Coexistence of craniomandibular dysfunction and phantom pain

The specialist clinical practice that treats craniomandibular dysfunctions (CMDs) is often the first port of call for patients with oral and maxillofacial pain of various origins. Odontalgia and temporomandibular joint (TMJ) and/or muscular pain are the most frequent causes of orofacial pain. Atypical forms of odontalgia, which can occur as a result of conservative or endodontic treatment or periradicular surgery and tooth extractions, hold a special position among the different types of odontalgia. According to the current state of knowledge, atypical odontalgia is classed as neuropathic pain with peripheral and central sensitization of the trigeminal system. The case described here involved atypical odontalgia in combination with myogenic CMD and previously inadequately treated residual dentition, and called for a multi-axis treatment concept. With the aid of targeted differential diagnostics, it was possible to contribute to the desired pain relief and improve the patient's functional situation using a combination of medication, occlusal splint therapy, and prosthetic treatment. In this article, the diagnostics and treatment models are presented and discussed with reference to the current literature. Keywords: CMD, chronic pain, neuropathic pain, palmitoylethanolamide (PEA)