RESUMO
Emerging evidence has revealed a cross-talk in the etiopathogenesis of burning mouth syndrome (BMS) related to peripheral nerve fibers (NF) and neuropeptides secreted by mast cells. Here, we investigated the S-100+ density and PGP 9.5+ integrity of peripheral NF and the tryptase+ mast cell density in the oral mucosa of BMS patients and healthy individuals. A total of 23 oral mucosa specimens (12 BMS and 11 controls) were evaluated. The clinical diagnosis of BMS was based on a careful examination, excluding other local and systemic causes. Samples were taken from an incisional biopsy of the tongue mucosa of individuals with symptomatic BMS, while the margins of the non-neoplastic tongue biopsy served as controls of healthy individuals. Immunohistochemistry was performed to determine the density/mm2 of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells. Similar densities of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells were found in cases of BMS, with a median value of 3.70, 0.70, and 29.24/mm2, respectively, and in the control group, with a median value of 2.60, 0.80, and 26.01/mm2, respectively (p > 0.05). Moreover, the relationship between S100+ and PGP 9.5+ peripheral NF was the same in both groups (p = 0.70). This study demonstrated that there were no alterations in the density and integrity of peripheral NF in the tongue of symptomatic BMS patients. However, the sensitization of peripheral NF in this disease may not depend on mast cell density.
Assuntos
Síndrome da Ardência Bucal , Mastócitos , Humanos , Mastócitos/patologia , Síndrome da Ardência Bucal/diagnóstico , Síndrome da Ardência Bucal/etiologia , Síndrome da Ardência Bucal/patologia , Triptases , Língua , Nervos Periféricos/patologiaRESUMO
Abstract The present study was carried out to evaluate the effect of Melatonin and Placebo in the patient with the Burning mouth (BMs). This double-blind, placebo-controlled randomized clinical trial study was carried out on 30 patients who were suffering from BMS. During this period patients were divided into 2 study and control groups. The study group used four 3 mg Melatonin daily and the control group received a placebo. Then the severity of the burning sensation was measured by the physician Sleep quality was measured using the VAS scale using the Petersburg questionnaire. Data in the application Enter SPSS 20 and then using T test or equivalent Nonparametric was analyzed, mean sleep score and mean severity of oral irritation before and after treatment in two the group was evaluated using T-test Independent. Level significance was considered 0.05. The results of the present study show that the use of melatonin and a placebo in patients with BMS reduces sensation and improves their sleep quality, although it may not reduce it completely. In this study severity of burning was 4.93±2.56 after treatment in the study group and 6.93±2.12 in the control group, which was statistically significant (P =0.036). No significant difference was observed between the two groups in the sleep quality score (P-value = 0.43). Using Melatonin can be a reliable way to treat pain for which there is no standard treatment to date. Although evidence suggests an association between sleep disorders and BMS, melatonin was not superior to a placebo in reducing BMS-induced burning in the present study. Identification of stressors and the ways to struggle with them, further studies with larger samples and higher oral doses, extended follow-up periods and control of psychological factors, and measurement of body mass index that may affect pharmacokinetics are recommended.
Assuntos
Humanos , Masculino , Feminino , Pacientes/classificação , Síndrome da Ardência Bucal/patologia , Método Duplo-Cego , Ensaio Clínico Controlado Aleatório , Melatonina/efeitos adversos , Placebos/efeitos adversos , Inquéritos e Questionários/classificaçãoRESUMO
The purpose of this study is to apply a machine learning approach to predict whether patients with burning mouth syndrome (BMS) respond to the initial approach and clonazepam therapy based on clinical data. Among the patients with the primary type of BMS who visited the clinic from 2006 to 2015, those treated with the initial approach of detailed explanation regarding home care instruction and use of oral topical lubricants, or who were prescribed clonazepam for a minimum of 1 month were included in this study. The clinical data and treatment outcomes were collected from medical records. Extreme Gradient-Boosted Decision Trees was used for machine learning algorithms to construct prediction models. Accuracy of the prediction models was evaluated and feature importance calculated. The accuracy of the prediction models for the initial approach and clonazepam therapy was 67.6% and 67.4%, respectively. Aggravating factors and psychological distress were important features in the prediction model for the initial approach, and intensity of symptoms before administration was the important feature in the prediction model for clonazepam therapy. In conclusion, the analysis of treatment outcomes in patients with BMS using a machine learning approach showed meaningful results of clinical applicability.
Assuntos
Síndrome da Ardência Bucal/terapia , Clonazepam/uso terapêutico , Aprendizado de Máquina , Prognóstico , Síndrome da Ardência Bucal/diagnóstico , Síndrome da Ardência Bucal/patologia , Clonazepam/efeitos adversos , Feminino , Humanos , Lubrificantes/efeitos adversos , Lubrificantes/uso terapêutico , Masculino , Pessoa de Meia-Idade , Mucosite/tratamento farmacológico , Mucosite/patologia , Resultado do TratamentoRESUMO
Taste and smell are considered to be functions that contribute to the maintenance of good nutritional status. The present study evaluates taste and smell function in patients with burning mouth syndrome (BMS) versus a control group. A cross-sectional study was made of 36 consecutive patients with BMS and 56 healthy patients. Smell was assessed using the Sniffin' Sticks test, while taste was evaluated with Taste Strips. Oral quality of life was assessed with the Oral Health Impact Profile-14 (OHIP-14), and the severity of dry mouth with the Thompson Xerostomia Inventory. The patients with BMS had a mean age of 60.4 0 ± 10.5 years, while the controls had a mean age of 61.3 ± 19 years. No significant differences in smell were recorded between the two groups. In contrast, significant differences in taste function were observed between the patients with BMS and the controls. In the patients with BMS, 44.4% suffered taste alterations compared with the 3.4% healthy controls. Further studies in such patients are needed to allow improved management of the chemosensory problems, mouth dryness, and oral health-related quality of life in BMS.
Assuntos
Síndrome da Ardência Bucal/patologia , Paladar/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distúrbios do PaladarRESUMO
BACKGROUND: The purpose of this study was to evaluate alterations in gray matter volume (GMV) and cerebral blood flow (CBF) using structural MRI and arterial spin labeling (ASL) perfusion MRI, respectively, in burning mouth syndrome (BMS) patients METHODS: We prospectively enrolled 12 patients with BMS and 14 healthy controls. Volumetric T1-weighted magnetization-prepared rapid gradient-echo imaging and pseudo-continuous ASL were performed to obtain GMV and CBF, respectively. We analyzed differences in the GMV and CBF between the two groups, and their correlations with clinical parameters. RESULTS: The GMV was smaller in the left thalamus and left middle temporal gyrus in the BMS group when compared to controls. Regional CBF in the BMS group was significantly decreased in the left middle temporal gyrus, left insula, right middle temporal gyrus, and right insula compared with controls. In BMS patients, there was a significant correlation between GMV and pain severity in the left middle temporal gyrus. CONCLUSION: The reduced GMV seen in the thalami of BMS patients is consistent with the pattern observed in those with chronic pain disease, which implies that the pathogenesis of BMS may be associated with atrophy of the brain structures associated with thalamocortical processing. In addition, changes in CBF in the insula and middle temporal gyrus were also observed.
Assuntos
Encéfalo/patologia , Síndrome da Ardência Bucal/patologia , Circulação Cerebrovascular , Substância Cinzenta/patologia , Encéfalo/diagnóstico por imagem , Estudos de Casos e Controles , Substância Cinzenta/diagnóstico por imagem , Humanos , Imageamento por Ressonância MagnéticaRESUMO
Burning mouth syndrome (BMS) is a complex condition that affects the oral cavity, and data regarding effective treatment are limited. The purpose of this study was to explore the demographic and clinical information along with treatment outcomes for patients with BMS treated in a large referral center. Clinical records of the Oral Medicine Clinic at the University of Florida College of Dentistry were retrospectively searched for patients diagnosed between 2009 and 2014. Clinical data and treatment effectiveness were recorded. The records of 64 patients were included in this study. Women represented the majority of patients (81.2%), and the average age of all patients was 65 years. The most common systemic diseases were hypertension (59.4%), psycho-logical disorders (51.6%), and gastroesophageal reflux disease (50.0%). The majority of patients were taking 5 or more medications (70.3%). Treatment frequency and efficacy were as follows: a-lipoic acid, 47.5% frequency (57 prescribed treatments of 120 total treatments) and lasting improvement reported with 45.6% of prescribed treatments; clonazepam, 17.5% frequency (21/120) and improvement reported with 33.0% of prescribed treatments; oral disintegrating clonazepam, 15.8% frequency (19/120) and improvement reported with 52.6% of prescribed treatments; and topical vitamin E, 5.0% frequency (6/120) and improvement reported with 33.0% of prescribed treatments. Chi-square analysis indicated that a significantly better response to treatment was reported by women (P = 0.010) and patients who reported involvement limited to the tongue rather than multifocal oral involvement (P = 0.040); however, the significant relationships did not persist when the variables were evaluated together using logistic regression analysis. No other clinical or demographic features showed significant differences in response to treatment. Although treatment effectiveness in this study was variable and limited for some regimens due to infrequent usage, many of the patients reported alleviation of symptoms.
Assuntos
Síndrome da Ardência Bucal/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Síndrome da Ardência Bucal/diagnóstico , Síndrome da Ardência Bucal/tratamento farmacológico , Síndrome da Ardência Bucal/etiologia , Clonazepam/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ácido Tióctico/uso terapêutico , Resultado do Tratamento , Vitamina E/uso terapêuticoRESUMO
OBJECTIVES: In the burning mouth syndrome (BMS), patients experience a burning sensation in the oral cavity with no associated injury or clinical manifestation. The etiology of this condition is still poorly understood, and therefore, treatment is challenging. The aim of this study is to perform a systematic review of treatment possibilities described in the literature for BMS. MATERIALS AND METHODS: PubMed, Embase, and SciELO databases were searched for randomized clinical trials published between 1996 and 2016. RESULTS: Following application of inclusion and exclusion criteria, 29 papers were analyzed and divided into five subcategories according to the type of treatment described: antidepressants, alpha-lipoic acid, phytotherapeutic agents, analgesic and anti-inflammatory agents, and non-pharmacological therapies. In each category, the results found were compared with regard to the methodology employed, sample size, assessment method, presence or absence of adverse effects, and treatment outcomes. CONCLUSIONS: The analysis revealed that the use of antidepressants and alpha-lipoic acid has been showing promising results; however, more studies are necessary before we can have a first-line treatment strategy for patients with BMS. CLINICAL RELEVANCE: To review systematically the literature about Burning Mouth Syndrome treatment may aid the clinicians to choose the treatment modality to improve patients symptoms based on the best evidence.
Assuntos
Síndrome da Ardência Bucal/terapia , Analgésicos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Antidepressivos/uso terapêutico , Antioxidantes/uso terapêutico , Síndrome da Ardência Bucal/patologia , Síndrome da Ardência Bucal/psicologia , Humanos , Fitoterapia/métodos , Ácido Tióctico/uso terapêuticoRESUMO
OBJECTIVES: We sought to determine the efficacy of psychotropic drug in the management of BMS-like oral symptoms in patients with reticular oral lichen planus (R-OLP) refractory to conventional therapies, and its impact on anxious and depressive symptoms. MATERIALS AND METHODS: We enrolled 28 cases of symptomatic R-OLP. The Numeric Rating Scale (NRS), the Total Pain Rating Index (T-PRI), the Hamilton rating scales for Depression (HAM-D) and Anxiety (HAM-A) were performed at baseline (time 0), after 2 months of topical clonazepam (time 1) and after 6 months of benzodiazepine and antidepressant drugs (time 2). RESULTS: R-OLP patients showed a statistically significant improvement in the NRS and T-PRI scores from time 0 [median: 9.0 (IQR: 7.2-10.0) and 10.5 (IQR: 7.0-13.0), respectively] to time 2 [(median: 2.0 (IQR: 2.0-3.0) (p < .001) and 3.0 (IQR: 2.0-4.7) (p < .001), respectively]. Similarly, the HAM-A and HAM-D scores showed an improvement from time 0 [(median: 15.0 (IQR: 10.2-17.8) and 13.0 (IQR: 12.0-15.0), respectively] to time 2 [median: 6.0 (IQR: 4.0-7.0) (p < .001) and 5.5 (IQR: 4.25-6.0) (p < .001), respectively]. CONCLUSIONS: Psychotropic drugs turned out to be effective in the management of BMS-like oral symptoms in R-OLP patients refractory to conventional immunosuppressive therapy, although in a long-term period.
Assuntos
Benzodiazepinas/uso terapêutico , Síndrome da Ardência Bucal/tratamento farmacológico , Clonazepam/uso terapêutico , Líquen Plano Bucal/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Antidepressivos/efeitos adversos , Antidepressivos/uso terapêutico , Ansiedade/patologia , Ansiedade/prevenção & controle , Benzodiazepinas/efeitos adversos , Síndrome da Ardência Bucal/complicações , Síndrome da Ardência Bucal/patologia , Clonazepam/efeitos adversos , Constipação Intestinal/etiologia , Depressão/patologia , Depressão/prevenção & controle , Feminino , Humanos , Líquen Plano Bucal/complicações , Líquen Plano Bucal/patologia , Masculino , Pessoa de Meia-Idade , Dor/patologia , Dor/prevenção & controle , Projetos PilotoRESUMO
BACKGROUND: Burning mouth syndrome (BMS) is a neuropathic orofacial pain condition of unknown aetiology that encompasses intra-oral burning pain without abnormal clinical findings. Psychological, neural and inflammatory processes are associated with BMS pathogenesis. Currently, studies characterising plasma cytokine/chemokine profiles with pain and depression in patients with BMS are lacking. Considering that inflammation is associated with the pathophysiology of BMS, and that inflammation is closely associated with pain and depression, we aimed to correlate depressive symptomatology and oral cavity pain with plasma cytokine/chemokine signatures in a cohort of patients with BMS. METHODS: In this study, plasma protein levels of Th1 cytokines (IFN-γ, IL-2, IL-12p70, TNF-α), Th2 cytokines (IL-4, IL-10, IL-6, IL-13) and the chemokine IL-8 were assessed in patients with BMS (n = 10) and healthy volunteers (n = 10), using pro-inflammatory-10-plex assays. Clinical histories, alongside self-rated oral cavity pain intensities and depressive symptomatology were assessed using a visual analogue scale and the 16-item Quick Inventory of Depressive Symptomatology questionnaires, respectively. RESULTS: We present evidence that BMS is associated with increased depressive symptomatology and enhanced oral cavity pain. Plasma isolated from BMS patients display enhanced expression of the pro-inflammatory chemokine IL-8, when compared to plasma from healthy individuals. Plasma IL-8 signature correlates with pain and depressive symptomatology in the study cohort. CONCLUSIONS: Overall, these findings indicate that plasma IL-8 profiles are dysregulated in BMS and that modulation of IL-8 production in the disorder may be a tool in the management of BMS symptomatology.
Assuntos
Síndrome da Ardência Bucal/fisiopatologia , Depressão/induzido quimicamente , Depressão/psicologia , Interleucina-8/sangue , Dor/induzido quimicamente , Dor/psicologia , Adulto , Idoso , Síndrome da Ardência Bucal/patologia , Quimiocinas/sangue , Estudos de Coortes , Citocinas/sangue , Feminino , Humanos , Inflamação , Masculino , Pessoa de Meia-Idade , Boca/fisiopatologia , Medição da Dor , Projetos Piloto , Inquéritos e Questionários , Células Th1 , Células Th2RESUMO
Sjögren's syndrome (SS) and burning mouth syndrome (BMS) typically occur in postmenopausal women. Although these conditions have significantly different etiopathogeneses, patients with SS or BMS often present with analogous oral complaints. The similarities between the two conditions have led to considerable confusion on the part of medical and dental practitioners, and those with BMS or SS often wait years to receive a diagnosis. Therefore, it is imperative for clinicians to understand the characteristic subjective and objective features of each disease and how these can be used to distinguish them. This review will discuss the proposed etiology, clinical manifestations, histopathology, diagnostic criteria, and patient management of SS and BMS. We also identify key differences between the two pathoses that aid in establishing the correct diagnosis. Recognition of the defining features of each condition will lead to reduced time to diagnosis and improved patient management for these poorly understood conditions.
Assuntos
Síndrome da Ardência Bucal/diagnóstico , Síndrome da Ardência Bucal/etiologia , Síndrome de Sjogren/diagnóstico , Síndrome de Sjogren/etiologia , Síndrome da Ardência Bucal/patologia , Síndrome da Ardência Bucal/terapia , Diagnóstico Diferencial , Humanos , Síndrome de Sjogren/patologia , Síndrome de Sjogren/terapiaRESUMO
In this descriptive study, we investigated the relationship between the clinical characteristics of idiopathic burning mouth syndrome (iBMS) and the quality of life. Eighteen iBMS patients were interviewed about their experience with pain, oral-associated complaints, cognitive status, and self-perceived quality of life using the French versions of the Hospital Anxiety and Depression Scale (HADS) and the Global Oral Health Assessment Index (GOHAI). The Spearman coefficient was used to analyze correlations. The level of significance was fixed at P < 0.05. The majority of patients described the association of oral burning sensations with other oral complaints, including dry mouth (77.8%), tactile abnormalities (66.7%), thermal abnormalities (44.5%), and taste disturbances (38.9%). HAD-anxiety scores were higher than 10 in 38.8% of iBMS patients and HAD-depression scores were higher than 10 in 33.3% of patients. A significant correlation was found between the number of associated complaints and HAD-depression scores. The mean GOHAI-add score was 37.9 ± 9.6 (mean ± SD), and 94.5% of iBMS patients had a score lower than 50. GOHAI-add scores strongly correlated with pain intensity, which was calculated using a visual analog scale and duration of pain. Our findings indicate a strong correlation between iBMS-related pain and self-perceived oral health-related quality of life. In addition, a correlation was observed between iBMS-associated oral complaints and cognitive status.(J Oral Sci 58, 475-481, 2016).
Assuntos
Síndrome da Ardência Bucal/patologia , Síndrome da Ardência Bucal/fisiopatologia , Qualidade de Vida , Adulto , Idoso , Síndrome da Ardência Bucal/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The aim of this study was to assess the serum zinc levels in patients with common oral mucosal diseases by comparing these to healthy controls. MATERIAL AND METHODS: A total of 368 patients, which consisted of 156 recurrent aphthous stomatitis (RAS) patients, 57 oral lichen planus (OLP) patients, 55 burning mouth syndrome (BMS) patients, 54 atrophic glossitis (AG) patients, 46 xerostomia patients, and 115 sex-and age-matched healthy control subjects were enrolled in this study. Serum zinc levels were measured in all participants. Statistical analysis was performed using a one-way ANOVA, t-test, and Chi-square test. RESULTS: The mean serum zinc level in the healthy control group was significantly higher than the levels of all other groups (p < 0.001). No individual in the healthy control group had a serum zinc level less than the minimum normal value. However, up to 24.7% (13/54) of patients with AG presented with zinc deficiency, while 21.2% (33/156) of patients with RAS, 16.4% (9/55) of patients with BMS, 15.2% (7/46) of patients with xerostomia, and 14.0% (8/57) of patients with OLP were zinc deficient. Altogether, the zinc deficiency rate was 19.02% (70/368) in the oral mucosal diseases (OMD) group (all patients with OMD). The difference between the OMD and healthy control group was significant (p <0.001). Gender differences in serum zinc levels were also present, although not statistically significant. CONCLUSIONS: Zinc deficiency may be involved in the pathogenesis of common oral mucosal diseases. Zinc supplementation may be a useful treatment for oral mucosal diseases, but this requires further investigation; the optimal serum level of zinc, for the prevention and treatment of oral mucosal diseases, remains to be determined.
Assuntos
Doenças da Boca/patologia , Zinco/sangue , Síndrome da Ardência Bucal/patologia , Estudos de Casos e Controles , Humanos , Líquen Plano Bucal/patologia , Estomatite Aftosa/patologiaRESUMO
BACKGROUND: The aim of this paper was to evaluate the efficacy and safety of topical cyclosporine applied as mouthwash in the treatment of burning mouth syndrome (BMS). METHODS: This was a prospective and pilot study conducted by the Department of Dermatology of the University of Rome Tor Vergata. Patients were treated with cyclosporine topically applied as mouthwash for 4 weeks. Clinical improvement was assessed using a 5 grade clinical evaluation scale and a visual analogue scale from 0 to 10 was also used to evaluate the burning symptoms. RESULTS: Fifteen patients between 22-85 years (61.1±19.3), 11 female and 4 male, with a mean duration of BMS of 12.5 months, completed the study. Five out of 15 patients presented a marked improvement, 6 patients showed a moderate response, 3 patients had a slight improvement and 1 patient did not show any change. The VAS showed a reduction from 8.7 to 3.5. Adverse events were not reported. CONCLUSIONS: Cyclosporine mouthwash appeared to be safe and beneficial for reducing the burning sensation in patients with BMS representing an alternative therapy in this condition.
Assuntos
Síndrome da Ardência Bucal/tratamento farmacológico , Ciclosporina/administração & dosagem , Imunossupressores/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Síndrome da Ardência Bucal/patologia , Ciclosporina/efeitos adversos , Feminino , Humanos , Imunossupressores/efeitos adversos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Projetos Piloto , Estudos Prospectivos , Resultado do Tratamento , Adulto JovemRESUMO
As defined by WHO experts, disease involves a change of the physical, mental and social welfare, generating chronic stress condition if unresolved. One of the symptoms almost constantly found in any condition is pain. This feeling manifests differently depending on the subjective perception. The burning mouth syndrome (BMS) is included in such a framework. The BMS is considered as one of the characteristic states of chronic stress syndromes associated with nonspecific clinical manifestations and requires special medical attention in terms of assessing and treating the condition. However, the insufficient knowledge of its etiopathogenic mechanisms requires comprehensive research undertaken on such a subject.
Assuntos
Síndrome da Ardência Bucal/patologia , Dente/patologia , Síndrome da Ardência Bucal/etiologia , Humanos , Dor/patologiaRESUMO
A síndrome da ardência bucal (SAB) é uma condição clínica pouco esclarecida caracterizada por sensação espontânea de ardência, dor ou prurido na mucosa oral, sem alterações locais ou sistêmicas identificáveis. Sua etiopatogenia é incerta, não havendo até o momento uma padronização dos critérios utilizados para o seu diagnóstico. O presente estudo objetivou verificar a associação de fatores psicológicos, hormonais e genéticos com a SAB no sentido de propor uma melhor caracterização de sua natureza. Além de uma análise descritiva da amostra estudada, os aspectos analisados foram especificamente os níveis de estresse e sua fase, depressão, e ansiedade, compondo os fatores psicológicos; mensuração dos níveis séricos de cortisol e desidroepiandrosterona (DHEA); bem como a verificação sobre a ocorrência de polimorfismos no gene da Interleucina-6 (IL6). Foram realizadas análises comparativas entre um grupo de pacientes com SAB e um grupo composto por indivíduos com ardor bucal secundário (AB). Os resultados revelaram diferenças estatisticamente significativas entre os dois grupos com relação aos seguintes aspectos: xerostomia (p=0,01) e hipossalivação em repouso (p<0,001), que foram mais prevalentes no grupo SAB; sintomas de depressão (p=0,033), também mais presentes no grupo SAB; e dosagem de DHEA, que apresentou níveis mais reduzidos no grupo SAB (p=0,003). A dosagem desse hormônio mostrou-se amplamente sensível e específica para o diagnóstico da síndrome em estudo, sendo verificado que níveis séricos de DHEA abaixo de 0,37µg/mL para mulheres, utilizando-se os procedimentos propostos na pesquisa, possuem um Odds Ratio de 4,0 95 por cento IC (0,37 a 2,71)]. Foi verificado ainda que o alelo C do polimorfismo rs2069849 da IL-6 pode representar um alelo de risco para a ocorrência de ardor bucal em ambos os grupos, no entanto, não se pode garantir sua real implicação nos processos inflamatórios da SAB
Os presentes resultados sugerem uma provável influência da depressão, bem como de níveis diminuídos do hormônio DHEA na SAB. (AU)
The burning mouth syndrome (BMS) is a clinical condition characterized by spontaneous burning sensation, pain or itching in the oral mucosa without identifiable local or systemic changes. Its pathogenesis is uncertain, with no observable standardization in previous literature of the criteria used for its diagnosis. The present study aimed to determine demographic, psychological, hormonal and genetic factors in patients with BMS and secondary burning mouth to propose a better characterization of the nature and classification of this condition. Besides a descriptive analysis of the sample of 163 individuals, were analyzed the levels of stress and its phase, depression and anxiety; measurement of serum levels of cortisol and dehydroepiandrosterone (DHEA), as well as checking on the occurrence of polymorphisms in the gene of interleukin-6 (IL6). Comparative analysis between a group of patients with BMS and a group of individuals with secondary burning mouth (BM) were performed. The results revealed statistically significant differences between the two groups with respect to the following aspects: xerostomia (p=0.01) and hyposalivation at rest (p<0.001), which were more prevalent in the BMS group; symptoms of depression (p=0.033), more present in the BMS group, and dosage of DHEA, which showed lower levels in BMS patients (p=0.003). The dosage of this hormone was largely specific and sensitive for the diagnosis of the studied syndrome, and was verified that serum levels of DHEA below 0.37 pg/mL in women, using the procedures proposed in this research, have an Odds Ratio of 4.0 95 per cent Cl (0.37 to 2.71)]. These results suggest a possible influence of depression and decreased levels of the hormone DHEA in the pathogenesis of BMS. (AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Glossalgia/diagnóstico , Glossalgia/etiologia , Sialorreia/diagnóstico , Sialorreia/patologia , Síndrome da Ardência Bucal/etiologia , Síndrome da Ardência Bucal/patologia , Xerostomia/diagnóstico , Xerostomia/patologia , Ansiedade/psicologia , Análise de Variância , Distribuição de Qui-Quadrado , Estatísticas não Paramétricas , Estudos Transversais/métodos , Hidrocortisona/uso terapêutico , Transtornos de Adaptação/psicologiaRESUMO
Burning mouth syndrome (BMS) is defined as a chronic pain condition characterized by a burning sensation in clinically healthy oral mucosa. Incidence BMS diagnosed in the Department of Oral Medicine - Oral Pathology Dental Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy Bucharest is 16,23%. The etiology of BMS remains far less known. This article makes an overview of the latest theories about possible etiopathogenic factors involved in the occurrence of BMS.
Assuntos
Síndrome da Ardência Bucal/epidemiologia , Síndrome da Ardência Bucal/etiologia , Síndrome da Ardência Bucal/patologia , Infecções Bacterianas/complicações , Síndrome da Ardência Bucal/classificação , Causalidade , Humanos , Hipersensibilidade/complicações , Incidência , Transtornos Mentais/complicações , Vias Neurais/patologia , Prevalência , Romênia/epidemiologia , Saliva/químicaRESUMO
Burning mouth syndrome (BMS) is a debilitating, idiopathic chronic pain condition. For many BMS patients, burning oral pain begins in late morning and becomes more intense throughout the day, peaking by late afternoon or evening. We investigated brain gray matter volume (GMV) with voxel-based morphometry (VBM), white matter fractional anisotropy (FA) with diffusion tensor imaging (DTI), and functional connectivity in resting state functional MRI (rsfMRI) in a tightly screened, homogeneous sample of 9 female, postmenopausal/perimenopausal BMS patients and 9 matched healthy control subjects. Patients underwent 2 scanning sessions in the same day: in the morning, when ongoing pain/burning was low, and in the afternoon, when pain/burning was significantly higher. Patients had increased GMV and lower FA in the hippocampus (Hc), and decreased GMV in the medial prefrontal cortex (mPFC). rsfMRI revealed altered connectivity patterns in different states of pain/burning, with increased connectivity between mPFC (a node in the default mode network) and anterior cingulate cortex, occipital cortex, ventromedial PFC, and bilateral Hc/amygdala in the afternoon compared with the morning session. Furthermore, mPFC-Hc connectivity was higher in BMS patients than control subjects for the afternoon but not the morning session. mPFC-Hc connectivity was related to Beck depression inventory scores both between groups and between burning states within patients, suggesting that depression and anxiety partially explain pain-related brain dysfunction in BMS. Overall, we provide multiple lines of evidence supporting aberrant structure and function in the mPFC and Hc, and implicate a circuit involving the mPFC and Hc in regulating mood and depressive symptoms in BMS.
Assuntos
Síndrome da Ardência Bucal/patologia , Hipocampo/patologia , Córtex Pré-Frontal/patologia , Mapeamento Encefálico , Síndrome da Ardência Bucal/fisiopatologia , Imagem de Tensor de Difusão , Feminino , Hipocampo/fisiopatologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Córtex Pré-Frontal/fisiopatologiaRESUMO
BACKGROUND: Burning Mouth Syndrome (BMS) is a chronic disease characterized by absence of any lesions and burning of the oral mucosa associated to a sensation of dry mouth and/or taste alterations. The purpose of our study is to estimate signs and symptoms of Temporomandibular Disorders (TMD) in patients with BMS and to investigate for the existence of an association between BMS and TMD. MATERIALS AND METHODS: Forty-four BMS patients were enrolled; BMS subtype was established according to the classification of Lamey. After a gnathological evaluation, according to the protocol of the European Academy of Craniomandibular Disorders, patients were classified by RDC/TMD criteria. The data were compared and analyzed using a chi-square test to describe the existence of an association between BMS and TMD. RESULTS: 65.9% the BMS patients showed disorders classified as primary signs and symptoms of TMD according to RDC / TMD criteria, and 72.7% showed parafunctional habits. The chi-square test revealed a statistically significant association (p = 0.035) between BMS and TMD. CONCLUSION: The data suggest that there is a possible relationship not yet well understood between BMS and TMD, may be for neurophatic alterations assumed for BMS that could be also engaged in TMD pathogenesis.
Assuntos
Síndrome da Ardência Bucal , Mucosa Bucal/patologia , Transtornos da Articulação Temporomandibular , Idoso , Idoso de 80 Anos ou mais , Síndrome da Ardência Bucal/complicações , Síndrome da Ardência Bucal/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/patologiaRESUMO
The aim of the research was to detect the stomatologic, endocrine and psycho-neurologic status in patients with burning mouth syndrome, elaborate different diagnostic criteria and effective therapy for the patients with burning mouth syndrome. 92 patients with burning mouth syndrome were studied. Patients ranged in age from 28 to 72 years. The conducted studies gave the possibility to make conclusions, the most important of which are: burning mouth syndrome (BMS) is not only stomatologic problem; this psychosomatic syndrome belongs to gerontologic disease and tendency of its "rejuvenation" was revealed as well (in the current study --2 women (28 and 32 year old, and 38 year old man); degree of revelation of the symptoms of depression, anxiety, obsession and somatization is closely related with duration of the diseases. These symptoms are progressing together with aging and reach the peak at 60-70 years old. Individual scheme of therapy was developed on the background of clinico-paraclinical study.