Persistent Periapical Pathology and Migraine Symptoms: Periradicular Surgery of a Radicular Cyst
DOI:
https://doi.org/10.24191/cos.v13i1.10713Keywords:
migraine, periradicular surgery, persistent symptoms, radicular cystAbstract
This case report describes a rare presentation of a large periapical lesion, suspected to be a radicular cyst, associated with a previously treated maxillary central incisor. The lesion impinged upon the incisive foramen, and the patient presented with persistent pain and worsening migraine episodes unresponsive to pharmacological management. Surgical management of the lesion resulted in significant symptom resolution. This case highlights the need for dental professionals to consider odontogenic sources of chronic facial pain and emphasizes the importance of anatomical relationships in interpreting unusual orofacial symptomatology.
References
Burstein, R., Noseda, R., & Borsook, D. (2015). Migraine: multiple processes, complex pathophysiology. The Journal of Neuroscience: The Official Journal of the Society for Neuroscience, 35(17), 6619–6629. https://doi.org/10.1523/JNEUROSCI.0373-15.2015
Dodick, D. W. (2018). A phase-by-phase review of migraine pathophysiology. Headache, 58 Suppl 1(S1), 4–16. https://doi.org/10.1111/head.13300
Edvinsson, L. (2021). CGRP and migraine: from bench to bedside. Revue Neurologique, 177(7), 785–790. https://doi.org/10.1016/j.neurol.2021.06.003
Kim, S., & Kratchman, S. (2006). Modern endodontic surgery concepts and practice: a review. Journal of Endodontics, 32(7), 601–623. https://doi.org/10.1016/j.joen.2005.12.010
Langford, R. J. (1989). The contribution of the nasopalatine nerve to sensation of the hard palate. The British Journal of Oral & Maxillofacial Surgery, 27(5), 379–386. https://doi.org/10.1016/0266-4356(89)90077-6
Malick, A., & Burstein, R. (2000). Peripheral and central sensitization during migraine. Functional Neurology, 15 Suppl 3, 28–35. https://www.ncbi.nlm.nih.gov/pubmed/11200798
Manjushree, R., & Prasad, K. (2021). Application of cone-beam computed tomography in the management of dilacerated maxillary central incisor associated with radicular cyst and external root resorption - A case report. Journal of Conservative Dentistry, 24(4), 399–403. https://doi.org/10.4103/jcd.jcd_57_21
Mier, R. W., & Dhadwal, S. (2018). Primary headaches. Dental Clinics of North America, 62(4), 611–628. https://doi.org/10.1016/j.cden.2018.06.006
Mohammed, M. M. A., Almayeef, D., Abbas, D., Ali, M., Haissam, M., Mabrook, R., Nizar, R., Eldoahji, T., & Al-Rawi, N. H. (2023). The association between periodontal disease and chronic migraine: A systematic review. International Dental Journal, 73(4), 481–488. https://doi.org/10.1016/j.identj.2023.04.007
Nair, P. N. R. (2004). Pathogenesis of apical periodontitis and the causes of endodontic failures. Critical Reviews in Oral Biology and Medicine, 15(6), 348–381. https://doi.org/10.1177/154411130401500604
Nair, P. N. R. (2006). On the causes of persistent apical periodontitis: a review. International Endodontic Journal, 39(4), 249–281. https://doi.org/10.1111/j.1365-2591.2006.01099.x
Rajesh, K. S., Farooq, R., Rajak, F. A., & Kumar, P. (2024). Treating apical fenestration in a previously endodontically treated tooth. Journal of Conservative Dentistry and Endodontics, 27(11), 1193–1195. https://doi.org/10.4103/JCDE.JCDE_562_24
Ricucci, D., Siqueira, J. F., Jr, Bate, A. L., & Pitt Ford, T. R. (2009). Histologic investigation of root canal-treated teeth with apical periodontitis: a retrospective study from twenty-four patients. Journal of Endodontics, 35(4), 493–502. https://doi.org/10.1016/j.joen.2008.12.014
Setzer, F. C., Kohli, M. R., Shah, S. B., Karabucak, B., & Kim, S. (2012). Outcome of endodontic surgery: a meta-analysis of the literature--Part 2: Comparison of endodontic microsurgical techniques with and without the use of higher magnification. Journal of Endodontics, 38(1), 1–10. https://doi.org/10.1016/j.joen.2011.09.021
Tsesis, I., Rosen, E., Taschieri, S., Telishevsky Strauss, Y., Ceresoli, V., & Del Fabbro, M. (2013). Outcomes of surgical endodontic treatment performed by a modern technique: an updated meta-analysis of the literature. Journal of Endodontics, 39(3), 332–339. https://doi.org/10.1016/j.joen.2012.11.044
Velvart, P. (2002). Papilla base incision: a new approach to recession-free healing of the interdental papilla after endodontic surgery. International Endodontic Journal, 35(5), 453–460. https://doi.org/10.1046/j.1365-2591.2002.00498.x
Watkins, L. R., Milligan, E. D., & Maier, S. F. (2001). Glial activation: a driving force for pathological pain. Trends in Neurosciences, 24(8), 450–455. https://doi.org/10.1016/s0166-2236(00)01854-3
Woolf, C. J. (2011). Central sensitization: implications for the diagnosis and treatment of pain. Pain, 152(3 Suppl), S2–S15. https://doi.org/10.1016/j.pain.2010.09.030
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