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<p>Painful Traumatic Trigeminal Neuropathy<br>MAJ Alexander Smith, DC, USA and CAPT Nicholas Mazzeo, DC, USN<br><br>Introduction<br>Dental procedures, such as pulpectomy, extraction, implant place-ment, soft tissue incision or administration of dental local anesthesia (LA), can injure neural tissue and induce neuropathy and/or neu-ropathic pain. Neuropathy is defined as a functional disturbance or pathologic change in the peripheral nervous system. According to the International Association for the Study of Pain, neuropathic pain arises as a direct consequence of lesions or diseases affecting the somatosensory system. Although the onset of neuropathy can be idiopathic, it is often related to nerve injury or trauma, and is commonly accompanied by pain. The initial, peripheral neuronal dam-age may lead to functional and structural CNS changes that establish a painful pathologic state. Pain from trauma or iatrogenic injury to the trigeminal nerve remains poorly defined. It has been classified as deafferentation pain, atypical facial pain, post-traumatic neuralgia, and most recently, painful traumatic trigeminal neuropathy (PTTN). This clinical update focuses on the pathophysiology, clinical presentation and management of PTTN.
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<br>Subjects: Neuralgia ; Pain ; Pulpectomy ; Trigeminal Nerve</div>
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U.S. Navy. Naval Postgraduate Dental School</div>
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