PO-90 | CAPSULASE® (PEA (palmitoylethanolamide), PHYTOSOME (quercetin from Sophora japonica L. 40% soy lecithin, microcrystalline cellulose, aerosil), CASPEROME (Boswellia serrata R., gum resin 40%, soy lecithin, microcrystalline cellulose, aerosil), bromelain 2

Ennio Pucci,¹ Ludovica Pucci,² Alberto Vercesio³ | ¹Department of Nervous System and Behavioral Sciences, University of Pavia; ²Nutritional biologist, Master in Nutritional and Clinical Dietetics, University of Pavia, Italy; ³Scientific Advisor

Background: Craniofacial pain is mediated for a large part of the territory by the trigeminocervical complex. The nasal and oral mucosa, the tongue and the teeth are structures that can be the cause of facial pain, as can dental treatments (such as avulsions) that lead to the establishment of so-called “atypical” facial pain conditions. The IHS classification establishes the diagnostic criteria in chapter 13 dedicated to Cranial neuralgia and facial pain of central origin.

Methods: We report the case of a 67-year-old female patient with orofacial pain and right hemifacial edema following avulsion of the upper right premolar arch due to the presence of a granuloma associated with the placement of synthetic bovine bone in the right maxillary area for maxillary sinus elevation. The patient was treated with antibiotic therapy for 7 days starting from the day before the surgery and therapy with Capsulase 1+1 cp/day was introduced to contain the edema and orofacial pain with neuralgic notes at the level of the I and II branch of the right trigeminal nerve. The patient filled out a diary on clinical evolution and especially pain monitoring using the VAS (Visual Analogue Scale). Data on efficacy and tolerability were also collected.

Results: The patient reported a reduction in edema after 7 days with elimination of the same after 14 days of administration of Capsulase 1+1 cp/day. The intensity of pain in the first 14 days was significantly reduced (VAS: 9 at T0; VAS: 2 at T1 – 14 days). The patient continued therapy with Capsulase 1+1 cp/day for another 45 days until the orofacial pain resolved. On the 14th day the stitches were removed (4) without worsening of the clinical picture.

Conclusion: As can be seen from the description of the case report, Capsulase can be used in the treatment of orofacial pain, especially in the presence of edema and therefore in all post-traumatic inflammatory circumstances, even in the medium-long term due to its efficacy and tolerability. The possibility of associating Capsulase with antiepileptic drug therapy, which is used in the treatment of typical and atypical neuralgia needs to be tested in future research.