TREATMENT OF ATYPICAL MIDFACIAL PAIN WITH A MAXILLARY SINUS LIFT PROCEDURE

I have found that atypical facial pain in the upper jaw is often related to a bone defect in the sinus wall which has healed with tissue ingrowth. This typically occurs as the result of dental trauma or a surgical defect after tooth extraction or orthognathic surgery, as examples. (J Oral Maxillofac Surg 72:2453.e1-2453.e5, 2014). Patients will have point tenderness to pressure or touch and in some cases overt pain. Organic pain can usually be differentiated from neurologic pain (brain origin-or central origin) by use of diagnostic local anesthetic blocks. Pain caused by local organic factors will typically be relieved for a short time by the local anesthetic blocking.

Historically, I have found satisfactory treatment with local bone grafting or connective tissue grafts after debridement of the areas. Guided bone regeneration (use of membranes) has also been helpful. With the advent of bone grafting techniques with alloplastic grafts such as human bone product plus LPRF/PRGF has seen good success in healing such defects and relieving these types of pain problems. Again, these would not be effective techniques to use for a condition such as trigeminal neuralgia.