Continuous Dentoalveolar Neuropathic Pain Response to Repeated Intravenous Ketamine Infusions: A Case Report.

This article describes a case of continuous dentoalveolar neuropathic pain in which relief was obtained following repeated administration of intravenous infusions of a subanesthetic dose of ketamine. A 50-year-old female presented in 2006 with a 1-year history of constant sharp pain in the gingiva surrounding the maxillary left second premolar and second molar rated as 10/10 on a pain intensity scale. After multiple systemic medications failed to adequately manage the patient's pain, partial pain reduction was obtained (4/10) with daily use of methadone 50 mg in combination with application of a topical compound including lidocaine, amitriptyline, and carbamazepine to the affected area as needed.

Improving a Dental School's Clinic Operations Using Lean Process Improvement.

The term "lean production," also known as "Lean," describes a process of operations management pioneered at the Toyota Motor Company that contributed significantly to the success of the company. Although developed by Toyota, the Lean process has been implemented at many other organizations, including those in health care, and should be considered by dental schools in evaluating their clinical operations. Lean combines engineering principles with operations management and improvement tools to optimize business and operating processes.

Chronic focal Langerhans cell histiocytosis of the left mandibular condyle presenting as limited jaw opening: a case report.

Temporomandibular joint (TMJ) disorders are common in the general population, with a particularly high prevalence among girls and women aged 15 to 25 years. The presence of chronic focal Langerhans cell histiocytosis in the mandibular condyle is rare, as only a few cases have been reported in the literature. We present the case of a 23-year-old woman who was referred to the Orofacial Pain Center at the University of Kentucky College of Dentistry with a chief complaint of limited jaw opening of 7 months' duration.

The efficacy of valacyclovir in preventing recurrent herpes simplex virus infections associated with dental procedures.

Background: Oral herpes simplex virus, or HSV, infections recur after trauma and stress. The prevalence of these infections after dental procedures is not known. Also, it is unclear whether antiviral agents are effective in preventing dental procedure-induced HSV recurrences.

Case report: dental considerations for managing a patient undergoing I-131 treatment for Graves' disease.

General dentists face many challenges when managing patients in an urgent care situation. Patients undergoing radioactive iodine therapy for Graves' disease pose a particular challenge, as they may exhibit a wide variety of symptoms during the active treatment phase. Proper management during the quarantine phase of treatment also involves a specific protocol for effective patient care.

The management of acute dental pain in the recovering alcoholic.

Although there have been many advances in our understanding of the neurophysiology of pain, the management of acute pain continues to be a challenge. When the need arises to provide adequate and effective pain management for the recovering alcoholic, the problem becomes much more complex. The clinician must provide the patient with adequate analgesia without causing a relapse.

A comparison between masticatory muscle pain patients and intracapsular pain patients on behavioral and psychosocial domains.

Aims: To identify differences between 2 groups of patients with temporomandibular disorders (TMD), those with masticatory muscle pain (MMP) versus intracapsular pain (ICP), and to compare these differences on behavioral and psychosocial domains.

Methods: There were 435 patients in the MMP group and 139 patients in the ICP group. The overall sample was 88.

Routine dental care in patients with temporomandibular disorders.

Aims: While a significant number of therapeutic models have been suggested for management of orofacial pain and limited opening in patients experiencing temporomandibular disorders (TMD), little attention has been given to the issue of routine daily care activities, such as toothbrushing and flossing. The purpose of this study was to develop an understanding of the extent to which TMD patients experience difficulty in performing routine daily mouth care.

Methods: Forty patients seeking care for TMD in the Orofacial Pain Center at the University of Kentucky College of Dentistry were age- and gender-matched to a group of general dentistry patients not experiencing TMD.

Reduction of pain and EMG activity in the masseter region by trapezius trigger point injection.

In this open, uncontrolled trial, 20 patients with upper trapezius muscle trigger point pain and ipsilateral masseter muscle pain received a single trigger point injection of 2% lidocaine solution (without epinephrine) in the upper trapezius muscle. Following the trapezius injection, there was a significant (P < 0.001) reduction in pain intensity ratings for pain in the masseter region.