referred from odontogenis structure onto the nonodontogenis ones, and vice versa. Knowing the pathways and mechanisms of pain, possible causes and different characters of orofacial pain, as well as a thorough anamnesis, clinical examination and testing will eventually lead to a proper diagnosis. An odontogenic source of pain is well defined and has an apparent cause, and therefore the provocation tests lead to the symptoms contained in the anamnesis. Any deviation from standard clinical status should be taken with caution. Once odontogenic cause of pain has been excluded, other potential causes of orofacial pain should be taken into consideration, in order to establish a valid diagnosis.Bol ima funkciju upozoravanja na oštećenje tkiva te funkciju aktivacije obrambenih refleksa radi prevencije daljnjeg oštećenja. Podražaj koji oštećuje tkivo ili prijeti oštećenjem tkiva aktivira nociceptore koji prenose informaciju sustavom neurona do kore velikog mozga, gdje se obrađuje i interpretira kao bol. Većinu somatosenzornih informacija iz područja orofacijalnog sustava prenosi n. trigeminus. Da bismo uklonili bol, potrebno je prepoznati i dijagnosticirati uzrok boli. To nije uvijek jednostavno zbog mnogih varijacija kliničke slike te mogućnosti boli da se referira iz odontogenih struktura u neodontogene i obratno. Poznavanje puta i mehanizma boli te mogućih uzroka i karaktera orofacijalne boli, odnosno detaljna anamneza, klinički pregled i testiranja, dovest će do prave dijagnoze. Odontogeni izvor boli obično ima tipičan karakter, evidentan uzrok, te se provokacijskim testovima dobivaju simptomi navedeni u anamnezi. Svakom odstupanju od klasične slike treba pristupiti s oprezom. Isključivanjem odontogenog uzroka boli treba ispitati ostale potencijalne uzroke orofacijalne boli kako bi se postavila pouzdana dijagnoza

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