747: Treatment Outcomes of Dental Procedure–Associated vs Spontaneous Onset Trigeminal Neuralgia

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Neuropathic pain , Pain in Special Populations , Treatment/management , Imaging (e.g. fMRI, PET, MRS)

Background and Aims: This study aimed to evaluate clinical characteristics, magnetic resonance imaging (MRI) findings, and treatment outcomes of patients presenting with trigeminal neuralgia (TN), with a focus on differences between dental procedure–associated and spontaneous onset cases, as well as the role of neurovascular compression (NVC).

Methods: A total of 27 patients diagnosed with TN and underwent MRI at Seoul National University Dental Hospital between January 2024 and January 2026 were included retrospectively. Patients were classified into a dental procedure–associated group (DP group) and a spontaneous onset group (SO group) based on the presence or absence of a preceding dental procedure. Demographic data, clinical features, and MRI findings—including trigeminal nerve pathway abnormalities, presence of NVC, and intracranial lesions—were collected. Pain intensity was assessed using the Numerical Rating Scale (NRS, 0–10).

Results: Among 27 patients (21 females, 6 males), 9 (33%) were classified as DP and 18 (67%) as SO. No significant differences were found between groups in age, sex distribution, pain duration, or treatment duration. Based on ICHD-3 criteria, 12 patients were classified as classical TN, 2 as secondary TN, and 13 as idiopathic TN. NVC was observed in 13 patients. NVC was identified in 5/9 (55.6%) patients in the DP group and 7/18 (38.9%) in the SO group. TN classification was not significantly associated with demographic variables.
Pain reduction was significantly greater in the SO group compared to the DP group. The mean NRS reduction was 2.3±1.8 (44.4%) in the DP group and 5.3±2.3 (67.5%) in the SO group (p<0.01). A ≥50% reduction in pain was observed in 55.6% of the DP group and 94.4% of the SO group (p=0.03).

Conclusions: Dental procedure–associated trigeminal neuralgia showed a poorer treatment response compared to spontaneous onset trigeminal neuralgia. These findings suggest that dental-triggered trigeminal neuralgia may represent a distinct clinical entity with different underlying mechanisms rather than classical trigeminal neuralgia. Accurate differentiation is essential for appropriate diagnosis and management.

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Presenting Author: Young Jun Kim
Submitting Author: JUNGHWAN JO

Senior Author: Jung Hwan Jo

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• Young Jun Kim: DDS - Seoul National University Dental Hospital
• Yuri Kim: DDS - Seoul National University Dental Hospital
• Jung Hwan Jo: DDS, PhD - Seoul National University, Seoul National University Dental Hospital