Frequency and pattern of presentation of neuralgia inducing cavitational osteonecrosis

ABSTRACT

Neuralgia inducing cavitational osteonecrosis is a bone disease which leads to neuralgia like pain. The aims of this study were to document the frequency and pattern of presentation of neuralgia inducing cavitational osteonecrosis and differentiate it from trigeminal neuralgia. This case series was conducted from August 2011 to July 2012 at Punjab Dental Hospital, Lahore. Patients having facial neuralgia like pain were assessed by history, clinical and radiographic examination. From these patients, seventy patients with signs and symptoms of neuralgia inducing cavitational osteonecrosis [i.e. oro-facial neuralgic pain with intra-oral trigger zone, previous history of surgical intervention and radiographic evidence of cavitational osteonecrosis in the jaws] were included in the study for surgical debridement and curettage of necrotic bone. Out of seventy patients, 25 were male [35.7%] and 45 were female [64.3%]. Age range was of 18 to 70 years. Positive diagnosis of neuralgia inducing cavitational osteonecrosis was confirmed in 45.7% of cases. Most of the patients were from fourth and fifth decade of life. Mandibular posterior region was mostly involved [61.4%] followed by maxillary posterior region [30%]. Anterior maxilla was involved [7.1%] more than anterior mandible [1.4%]. NICO most often causes sharp, shooting pain and is frequently misdiagnosed as trigeminal neuralgia. Consequently, patients are prescribed unwarranted anticonvulsant drugs and/or a variety of surgical procedures without significant pain relief. Such patients should be diagnosed properly for effective management i.e. surgical debridement of involved region