Efficacy of 660 nm Photobiomodulation in Burning Mouth Syndrome Management: A Single-Blind Quasi-Experimental Controlled Clinical Trial.

Background: Burning mouth syndrome (BMS) is characterized by a burning sensation of the oral mucosa without any evidence of clinical signs or underlining condition. Several treatment modalities have been utilized with various results and levels of evidence. Lately, photobiomodulation (PBM) has emerged as a noninvasive effective therapy due to its anti-inflammatory and biostimulatory effects, especially the low-power laser setting of red wavelength. Objective: This single-blind quasi-experimental controlled clinical trial aimed to evaluate the PBM effectiveness at a low level of red laser light in patients with BMS compared with sham control. Materials and methods: Thirty patients diagnosed with BMS were consecutively assigned to intervention (PBM therapy) and control (sham) groups. The protocol for PBM dosimetry was as follows: laser 660 nm; spot size: 0.04 cm2; power output: 100 mW; emission mode: continuous wave; power density: 6 J/cm2; irradiation time: 10 sec per point within 1 cm2 surface area of the symptomatic area. The treatment protocol was based on once a week for a total of 10 sessions. Results: Our results showed no statistically significant difference in reduction of pain intensity between the two groups at all the evaluated timepoints during the course of treatment. However, in both groups, we observed a statistically significant reduction of maximum pain intensity of 50% compared with patient-self reporting before the treatment. Conclusions: Further randomized clinical trials to validate our positive results with a large sample size with a long-term follow-up and understanding further the sham placebo effect are warranted.

Desquamative gingivitis treatment with topical tacrolimus applied to a custom tray: an open trial regarding its efficacy on patients' symptoms.

OBJECTIVE: To evaluate the efficacy of topical tacrolimus offered on a custom tray to treat desquamative gingivitis (DG). STUDY DESIGN: Eighteen patients with symptomatic DG related to oral lichen planus (OLP) or mucous membrane pemphigoid (MMP) were selected, of which 13 completed the study. Periodontal treatment was followed by the fabrication of a custom silicone tray to apply a tacrolimus gel formulation (0.1%). Clinical evaluation (complaint of pain and burning - visual analog scale from 0 to 10; and the presence of erythema, desquamation, vesicle/blister, erosion, ulcer, and bleeding) was performed by the same examiner on day 1, and every 15 days for 90 days. RESULTS: Total remission was found in 4 patients (30.76%). Partial remission was found in 69.24% of the patients, classified with an excellent (30.76%), good (30.76%), and regular (7.69%) recovery, respectively. There was a reduction of about 60% in pain and 65% in burning sensation complaints. Wilcoxon test revealed significant differences between pre- and post-treatment pain and burning sensation symptoms (P < .01). CONCLUSION: Topical application of 0.1% tacrolimus gel was effective in the treatment of DG in controlling pain and burning sensation, leading to the clinical remission of gingival lesions in patients with OLP and MMP.

Voltage-gated sodium channels gene expression in Burning Mouth Syndrome: a case-control study.

Burning mouth syndrome (BMS) is a condition characterized by painful symptoms of the oral mucosa, despite the absence of any clinical signs. Its etiology is unknown, and there is still no effective treatment to date. Current evidence has shown neuropathic impairment in BMS patients. Neuropathic pain can be related to the dysfunction of voltage-gated sodium channels, considering that these receptors regulate the induction of action potentials in nociceptive neurons. This study evaluated the gene expression of voltage-gated sodium channels Na v 1.7, Na v 1.8 and Na v 1.9 in these patients. The gene expressions of these channels were assessed by real time RT-PCR analysis of fresh-frozen tongue biopsies in a case-control study composed of 12 patients with BMS, and 5 healthy control patients, proportionally matched by sex and age, and analyzed using the 2^(-Delta Delta CT) method. There was no statistically significant difference between the analyzed groups, despite the increase in Na v 1.7 (fold-change = 3.13, p = 0.52) and decrease in Na v 1.9 (fold-change = 0.45, p = 0.36) gene expression in the BMS group. The Na v 1.8 gene was not expressed in any of the samples analyzed. Although the gene expression in the voltage-gated sodium channels in BMS under study seems to be comparable with that of the normal oral mucosa, the functionality of these channels in BMS has not yet been identified, thus suggesting that further research is needed to better understand these voltage-gated sodium channels.

Serum and salivary cytokines in patients with oral lichen planus treated with Photobiomodulation.

OBJECTIVES: To evaluate the serum and salivary levels of IL-1ß, IL-6, IL-17A, TNF-α, IL-4, and IL-10 in patients with oral lichen planus (OLP) treated with Photobiomodulation (PBM) and clobetasol propionate 0.05%. MATERIAL AND METHODS: Thirty-four OLP patients were randomized into two groups: Control (clobetasol propionate 0.05%) and PBM (660 nm, 100 mW, 177 J/cm2 , 5 s, 0.5 J per point). Serum and saliva were collected at baseline and at the end of treatment (after 30 days) and evaluated using ELISA. The cytokine results were correlated with pain, clinical subtypes, and clinical scores of OLP. RESULTS: IL-1ß, IL-6, IL-17A, TNF-α, and IL-4 levels were higher in saliva in relation to serum. IL-1ß was the most concentrated cytokine in saliva, and a positive correlation with the severity of OLP was noticed. After treatment with corticosteroid, IL-1ß in saliva decreased significantly. No modulation of all cytokines was observed after PBM. CONCLUSION: IL-1ß appears to be an important cytokine involved in OLP pathogenesis. In addition, the mechanisms of action of PBM do not seem to be linked to the modulation of pro or anti-inflammatory cytokines at the end of treatment. It is possible that this events occurred early during treatment.

Voltage-gated sodium channels gene expression in Burning Mouth Syndrome: a case-control study

Abstract Burning mouth syndrome (BMS) is a condition characterized by painful symptoms of the oral mucosa, despite the absence of any clinical signs. Its etiology is unknown, and there is still no effective treatment to date. Current evidence has shown neuropathic impairment in BMS patients. Neuropathic pain can be related to the dysfunction of voltage-gated sodium channels, considering that these receptors regulate the induction of action potentials in nociceptive neurons. This study evaluated the gene expression of voltage-gated sodium channels Na v 1.7, Na v 1.8 and Na v 1.9 in these patients. The gene expressions of these channels were assessed by real time RT-PCR analysis of fresh-frozen tongue biopsies in a case-control study composed of 12 patients with BMS, and 5 healthy control patients, proportionally matched by sex and age, and analyzed using the 2^(-Delta Delta CT) method. There was no statistically significant difference between the analyzed groups, despite the increase in Na v 1.7 (fold-change = 3.13, p = 0.52) and decrease in Na v 1.9 (fold-change = 0.45, p = 0.36) gene expression in the BMS group. The Na v 1.8 gene was not expressed in any of the samples analyzed. Although the gene expression in the voltage-gated sodium channels in BMS under study seems to be comparable with that of the normal oral mucosa, the functionality of these channels in BMS has not yet been identified, thus suggesting that further research is needed to better understand these voltage-gated sodium channels.

Oral cancer analysis in a Brazilian city: interval between diagnosis and treatment.

In Brazil, there are 15,500 incident cases of oral cancer (OC) yearly, and early diagnosis is the main factor for a better prognosis. The objective of this study was to analyze the interval between the first symptoms, diagnosis, and treatment commencement in patients with malignant neoplasms in the oral cavity, lips, and oropharynx diagnosed between 2012-2018. Epidemiological data, duration, history of lesion, biopsy, and diagnosis were obtained from the medical records of these patients, who were then contacted via phone and interviewed about their oncological treatment. The results were analyzed and expressed as mean, median, and SD. Of 184 patients, most were men, white, 50-69 years old, smokers, and alcoholics. The longest interval was between the first symptoms and first evaluation (a mean of 275 days). The interval between the first appointment and the result of the biopsy was shorter (13 days). Among the 85 patients interviewed, the interval between the diagnosis, the first appointment at the oncological clinic and treatment commencement was 55 days (mean) for patients using private-sector health care, and 96 days (mean) for patients using public health care. The interval was twice as long in the public health system compared with the private sector, which highlights the inequality of access to health care in Brazil. Delay in seeking health care after the appearance of the first symptoms remains a major problem.

Treatment of oral leukoplakia with CO2 laser (10,600 nm): analysis of 37 cases.

Oral leukoplakia is a potentially malignant disorder, defined as a white plaque that cannot be diagnosed as another known disease or disorder, and has an increased risk of malignancy. The aim of the present study was to evaluate the results of CO2 laser treatment in a well-defined cohort of patients with oral leukoplakia in order to identify the occurrence of clinical outcomes of relapse, resolution, or malignancy after treatment. The study group comprised 37 patients. Before treatment, clinical photographs and incisional biopsies were obtained in all cases. In addition, the post-treatment results were documented using photographs. Evaluation of treatment results was performed by an independent researcher who had not performed the surgery. The minimum, maximum, and mean values of continuous variables were calculated. Statistically significant relationships were tested using the Cox regression analysis. A survival curve was constructed according to the Kaplan-Meier method to analyze the malignant transformation and recurrence of oral leukoplakia. The clinical outcomes analyzed were resolution, recurrence, and malignancy. The mean follow-up period was 36 months (range, 6-239 months). In 13/37 patients, leukoplakia recurred between 6 and 93 months (mean, 38.2 months). In 8/37 patients, a malignant transformation occurred (mean, 50.6 months). In 16/37 patients, lesion resolution occurred. No risk factor was statistically significant for malignancy or recurrence of lesions. The treatment of the lesions by CO2 laser was efficient in the removal of the lesions; however, it did not avoid the clinical outcomes of recurrence or malignancy.

Oral cancer analysis in a Brazilian city: interval between diagnosis and treatment

Abstract: In Brazil, there are 15,500 incident cases of oral cancer (OC) yearly, and early diagnosis is the main factor for a better prognosis. The objective of this study was to analyze the interval between the first symptoms, diagnosis, and treatment commencement in patients with malignant neoplasms in the oral cavity, lips, and oropharynx diagnosed between 2012-2018. Epidemiological data, duration, history of lesion, biopsy, and diagnosis were obtained from the medical records of these patients, who were then contacted via phone and interviewed about their oncological treatment. The results were analyzed and expressed as mean, median, and SD. Of 184 patients, most were men, white, 50-69 years old, smokers, and alcoholics. The longest interval was between the first symptoms and first evaluation (a mean of 275 days). The interval between the first appointment and the result of the biopsy was shorter (13 days). Among the 85 patients interviewed, the interval between the diagnosis, the first appointment at the oncological clinic and treatment commencement was 55 days (mean) for patients using private-sector health care, and 96 days (mean) for patients using public health care. The interval was twice as long in the public health system compared with the private sector, which highlights the inequality of access to health care in Brazil. Delay in seeking health care after the appearance of the first symptoms remains a major problem.

Treatment of oral leukoplakia with CO2 laser (10,600 nm): analysis of 37 cases

Abstract Oral leukoplakia is a potentially malignant disorder, defined as a white plaque that cannot be diagnosed as another known disease or disorder, and has an increased risk of malignancy. The aim of the present study was to evaluate the results of CO2 laser treatment in a well-defined cohort of patients with oral leukoplakia in order to identify the occurrence of clinical outcomes of relapse, resolution, or malignancy after treatment. The study group comprised 37 patients. Before treatment, clinical photographs and incisional biopsies were obtained in all cases. In addition, the post-treatment results were documented using photographs. Evaluation of treatment results was performed by an independent researcher who had not performed the surgery. The minimum, maximum, and mean values of continuous variables were calculated. Statistically significant relationships were tested using the Cox regression analysis. A survival curve was constructed according to the Kaplan-Meier method to analyze the malignant transformation and recurrence of oral leukoplakia. The clinical outcomes analyzed were resolution, recurrence, and malignancy. The mean follow-up period was 36 months (range, 6-239 months). In 13/37 patients, leukoplakia recurred between 6 and 93 months (mean, 38.2 months). In 8/37 patients, a malignant transformation occurred (mean, 50.6 months). In 16/37 patients, lesion resolution occurred. No risk factor was statistically significant for malignancy or recurrence of lesions. The treatment of the lesions by CO2 laser was efficient in the removal of the lesions; however, it did not avoid the clinical outcomes of recurrence or malignancy.

Sialolithiasis of minor salivary gland in labial mucosa: a clinical finding / Sialolitíase de glândula salivar menor na mucosa labial: um achado clínico

Introduction: sialolithiasis is the most common form of obstructive sialadenitis caused by a mixture of different calcium phosphates and an organic matrix. It is one of the most common salivary gland diseases, often attributed to the submandibular gland, with no relation to age or gender. However, it is rarely reported in the minor salivary glands. Objective: the present study aims to report auncommon clinical finding case of a sialolithiasisof minor salivary gland in labial mucosa. Case report: a 43-year-old female patient presented with a single, yellow and asymptomatic nodule in the labial mucosa at clinical examination. The clinical hypotheses were lipoma and fibrous hyperplasia. The lesion was biopsied, and the histopathological analysis showed a mineralized tissue. The final diagnosis was sialolithiasis and the patient remained under follow-up (8 months) without relapse. Conclusion: this case shows that sialolithiasis should be included in the diagnostic hypotheses when occur in a minor salivary glands area and emphasizes the importance of a complete clinical examination since it was not complaint of the patient.(AU)

Introdução: a sialolitíase é a forma mais comum de sialadenite obstrutiva causada por um composto de diferentes produtos, como fosfato de cálcio e matriz orgânica. É uma das doenças mais comuns das glândulas salivares, geralmente atribuídas à glândula submandibular, sem relação com idade ou sexo. No entanto, raramente é relatada nas glândulas salivares menores. Objetivo: reportar um achado clínico incomum de sialolitíase em glândula oral menor na mucosa labial. Relato de caso: uma paciente do sexo feminino, de 43 anos, apresentou nódulo único, amarelo e assintomático na mucosa labial durante o exame clínico. As hipóteses clínicas foram lipoma e hiperplasia fibrosa. A lesão foi encaminhada para biópsia e a análise histopatológica mostrou um tecido mineralizado. O diagnóstico final foi de sialolitíase e o paciente permaneceu em acompanhamento por 8 meses sem recidiva. Conclusão: este caso mostra que a sialolitíase deve ser incluída nas hipóteses diagnósticas de lesões em áreas de glândulas salivares menores e enfatiza a importância de um exame clínico completo, pois não se tratava da queixa principal da paciente.(AU)

Efficacy of photobiomodulation on oral lichen planus: a protocol study for a double-blind, randomised controlled clinical trial.

INTRODUCTION: Oral lichen planus (OLP) is an idiopathic chronic mucocutaneous disease with a wide range of clinical manifestations, including white reticular patches, erosive/ulcerative and atrophic lesions, both associated with intense symptomatology. Topical corticosteroids are commonly used as standard therapy. However, patients frequently present relapses after the discontinuation of treatment as well as developing resistance to corticosteroid therapy. Photobiomodulation (PBM) has been shown to be a potential therapeutic tool to treat inflammatory disorders, including OLP. The aim of this study was to compare the efficacy of PBM (660 nm) with corticosteroid therapy with clobetasol propionate 0.05% for the treatment of OLP. METHODS AND ANALYSIS: Forty-four patients with symptomatic and histopathological diagnosis of OLP will be randomised into two experimental groups in a double-blind manner: control group (n=22): clobetasol propionate 0.05%+placebo PBM, and experimental group (n=22): PBM (λ=660 nm, power 100 mW, radiant exposure: 177 J/cm2 and 0.5J per point)+placebo gel. Laser will be applied 2×/week for 1 month and clobetasol propionate three times a day for 30 days and the same for placebo treatments. The primary variable (pain) and the secondary variables (clinical score, evaluation of functional scores, clinical resolution, OLP recurrence, quality of life and anxiety and depression) will be evaluated at the baseline, once a week during treatment (depending on the variables) and after 30 days and 60 days of follow-up. Pain will be evaluated using visual analogue scale and clinical characteristics will be scored using the Thongprasom Index. The quality of life and anxiety and depression will be evaluated by Oral Health Impact Profile-14 questionnaire and by Hospital Anxiety and Depression Scale for anxiety scale, respectively. The serum and salivary levels of interleukin (IL)-6, IL-10, IL-1ß, INF-γ and tumour necrosis factor-α will be evaluated by ELISA at baseline and at the end of treatment. ETHICS AND DISSEMINATION: This protocol was approved (#2.375.410) by the Nove de Julho University (UNINOVE) Research Ethics Committee. The data gathered using this protocol will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT03320460.

Paracoccidioidomicose com repercussão oral: relato de caso em zona urbana / Paracoccidioidomycosis with oral impact: case report in an urban area

Objetivo: relatar um caso de paracoccidioidomicose (Pbmicose), diagnosticado pelo cirurgião-dentista, e o tratamento instituído a um morador de zona urbana. Relato de caso: paciente do sexo masculino, com 59 anos de idade, leucoderma, compareceu à clínica odontológica com lesão em boca há cerca de vinte dias e queixa de mobilidade dental na região anteroinferior. Durante a anamnese, constatou-se dificuldade respiratória, hipertensão controlada, tabagismo e etilismo crônico. No exame físico, foi observado aumento de volume do lábio inferior, linfadenopatia bilateral submandibular e lesões ulceradas com aspecto moriforme em mucosa bucal e gengiva inserida do elemento 31 ao 45. Foi realizada biópsia incisional na lesão com resultado positivo para Pbmicose. O paciente foi medicado com itraconazol e apresenta-se periodicamente para acompanhamento. Considerações finais: as lesões bucais dessa doença correspondem a úlceras crônicas e granulomatosas, semelhantes à lesão provocada pelo carcinoma epidermoide oral, assim, o cirurgião-dentista deve conhecer esta micose e considerá-la na elaboração do diagnóstico diferencial. (AU)

Objective: to report a case of paracoccidioidomycosis (Pbmycosis) diagnosed by the dentist, as well as the treatment applied to a resident of an urban area. Case report: male patient, 59 years old, white, referred to the dental clinic with a lesion in the mouth of around 20 days and complaint of tooth mobility in the anteroinferior region. The anamnesis showed respiratory distress, controlled hypertension, and chronic smoking and alcoholism. The physical examination showed increased volume of the lower lip, bilateral submandibular lymphadenopathy, moriform ulcerated lesions in the buccal mucosa, and gum insertion from tooth 31 to 45. An incisional biopsy was performed on the lesion with a positive result for Pbmycosis. The patient was treated with itraconazole and he shows up periodically for follow-up. Final considerations: the oral lesions of this disease correspond to chronic and granulomatous ulcers, similar to the lesion caused by the oral squamous cell carcinoma, thus, the dentist should understand this mycosis and consider it when producing the differential diagnosis. (AU)

Odontogenic myxoma in a child treated with enucleation and curettage.

Odontogenic myxoma is an aggressive benign odontogenic tumor, accounting for 3-6% of all the odontogenic tumors in adults. The incidence among children is lower. Due to its clinical behavior, there is no consensus on the best treatment. In this paper, the authors report the case of a 9-year-old girl with the diagnosis of odontogenic myxoma. The panoramic X-ray showed an extensive radiolucent lesion involving the left mandibular body causing teeth displacement. The treatment consisted of tumor enucleation followed by vigorous curettage of the bone walls. Both the base of the mandible and the inferior alveolar nerve were preserved. The patient is asymptomatic after 6 months of surgery. The age of the patient and the radiographic features were taken into account when deciding in favor of the conservative treatment.

Gingival complex odontoma: a rare case report with a review of the literature.

Odontomas are odontogenic tumors composed of a mixture of dental tissues. They are very common hamartomas of the jaws. However, their peripheral or gingival counterparts are extremely uncommon. The objective of this article is to report a rare case of gingival complex odontoma in an 11-year-old patient, and also to review all published cases of this type of lesion.

Gingival complex odontoma: a rare case report with a review of the literature

Odontomas are odontogenic tumors composed of a mixture of dental tissues. They are very common hamartomas of the jaws. However, their peripheral or gingival counterparts are extremely uncommon. The objective of this article is to report a rare case of gingival complex odontoma in an 11-year-old patient, and also to review all published cases of this type of lesion.

Hiperplasia Endotelial Papilífera Intravascular Oral: relato de dois casos / Oral intravascular papillary endothelial hyperplasia: two cases report

A hiperplasia endotelial papilífera intravascular (HEPI) é uma lesão vascular não neoplásica, benigna e rara, especialmente em cavidade bucal. O presente artigo relata dois casos com diferentes apresentações clínicas de HEPI, envolvendo o lábio inferior. O primeiro caso se refere a um paciente que apresentava nódulo único submucoso, endurecido, arroxeado e assintomático em mucosa labial inferior. E o segundo se reporta a uma paciente que apresentava aumento de volume assintomático em lábio inferior com a mucosa entumecida e arroxeada desde o fundo de sulco. O exame histológico revelou vasos dilatados com proliferação de células endoteliais arredondadas, associadas a estruturas papilares, de tecido conjuntivo projetadas para o lúmen vascular, associadas a um trombo organizado, no primeiro caso, e a um hemangioma, no segundo. A ausência de células inflamatórias, atipia e necrose celular excluíram outras lesões vasculares, sendo o diagnóstico final de HEPI. O prognóstico da HEPI é excelente, uma vez que recidivas são raramente relatadas. A HEPI pode ser incluída no diagnóstico diferencial clínico de lesões labiais únicas, arroxeadas e endurecidas. E por caracterizarse histologicamente por uma proliferação de células endoteliais, é importante estabelecer o diagnóstico diferencial com o angiossarcoma, uma lesão de tratamento mais agressivo e pior prognóstico... (AU)

Intravascular papillary endothelial hyperplasia (IPEH) is a nonneoplastic vascular benign and rare lesion, especially in oral cavity. This article reports two cases of IPEH, with different clinical presentation, involving the inferior lip. The first case refers to a patient presenting a single submucosal indurated purplish and asymptomatic nodule in the lower labial mucosa. And the second, to a patient presenting an asymptomatic increase in the lower lip associated with a swelling and purplish oral mucosa. Histological examination showed dilated vessels with rounded endothelial cells proliferation associated with papillary structures of connective tissue projected to vascular lumen, associated with an organized thrombus in first case and a hemangioma in the second. The absence of inflammatory cells, cytologic atypia and necrosis excluded other vascular lesions, being the final diagnosis of IPEH. The prognosis of IPEH is excellent since recurrences are rarely reported. Isolated purplish and indurated labial lesions can include the IPEH as a possible clinical hypothesis. And, since is histologically characterized by a proliferation of endothelial cells, is crucial the establishment of the histological differential diagnosis with angiosarcoma, which requires a more aggressive treatment and has worse prognosis... (AU)

Clinical characteristics and therapeutic response in patients with Burning Mouth Syndrome: accompanying 2 years / Características clínicas e resposta terapêutica em pacientes portadores da Síndrome de Ardência Bucal: acompanhamento de 2 anos

Introduction: Burning Mouth Syndrome (BMS) is a condition characterized by burning symptom of the oral mucosa in the absence of clinical signs. Its etiology is still unknown and, and to date there is no effective treatment. Purpose: The aim of this study was to evaluate patients with BMS profile and the therapies results in a retrospective study. Material and method: Clinical and therapeutic data were collected from records of patients with BMS diagnosed between January 2013 to April 2015 at the Clinic of Stomatology Clinic, Faculdade de Odontologia of Universidade de São Paulo, according to the criteria established by the International Headache Society in 2013. The therapies used for BMS control were also evaluated. Result: Twelve patients were diagnosed with BMS at this period. All of them were women with a mean age of 61.18 years and the apex of the tongue was the most common affected site and the duration of the burning sensation ranged from 6 months to 25 years. Many therapies were prescribed for BMS control, such as topical capsaicin, topical clonazepan, low level laser therapy and homeopathy. Among the established therapies, capsaicin has immediate effect in reducing symptoms. Conclusion: The present study showed that the challenges towards an effective treatment for BMS are varied and are mainly related to the lack knowing of the pathogenesis of this disease. The demographic profile of patients studied here was similar to that described in the available literature, however, the variables represented by secondary symptoms (medical history, anxiety and depression levels) may be modifying factors of therapeutic response and the pathogenesis of the disease itself.

Introdução: A Síndrome de Ardência Bucal (SAB) é uma condição caracterizada pelo sintoma de ardência na mucosa oral na ausência de qualquer sinal clínico. Sua etiologia ainda é desconhecida e, até o momento, não dispõe de tratamento efetivo. Objetivo: Avaliar o perfil do paciente portador de SAB, as terapias instituídas e seus resultados em estudo retrospectivo. Material e método: Foram coletados os dados clínicos e terapêuticos dos prontuários de pacientes diagnosticados com SAB, no período de janeiro de 2013 a abril de 2015, no Ambulatório da Disciplina de Estomatologia Clínica da Faculdade de Odontologia da Universidade de São Paulo. Os critérios para o diagnóstico utilizados se basearam nos estabelecidos pela International Headache Society em 2013 e foram observadas as terapêuticas empregadas e seus resultados. Resultado: Doze pacientes foram diagnosticadas com SAB neste período, todas do sexo feminino, média de idade 61,18 anos, e a principal região acometida pelo sintoma de ardor foi o ápice de língua. O tempo de duração deste sintoma variou de 6 meses a 25 anos. As terapias utilizadas para o controle de sintomas da SAB foram capsaicina, clonazepan tópico, laserterapia e homeopatia. Dentre as terapias instituídas, a capsaicina apresentou efeito imediato na redução dos sintomas. Conclusão: O presente estudo demonstrou que os desafios que circundam a obtenção de um tratamento efetivo para a SAB são diversos e estão principalmente relacionados ao desconhecimento da etiopatogenia da doença. O perfil demográfico dos pacientes aqui estudados foi semelhante ao descrito na literatura disponível, entretanto, as variáveis representadas por sintomas secundários (história médica, níveis de ansiedade e depressão) podem constituir fatores modificadores da resposta terapêutica e da própria etiopatogenia da doença.

Low Intensity laser therapy in patients with burning mouth syndrome: a randomized, placebo-controlled study.

The aim of this study was to assess the effectiveness of low intensity laser therapy in patients with Burning Mouth Syndrome (BMS). Thirty BMS subjects were randomized into two groups - Laser (LG) and Placebo (CG). Seven patients dropped out, leaving 13 patients in LG and 10 patients in CG. Each patient received 4 irradiations (laser or placebo) twice a week, for two consecutive weeks (blinded to the type of irradiation received). Infrared laser (AsGaAI) irradiations were applied to the affected mucosa in scanning mode, wavelength of 790 nm, output power of 20 mW and fluence of 6 J/cm2. A visual analogue scale (VAS) was used to assess the therapeutic effect before and after each irradiation, and at all the control time periods: 7, 14, 30, 60 and 90 days after the last irradiation. One researcher delivered irradiation and another recorded the results. Both researchers were blinded, the first to the results, and the second to the type of radiation applied. The results were categorized according to the percentage of symptom level variation, and showed a statistically better response in LG in only two categories of the control checkpoints (p=0.02; Fisher's Exact Test). According to the protocol used in this study, low intensity laser therapy is as beneficial to patients with BMS as placebo treatment, indicating a great emotional component of involvement in BMS symptomatology. Nevertheless, there were positive results in some statistical analyses, thus encouraging further research in BMS laser therapy with other irradiation parameters.

Low Intensity laser therapy in patients with burning mouth syndrome: a randomized, placebo-controlled study

Abstract The aim of this study was to assess the effectiveness of low intensity laser therapy in patients with Burning Mouth Syndrome (BMS). Thirty BMS subjects were randomized into two groups - Laser (LG) and Placebo (CG). Seven patients dropped out, leaving 13 patients in LG and 10 patients in CG. Each patient received 4 irradiations (laser or placebo) twice a week, for two consecutive weeks (blinded to the type of irradiation received). Infrared laser (AsGaAI) irradiations were applied to the affected mucosa in scanning mode, wavelength of 790 nm, output power of 20 mW and fluence of 6 J/cm2. A visual analogue scale (VAS) was used to assess the therapeutic effect before and after each irradiation, and at all the control time periods: 7, 14, 30, 60 and 90 days after the last irradiation. One researcher delivered irradiation and another recorded the results. Both researchers were blinded, the first to the results, and the second to the type of radiation applied. The results were categorized according to the percentage of symptom level variation, and showed a statistically better response in LG in only two categories of the control checkpoints (p=0.02; Fisher's Exact Test). According to the protocol used in this study, low intensity laser therapy is as beneficial to patients with BMS as placebo treatment, indicating a great emotional component of involvement in BMS symptomatology. Nevertheless, there were positive results in some statistical analyses, thus encouraging further research in BMS laser therapy with other irradiation parameters.