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Differential Diagnosis of Orofacial Pain






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Differential Diagnosis of Orofacial Pain. By S. Wanachantararak. Pain for Intraoral Origin. Pain from Dentine Pain from Pulp Pain from Gingiva Pain from Periodontatitis Pain from Periapical periodontitis Pain from oral mucosa. Non Vascular Origin Orofacial Pain. Pain from Teeth (pulp)
Differential Diagnosis of Orofacial Pain

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Slide 1

Differential Diagnosisof Orofacial Pain

By

S. Wanachantararak

Slide 2

Pain for Intraoral Origin

  • Pain from Dentine

  • Pain from Pulp

  • Pain from Gingiva

  • Pain from Periodontatitis

  • Pain from Periapical periodontitis

  • Pain from oral mucosa

Slide 3

Non Vascular Origin Orofacial Pain

  • Pain from Teeth (pulp)

  • Pain from TM muscle

  • Pain from TMJ

  • Sinusitis

  • Salivary gland

  • Trigeminal Neuralgia

  • Atypical Neuralgia

Slide 4

Vascular Origin Orofacial Pain

  • Migraine Headache

  • Cluster Headache

  • Peroxymal hemicrania

  • Vascular Headache

Slide 5

History Examination ofOrofacial Pain

Slide 6

History Ex. of Orofacial Pain

C. Characteristics of pain

  • Quality of pain

  • Behaviour of pain

    • Temporal

    • Frequency

    • Duration

  • Intensity

  • Concomitant symptoms

  • Flow of pain

1. Chief complaints

A. Location of pain

B. Onset of pain

  • Association with other factors

  • Progression

Slide 7

History Ex. of Orofacial Pain

  • E. Past consultation and/or treatment

  • F. Relationship to other complaints

  • 2. Past medical history

  • 3. Review of systems

  • 4. Psychological assessment

  • 1. Chief complaints (cont.)

    D. Aggravating and alleviating factors

    • Physical modalities

    • Function and parafunction

    • Sleep disturbances

    • Medications

    • Emotional stress

    Slide 8

    Clinical Examination of Orofacial Pain

    Slide 9

    Clinical Examination

    E. Cervical evaluation

    F. Balance and co-ordination

    2. Muscle examination

    A. Pulpation

    • Pain and tenderness

    • Trigger points and pain referal

    1. General examination

    A. Vital signs

    • Blood pressure

    • Pulse rate

    • Respiratory rate

    • Temperature

      B. Cranial nerve evaluation

      C. Eye evaluation

      D. Ear evaluation

    Slide 10

    Clinical Examination

    C. Oral structures

    • Mucogingival tissues

    • Teeth

    • Periodontium

    • Occlusion

      4. Other diagnostic tests

      A. Imaging

      B. Laboratory tests

      C. Psychologic provocation tests

    3. Masticatory evaluation

    A. Range of mandibular movement

    • Measurement

    • Pain

      B. Temoromandibular joint evaluation

    • Pain

    • Dysfunction

    Slide 11

    Pain from Intraoral Origin

    Slide 12

    Pain for Intraoral Origin

    • Pain from Dentine

    • Pain from Pulp

    • Pain from Gingiva

    • Pain from Periodontatitis

    • Pain from Periapical periodontitis

    • Pain from oral mucosa

    Slide 13

    Pain for Intraoral Origin

    • Pain from Dentine

    • Pain from Pulp

    • Pain from Gingiva

    • Pain from Periodontatitis

    • Pain from Periapical periodontitis

    • Pain from oral mucosa

    Slide 14

    Pain for Intraoral Origin

    Slide 15

    Pain for Intraoral Origin

    Slide 16

    Pain for Intraoral Origin

    • Pain from Dentine

    • Pain from Pulp

    • Pain from Gingiva

    • Pain from Periodontatitis

    • Pain from Periapical periodontitis

    • Pain from oral mucosa

    Slide 17

    Pain for Intraoral Origin

    Slide 18

    Pain for Intraoral Origin

    Slide 19

    Pain for Intraoral Origin

    • Pain from Dentine

    • Pain from Pulp

    • Pain from Gingiva

    • Pain from Periodontatitis

    • Pain from Periapical periodontitis

    • Pain from oral mucosa

    Slide 20

    Pain for Intraoral Origin

    Slide 21

    Pain for Intraoral Origin

    Slide 22

    Pain for Intraoral Origin

    • Pain from Dentine

    • Pain from Pulp

    • Pain from Gingiva

    • Pain from Periodontatitis

    • Pain from Periapical periodontitis

    • Pain from oral mucosa

    Slide 23

    Pain for Intraoral Origin

    Slide 24

    Pain for Intraoral Origin

    Slide 25

    Pain for Intraoral Origin

    • Pain from Dentine

    • Pain from Pulp

    • Pain from Gingiva

    • Pain from Periodontatitis

    • Pain from Periapical periodontitis

    • Pain from oral mucosa

    Slide 26

    Pain for Intraoral Origin

    Slide 27

    Pain for Intraoral Origin

    Slide 28

    Pain for Intraoral Origin

    • Pain from Dentine

    • Pain from Pulp

    • Pain from Gingiva

    • Pain from Periodontatitis

    • Pain from Periapical periodontitis

    • Pain from oral mucosa

    Slide 29

    Pain for Intraoral Origin

    Slide 30

    Pain for Intraoral Origin

    Slide 31

    Non Vascular OriginOrofacial Pain

    Slide 32

    Non Vascular Origin Orofacial Pain

    • Pain from Teeth (pulp)

    • Pain from TM muscle

    • Pain from TMJ

    • Sinusitis

    • Salivary gland

    • Trigeminal Neuralgia

    • Atypical Neuralgia

    Slide 33

    Non Vascular Origin Orofacial Pain

    • Pain from Teeth (pulp)

    • Pain from TM muscle

    • Pain from TMJ

    • Sinusitis

    • Salivary gland

    • Trigeminal Neuralgia

    • Atypical Neuralgia

    Slide 34

    Non Vascular Origin Orofacial Pain

    Slide 35

    Non Vascular Origin Orofacial Pain

    Slide 36

    Non Vascular Origin Orofacial Pain

    • Pain from Teeth (pulp)

    • Pain fromTM muscle

    • Pain from TMJ

    • Sinusitis

    • Salivary gland

    • Trigeminal Neuralgia

    • Atypical Neuralgia

    Slide 37

    Non Vascular Origin Orofacial Pain

    Slide 38

    Non Vascular Origin Orofacial Pain

    Slide 39

    Non Vascular Origin Orofacial Pain

    • Pain from Teeth (pulp)

    • Pain from TM muscle

    • Pain fromTMJ

    • Sinusitis

    • Salivary gland

    • Trigeminal Neuralgia

    • Atypical Neuralgia

    Slide 40

    Non Vascular Origin Orofacial Pain

    Slide 41

    Non Vascular Origin Orofacial Pain

    Slide 42

    Non Vascular Origin Orofacial Pain

    • Pain from Teeth (pulp)

    • Pain from TM muscle

    • Pain from TMJ

    • Sinusitis

    • Salivary gland

    • Trigeminal Neuralgia

    • Atypical Neuralgia

    Slide 43

    Non Vascular Origin Orofacial Pain

    Slide 44

    Non Vascular Origin Orofacial Pain

    Slide 45

    Non Vascular Origin Orofacial Pain

    • Pain from Teeth (pulp)

    • Pain from TM muscle

    • Pain from TMJ

    • Sinusitis

    • Salivary gland

    • Trigeminal Neuralgia

    • Atypical Neuralgia

    Slide 46

    Non Vascular Origin Orofacial Pain

    Slide 47

    Non Vascular Origin Orofacial Pain

    Slide 48

    Non Vascular Origin Orofacial Pain

    • Pain from Teeth (pulp)

    • Pain from TM muscle

    • Pain from TMJ

    • Sinusitis

    • Salivary gland

    • Trigeminal Neuralgia

    • Atypical Neuralgia

    Slide 49

    Non Vascular Origin Orofacial Pain

    Slide 50

    Non Vascular Origin Orofacial Pain

    Slide 51

    Non Vascular Origin Orofacial Pain

    • Pain from Teeth (pulp)

    • Pain from TM muscle

    • Pain from TMJ

    • Sinusitis

    • Salivary gland

    • Trigeminal Neuralgia

    • Atypical Neuralgia

    Slide 52

    Non Vascular Origin Orofacial Pain

    Slide 53

    Non Vascular Origin Orofacial Pain

    Slide 54

    Vascular OriginOrofacial Pain

    Slide 55

    Vascular Origin Orofacial Pain

    • Migraine Headache

    • Cluster Headache

    • Peroxymal hemicrania

    • Vascular Headache

    Slide 56

    Vascular Origin Orofacial Pain

    • Migraine Headache

    • Cluster Headache

    • Peroxymal hemicrania

    • Vascular Headache

    Slide 57

    Vascular Origin Orofacial Pain

    Slide 58

    Vascular Origin Orofacial Pain

    Slide 59

    Vascular Origin Orofacial Pain

    • Migraine Headache

    • Cluster Headache

    • Peroxymal hemicrania

    • Vascular Headache

    Slide 60

    Vascular Origin Orofacial Pain

    Slide 61

    Vascular Origin Orofacial Pain

    Slide 62

    Vascular Origin Orofacial Pain

    • Migraine Headache

    • Cluster Headache

    • Peroxymal hemicrania

    • Vascular Headache

    Slide 63

    Vascular Origin Orofacial Pain

    Slide 64

    Vascular Origin Orofacial Pain

    Slide 65

    Vascular Origin Orofacial Pain

    • Migraine Headache

    • Cluster Headache

    • Peroxymal hemicrania

    • Vascular Headache

    Slide 66

    Vascular Origin Orofacial Pain

    Slide 67

    Vascular Origin Orofacial Pain

    Slide 68

    Pain for Intraoral Origin

    • Pain from Dentine

    • Pain from Pulp

    • Pain from Gingiva

    • Pain from Periodontatitis

    • Pain from Periapical periodontitis

    Slide 69

    Non Vascular Origin Orofacial Pain

    • Pain from Teeth (pulp)

    • Pain from TM muscle

    • Pain from TMJ

    • Sinusitis

    • Salivary gland

    • Trigeminal Neuralgia

    • Atypical Neuralgia

    Slide 70

    Vascular Origin Orofacial Pain

    • Migraine Headache

    • Cluster Headache

    • Peroxymal hemicrania

    • Vascular Headache

    Slide 71

    Thank You


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