Florid cemento-osseous dysplasia as a possible aggravating factor in a case of trigeminal neuralgia.

Authors

  • C.H. Siar Department of Oral Pathology, Oral Medicine & Periodontology, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia.
  • N. Ibrahim Department of Oral Pathology and Oral Medicine, Faculty of Dentistry, National University of Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia.
  • A.N. Omar Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia.
  • Z.A. Abdul Rahman Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia.

DOI:

https://doi.org/10.22452/adum.vol17no1.4

Keywords:

trigeminal neuralgia, florid cementoosseous dysplasia, pain

Abstract

Differential diagnosis of orofacial pain is crucial, as the course of each process and its clinical management varies markedly. A case is illustrated here of trigeminal neuralgia in a 49-year-old Indian female whose complaint was initially diagnosed as dental pain leading to sequential extractions of her right mandibular and maxillary molars but with no pain abatement. Subsequent neurological assessment diagnosed her complaint as trigeminal neuralgia but pain remained poorly controlled even with high doses of carbamazepine and gabapentin. A dental referral and orthopantomographic examination revealed multifocal sclerotic masses in her jaws, suggestive of florid cemento-osseous dysplasia (FCOD). Right mandibular incisional biopsy confirmed the diagnosis. A decision was made to curette the right mandibular masses and lateralised the right inferior dental nerve. Follow-up disclosed considerable pain reduction. This case raises the issue as to whether the sclerotic bone masses in FCOD may have caused nerve compression which aggravated her neuralgic pain.

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Published

2010-12-31

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