A Case Report of Referral Pain on Mandibular Toothache Originated from Myofascial Pain

근막동통으로 인한 하악 구치부 연관통의 임상증례

  • Kang, Jin-Kyu (Department of Oral Medicine, College of Dentistry, Wonkwang University)
  • 강진규 (원광대학교 치과대학 구강내과학 교실)
  • Published : 2007.12.30


Majority of toothache is caused by abnormality of pulpal or periodontal tissues. However, there are numerous nonodontogenic sources that may be responsible for pain felt in the tooth. Nonodontogenic toothache may result from muscle, maxillary sinus, neuropathic, neurovascular, even cardiac and psychogenic problems. Myofascial pain is one of the most common abnormality characterized by palpation of a hard band which acts as the trigger point that causes stiffness and fatigue of the muscle, referral pain in tooth, tension-type headache, and hyperalgesia. Masseter muscle particularly induce referral pain in maxillary and mandibular molars. This case reported the treatment of the pain in right mandibular molar originated from myofascial pain of the right masseter. The pain is improved by general and reversible treatments such as muscle exercise, physical therapy, and medication. Nonodontogenic toothache should undergo proper differential diagnosis in order to avoid unnecessary dental treatments, such as endodontic, periodontic treatment, and tooth extraction, which would fail to alleviate the symptom of the patient.


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