RESUMO
OBJECTIVE: To compare the effect of photobiomodulation (PBM) and transcutaneous electrical nerve stimulation (TENS) in the treatment of burning mouth. MATERIALS AND METHODS: Randomized clinical trial of 25 patients with burning mouth treated by TENS (n=12) and PBM (n=13). The patients were treated weekly for 8 weeks. Two-factor ANOVA was used to determine whether the two interventions promoted significant differences in symptoms (measured with a visual analogue scale), unstimulated salivary flow, xerostomia, and dysgeusia between T0 (baseline), T1 (after the 4th treatment session), T2 (after the 8th treatment session), and T3 (30 days after the end of treatment). RESULTS: Intragroup comparison of VAS scores for pain showed a significant difference between T0xT1, T0xT2, and T0xT3 in the TENS group and between T0xT2 and T0xT3 in the PBM group (pË0.001). Intergroup comparison of VAS scores for pain between T2xT3 showed a better response to PBM than to TENS (p=0.003). Patients of the TENS group showed an increase in salivary flow between T1 and T2 (p=0.052). There were no expressive variations in xerostomia or dysgeusia in the two groups analyzed. CONCLUSION: TENS and PBM were effective in reducing the symptoms of burning mouth during and after treatment. The PBM group showed a better response during follow-up. TRIAL REGISTRATION: This clinical trial was registered at http://clinicaltrials.gov (Number: NCT05816200). CLINICAL RELEVANCE: TENS was found to be a safe and effective therapy for burning mouth. Trial registration number (TRN) and date of registration: This clinical trial was registered at http://clinicaltrials.gov (Number: NCT05816200; date: May 08, 2023).
RESUMO
O surto de um novo coronavírus SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2), foi identificado em Wuhan, na China no final de 2019. O SARS-CoV-2, se propaga através de gotículas respiratórias de uma pessoa infectada e causa uma doença respiratória denominada Covid-19 (Coronavirus Disease, 2019). Seu comportamento clínico é variável e manifesta-se com sintomas leves ou moderado, podendo desenvolver uma infecção respiratória grave. A cavidade oral foi identificada como uma das portas de entrada para o SARS-CoV-2, e seu possível papel como agravante na infectividade e progressão da infecção viral têm sido controversos. Foi realizado um estudo de coorte retrospectivo com dados obtidos de 274 prontuários de pacientes com COVID-19. Foi coletado dados na admissão do paciente, com sete e quatorze dias para analisar a ocorrência de alterações bucais e relacioná-las com a severidade da infecção. Foram encontrados 154 pacientes com alteração bucal e 120 sem alteração. Dos 154 pacientes que apresentaram alteração bucal na admissão, 39 obtiveram remissão em 7 dias, 54 pacientes obtiveram remissão em 14 dias e 61 mantiveram alteração bucal até o fim do estudo. Dos 120 pacientes que não apresentavam alteração bucal na admissão, apenas 2 desenvolveram alteração bucal em 7 dias e estes foram a óbito. A alteração bucal mais frequente foi a úlcera nos três tempos de coleta ( T0: 43,8%, T1: 33,6% e T2: 21,2%). As análises dos exames complementares alteradas mais prevalentes entre os pacientes foram as hemácias, plaquetas, leucócitos, tempo de sangramento, TGP, TGO, albumina, creatinina, PCR, ureia, d-dímero e razão leucócito-linfócito. Não foram observados fatores preditores para o desenvolvimento de alterações bucais em pacientes com COVID 19. As alterações em mucosa oral foram observadas na maioria dos pacientes com COVID-19 analisados nessa pesquisa. Não foi observada associação entre as comorbidades e a presença de lesões orais nos pacientes avaliados. Os fatores de prognósticos foram avaliados pela análise multivariada de Cox que determinou que não fazer uso de medicação para o aparelho digestivo e metabolismo (HR: 2,18; IC95%: 1,13-4,22) e não apresentar hipertensão arterial sistêmica (HR: 1,78; IC95%: 1,13- 2,79) são fatores prognósticos para remissão de alteração bucal em pacientes com COVID-19 (AU).
An outbreak of a new SARS-CoV-2 coronavirus (Severe acute respiratory syndrome coronavirus 2) was identified in Wuhan, China in late 2019. SARS-CoV-2, spreads through respiratory droplets from an infected person and causes a respiratory disease called Covid-19 (Coronavirus Disease, 2019). Its clinical behavior is variable and manifests with mild or moderate symptoms, and may develop a severe respiratory infection. The oral cavity has been identified as one of the gateways for SARS-CoV-2, and its possible role as an aggravating factor in the infectivity and progression of viral infection has been controversial. A retrospective cohort study was carried out with data obtained from 274 medical records of patients with COVID-19. Data was collected on the admission of the patient, with seven and fourteen days to analyze the occurrence of oral changes and relate them to the severity of the infection. A total of 154 patients with oral alterations and 120 without alterations were found. Of the 154 patients who presented oral changes on admission, 39 achieved remission within 7 days, 54 patients achieved remission within 14 days, and 61 maintained oral changes until the end of the study. Of the 120 patients who did not present oral changes on admission, only 2 developed oral changes within 7 days and these died. The most frequent oral alteration was an ulcer in the three collection times (T0: 43.8%, T1: 33.6% and T2: 21.2%). The most prevalent abnormal exam analyses among patients were red blood cells, platelets, leukocytes, bleeding time, TGP, TGO, albumin, creatinine, CRP, urea, d-dimer, and leukocyte-lymphocyte ratio. No predictors were observed for the development of oral alterations in patients with COVID 19. Alterations in the oral mucosa were observed in most patients with COVID-19 analysed in this study. There was no association between comorbidities and the presence of oral lesions in the patients evaluated. Prognostic factors were evaluated by Cox's multivariate analysis, which determined that they did not use medication for the digestive system and for metabolism (HR: 2.18; 95%CI: 1.13- 4.22) and did not have systemic arterial hypertension (HR: 1.78; 95%CI: 1.13-2.79), these are prognostic factors for remission of oral changes in patients with COVID-19 (AU).
