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Morgan RM, Wheeler TD, Poolman MA, Haugen ENJ, LeMire SD, Fitzgerald JS. Effects of Photobiomodulation on Pain and Return to Play of Injured Athletes: A Systematic Review and Meta-analysis. J Strength Cond Res 2024; 38:e310-e319. [PMID: 38781474 DOI: 10.1519/jsc.0000000000004752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
ABSTRACT Morgan, RM, Wheeler, TD, Poolman, MA, Haugen, ENJ, LeMire, SD, and Fitzgerald, JS. Effects of photobiomodulation on pain and return to play of injured athletes: A systematic review and meta-analysis. J Strength Cond Res 38(6): e310-e319, 2024-The aims of this systematic review and meta-analysis were to evaluate the effect of photobiomodulation (PBM) on musculoskeletal pain in injured athletes and to determine if the effects of PBM allowed injured athletes to return to play faster. Electronic databases (MEDLINE Complete, CINAHL, and SPORTDiscus, PubMed, Web of Science, and Embase) were systematically searched (up to and including November 7, 2023) for peer-reviewed randomized controlled trials (RCTs) meeting criteria. Six RCTs, representing 205 competitive and recreational athletes with a mean age of 24 years, were included in the analysis. There were 6 intervention groups using standard physical therapy (n = 1), placebo PBM (n = 4), and aloe gel (n = 1) lasting between 10 minutes and 8 weeks in duration. The level of significance set for the study was p < 0.05. Overall, the use of PBM indicated a positive effect on pain reduction for PBM vs. control groups, standardized mean differences = 1.03, SE = 0.22, 95% confidence intervals = [0.43-1.63], p = 0.0089, but the 2 RCTs found evaluating the effect of PBM on time to return to play after injury in athletes do not support a benefit. Allied healthcare professionals may use PBM to reduce pain, thus allowing an athlete to return to their normal biomechanical movement faster; however, limited evidence suggests that PBM does not reduce time to return to play after an injury.
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Affiliation(s)
- Richard M Morgan
- Department of Physical Therapy, University of North Dakota, Grand Forks, North Dakota
| | - Tyler D Wheeler
- Department of Athletic Training, Training HAUS, Eagan, Minnesota
| | - Mark A Poolman
- Department of Sports Medicine, University of North Dakota, Grand Forks, North Dakota
| | - Erin N J Haugen
- Department of Clinical and Sport Psychology, Assessment and Therapy Associates of Grand Forks, PLLC, Grand Forks, North Dakota
| | - Steven D LeMire
- Department of Educational Foundations and Research, University of North Dakota, Grand Forks, North Dakota; and
| | - John S Fitzgerald
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, North Dakota
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Garcia Martinez A, Lopez-Jornet P, Pardo Marin L, Pons-Fuster E, Tvarijonaviciute A. Burning Mouth Syndrome Treated with Low-Level Laser and Clonazepam: A Randomized, Single-Blind Clinical Trial. Biomedicines 2024; 12:1048. [PMID: 38791010 PMCID: PMC11118462 DOI: 10.3390/biomedicines12051048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 04/30/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
OBJECTIVE Burning mouth syndrome (BMS) is a chronic pain disorder characterized by intraoral burning or dysaesthetic sensation, with the absence of any identifiable lesions. Numerous treatments for BMS have been investigated, though without conclusive results. An analysis was conducted of the efficacy of treatment with a low-level diode laser and clonazepam in patients with BMS, and a study was carried out on the levels of different salivary biomarkers before and after treatment. MATERIAL AND METHODS A randomized, single-blind clinical trial was carried out involving 89 patients divided into the following groups: group 1 (laser, The Helbo® Theralite Laser 3D Pocket Probe + clonazepam) (n = 20), group 2 (sham laser placebo) (n = 19), group 3 (laser) (n = 21) and group 4 (clonazepam) (n = 18). Symptom intensity was scored based on a visual analogue scale (VAS). Sialometry was performed before and after treatment, and the Xerostomia Inventory, Oral Health Impact Profile-14 (OHIP-14) and Mini-Nutritional Assessment (MNA) questionnaires were administered. The following markers were measured in saliva samples: interleukins (IL2, IL4, IL5, IL6, IL7, IL8, IL1β, IL10, IL12, IL13, IL17, IL21 and IL23), proteins (MIP-3α, MIP-1α and MIP-1β), GM-CSF, interferon gamma (IFNγ), interferon-inducible T-cell alpha chemoattractant (ITAC), fractalkine and tumor necrosis factor α (TNFα). RESULTS A significant decrease in the VAS scores was observed after treatment in group 1 (laser + clonazepam) (p = 0.029) and group 3 (laser) (p = 0.005). In turn, group 3 (laser) showed a decrease in the salivary concentration of fractalkine (p = 0.025); interleukins IL12 (p = 0.048), IL17 (p = 0.020), IL21 (p = 0.008), IL7 (p = 0.001) and IL8 (p = 0.007); proteins MIP1α (p = 0.048) and MIP1β (p = 0.047); and TNFα (p = 0.047) versus baseline. Following treatment, group 1 (laser + clonazepam) showed significant differences in IL21 (p = 0.045) and IL7 (p = 0.009) versus baseline, while group 4 (clonazepam) showed significant differences in IL13 (p = 0.036), IL2 (p = 0.020) and IL4 (p = 0.001). No significant differences were recorded in group 2 (sham laser placebo). CONCLUSIONS The low-level diode laser is a good treatment option in BMS, resulting in a decrease in patient symptoms and in salivary biomarkers. However, standardization of the intervention protocols and laser intensity parameters is needed in order to draw more firm conclusions.
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Affiliation(s)
- Ana Garcia Martinez
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Faculty of Medicine, University of Murcia, Hospital Morales Meseguer Clinica Odontologica Marques Velez S/N, 30008 Murcia, Spain;
| | - Pia Lopez-Jornet
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Faculty of Medicine, University of Murcia, Hospital Morales Meseguer Clinica Odontologica Marques Velez S/N, 30008 Murcia, Spain;
| | - Luis Pardo Marin
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence ‘Campus Mare Nostrum’, University of Murcia, Espinardo, 30100 Murcia, Spain; (L.P.M.); (A.T.)
| | - Eduardo Pons-Fuster
- Department Anatomy, Faculty of Medicine, University of Murcia, El Palmar, 30120 Murcia, Spain;
| | - Asta Tvarijonaviciute
- Interdisciplinary Laboratory of Clinical Analysis, Interlab-UMU, Regional Campus of International Excellence ‘Campus Mare Nostrum’, University of Murcia, Espinardo, 30100 Murcia, Spain; (L.P.M.); (A.T.)
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Li X, Li Q, Li J, Wang X, Zou H, Wang S, Fan J. The improvement of pain symptoms in patients with burning mouth syndrome through combined laser and medication therapy. Technol Health Care 2024:THC284044. [PMID: 38759078 DOI: 10.3233/thc-248044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
BACKGROUND The etiology of Burning Mouth Syndrome (BMS) remains unclear. OBJECTIVE To explore the differences in the therapeutic efficacy of pain improvement between medication therapy and laser therapy in patients with BMS. METHODS 45 BMS patients were randomly divided into three groups: The Combination therapy group (Group A, n= 15), The Medication therapy group (Group B, n= 15), and the Laser therapy group (Group C, n= 15). The pain condition of the patients was evaluated using the Numeric Rating Scale (NRS), and the improvement in pain before and after treatment was compared among the three groups. RESULTS All three groups (A, B, and C) showed a significant reduction in NRS scores after treatment, with statistically significant differences observed among the different groups. Group A exhibited the most significant improvement, with a statistically significant difference before and after treatment. CONCLUSION Laser and medication therapy are effective methods for reducing oral burning pain * symptoms, and their combined use yields more significant therapeutic effects.
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Affiliation(s)
- Xingcen Li
- School of Stomatology, Kunming Medical University, Yunnan, China
| | - Qianpeng Li
- Department of General, School of Stomatology, Kunming Medical University, Yunnan, China
| | - Jinhan Li
- School of Stomatology, Kunming Medical University, Yunnan, China
| | - Xiaoyi Wang
- School of Stomatology, Kunming Medical University, Yunnan, China
| | - Huaxiu Zou
- School of Stomatology, Kunming Medical University, Yunnan, China
| | - Shuyang Wang
- School of Stomatology, Kunming Medical University, Yunnan, China
| | - Jingyi Fan
- The Department of Statistics, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China
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Gonçalves DR, Botelho LM, Carrard VC, Martins MAT, Visioli F. Amitriptyline effectiveness in burning mouth syndrome: An in-depth case series analysis. Gerodontology 2024. [PMID: 38515010 DOI: 10.1111/ger.12750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES To assess the effectiveness of amitriptyline (AMT), and to identify the determinants of the treatment's effectiveness in patients diagnosed with burning mouth syndrome (BMS). BACKGROUND Treatment of BMS is challenging and no established treatment protocol is available. AMT may be an important treatment option, cout not all patients benefit from this drug. Studies assessing factors related to treatment response are valuable in improving decision-making. MATERIALS AND METHODS This case series study examined the medical records of all patients diagnosed with BMS at an oral medicine unit in a university hospital from 2008 to 2022. The patients were divided into responders to AMT and non-responders to AMT. Data on demographic information, comorbidities, medications, types of symptoms and oral subsites affected were collected. Descriptive and bivariate analyses were conducted to assess the association between the independent variables and the outcome, using the Chi-squared test (P < .05). RESULTS Three hundred and fourty-nine patients reported a burning mouth sensation, 50 of them (14.3%) being diagnosed with primary BMS. Of these, 35 were treated with AMT, and 26 (74.2%) responded significantly to AMT. All males responded to AMT, whereas only 67.9% of females responded. The mean dose of AMT among responders was 29.8 ± 12.3 mg, with most patients achieving a response with 25 mg (61.5% of patients), followed by 50 mg (23%). The concomitant use of an anticonvulsant resulted in non-response. CONCLUSIONS AMT may be effective in BMS management for most patients.
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Affiliation(s)
- Douglas Rodrigues Gonçalves
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Oral Medicine Unit, Otorhinolaryngology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Leonardo Monteiro Botelho
- Pain Management and Palliative Medicine Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Vinícius Coelho Carrard
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Oral Medicine Unit, Otorhinolaryngology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Marco Antônio Trevizani Martins
- Oral Medicine Unit, Otorhinolaryngology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernanda Visioli
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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Marotta BM, Sugaya NN, Hanna R, Gallo CDB. Efficacy of 660 nm Photobiomodulation in Burning Mouth Syndrome Management: A Single-Blind Quasi-Experimental Controlled Clinical Trial. Photobiomodul Photomed Laser Surg 2024; 42:225-229. [PMID: 38407832 DOI: 10.1089/photob.2023.0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
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.
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Affiliation(s)
- Bruno Munhoz Marotta
- Department of Stomatology, School of Dentistry of the Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Norberto Nobuo Sugaya
- Department of Stomatology, School of Dentistry of the Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Reem Hanna
- Department of Oral Surgery, King's College Hospital NHS Foundation Trust, London, United Kingdom
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
- Department of Dental Sciences, UCL-Eastman Dental Institute, University College London, London, United Kingdom
| | - Camila de Barros Gallo
- Department of Stomatology, School of Dentistry of the Universidade de Sao Paulo, Sao Paulo, Brazil
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Lu C, Yang C, Li X, Du G, Zhou X, Luo W, Du Q, Tang G. Effects of low-level laser therapy on burning pain and quality of life in patients with burning mouth syndrome: a systematic review and meta-analysis. BMC Oral Health 2023; 23:734. [PMID: 37814265 PMCID: PMC10561515 DOI: 10.1186/s12903-023-03441-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 09/21/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Burning mouth syndrome (BMS) is a complex chronic pain disorder that significantly impairs patients' quality of life. Low-level laser therapy (LLLT) uses infrared or near-infrared light to produce analgesic, anti-inflammatory, and biological stimulation effects. The aim of this systematic review is to evaluate the effect of LLLT on burning pain, quality of life, and negative emotions in patients with BMS. METHODS The PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane Library, Web of Science, and Scopus databases were searched up January 2023 to identify relevant articles. All randomized controlled trials that were published in English and examined the use of LLLT treatment for BMS were included. The methodological quality of the included trials was assessed using the Cochrane risk of bias tool for randomized controlled trials (RCTs). A meta-analysis was performed to evaluate burning pain, quality of life, and negative emotions. Sensitivity, subgroup, and funnel plot analyses were also carried out. RESULTS Fourteen RCTs involving a total of 550 patients with BMS met the inclusion criteria. The results showed that LLLT (measured by the Visual Analog Scale; SMD: -0.87, 95% CI: -1.29 to -0.45, P < 0.001) was more effective for reducing burning pain than placebo LLLT or clonazepam. LLLT improved quality of life (evaluated by the Oral Health Impact Profile-14; SMD: 0.01, 95% CI: -0.58 to 0.60, P = 0.97) and negative emotions (evaluated by the Hospital Anxiety and Depression Scale; SMD: -0.12, 95% CI: -0.54 to 0.30, P = 0.59), but these effects were not statistically significant. CONCLUSIONS The meta-analysis revealed that LLLT may be an effective therapy for improving burning pain in patients with BMS, and producing a positive influence on quality of life and negative emotions. A long-term course of intervention, a larger sample size, and a multidisciplinary intervention design are urgently needed in future research. TRIAL REGISTRATION PROSPERO registration number: CRD42022308770.
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Affiliation(s)
- Chenghui Lu
- Department of Oral Mucosal Diseases, The Affiliated Stomatological Hospital of Guilin Medical University, Guilin, 541004, China
| | - Chenglong Yang
- Department of Stomatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Xin Li
- Department of Rehabilitation, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Guanhuan Du
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Xuan Zhou
- Department of Rehabilitation, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Wenhai Luo
- Department of Oral Mucosal Diseases, The Affiliated Stomatological Hospital of Guilin Medical University, Guilin, 541004, China
| | - Qing Du
- Department of Rehabilitation, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Guoyao Tang
- Department of Stomatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.
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Medeiros CKS, Serrão MDCPN, de Lima AAS, da Silveira ÉJD, de Oliveira PT. Comparative analysis of photobiomodulation therapy and transcutaneous electrical nerve stimulation for burning mouth: a randomized clinical trial. Clin Oral Investig 2023; 27:6157-6165. [PMID: 37656286 DOI: 10.1007/s00784-023-05232-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/18/2023] [Indexed: 09/02/2023]
Abstract
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 (p˂0.001). 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).
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Affiliation(s)
- Cristianne Kalinne Santos Medeiros
- Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil.
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil.
| | | | - Antonio Adilson Soares de Lima
- Department of Stomatology, Graduate School of Dentistry, Federal University of Paraná, Rua Prefeito Lothário Meissner, 632, Campus Jardim Botânico, Curitiba, PR, 80210-170, Brazil
| | - Éricka Janine Dantas da Silveira
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil
| | - Patrícia Teixeira de Oliveira
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil
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Hanna R, Bensadoun RJ, Beken SV, Burton P, Carroll J, Benedicenti S. Outpatient Oral Neuropathic Pain Management with Photobiomodulation Therapy: A Prospective Analgesic Pharmacotherapy-Paralleled Feasibility Trial. Antioxidants (Basel) 2022; 11:533. [PMID: 35326183 PMCID: PMC8944471 DOI: 10.3390/antiox11030533] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 12/15/2022] Open
Abstract
Neuropathic pain (NP) can be challenging to treat effectively as analgesic pharmacotherapy (MED) can reduce pain, but the majority of patients do not experience complete pain relief. Our pilot approach is to assess the feasibility and efficacy of an evidence-based photobiomodulation (PBM) intervention protocol. This would be as an alternative to paralleled standard analgesic MED for modulating NP intensity-related physical function and quality of life (QoL) prospectively in a mixed neurological primary burning mouth syndrome and oral iatrogenic neuropathy study population (n = 28). The study group assignments and outcome evaluation strategy/location depended on the individual patient preferences and convenience rather than on randomisation. Our prospective parallel study aimed to evaluate the possible pre/post-benefit of PBM and to allow for a first qualitative comparison with MED, various patient-reported outcome measures (PROMs) based on Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT-II) were used for up to a nine-month follow-up period in both intervention groups (PBM and MED). The PBM protocol applied to the PBM group was as follows: λ810 nm, 200 mW, 0.088 cm2, 30 s/point, 9 trigger and affected points, twice a week for five consecutive weeks, whereas the MED protocol followed the National Institute of Clinical Excellence (NICE) guidelines. Our results showed that despite the severe and persistent nature of the symptoms of 57.50 ± 47.93 months at baseline in the PBM group, a notably rapid reduction in PISmax on VAS from 7.6 at baseline (T0) to 3.9 at one-month post-treatment (T3) could be achieved. On the other hand, mean PISmax was only reduced from 8.2 at baseline to 6.8 at T3 in the MED group. Our positive PBM findings furthermore support more patients' benefits in improving QoL and functional activities, which were considerably impaired by NP such as: eating, drinking and tasting, whereas the analgesic medication regimens did not. No adverse events were observed in both groups. To the best knowledge of the authors, our study is the first to investigate PBM efficacy as a monotherapy compared to the gold standard analgesic pharmacotherapy. Our positive data proves statistically significant improvements in patient self-reported NP, functionality, psychological profile and QoL at mid- and end-treatment, as well as throughout the follow-up time points (one, three, six and nine months) and sustained up to nine months in the PBM group, compared to the MED group. Our study, for the first time, proves the efficacy and safety of PBM as a potent analgesic in oral NP and as a valid alternative to the gold standard pharmacotherapy approach. Furthermore, we observed long-term pain relief and functional benefits that indicate that PBM modulates NP pathology in a pro-regenerative manner, presumably via antioxidant mechanisms.
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Affiliation(s)
- Reem Hanna
- Department of Oral Surgery, Dental Institute, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Viale Benedetto XV,6, 16132 Genoa, Italy;
| | - René Jean Bensadoun
- Department of Radiology Oncology, Centre De Haute Energie, 10 Boulevard Pasteur, 06000 Nice, France;
| | - Seppe Vander Beken
- Bredent Medical GmbH & Co., Gewerbegebiet Gartenäcker, Weißenhorner Str. 2, 89250 Senden, Germany;
| | - Patricia Burton
- Thor Photomedicine Ltd., Water Meadow, Chesham HP5 1LF, UK; (P.B.); (J.C.)
| | - James Carroll
- Thor Photomedicine Ltd., Water Meadow, Chesham HP5 1LF, UK; (P.B.); (J.C.)
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Viale Benedetto XV,6, 16132 Genoa, Italy;
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Camolesi GCV, Marichalar-Mendía X, Padín-Iruegas ME, Spanemberg JC, López-López J, Blanco-Carrión A, Gándara-Vila P, Gallas-Torreira M, Pérez-Sayáns M. Efficacy of photobiomodulation in reducing pain and improving the quality of life in patients with idiopathic burning mouth syndrome. A systematic review and meta-analysis. Lasers Med Sci 2022; 37:2123-2133. [PMID: 35122543 PMCID: PMC9148274 DOI: 10.1007/s10103-022-03518-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/28/2022] [Indexed: 12/28/2022]
Abstract
Burning mouth syndrome is a chronic condition, which is characterised by a burning sensation or pain in the mucosa of the oral cavity. Treatment options include antidepressants, antipsychotics, anticonvulsants, analgesics, hormone replacement therapies and more recently photobiomodulation. This study aims to perform a systematic review with meta-analysis in order to determine the effect of photobiomodulation on pain relief and the oral health-related quality of life associated with this condition. A bibliographical search of the Pubmed, Embase, Web of Science and Scopus databases was conducted. Only randomised clinical trials were included. Pain and quality of life were calculated as mean difference and pooled at different treatment points (baseline = T0 and final time point = Tf) and laser modality. From a total of 103 records, 7 articles were retrieved for inclusion. PBM group had a greater decrease in pain than control group at Tf with a mean difference = − 2.536 (IC 95% − 3.662 to − 1.410; I2 = 85.33%, p < 0.001). An improvement in oral health-related quality of life was observed in both groups, although this was more significant in the photobiomodulation group mean difference = − 5.148 (IC 95% − 8.576 to − 1.719; I2 = 84.91%, p = 0.003). For the red laser, a greater improvement than infrared was observed, in pain, mean difference = − 2.498 (IC 95% − 3.942 to − 1.053; I2 = 79.93%, p < 0.001), and in quality of life, mean difference = − 8.144 (IC 95% − 12.082 to − 4.206; I2 = 64.22%, p = 0.027). Photobiomodulation, in particular, red laser protocols, resulted in improvement in pain and in quality of life of burning mouth syndrome patients.
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Affiliation(s)
- Gisela Cristina Vianna Camolesi
- Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela C.P, Entrerríos s/n, 15782, Galicia, Spain.,Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela C.P, Entrerríos s/n, 15782, Galicia, Spain
| | - Xabier Marichalar-Mendía
- Nursing I Department, University of the Basque Country (UPV/EHU), C.P. 48940, Leioa, Bizkaia, Spain
| | - Maria Elena Padín-Iruegas
- Human Anatomy and Embryology Area, Department of Functional Biology and Health Sciences, Faculty of Physiotherapy, Pontevedra, Spain.
| | - Juliana Cassol Spanemberg
- Oral Medicine and Public Health, Faculty of Dentistry, Universidad Fernando Pessoa-Canarias, Santa María de Guía, Calle de la Juventud s/n, C.P. 35450, Gran Canaria, Spain
| | - Jose López-López
- Department of Odontostomatology, Faculty of Medicine and Health Sciences, School of Dentistry, University of Barcelona//Oral Health and Masticatory System Group-IDIBELL, C.P. 08907, Barcelona, Cataluña, Spain
| | - Andrés Blanco-Carrión
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela C.P, Entrerríos s/n, 15782, Galicia, Spain.,Health Research Institute of Santiago (IDIS) (ORALRES), Santiago de Compostela, Spain
| | - Pilar Gándara-Vila
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela C.P, Entrerríos s/n, 15782, Galicia, Spain.,Health Research Institute of Santiago (IDIS) (ORALRES), Santiago de Compostela, Spain
| | - Mercedes Gallas-Torreira
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela C.P, Entrerríos s/n, 15782, Galicia, Spain.,Health Research Institute of Santiago (IDIS) (ORALRES), Santiago de Compostela, Spain
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela C.P, Entrerríos s/n, 15782, Galicia, Spain.,Health Research Institute of Santiago (IDIS) (ORALRES), Santiago de Compostela, Spain
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10
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Tan HL, Smith JG, Hoffmann J, Renton T. A systematic review of treatment for patients with burning mouth syndrome. Cephalalgia 2022; 42:128-161. [PMID: 34404247 PMCID: PMC8793318 DOI: 10.1177/03331024211036152] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/29/2021] [Accepted: 07/13/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Burning mouth syndrome is a chronic idiopathic intractable intraoral dysaesthesia that remains a challenge to clinicians due to its poorly understood pathogenesis and inconsistent response to various treatments. AIM This review aimed to study the short- (≤3 months) and long-term (>3 months) effectiveness and sustainable benefit of different burning mouth syndrome treatment strategies and the associated side effects. MATERIALS AND METHODS Randomised controlled trials of burning mouth syndrome treatment compared with placebo or other interventions with a minimum follow up of 2 months were searched from the PubMed, Embase and Cochrane database (published to July 2020). RESULTS Twenty-two studies were selected based on the inclusion and exclusion criteria and analysed. Nine categories of burning mouth syndrome treatment were identified: Anticonvulsant and antidepressant agents, phytomedicine and alpha lipoic acid supplements, low-level laser therapy, saliva substitute, transcranial magnetic stimulation, and cognitive behaviour therapy. Cognitive behaviour therapy, topical capsaicin and clonazepam, and laser therapy demonstrated favourable outcome in both short- and long-term assessment. Phytomedicines reported a short-term benefit in pain score reduction. The pooled effect of alpha lipoic acid (ALA) pain score improvement was low, but its positive effects increased in long term assessment. CONCLUSION A more significant volume in terms of sample size, multi-centres, and multi-arm comparison of therapeutic agents with placebo and longitudinal follow-up studies is recommended to establish a standardised burning mouth syndrome treatment protocol. Further studies are required to assess the analgesic benefits of topical clonazepam and capsaicin, alternative medicines with neurodegenerative prevention capability and psychology support in treating burning mouth syndrome and reducing systemic adverse drug reactions.Registration International Prospective Register of Systematic Reviews (PROSPERO):Protocol ID - CRD42020160892.
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Affiliation(s)
- Huann Lan Tan
- Faculty of Dentistry, Oral & Craniofacial Science, King’s College London, London, UK
- Faculty of Dentistry, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Jared G Smith
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Jan Hoffmann
- Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- NIHR-Wellcome Trust King’s Clinical Research Facility/SLaM Biomedical Research Centre, King’s College Hospital, London, UK
| | - Tara Renton
- Faculty of Dentistry, Oral & Craniofacial Science, King’s College London, London, UK
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11
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Hanna R, Dalvi S, Bensadoun RJ, Raber-Durlacher JE, Benedicenti S. Role of Photobiomodulation Therapy in Neurological Primary Burning Mouth Syndrome. A Systematic Review and Meta-Analysis of Human Randomised Controlled Clinical Trials. Pharmaceutics 2021; 13:1838. [PMID: 34834253 PMCID: PMC8624276 DOI: 10.3390/pharmaceutics13111838] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/17/2021] [Accepted: 10/26/2021] [Indexed: 12/22/2022] Open
Abstract
Mitochondrial homeostasis is crucial for energy production and neuronal survival in neurological primary burning mouth syndrome (npBMS). Photobiomodulation therapy (PBMT) has been utilised in npBMS management, however, its role of intervention remains controversial. The aim of this systematic review and meta-analysis of CRD 42020198921 PROSPERO registration reference was to oversee and determine the efficacy of PBMT in patients with npBMS, identifying the gaps and bridge them by proposing recommendations for future studies purposes. PRISMA guidelines and Cochrane Collaboration recommendations followed. Various search engines employed to analyse a total of 351 studies of which 12 were included. A wide range of utilised PBM wavelengths was between 635-980 nm and the power output ranged between 30 mW and 4000 mW. A high risk of bias (RoB) was noted in 7 out of 12 included studies (58.3%), as results of qualitative analysis. Meta-analysis findings of 4 out of 12 studies showed statistically significant intergroup differences (SSID) for visual analogue scale (VAS) values (MD = -1.47; 95% CI = -2.40 to -0.53; Z = 3.07 (p = 0.002) whereas meta-analysis on 5 out of 12 studies revealed SSID for anxiety/depression and quality of life (MD = -1.47; 95% CI = -2.40 to -0.53; Z = 3.07 (p = 0.002), favouring PBMT group to the control treatment strategies. Despite the inconsistency and diversity in PBM parameters (wavelength, power, light source, spot size, emission mode, energy per point, total energy) and treatment protocols (exposure time, number of sessions, time interval between sessions, treatment duration)-majority of the included studies showed positive PBM results. The high RoB and meta-analytical heterogeneity in the eligible studies warrant the necessity to perform well-designed and robust RCTs after acknowledging the drawbacks of the available scientific literature and addressing our suggested recommendations highlighted in our review.
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Affiliation(s)
- Reem Hanna
- Laser Therapy Centre, Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy;
- Department of Oral Surgery, Dental Institute, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK
| | - Snehal Dalvi
- Department of Periodontology, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur 441110, India;
| | - Rene Jean Bensadoun
- Centre De Haute Energie, Department of Oncology Radiology, 10 Boulevard Pasteur, 06000 Nice, France;
| | - Judith E. Raber-Durlacher
- Academic Centre for Dentistry Amsterdam, Department of Oral Medicine, University of Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands;
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, De Boelelaan 1117, 1118, 1081 HV Amsterdam, The Netherlands
| | - Stefano Benedicenti
- Laser Therapy Centre, Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy;
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12
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Orliaguet M, Misery L. Neuropathic and Psychogenic Components of Burning Mouth Syndrome: A Systematic Review. Biomolecules 2021; 11:biom11081237. [PMID: 34439903 PMCID: PMC8393188 DOI: 10.3390/biom11081237] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 12/27/2022] Open
Abstract
The pathophysiology of primary burning mouth syndrome (BMS) has been extensively debated but is poorly understood despite a large number of hypotheses attempting to explain its etiopathogenic mechanisms. The aim of the present work was to systematically review papers that could provide arguments in favour of the neuropathic and psychogenic components of primary BMS for a better understanding of the disease. This systematic review (SR) was registered in PROSPERO (CRD42021224160). The search was limited to articles in English or French from 1990 to 01 December 2020. A total of 113 articles were considered for data extraction. We divided them into four subgroups: pharmacological and nonpharmacological management studies (n = 23); neurophysiological studies (n = 35); biohistopathological studies (n = 25); and questionnaire-based studies (n = 30). Several of these studies have shown neuropathic involvement at various levels of the neuraxis in BMS with the contribution of quantitative sensory testing (QST), functional brain imaging, and biohistopathological or pharmacologic studies. On the other hand, the role of psychological factors in BMS has also been the focus of several studies and has shown a link with psychiatric disorders such as anxiety and/or depression symptoms. Depending on the patient, the neuropathic and psychogenic components may exist simultaneously, with a preponderance of one or the other, or exist individually. These two components cannot be dissociated to define BMS. Consequently, BMS may be considered nociplastic pain.
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Affiliation(s)
- Marie Orliaguet
- LIEN, Department of Oral Surgery, University of Western Brittany, F-29200 Brest, France;
| | - Laurent Misery
- LIEN, Department of Dermatology, University of Western Brittany, F-29200 Brest, France
- Correspondence: ; Tel.: +33-2-9888-3527
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13
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Matos AL, Silva PU, Paranhos LR, Santana IT, Matos FR. Efficacy of the laser at low intensity on primary burning oral syndrome: a systematic review. Med Oral Patol Oral Cir Bucal 2021; 26:e216-e225. [PMID: 33609024 PMCID: PMC7980289 DOI: 10.4317/medoral.24144] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 01/07/2021] [Indexed: 11/06/2022] Open
Abstract
Background Primary burning mouth syndrome (BMS) is a chronic clinical condition of idiopathic mainly characterized by pain and a burning sensation in the oral cavity. The application of laser at low intensity therapy is a treatment option. This systematic review evaluated the efficacy of laser therapy in treating symptoms of burning mouth syndrome.
Material and Methods The study was formulated according to the PRISMA and Cochrane guidelines. Seven databases were used as primary sources of research. Only randomized controlled clinical trials were included. The efficacy of the therapy was estimated comparing the values of the visual and numerical scales of pain before and after laser treatment, through qualitative analysis.
Results The search resulted in 348 records and only eight filled the eligibility criteria and were included. All studies evaluated pain and / or a burning sensation considering a time interval of two to ten weeks. The total sample consisted of 314 patients submitted to treatment: 123 from the control group, who participated with laser off or with the tip blocked, and 191 from the intervention group, treated with low-level laser therapy. The female gender stood out and the average age of the participants was 60.89 years. The main symptoms reported were pain and a burning sensation in the oral mucosa and tongue. The parameters adopted by the authors for laser treatment were diverse and the variables were not fully described in the published studies. Visual analog and numerical scales were used to assess symptoms and only three studies showed statistical significance.
Conclusions It is suggested that laser therapy may be an effective alternative in the treatment of BMS. New randomized clinical trials should consider well-established protocols to better understand the efficacy of laser therapy without confounding the effects. Key words:Efficacy, systematic review, burning mouth syndrome, low level laser therapy.
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Affiliation(s)
- A-L Matos
- Department of Dentistry Avenida Governador Marcelo Deda, 300 Postal Code 49400-000. São José Lizard, Lagarto (SE). Brazil
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14
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Pereira JV, Normando AGC, Rodrigues-Fernandes CI, Rivera C, Santos-Silva AR, Lopes MA. The impact on quality of life in patients with burning mouth syndrome: A systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 131:186-194. [DOI: 10.1016/j.oooo.2020.11.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/05/2020] [Accepted: 11/16/2020] [Indexed: 10/22/2022]
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15
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Abstract
Background:Burning mouth syndrome (BMS) is a chronic and debilitating oral pain of the normal oral mucosa. It mainly affects women in their fifth to seventh decade. Its aetiopathogenesis remains unclear and is probably of multifactorial origin, with increasing evidence that BMS may be a neuropathic disorder. BMS is classified as an idiopathic (nociplastic) orofacial pain with or without somatosensory changes by International Classification of Orofacial Pain (ICOP 2020). The diagnosis of BMS, having excluded ‘oral burning mouth symptoms’, has evolved from basic intraoral exclusion screening to extensive clinical and laboratory investigations, which include the screening of comorbidities and other chronic pains and somatosensory testing. There is no standardised treatment in managing BMS, but a proposed combination of supportive and pharmacological treatment has been recommended.Aim:To review the current concepts of BMS definitions, classifications, aetiopathogenesis, diagnosis techniques, and evidence-based treatments in managing BMS patients.Conclusion:As BMS is a diagnosis by exclusion, thus a stratified approach is required for assessment of patients presenting BMS. A BMS diagnosis protocol is desired using a standardised screening to distinguish BMS from patient’s presenting with ‘oral burning symptoms’, and evaluation of comorbid chronic pain disorders or other medical comorbidities, which will include haematological, fungal, salivary flow, and qualitative sensory testing. Axis II and other additional quantitative sensory testing may further elucidate the causes of this condition. For future BMS prediction and prevention, will be based upon research on the relationship between other chronic pain disorders and familial history, environmental and genetic information.
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Affiliation(s)
- Huann Lan Tan
- King’s College London, London, UK
- Dentistry, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Tara Renton
- Dentistry, Oral & Craniofacial Science, King’s College London, London, UK
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16
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Galiano-Castillo N, Liu L, Lozano-Lozano M, Tumilty S, Cantarero-Villanueva I, Baxter GD. Acute and cumulative benefits of Photobiomodulation for xerostomia: A systematic review and meta-analysis. Oral Dis 2020; 27:1115-1126. [PMID: 32964596 DOI: 10.1111/odi.13648] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 08/21/2020] [Accepted: 09/09/2020] [Indexed: 12/20/2022]
Abstract
The objective was to explore the effectiveness of photobiomodulation therapy for treating patients who suffer xerostomia and/or hyposalivation due to the most prevalent clinical diagnoses. We searched PubMed, Scopus, Web of Science, CINAHL and Cochrane Library for randomized or clinical controlled trials published until 31 October 2019. Risk of bias assessment and meta-analysis were conducted using the Cochrane tools. A total of 274 records were retrieved, and 11 met the inclusion criteria. Interventions whose parameters ranged between wavelengths of 790-830 nm (infrared), 30-120 mW of power and an energy density below 30 J/cm-2 were associated with improvements in xerostomia/hyposalivation. As for the assessment of methodological quality, 10 of the 11 articles included had a high risk of overall bias. Only 3 articles provided sufficient information to conduct a meta-analysis for quality of life, compared with placebo in patients with burning mouth syndrome, showing a standardized mean difference between groups from baseline of -0.90 (-1.48; -0.32). The present review and meta-analysis suggest that photobiomodulation therapy is an effective, non-invasive and safe approach in patients with xerostomia. However, despite the potential, it is not possible to reach a reliable consensus on the parameters to be used, and future studies should be conducted by standardizing intervention protocols.
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Affiliation(s)
- Noelia Galiano-Castillo
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health Joint University Institute (iMUDS), Granada, Spain.,Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain.,'Cuídate' Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | - Lizhou Liu
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Mario Lozano-Lozano
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health Joint University Institute (iMUDS), Granada, Spain.,Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain.,'Cuídate' Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | - Steve Tumilty
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Irene Cantarero-Villanueva
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health Joint University Institute (iMUDS), Granada, Spain.,Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain.,'Cuídate' Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | - George David Baxter
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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17
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Ślebioda Z, Lukaszewska-Kuska M, Dorocka-Bobkowska B. Evaluation of the efficacy of treatment modalities in burning mouth syndrome-A systematic review. J Oral Rehabil 2020; 47:1435-1447. [PMID: 32979878 DOI: 10.1111/joor.13102] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Burning mouth syndrome (BMS) is a medical entity characterised by a spontaneous sensation of burning, numbness or pain of the oral mucosa in the absence of clinical symptoms. The goal of this systematic review was to assess the efficacy of various current treatments for BMS. METHODS The literature search used the following inclusion criteria: randomised controlled trials (RCTs) which compared one or more treatment strategies for patients with primary/idiopathic BMS with a placebo group describing all types of interventions. The primary and secondary outcome measures included: relief of pain/burning sensations, changes in psychosocial factors and feeling of sensation of dryness. A computer and manual search was performed in Pubmed, Web of Science and Cochrane Library up to 5 November 2019 and updated on 28 June 2020. The risk of bias was measured with the Cochrane Collaboration tool. RESULTS Thirty RCTs which included 727 study participants and 589 controls were identified. The following interventions were introduced: dietary supplements, anticonvulsants, benzodiazepines, antidepressants, analgesics, topical agents, electromagnetic radiation or induction, physical barriers and psychological therapies. The most successful therapeutic outcomes were observed for clonazepam tested in 3 RCTs, where significant pain reduction appeared after both topical and systemic application. Evident pain reduction was also reported for tongue protectors and capsaicin in 2 separate studies. DISCUSSION Short follow-up periods, low numbers of participants, variability of the metrics used in the evaluation of the results and heterogeneous study design were the main limitations of the reviewed studies. Based on our analysis, clonazepam appears to be the most effective treatment option for BMS.
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Affiliation(s)
- Zuzanna Ślebioda
- Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Barbara Dorocka-Bobkowska
- Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, Poznan, Poland
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18
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Effectiveness of photobiomodulation in the treatment of primary burning mouth syndrome-a systematic review and meta-analysis. Lasers Med Sci 2020; 36:239-248. [PMID: 32725428 DOI: 10.1007/s10103-020-03109-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 07/22/2020] [Indexed: 10/23/2022]
Abstract
To evaluate the effectiveness of photobiomodulation (PBM) on primary burning mouth syndrome (pBMS). We searched Chinese and English studies published before February 10, 2020. The databases used include PubMed, EMBASE, the Cochrane Library, Web of Science, Wanfang Database, and China National Knowledge Infrastructure (CNKI). Randomized controlled clinical trials (RCTs) that used the PBM to treat pBMS and reported specific treatment outcomes were considered for inclusion. We eventually included 12 RCTs, and 574 samples were included in these studies. The primary outcomes investigated were pain reduction and life quality improvement. A meta-analysis performed on 9 groups in 5 trials showed that PBM was effective in reducing pain compared with placebo (MD - 1.86, 95% CI - 2.59 to - 1.13, Z = 4.99, P < 0.00001). Meta-analysis was also performed on 7 groups in 4 trials and showed that PBM was effective in improving life quality compared with placebo (MD - 3.43, 95% CI - 5.11 to - 1.75, Z = 4.00, P < 0.0001). Qualitative analysis of the included RCTs found that PBM might also play a role in the decrease of TNF-α and IL-6 in saliva. Three studies that compared PBM with medications were evaluated by descriptive analysis. None of the treatment-related adverse event was reported. Up to date, PBM appears to have an effect on pain reduction and life quality improvement in pBMS patients. However, more evidence is still required to warrant its efficacy and safety in treating pBMS.
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19
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de Pedro M, López‐Pintor RM, Casañas E, Hernández G. Effects of photobiomodulation with low‐level laser therapy in burning mouth syndrome: A randomized clinical trial. Oral Dis 2020; 26:1764-1776. [DOI: 10.1111/odi.13443] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/15/2020] [Accepted: 05/17/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Miguel de Pedro
- Department of Dental Clinical Specialties ORALMED Research Group School of Dentistry Complutense University Madrid Spain
| | - Rosa María López‐Pintor
- Department of Dental Clinical Specialties ORALMED Research Group School of Dentistry Complutense University Madrid Spain
| | - Elisabeth Casañas
- Department of Dental Clinical Specialties ORALMED Research Group School of Dentistry Complutense University Madrid Spain
| | - Gonzalo Hernández
- Department of Dental Clinical Specialties ORALMED Research Group School of Dentistry Complutense University Madrid Spain
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20
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Škrinjar I, Lončar Brzak B, Vidranski V, Vučićević Boras V, Rogulj AA, Pavelić B. Salivary Cortisol Levels and Burning Symptoms in Patients with Burning Mouth Syndrome before and after Low Level Laser Therapy: a Double Blind Controlled Randomized Clinical Trial. Acta Stomatol Croat 2020; 54:44-50. [PMID: 32523156 PMCID: PMC7233125 DOI: 10.15644/asc54/1/5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objectives Burning mouth syndrome (BMS) is a disorder which is described as burning sensation of the oral mucosa without pathological changes. Most of the patients have some underlying stressful conditions. Stress induces an increase in secretion of different endocrine glands resulting in higher levels of glucocorticoids. One of the options for treatment of BMS includes low level laser therapy (LLLT). The aim of this research was to determine salivary cortisol levels and intensity of burning symptoms in BMS patients before and after LLLT. Materials and Methods Twenty-three participants were allocated by randomization in two groups: 12 patients in the study group and 11 patients in the placebo group. Cortisol levels in all patients were analyzed from the sample of saliva collected without stimulation. In both groups, the LLLT was performed once a day for ten consecutive days (excluding weekend) with Ga-Al-As light-emitting diode type of laser, with a wavelength of 685nm. In the control group, LLLT was done with inactive laser probe which was only emitting audio signal. The intensity of burning symptoms was measured by a visual analogue scale (VAS). The VAS and unstimulated saliva were measured at baseline and on the last day of the LLLT. A quantitative analysis of saliva was performed using competitive commercial ELISA-kit. Results VAS scores and salivary cortisol levels were significantly lower in both groups after LLLT. Conclusions LLLT can be useful in patients with BMS for reducing burning symptoms and salivary cortisol level. Future studies on a larger number of patients should clarify whether the positive results are an outcome of laser effectiveness or of placebo effect.
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Affiliation(s)
- Ivana Škrinjar
- Department of Oral Medicine, University Hospital Center Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Božana Lončar Brzak
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Valentina Vidranski
- Department of Oncology and Nuclear Medicine, University Clinical Hospital Sisters of Mercy, Vinogradska cesta 29, 10000 Zagreb, Croatia
| | - Vanja Vučićević Boras
- Department of Oral Medicine, School of Dental Medicine University of Zagreb and University Clinical Hospital Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Ana Andabak Rogulj
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Božidar Pavelić
- Department of Restorative Dentistry, School of Dental Medicine, University of Zagreb and University Hospital Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
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21
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Abstract
Burning mouth syndrome/glossodynia and trigeminal neuropathic conditions can have serious negative impact on a patient's overall quality of life. These conditions are often hard to diagnose and even harder to fully treat and manage, but it is important for dentists/oral and maxillofacial surgeons to be aware of these conditions and modalities of their treatment. Often the only method for arriving at the proper diagnosis is for patients to undergo traditional approaches for treatment of presenting signs and symptoms, and it is the unexpected failure of interventional therapies that leads ultimately to a proper diagnosis.
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22
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Kalhori KA, Vahdatinia F, Jamalpour MR, Vescovi P, Fornaini C, Merigo E, Fekrazad R. Photobiomodulation in Oral Medicine. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:837-861. [DOI: 10.1089/photob.2019.4706] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
| | - Farshid Vahdatinia
- Dental Implants Research Center, Dental School of Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Reza Jamalpour
- Department of Oral and Maxillofacial Surgery, Dental Implants Research Center, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Paolo Vescovi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Carlo Fornaini
- Group of Applied ElectroMagnetics, Department of Engineering and Architecture, University of Parma, Parma, Italy
- Laboratoire MicOralIS (Microbiologie Orale, Immunothérapie et Santé) EA7354, UFR d'Odontologie, Université Nice Sophia Antipolis, Nice, France
| | - Elisabetta Merigo
- Laboratoire MicOralIS (Microbiologie Orale, Immunothérapie et Santé) EA7354, UFR d'Odontologie, Université Nice Sophia Antipolis, Nice, France
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran
- International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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23
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Țenț PA, Juncar RI, Juncar M. Clinical patterns and characteristics of midfacial fractures in western romanian population: a 10-year retrospective study. Med Oral Patol Oral Cir Bucal 2019; 24:e792-e798. [PMID: 31655842 PMCID: PMC6901137 DOI: 10.4317/medoral.23153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 05/14/2019] [Indexed: 01/08/2023] Open
Abstract
Background The aim of this study was to identify the clinical pattern of midfacial fractures and concomitant associated injuries in our geographical area, as well as to correlate them in order to determine the type of fracture with the highest incidence of associated injuries.
Material and Methods A 10-year retrospective evaluation of midfacial fractures was performed in 379 patients.
Results Zygomatic complex fractures had the highest incidence (n=242, 50%). The majority of the fractures were complete (n=561, 92.42%), closed (n=473, 84.16%) and without displacement (n=454, 80.78%) regardless of the location of the fracture line (p=0.014). All patients had at least one associated soft tissue injury (n=379, 100%). The most frequent associated injury was hematoma (n=308, 73.51%). Hematomas were predominant in the case of single fractures, while lacerations and excoriations were prevalent in the case of multiple fractures (p=0.000).
Conclusions Following trauma of the midface, patients with soft tissue hematomas will most probably have an underlying fracture with a single trajectory, while patients with lacerations will most probably have concomitant multiple bone fractures. Key words:Midface, fracture, trauma, pattern, associated injuries.
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Affiliation(s)
- P-A Țenț
- Faculty of Medicine and Pharmacy University of Oradea, Romania Str. Piața 1 Decembrie, no.10, 410073
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Bardellini E, Amadori F, Conti G, Majorana A. Efficacy of the photobiomodulation therapy in the treatment of the burning mouth syndrome. Med Oral Patol Oral Cir Bucal 2019; 24:e787-e791. [PMID: 31655841 PMCID: PMC6901136 DOI: 10.4317/medoral.23143] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 07/07/2019] [Indexed: 12/16/2022] Open
Abstract
Background This study aims to evaluate the efficacy of the photobiomodulation therapy (PBMT) - in terms of pain and of quality of life- in patients affected by burning mouth syndrome (BMS).
Material and Methods This study was designed as a randomised double-blinded prospective study. Patients diagnosed with BMS in the period from June 2015 to June 2018 were recruited. The patients were randomised into two groups and each received treatment once a week for ten weeks: group A received laser therapy (K Laser Cube 3®) while group B was given sham therapy (placebo). Pain was evaluated through the Visual Analogue Scale (VAS) and quality of life was assessed with the short form of the Oral Health Impact Profile (OHIP-14). Assessment was done at baseline and after every therapy session. The researchers were blind to the randomised allocations.
Results A total of 85 patients were analysed. Group A (laser treatment) was composed of 43 patients while group B (sham therapy) of 42 patients. Patients treated with PBMT showed a significant decrease in symptoms (p=0.0008) and improved quality of life related to oral health (p=0.0002). Conclusions PBMT has demonstrated to have a positive effect in relieving BMS symptoms and in improving a patient’s overall quality of life. Key words:Burning mouth syndrome, oral cavity, lasers, life quality.
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Affiliation(s)
- E Bardellini
- Dental Clinic, p.le Spedali Civili n.1 25133 Brescia
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Zhang J, Sun J, Zheng Q, Hu X, Wang Z, Liang Z, Li K, Song J, Ding T, Shen X, Zhang J, Qiao L. Low-level laser therapy 810-nm up-regulates macrophage secretion of neurotrophic factors via PKA-CREB and promotes neuronal axon regeneration in vitro. J Cell Mol Med 2019; 24:476-487. [PMID: 31667932 PMCID: PMC6933332 DOI: 10.1111/jcmm.14756] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 09/18/2019] [Accepted: 09/29/2019] [Indexed: 12/17/2022] Open
Abstract
Macrophages play key roles in the secondary injury stage of spinal cord injury (SCI). M1 macrophages occupy the lesion area and secrete high levels of inflammatory factors that hinder lesion repair, and M2 macrophages can secrete neurotrophic factors and promote axonal regeneration. The regulation of macrophage secretion after SCI is critical for injury repair. Low‐level laser therapy (810‐nm) (LLLT) can boost functional rehabilitation in rats after SCI; however, the mechanisms remain unclear. To explore this issue, we established an in vitro model of low‐level laser irradiation of M1 macrophages, and the effects of LLLT on M1 macrophage polarization and neurotrophic factor secretion and the related mechanisms were investigated. The results showed that LLLT irradiation decreased the expression of M1 macrophage‐specific markers, and increased the expression of M2 macrophage‐specific markers. Through forward and reverse experiments, we verified that LLLT can promote the secretion of various neurotrophic factors by activating the PKA‐CREB pathway in macrophages and finally promote the regeneration of axons. Accordingly, LLLT may be an effective therapeutic approach for SCI with clinical application prospects.
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Affiliation(s)
- Jiawei Zhang
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jiakai Sun
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Qiao Zheng
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xueyu Hu
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Zhe Wang
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Zhuowen Liang
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Kun Li
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jiwei Song
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Tan Ding
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xuefeng Shen
- Department of Occupational and Environmental Health and the Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Fourth Military Medical University, Xi'an, China
| | - Jianxin Zhang
- Department of Orthopedics, Weinan Central Hospital, Weinan, China
| | - Lin Qiao
- Department of Orthopedics, Third Hospital of Chinese PLA, Baoji, China
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Farag AM, Albuquerque R, Ariyawardana A, Chmieliauskaite M, Forssell H, Nasri‐Heir C, Klasser GD, Sardella A, Mignogna MD, Ingram M, Carlson CR, Miller CS. World Workshop in Oral Medicine VII: Reporting of IMMPACT‐recommended outcome domains in randomized controlled trials of burning mouth syndrome: A systematic review. Oral Dis 2019; 25 Suppl 1:122-140. [DOI: 10.1111/odi.13053] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 01/27/2019] [Accepted: 01/29/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Arwa M. Farag
- Department of Oral Diagnostic Sciences, Faculty of Dentistry King AbdulAziz University Jeddah Saudi Arabia
- Division of Oral Medicine, Department of Diagnostic Sciences Tufts School of Dental Medicine Boston Massachusetts
| | - Rui Albuquerque
- Oral Medicine Department Guy’s and St. Thomas Hospital NHS Foundation Trust, King’s College London London UK
| | - Anura Ariyawardana
- College of Medicine and Dentistry James Cook University Brisbane Queensland Australia
- Clinical Principal Dentist Metro South Oral Health Brisbane Queensland Australia
| | - Milda Chmieliauskaite
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, School of Dental Medicine Case Western Reserve University Cleveland Ohio
| | - Heli Forssell
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry University of Turku Turku Finland
| | - Cibele Nasri‐Heir
- Department of Diagnostic Sciences, Center for Temporomandibular Disorders and Orofacial Pain, Rutgers School of Dental Medicine The State University of New Jersey Newark New Jersey
| | - Gary D. Klasser
- Department of Diagnostic Sciences, School of Dentistry Louisiana State University Health Sciences Center New Orleans, Los Angeles
| | - Andrea Sardella
- Department of Biomedical, Surgical and Dental Sciences, Unit of Oral Medicine, Oral Pathology and Gerodontology University of Milan Milano Italy
| | - Michele D. Mignogna
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine Federico II University of Naples Naples Italy
| | - Mark Ingram
- Medical Center Library, College of Communication and Information University of Kentucky Lexington Kentucky
| | - Charles R. Carlson
- Orofacial Pain Clinic, College of Dentistry University of Kentucky Lexington Kentucky
| | - Craig S. Miller
- Department of Oral Health Practice, College of Dentistry University of Kentucky Lexington Kentucky
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27
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Ariyawardana A, Chmieliauskaite M, Farag AM, Albuquerque R, Forssell H, Nasri‐Heir C, Klasser GD, Sardella A, Mignogna MD, Ingram M, Carlson CR, Miller CS. World Workshop on Oral Medicine VII: Burning mouth syndrome: A systematic review of disease definitions and diagnostic criteria utilized in randomized clinical trials. Oral Dis 2019; 25 Suppl 1:141-156. [DOI: 10.1111/odi.13067] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 02/14/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Anura Ariyawardana
- College of Medicine and DentistryJames Cook University Queensland Australia
- Clinical Principal DentistMetro South Oral Health Brisbane Queensland Australia
| | - Milda Chmieliauskaite
- Department of Oral and Maxillofacial Medicine and Diagnostic SciencesSchool of Dental MedicineCase Western Reserve University Cleveland Ohio
| | - Arwa M. Farag
- Department of Oral Diagnostic SciencesFaculty of DentistryKing AbdulAziz University Jeddah Saudi Arabia
- Division of Oral MedicineDepartment of Diagnostic SciencesTufts School of Dental Medicine Boston Massachusetts
| | - Rui Albuquerque
- Oral Medicine DepartmentGuy's and St Thomas Hospital NHS Foundation TrustKing's college London London UK
| | - Heli Forssell
- Department of Oral and Maxillofacial SurgeryInstitute of DentistryUniversity of Turku Turku Finland
| | - Cibele Nasri‐Heir
- Department of Diagnostic SciencesRutgers School of Dental MedicineCenter for Temporomandibular Disorders and Orofacial PainRutgers The State University of New Jersey Newark New Jersy
| | - Gary D. Klasser
- Department of Diagnostic SciencesSchool of DentistryLouisiana State University Health Sciences Center New Orleans Louisiana
| | - Andrea Sardella
- Department of Biomedical, Surgical and Dental SciencesUnit of Oral Medicine, Oral Pathology and GerodontologyUniversity of Milan Milano Italy
| | - Michele D. Mignogna
- Department of Neurosciences, Reproductive and Odontostomatological SciencesSchool of MedicineFederico II University of Naples Naples Italy
| | - Mark Ingram
- Medical Center LibraryUniversity of Kentucky Lexington Kentucky
| | - Charles R. Carlson
- Department of PsychologyCollege of Art & SciencesCollege of DentistryOrofacial Pain ClinicUniversity of Kentucky Lexington Kentucky
| | - Craig S. Miller
- Department of Oral Health PracticeCollege of DentistryUniversity of Kentucky Lexington Kentucky
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What still remains missing from participants' selection criteria in clinical trials and systematic reviews? J Am Dent Assoc 2019; 149:931-934. [PMID: 30724166 DOI: 10.1016/j.adaj.2018.08.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 08/30/2018] [Indexed: 01/09/2023]
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Spanemberg JC, Segura-Egea JJ, Rodríguez-de Rivera-Campillo E, Jané-Salas E, Salum FG, López-López J. Low-level laser therapy in patients with Burning Mouth Syndrome: A double-blind, randomized, controlled clinical trial. J Clin Exp Dent 2019; 11:e162-e169. [PMID: 30805121 PMCID: PMC6383904 DOI: 10.4317/jced.55517] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 01/14/2019] [Indexed: 02/04/2023] Open
Abstract
Background Evaluate the effect of LLLT in the treatment of burning mouth syndrome (BMS). Material and Methods Twenty-one BMS patients were randomly assigned to two groups: 12 in the laser group (LG) and 9 in the control group (CG). Patients in the LG underwent 2-week sessions of LLLT for 4 weeks. The spot tip area of this tool is 0.088cm2, semi-conductor GaAlAs, with a wavelength of 808nm ±5nm (infrared), 200 mW output power, 1.97W/cm2 of power density, 3 J energy per point and application time 15 seconds per point. LLLT was applied punctually, in continuous emissions, on each of the sites where there was a symptom. Symptoms were evaluated with a visual analogue scale (VAS) and patient psychological profiles were assessed using the Hospital Anxiety-Depression Scale. No side effects were recorded. Statistical analysis was carried out via ANOVA and logistic regression analysis. Results The initial VAS score mean was 8.9 for the LG and 8.3 for the CG (p >0.05). After the eighth session the VAS score was 5.5 and 5.8 respectively, and at two months it was 4.7 and 5.1 respectively. Improvement variables were established by dichotomizing the pain scales. We obtained levels of significance for the improvement variable for the LG at the two-month follow-up (p=0.0038) and for the univariate analysis of the treatment. The improvement was marginally significant in the multivariant analysis of: dry mouth, dysgeusia, pain and the treatment (p=0.0538). Conclusions LLLT may be an alternative treatment for the relief of oral burning in patients with BMS. Key words:Burning mouth syndrome, oral pain, laser dentistry, laser therapy, low intensity laser therapy.
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Affiliation(s)
- Juliana-Cassol Spanemberg
- PhD. Postdoctoral Research Fellow. Specialist in Stomatology and Public Health. Department of Odontoestomatology - Faculty of Medicine and Health Sciences (School of Dentistry)
| | - Juan-Jose Segura-Egea
- PhD, MD, DDS, Doctor Specialist in Stomatology. Department of Stomatology, School of Dentistry, University of Seville, Spain
| | | | - Enric Jané-Salas
- MD, DDS, PhD. Doctor, Specialist in Stomatology. Professor of Oral Pathology, School of Dentistry, University of Barcelona, Spain / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Spain
| | - Fernanda-Gonçalves Salum
- PhD, Senior Lecturer, School of Dentistry, Oral Medicine Division, São Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Jose López-López
- Facultative Director and Clinical Head of the Surgical Medical Area of the Odontological Hospital University of Barcelona
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Sikora M, Včev A, Siber S, Vučićević Boras V, Rotim Ž, Matijević M. The Efficacy of Low-Level Laser Therapy in Burning Mouth Syndrome - A Pilot Study. Acta Clin Croat 2018; 57:312-315. [PMID: 30431725 PMCID: PMC6531994 DOI: 10.20471/acc.2018.57.02.12] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
SUMMARY – The aim of this clinical study was to compare low-level laser therapy (LLLT) switched on and switched off in the treatment of burning mouth syndrome (BMS). BMS is a debilitating condition for patients and highly demanding for physicians, characterized by burning symptoms in the oral cavity. Despite extensive research, so far only cognitive behavioral therapy and clonazepam have been proven successful for its treatment in randomized controlled trials. Forty-four patients with BMS were randomly assigned to the study laser group (LLLT) or the sham laser group. LLLT was performed with the GaAlAs laser (830 nm) used in non-contact mode on the site in the mouth where burning symptoms were present; study patients received 10 sessions (10 days). Each participant filled out the visual analog scale (VAS) and oral health impact on the quality of life scale (OHIP-CRO 14) before and after either therapy protocol. There were no significant differences between the groups before and after LLLT (switched on and off) in the quality of life (OHIP CRO 14 scores) (p>0.05). There was significant decrease in pain symptoms (VAS) in both LLLT switched on and LLLT switched off groups (p<0.05). Both LLLT switched on and switched off decreased pain symptoms (VAS) in patients with BMS; however, neither LLLT switched off or switched on improved the OHIP-CRO 14 scores.
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Affiliation(s)
| | - Aleksandar Včev
- School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Stjepan Siber
- School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Vanja Vučićević Boras
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Željko Rotim
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb Zagreb, Croatia
| | - Marko Matijević
- School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
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31
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Treatment modalities for burning mouth syndrome: a systematic review. Clin Oral Investig 2018; 22:1893-1905. [DOI: 10.1007/s00784-018-2454-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 04/16/2018] [Indexed: 10/17/2022]
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Barbosa NG, Gonzaga AKG, de Sena Fernandes LL, da Fonseca AG, Queiroz SIML, Lemos TMAM, da Silveira ÉJD, de Medeiros AMC. Evaluation of laser therapy and alpha-lipoic acid for the treatment of burning mouth syndrome: a randomized clinical trial. Lasers Med Sci 2018; 33:1255-1262. [PMID: 29502160 DOI: 10.1007/s10103-018-2472-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 02/20/2018] [Indexed: 12/16/2022]
Abstract
The aim of this study was to evaluate the efficacy of low-level laser therapy (LLLT) and alpha-lipoic acid (ALA) in the treatment of burning mouth syndrome (BMS) and secondary oral burning (SOB) by unstimulated sialometry, symptom assessment, and measurement of salivary TNF-α levels. Forty-four patients were randomized into four treatment groups: BMS/laser (n = 10), BMS/ALA (n = 5), SOB/laser (n = 15), and SOB/ALA (n = 14). The control group consisted of eight healthy female subjects. Unstimulated salivary flow was measured before and after treatment, and the collected saliva was stored at - 20 °C for the analysis of TNF-α. Symptoms were evaluated before and after treatment using a pain visual analog scale. Most patients were women (81.8%) during menopause (72.2%). LLLT and ALA were efficient in increasing salivary flow only in BMS but provided symptom relief in both conditions. TNF-α levels did not differ between patients with BMS and SOB or between those patients and the control group. No differences were observed in posttreatment TNF-α levels in either condition. The results of this study suggest that LLLT and ALA are efficient therapies in reducing burning mouth symptoms, with LLLT being more efficient than ALA.
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Affiliation(s)
- Natália Guimarães Barbosa
- Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Amanda Katarinny Goes Gonzaga
- Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte, Natal, RN, Brazil. .,Departamento de Odontologia, Universidade Federal do Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN, CEP 59056-000, Brazil.
| | - Luzia Leiros de Sena Fernandes
- Postgraduate Program in Technological Development and Innovation in Medicines, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Aldilane Gonçalves da Fonseca
- Postgraduate Program in Technological Development and Innovation in Medicines, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Telma Maria Araújo Moura Lemos
- Postgraduate Program in Technological Development and Innovation in Medicines, Federal University of Rio Grande do Norte, Natal, Brazil
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Al-Maweri SA, Javed F, Kalakonda B, AlAizari NA, Al-Soneidar W, Al-Akwa A. Efficacy of low level laser therapy in the treatment of burning mouth syndrome: A systematic review. Photodiagnosis Photodyn Ther 2017; 17:188-193. [DOI: 10.1016/j.pdpdt.2016.11.017] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 11/23/2016] [Accepted: 11/29/2016] [Indexed: 12/13/2022]
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Valenzuela S, Lopez-Jornet P. Effects of low-level laser therapy on burning mouth syndrome. J Oral Rehabil 2016; 44:125-132. [PMID: 27893167 DOI: 10.1111/joor.12463] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2016] [Indexed: 01/03/2023]
Abstract
To investigate low-level laser therapy (LLLT) applied to treat burning mouth syndrome (BMS). This prospective, comparative, partially blinded, single-centre, clinical trial of GaAlAs Laser, with 815 nm wavelength, included 44 BMS patients divided randomly into three groups: Group I (n = 16): GaAlAs laser 815 nm wavelength, 1 W output power, continuous emissions, 4 s, 4 J and fluence rate 133·3 J cm-2 ; Group II (n = 16): GaAlAs infrared laser, 815 nm wavelength, 1 W output power, continuous emissions, 6 s, 6 J and fluence rate 200 J cm-2 ; Group III (n = 12) placebo group, sham laser. All groups received a weekly dose for 4 weeks. Pain intensity was recorded using a 10-cm visual analogue scale; patients responded to the oral health impact profile (OHIP-14), xerostomia severity test and the hospital anxiety-depression scale (HAD). These assessments were performed at baseline, 2 and 4 weeks. LLLT decreased pain intensity and improved OHIP-14 scores significantly from baseline to 2 weeks in groups I and II compared with the placebo group. No statistically significant differences were found from 2 to 4 weeks. Overall improvements in visual analogue scale (VAS) scores from baseline to the end of treatment were as follows: Group I 15·7%; Group II 15·6%; Group III placebo 7·3%. LLLT application reduces symptoms slightly in BMS patients.
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Affiliation(s)
- S Valenzuela
- Department of Oral Medicine, Faculty of Medicine, University of Murcia, Murcia, Spain.,Medicina Oral, Clínica Odontológica Universitária Hospital Morales Meseguer, Murcia, Spain
| | - P Lopez-Jornet
- Department of Oral Medicine, Faculty of Medicine, University of Murcia, Murcia, Spain.,Medicina Oral, Clínica Odontológica Universitária Hospital Morales Meseguer, Murcia, Spain.,Murcia Institute of Bio-Health Research (IMIB-Arrixaca), Murcia, Spain
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McMillan R, Forssell H, Buchanan JAG, Glenny A, Weldon JC, Zakrzewska JM. Interventions for treating burning mouth syndrome. Cochrane Database Syst Rev 2016; 11:CD002779. [PMID: 27855478 PMCID: PMC6464255 DOI: 10.1002/14651858.cd002779.pub3] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Burning mouth syndrome (BMS) is a term used for oral mucosal pain (burning pain or discomfort in the tongue, lips or entire oral cavity) without identifiable cause. General population prevalence varies from 0.1% to 3.9%. Many BMS patients indicate anxiety, depression, personality disorders and impaired quality of life (QoL). This review updates the previous versions published in 2000 and 2005. OBJECTIVES To determine the effectiveness and safety of any intervention versus placebo for symptom relief and changes in QoL, taste, and feeling of dryness in people with BMS. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 31 December 2015), the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 11) in the Cochrane Library (searched 31 December 2015), MEDLINE Ovid (1946 to 31 December 2015), and Embase Ovid (1980 to 31 December 2015). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. We placed no restrictions on the language or date of publication when searching the electronic databases SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing any treatment against placebo in people with BMS. The primary outcomes were symptom relief (pain/burning) and change in QoL. Secondary outcomes included change in taste, feeling of dryness, and adverse effects. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Outcome data were analysed as short-term (up to three months) or long-term (three to six months). MAIN RESULTS We included 23 RCTs (1121 analysed participants; 83% female). Interventions were categorised as: antidepressants and antipsychotics, anticonvulsants, benzodiazepines, cholinergics, dietary supplements, electromagnetic radiation, physical barriers, psychological therapies, and topical treatments.Only one RCT was assessed at low risk of bias overall, four RCTs' risk of bias was unclear, and 18 studies were at high risk of bias. Overall quality of the evidence for effectiveness was very low for all interventions and all outcomes.Twenty-one RCTs assessed short-term symptom relief. There is very low-quality evidence of benefit from electromagnetic radiation (one RCT, 58 participants), topical benzodiazepines (two RCTs, 111 participants), physical barriers (one RCT, 50 participants), and anticonvulsants (one RCT, 100 participants). We found insufficient/contradictory evidence regarding the effectiveness of antidepressants, cholinergics, systemic benzodiazepines, dietary supplements or topical treatments. No RCT assessing psychological therapies evaluated short-term symptom relief.Four studies assessed long-term symptom relief. There is very low-quality evidence of a benefit from psychological therapies (one RCT, 30 participants), capsaicin oral rinse (topical treatment) (one RCT, 18 participants), and topical benzodiazepines (one RCT, 66 participants). We found no evidence of a difference for dietary supplements or lactoperoxidase oral rinse. No studies assessing antidepressants, anticonvulsants, cholinergics, electromagnetic radiation or physical barriers evaluated long-term symptom relief.Short-term change in QoL was assessed by seven studies (none long-term).The quality of evidence was very low. A benefit was found for electromagnetic radiation (one RCT, 58 participants), however findings were inconclusive for antidepressants, benzodiazepines, dietary supplements and physical barriers.Secondary outcomes (change in taste and feeling of dryness) were only assessed short-term, and the findings for both were also inconclusive.With regard to adverse effects, there is very low-quality evidence that antidepressants increase dizziness and drowsiness (one RCT, 37 participants), and that alpha lipoic acid increased headache (two RCTs, 118 participants) and gastrointestinal complaints (3 RCTs, 138 participants). We found insufficient/contradictory evidence regarding adverse events for anticonvulsants or benzodiazepines. Adverse events were poorly reported or unreported for cholinergics, electromagnetic radiation, and psychological therapies. No adverse events occurred from physical barriers or topical therapy use. AUTHORS' CONCLUSIONS Given BMS' potentially disabling nature, the need to identify effective modes of treatment for sufferers is vital. Due to the limited number of clinical trials at low risk of bias, there is insufficient evidence to support or refute the use of any interventions in managing BMS. Further clinical trials, with improved methodology and standardised outcome sets are required in order to establish which treatments are effective. Future studies are encouraged to assess the role of treatments used in other neuropathic pain conditions and psychological therapies in the treatment of BMS.
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Affiliation(s)
- Roddy McMillan
- Eastman Dental HospitalDepartment of Oral Medicine and Facial Pain256 Gray's Inn RoadLondonUKWC1X 8LD
| | - Heli Forssell
- University of TurkuOral & Maxillofacial Surgery, Institute of DentistryLemminkäisenkatu 220520TurkuFinland
| | - John AG Buchanan
- Barts and The London School of Medicine and DentistryDepartment of Oral MedicineTurner StreetLondonUKE1 2AD
| | - Anne‐Marie Glenny
- The University of ManchesterDivision of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and HealthJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Jo C Weldon
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Joanna M Zakrzewska
- Eastman Dental HospitalDepartment of Oral Medicine and Facial Pain256 Gray's Inn RoadLondonUKWC1X 8LD
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Arduino PG, Cafaro A, Garrone M, Gambino A, Cabras M, Romagnoli E, Broccoletti R. A randomized pilot study to assess the safety and the value of low-level laser therapy versus clonazepam in patients with burning mouth syndrome. Lasers Med Sci 2016; 31:811-6. [PMID: 26873501 DOI: 10.1007/s10103-016-1897-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 01/27/2016] [Indexed: 12/26/2022]
Abstract
Comparison between low-level laser therapy (LLLT) and clonazepam for treating burning mouth syndrome (BMS) patients has never been documented; the aim of this study was to assess the effects of LLLT photobiomodulation versus medical therapy with clonazepam on BMS. Thirty-three patients (25 female, 8 male, mean age = 67.12) were randomly allocated to two different groups: the first one (group A, 18 patients) underwent two laser irradiation sessions weekly for 5 weeks, whereas the second one (group B, 15 patients) received topical clonazepam therapy [half a tablet (2 mg) in the mouth without swallowing for 3 min, three times a day for 21 days]. LLLT was delivered with a continuous wave 980-nm aluminum gallium arsenide (AlGaAs) diode laser and the output of 300 mW, delivering a Fluence of 10 J/cm(2), using a "spot technique," with an average power density of about 1 W/cm(2). The laser probe was held perpendicularly at a distance of about 2 mm from the mucosa. Visual analogue scale (VAS), McGill Pain Questionnaire, present pain intensity (PPI), and Oral Health Impact Profile (OHIP-49) assessed sensation of pain. Hospital Anxiety and Depression Scale and Geriatric Depression Scale assessed levels of anxiety and depression. Twelve weeks after the end of treatment, patients treated with LLLT experienced a decrease in pain sensation reported for all the parameters analyzed: VAS (P = 0.004), McGill Pain Questionnaire (P = 0.002), PPI (P = 0.002), and OHIP-49 (P = 0.010). The group treated with clonazepam had less favorable results for VAS (P = 0.33), McGill Pain Questionnaire (P = 0.005), PPI (P = 0.013), and OHIP-49 (P = 0.25). Levels of anxiety and depression did not change statistically in any groups (P > 0.05). Comparing the two groups, LLLT appeared to be superior in improving pain perception, but statistically only at 8 weeks after the end of the protocol proposed (P = 0.026). Based on this preliminary trial, LLLT is capable of reducing the symptoms of patients with BMS with a constant and long-lasting effect, experienced since the end of the first applications.
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Affiliation(s)
- Paolo G Arduino
- Department of Surgical Sciences, Oral Medicine Section, University of Turin, Unito Lingotto Dental Institute c/o Lingotto, Via Nizza 230, 10126, Turin, Italy.
| | - Adriana Cafaro
- Department of Surgical Sciences, Oral Medicine Section, University of Turin, Unito Lingotto Dental Institute c/o Lingotto, Via Nizza 230, 10126, Turin, Italy
| | - Marco Garrone
- Department of Surgical Sciences, Oral Medicine Section, University of Turin, Unito Lingotto Dental Institute c/o Lingotto, Via Nizza 230, 10126, Turin, Italy
| | - Alessio Gambino
- Department of Surgical Sciences, Oral Medicine Section, University of Turin, Unito Lingotto Dental Institute c/o Lingotto, Via Nizza 230, 10126, Turin, Italy
| | - Marco Cabras
- Department of Surgical Sciences, Oral Medicine Section, University of Turin, Unito Lingotto Dental Institute c/o Lingotto, Via Nizza 230, 10126, Turin, Italy
| | - Ercole Romagnoli
- Department of Surgical Sciences and Integrated Diagnostics, Genoa University, Genoa, Italy
| | - Roberto Broccoletti
- Department of Surgical Sciences, Oral Medicine Section, University of Turin, Unito Lingotto Dental Institute c/o Lingotto, Via Nizza 230, 10126, Turin, Italy
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