{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T05:48:08Z","timestamp":1793944088590,"version":"4.8.0"},"reference-count":125,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Public Dental Health Service, Uppsala, Sweden","award":["FTVLUL-984093 and FTVLUL-991859"],"award-info":[{"award-number":["FTVLUL-984093 and FTVLUL-991859"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background\/Aim<\/jats:title>\n                    <jats:p>Persistent idiopathic facial pain (PIFP) is a rare condition with a lifetime prevalence of approximately 0.03%. It is characterized by persistent daily facial pain without identifiable cause and presents diagnostic and therapeutic challenges due to unknown pathophysiology, symptom overlap with other painful disorders, and limited evidence-based treatments. The aim of this Delphi study was to establish international consensus-derived guidelines for the management of patients with PIFP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A three-round Delphi study was conducted with 16 international pain experts, each with \u226510 years of clinical experience in pain management and extensive peer-reviewed publications. The first round involved open-ended questions, and the qualitative data were analyzed using systematic text condensation, resulting in a quantitative questionnaire with 42 statements. Subsequent rounds employed Likert-scale responses to these statements. Consensus was defined as \u226580% agreement or disagreement. In addition, if 11\u201312 (68\u201375 percent) out of the 16 experts agreed or disagreed, consensus was not reached, but a majority was considered to have a particular opinion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Consensus was reached in 35 out of the 42 statements (83%), emphasizing multidisciplinary collaboration and avoidance of invasive procedures in the treatment of PIFP. In an additional three statements (7%) a majority of the experts agreed with each other. In four statements (10%), no consensus or majority was reached. Pharmacological treatments, including tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, and gabapentinoids, may be considered; however, opioids should generally be avoided in the treatment of PIFP. Patient education and behavioral therapies are important interventions, and the most important measure of therapeutic success is improved quality of life<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The present Delphi study has established internationally derived consensus guidelines and recommendations for the evaluation and comprehensive management of patients with PIFP. This is a first step in gathering knowledge for future evidence-based guidelines and more specific treatment recommendations. These international expert consensus guidelines recommend a multi- or interdisciplinary approach in managing PIFP, avoiding invasive interventions and prioritizing patient-centered outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03331024251399927","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T09:41:51Z","timestamp":1764668511000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Management of persistent idiopathic facial pain (PIFP) \u2013 An international Delphi study"],"prefix":"10.1177","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8546-653X","authenticated-orcid":false,"given":"Erik","family":"Lindfors","sequence":"first","affiliation":[{"name":"Uppsala University"},{"name":"Department of Orofacial Pain and Jaw Function, Public Dental Health Service, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Alstergren","sequence":"additional","affiliation":[{"name":"Malm\u00f6 University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Benoliel","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Rutgers State University of New Jersey, Newark, NJ, USA"},{"name":"Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo","family":"Conti","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of S\u00e3o Paulo, Bauru, Brazil"},{"name":"Bauru Orofacial Pain Group, University of S\u00e3o Paulo, Bauru, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Durham","sequence":"additional","affiliation":[{"name":"School of Dental Sciences, Newcastle University, Newcastle, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Paul","family":"Goulet","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, Laval University, Quebec City, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Komiyama","sequence":"additional","affiliation":[{"name":"Nihon University School of Dentistry at Matsudo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"List","sequence":"additional","affiliation":[{"name":"Malm\u00f6 University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3499-1506","authenticated-orcid":false,"given":"Arne","family":"May","sequence":"additional","affiliation":[{"name":"Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimos-Dimitrios","family":"Mitsikostas","sequence":"additional","affiliation":[{"name":"Aeginition Hospital, Medical School, National and Kapodistrian University of Athens"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald R.","family":"Nixdorf","sequence":"additional","affiliation":[{"name":"Division of TMD &amp; Orofacial Pain, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Pigg","sequence":"additional","affiliation":[{"name":"Malm\u00f6 University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara","family":"Renton","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, Oral &amp; Craniofacial Science, King's College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnar","family":"Skagerberg","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Pain Rehabilitation, Lund University Hospital, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9524-8089","authenticated-orcid":false,"given":"Peter","family":"Svensson","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf-Detlef","family":"Treede","sequence":"additional","affiliation":[{"name":"Heidelberg University"},{"name":"Heidelberg University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens Christoph","family":"T\u00fcrp","sequence":"additional","affiliation":[{"name":"Department of Oral Health &amp; 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