Acta Medica Bulgarica (Dec 2018)
Comprehensive Analysis of Pain Syndrome in Patients With Mandibular Fractures Treated With Nucleo CMP Forte
Abstract
The objective of this study was to perform a comprehensive evaluation of major indices of pain syndrome in patients with mandibular fractures accompanied by damage of inferior alveolar nerve using conventional therapeutic regimen supplemented by the administration of drug product Nucleo CMP Forte. Operative and postoperative treatment of 50 patients with angular fractures of the mandible, accompanied by clinical manifestations of inferior alveolar nerve damage, was performed. The severity of pain syndrome and neuropathy symptoms was evaluated using the LANSS pain scale, DN4 questionnaire, the Visual Analogue Scale (VAS) and Neuropathy Total Symptom Scores (NTSS-9). Decrease of pain syndrome was revealed in both groups but with different dynamic pattern. In the treatment group pain syndrome manifestations and neuropathy symptoms decreased quicker than in the comparison group. As LANSS, DN4, VAS and NTSS-9 scales characterize pain syndrome from various perspectives, the results were different but similar tendency was shown. At the beginning of the study LANSS scale indices were nearly identical in both groups, while on the 7th and 14th day they were 1.35 and 2.03 times lower, respectively, in the treatment group compared to the control group. On the first day NTSS-9 scale values did not practically differ in between the studied patients, being somewhat higher in the treatment group. On the 7th and 14th day the values increased 1.24 and 3.82 times, in the treatment group and in the group of comparison, respectively. Thus, the patients in the treatment group showed significantly greater pain relief than those in the comparison group. The analysis of dynamic pattern of complaints as well as the objective findings in angular fractures of the mandible, accompanied by the damage of inferior alveolar nerve, demonstrated that the administration of drug product Nucleo CMP Forte led to a more pronounced improvement of pain syndrome in the course of treatment. Because of the fact that neuropathic pain can develop in orthodontic treatment, as well as when partial and complete removable dentures are used, the administration of drug product Nucleo CMP Forte is warranted in combined therapy of both mandibular fractures followed by the clinical manifestations of inferior alveolar nerve damage, and neuropathic pain management in orthodontics and orthopedic stomatology.
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