Development and Evaluation of a GPT4-Based Orofacial Pain Clinical Decision Support System.

: Orofacial pain (OFP) encompasses a complex array of conditions affecting the face, mouth, and jaws, often leading to significant diagnostic challenges and high rates of misdiagnosis. Artificial intelligence, particularly large language models like GPT4 (OpenAI, San Francisco, CA, USA), offers potential as a diagnostic aid in healthcare settings. : To evaluate the diagnostic accuracy of GPT4 in OFP cases as a clinical decision support system (CDSS) and compare its performance against treating clinicians, expert evaluators, medical students, and general practitioners.

Establishing universal sectioning depth and angle for surgical coronectomy of impacted mandibular third molars: an imaging-based study.

Introduction: Coronectomy is a safer option than extraction for third molars with an increased risk of injury to the inferior alveolar nerve. However, it can still cause complications due to a lack of standardized and effective tooth sectioning techniques. We proposed a standardized protocol for third molar coronectomy involving standardized tooth sectioning parameters to minimize potential complications, surgical failure, and the need for further procedures.

Impact of migraine and fibromyalgia on temporomandibular disorder: A retrospective study on pain, psychological factors and quality of life.

Objectives: This study assessed the impact of migraine and fibromyalgia (FM) in TMD patients, focusing on pain, anxiety, depression, and quality of life (QoL). Additionally, we investigated how these variables relate to the total number of comorbidities to gain insights into their interactions.

Methods: A retrospective data collection was conducted during January 2016 to December 2022, involving 409 adult TMD patients.

Is painful temporomandibular disorder a real headache for many patients?

Temporomandibular disorders (TMDs) and primary headaches are common pain conditions and often co-exist. TMD classification includes the term 'headache secondary to TMD' but this term does not acknowledge the likelihood that primary headache pathophysiology underpins headache causing painful TMD signs and symptoms in many patients. The two disorders have a complex link and we do not fully understand their interrelationship.

Temporomandibular Disorders and Fibromyalgia Prevalence: A Systematic Review and Meta-Analysis.

Purpose: To evaluate the prevalence of chronic widespread pain (CWP) and fibromyalgia syndrome (FMS) in TMD patients and the prevalence of TMDs in patients with FMS.

Method: A systematic search was performed in electronic databases. Studies published in English examining the prevalence of comorbid TMDs and CWP/FMS were included.

Sleep disturbances are associated with pain intensity and pain-related functional interference in patients experiencing orofacial pain.

Background: Sleep and pain have a reciprocal relationship, interacting with psychosocial aspects including depression, anxiety, somatization and significant stressful events.

Objective: The aim of this study was to assess patients with oro-facial pain (OFP) and related sleep disturbances and determine the strongest psychosocial correlates.

Methods: A cross-sectional study of anonymized data of consecutive patients with OFP {January 2019 and February 2020} were analysed.

Investigating genotype-phenotype relationship of extreme neuropathic pain disorders in a UK national cohort.

The aims of our study were to use whole genome sequencing in a cross-sectional cohort of patients to identify new variants in genes implicated in neuropathic pain, to determine the prevalence of known pathogenic variants and to understand the relationship between pathogenic variants and clinical presentation. Patients with extreme neuropathic pain phenotypes (both sensory loss and gain) were recruited from secondary care clinics in the UK and underwent whole genome sequencing as part of the National Institute for Health and Care Research Bioresource Rare Diseases project. A multidisciplinary team assessed the pathogenicity of rare variants in genes previously known to cause neuropathic pain disorders and exploratory analysis of research candidate genes was completed.

Posttraumatic Trigeminal Neuropathic Pain in Association with Dental Implant Surgery.

Posttraumatic trigeminal neuropathy in association with dental implant surgery is preventable, and this should be the emphasis for all clinicians considering this treatment for a patient. Once the nerve injury and posttraumatic neuropathy with or without pain ensues, there is very little the clinician can do to reverse it and the high pain and permanency of the neuropathy will have a significant functional and psychological impact on the patient. Immediate implant removal is required, and home check should be routine for all cases.

Psychologic Impact of Chronic Orofacial Pain: A Critical Review.

Aims: To explore the prevalence of clinically significant anxiety and depression in adult patients with chronic orofacial pain (COFP) conditions.

Methods: A systematic online search of the Medline (PubMed) and Ovid databases was performed for articles published from 2006 to 2019. Observational studies- including cross-sectional, case-control, and case series-and longitudinal prospective studies were included.

Healthcare costs of post-traumatic trigeminal neuropathy in Belgium - A retrospective analysis.

The present aim was to estimate direct health care costs of patients suffering from post-traumatic trigeminal neuropathy (PTTN) and to compare the use of health care services, medications, and costs between temporary and persistent (>3 months) PTTN cohorts. A pre-existing clinical dataset of PTTN patients visiting a tertiary orofacial pain clinic in Belgium was utilized, including symptoms and quality of life measurements. Cost and resource utilization data were obtained by Belgium's largest health insurance provider for a period of 5 years after onset.

Patient safety in dentistry - the bigger picture.

Background Patient safety incidents (PSIs) have recently become a topic of discussion within dentistry. NHS England data has highlighted that wrong tooth extraction is the most common surgical Never Event (NE); however, this data reflects mainly a secondary care picture. Consideration needs to be given to reporting of PSIs occurring in primary care.

A Narrative Review of Therapeutic Peripheral Nerve Blocks for Chronic Orofacial Pain Conditions.

Aims: To provide an analysis of the different therapeutic peripheral nerve blocks (PNBs), as well as their limitations and the related evidence base for their use in chronic orofacial pain (OFP) conditions, excluding migraine and other headache conditions.

Methods/results: The evidence base for therapeutic PNBs for chronic OFP is poor and highlights the need for improved research in this area. The diagnostic criteria and interventional PNB definitions and techniques varied between studies.

Refractory Orofacial Pain: Is It the Patient or the Pain?

Aims: To highlight and discuss the term "refractory" when used to describe pain conditions and its application to orofacial pain, as well as to highlight the factors that must be considered in a refractory patient.

Methods: A scoping review of recent publications (2010 to 2021) applying the term "refractory" to orofacial pain was conducted, and this paper presents their limitations and definitions.

Results: The term "refractory" is often used to describe pain instead of "persistent" or "nonresponsive.

Causes of subcutaneous emphysema following dental procedures: a systematic review of cases 1993-2020.

Objectives Causes of subcutaneous emphysema (SE) following dental treatment have changed with new operative techniques and equipment. This review demonstrates the frequency and aetiology of SE to inform prevention strategies for reducing SE occurrences.Methods A systematic search of Medline, Embase and PubMed databases identified 135 cases of SE which met inclusion criteria after independent review by two authors.

A systematic review of treatment for patients with burning mouth syndrome.

Background: Burning mouth syndrome is a chronic idiopathic intractable intraoral dysaesthesia that remains a challenge to clinicians due to its poorly understood pathogenesis and inconsistent response to various treatments.

Aim: This review aimed to study the short- (≤3 months) and long-term (>3 months) effectiveness and sustainable benefit of different burning mouth syndrome treatment strategies and the associated side effects.

Materials And Methods: Randomised controlled trials of burning mouth syndrome treatment compared with placebo or other interventions with a minimum follow up of 2 months were searched from the PubMed, Embase and Cochrane database (published to July 2020).

Prognostic factors, symptom evolution, and quality of life of posttraumatic trigeminal neuropathy.

Neurosensory disturbances (NSDs) caused by injury to the trigeminal nerve can affect many aspects of daily life. However, factors affecting the persistence of NSDs in patients with posttraumatic trigeminal neuropathies (PTTNs) remain largely unknown. The identification of such risk factors will allow for the phenotyping of patients with PTTNs, which is crucial for improving treatment strategies.

Regional cerebral blood flow as predictor of response to occipital nerve block in cluster headache.

Background: Cluster headache is an excruciating disorder with no cure. Greater occipital nerve blockades can transiently suppress attacks in approximately 50% of patients, however, its mechanism of action remains uncertain, and there are no reliable predictors of treatment response. To address this, we investigated the effect of occipital nerve blockade on regional cerebral blood flow (rCBF), an index of brain activity, and differences between treatment responders and non-responders.

Post-traumatic trigeminal neuropathy: correlation between objective and subjective assessments and a prediction model for neurosensory recovery.

Background: Post-traumatic trigeminal neuropathy (PTN) can have a substantial effect on patient well-being. However, the relation between the neuropathic symptoms and their effect on psychosocial functioning remains a matter of debate. The purpose of this study was to evaluate the association between objective and subjective assessments of neurosensory function in PTN and predict neurosensory outcome using baseline measurements.

The Diagnostic Value of Magnetic Resonance Imaging in Posttraumatic Trigeminal Neuropathic Pain.

Aims: To evaluate the diagnostic value of non-nerve-selective MRI sequences in posttraumatic trigeminal neuropathic pain (PTNP).

Methods: This study retrospectively analyzed all MRI protocols performed between February 2, 2012 and June 20, 2018 commissioned by the Department of Oral and Maxillofacial Surgery, University Hospitals Leuven. Demographic, clinical, and radiologic data were extracted from the records of patients with an MRI in the context of PTNP.

A 15-year unique observational study of intraligamentary local anaesthesia for posterior mandibular extractions.

Introduction Intraligamentary local anaesthesia (ILA) with articaine is described as an effective alternative to inferior alveolar nerve block (IANB) for extraction of posterior teeth in the mandible, with reduced risk of complications.Aim To investigate ILA with 4% articaine and conventional syringe as a unique method for providing tooth extractions in the posterior mandible.Materials and methods All consecutive teeth to be extracted in the posterior mandible were recruited to the study, within exclusion criteria, between 2002 and 2017 in one London NHS and private dental practice.

Magnetic resonance neurography of the head and neck: state of the art, anatomy, pathology and future perspectives.

Magnetic resonance neurography allows for the selective visualization of peripheral nerves and is increasingly being investigated. Whereas in the past, the imaging of the extracranial cranial and occipital nerve branches was inadequate, more and more techniques are now available that do allow nerve imaging. This basic review provides an overview of the literature with current state of the art, anatomical landmarks and future perspectives.

Catastrophising, pain self-efficacy and acceptance in patients with Burning Mouth Syndrome.

Background: Little is known about pain catastrophising, pain self-efficacy and chronic pain acceptance in burning mouth syndrome (BMS) and their effect on health-related quality of life (HRQoL) and symptoms of anxiety and depressive disorders.

Objectives: To describe pain catastrophising, pain self-efficacy and pain acceptance in BMS patients and explore associations with affective function and HRQoL.

Methods: A cross-sectional study of 36 BMS patients (31 female) referred to an Orofacial Pain Clinic completed the Pain Catastrophizing Scale, the Pain Self-Efficacy Questionnaire and the Chronic Pain Acceptance Questionnaire-8 in addition to standardised self-reported questionnaires measuring mood and oral and generic HRQoL.

New International Classification of Orofacial Pain: What Is in It For Endodontists?

Pain is a common symptom in endodontic conditions, but differential diagnostic procedures are often needed to exclude other pain origins. Thus, general dentists and endodontists need to be aware of alternative painful orofacial conditions and be able to identify them. The new International Classification of Orofacial Pain (ICOP) is the first comprehensive classification that uniquely deals with orofacial pain.