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Original Research

Open Access

Various topical drug combination assessed using a neurosensory stent for chronic intraoral neuropathic pain: a pilot study

  • Yair Sharav1
  • Yuval Shalit2
  • Rakefet Czerninski1
  • Shirley Leibowiz3
  • Doron J Aframian1
  • Yaron Haviv1,*,

1Department of Oral Medicine, Sedation and Imaging, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, 9112001 Jerusalem, Israel

2Hebrew University-Hadassah School of Dental Medicine, 9112001 Jerusalem, Israel

3Department of Pediatric Dentistry, Barzilai Medical Center, 7830604 Ashkelon, Israel

DOI: 10.22514/jofph.2024.025 Vol.38,Issue 3,September 2024 pp.38-45

Submitted: 28 March 2024 Accepted: 23 April 2024

Published: 12 September 2024

*Corresponding Author(s): Yaron Haviv E-mail: yaronha@hadassah.org.il; yaron.haviv@gmail.com

Abstract

Chronic intraoral neuropathic pain (NP), often developing post-dental procedures, poses significant management challenges. The prevalent use of systemic treatments, with their frequent substantial side effects, emphasizes the need for alternative therapeutic strategies. Our aim is to explore the efficacy and adherence with a topical drug regimen delivered through a neurosensory stent (NS) for treating chronic neuropathic pain (NP) within the oral cavity. A retrospective analysis in addition to a telephone structured questionnaire conducted on patients with chronic intraoral NP treated at the Orofacial Pain Clinic, Hadassah Medical Center, between 2017 and 2020. A standard combination of lidocaine 2%, pregabalin 5%, ibuprofen 5% and optionally amitriptyline 2% was administered using a custom-made NS. Out of 12 participants, 6 reported more than 50% pain relief, indicating high effectiveness. Notably, females showed a more favorable response than males. 75% of patients used the NS consistently. No significant difference in pain relief was observed between the standard formula and the one with supplementary amitriptyline. The results highlight the potential of NS as an alternative, or adjunct treatment that may reduce the dosage of systemic medications for chronic NP. Additionally, the NS device can be used as an “escape drug”, or add-on, method if pain exacerbates under systemic therapy or if higher dose of systemic therapy causes serious side effects. Large scale prospective double-blind studies are required to substantiate the findings of this pilot study.


Keywords

Neuropathic pain; Topical treatment; Oral pain; Neurosensory stent


Cite and Share

Yair Sharav,Yuval Shalit,Rakefet Czerninski,Shirley Leibowiz,Doron J Aframian,Yaron Haviv. Various topical drug combination assessed using a neurosensory stent for chronic intraoral neuropathic pain: a pilot study. Journal of Oral & Facial Pain and Headache. 2024. 38(3);38-45.

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