|
 |
 |
|
|
|
| OROFACIAL PAIN CLASSIFICATION |
The most logical way to classify the pain is in function of the its precedence, that is to say, in relation to the primary source of the pain. They are considered that three pain types exist:
The SOMATIC Pain it is that that originates in the somatic structures of the organism. The somatic structures include all the structures that compose the body (soma), except the neurological structures. The SOMATIC Pain is due to the noxious stimulation of the nociceptors of the somatic structures as consequence of a physical alteration or chemistry of the tissular structures . These nociceptives inputs are received and transmitted by normal components of the sensitive nervous system. The somatic structures are divided in two types: superficial and deep. The superficial somatic structures are the skin and mucogingival tissues. The deep somatic structures constitute the rest of the corporal tissues and they are divided in: musculoesqueletical and visceral. The NEUROPATHIC Pain it is the associated with lesions of afferent nervous structures to inervate a certain area that doesn't present abnormalities in their tissues components. Therefore, NEUROPATHIC pain is caused by the alteration of the sensitive inervation of the affected area, without tissular lesion exists. The Non SOMATIC non NEUROPATHIC Pain doesn't take place neither for nociceptive stimulation for tissular lesion of a tissue (as the somatic pain), neither for alteration of the sensitive inervation (as the neuropathic pain). They are clinical entities that usually associate to the presence of important psychic factors, although antecedents of somatic or neuropathic pain can exist. For the orofacial pain classification is also used based on two axes. The Axis I represents the painful alterations that have a physical base. The Axis II represent the painful alterations that don't have a physical base. The SOMATIC Pain and the NEUROPATHIC Pain they belong to the Axis I and the non SOMATIC non NEUROPATHIC Pain to the Axis II. It is necessary to understand that any clinical square of the Axis I will be influenced by the presence of factors of the Axis II. For a correct diagnosis and a good treatment plan the presence and the influence of each Axis must evaluate. In certain clinical squares of orofacial pain, especially of chronic type, to try alone the factors of the Axis I won't solve the patient's problem completely. |
| SOMATIC PAIN
|
NEUROPATHIC PAIN
|
NON SOMATIC NON NEUROPATHIC PAIN
|
|
|||||||