Mirogabalin as a Therapeutic Option for Neuropathic Pain Emerging Post-Endodontic Treatment: An Observational Study

Introduction: We have recently reported the clinical efficacy of mirogabalin for occlusal pain due to post-traumatic trigeminal neuropathic pain (PTTN-occlusal pain) after endodontic treatment according to the International Classification of Orofacial Pain criteria. This study aimed to determine the mirogabalin administration period and timing of dose reduction and suspension for treating this condition based on managing a certain number of cases.

Methods: Patients diagnosed with PTTN-occlusal pain after or during endodontic treatment were included in the study. An endodontist retreated if necessary. Patients who initially experienced occlusal pain but gradually adapted to bite well without medication were classified into the provisional restoration group (PRG, n = 13). Patients who experienced severe pain during mastication and could not chew with a provisional restoration were classified into the mirogabalin medication group (MMG, n = 15). Mirogabalin (10 mg/ day) was prescribed once a day before bedtime. The patients receiving visual analog scale (VAS) were instructed to record daily changes in pain intensity in a VAS diary. The practitioners also recorded scores during consultations.

Results: In the PRG, VAS scores significantly decreased from week 6 and plateaued from week 11 (P < 0.05). This adaptation period was applied to reduction or discontinuation of mirogabalin treatment in the MMG. After initiating mirogabalin, VAS scores significantly decreased gradually from week 1 (P < 0.05). Although the dose was tapered around week 7 and discontinued by week 11, no recurrence of pain was observed following dose reduction or discontinuation.

Conclusions: Mirogabalin was effective in treating PTTN-occlusal pain.