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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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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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Fernández-Agra M, González-Serrano J, de Pedro M, Virto L, Caponio VCA, Ibáñez-Prieto E, Hernández G, López-Pintor RM. Salivary biomarkers in burning mouth syndrome: A systematic review and meta-analysis. Oral Dis 2023; 29:2600-2613. [PMID: 36135356 DOI: 10.1111/odi.14390] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/02/2022] [Accepted: 09/20/2022] [Indexed: 12/01/2022]
Abstract
The objective of this systematic review was to evaluate which salivary biomarkers are altered in patients with burning mouth syndrome (BMS) compared to a control group (CG). A comprehensive literature search was conducted in four databases. Case-control studies evaluating salivary biomarkers in BMS patients were included. Risk of bias was assessed using the Newcastle-Ottawa tool. RevMan was used for meta-analysis. Seventeen studies were selected. The included studies collected 54 different biomarkers. Of these biomarkers, only three (cortisol, α-amylase, and dehydroepiandrosterone) were analyzed in three or more studies. Dehydroepiandrosterone obtained contradictory results among the studies. However, cortisol and α-amylase levels were found to be higher in BMS patients. Cortisol was the only biomarker which could be included for meta-analysis. Cortisol levels were significantly higher in the BMS group compared to the CG (Mean Difference = 0.39; 95% CI [0.14-0.65]; p = 0.003). In conclusion, different studies investigated salivary biomarkers in patients with BMS compared to a CG, with controversial results. Meta-analysis, confirmed by trial-sequential analysis, showed how cortisol levels were significantly higher in BMS. Cortisol emerges as an interesting salivary biomarker in BMS, but future properly designed studies are needed to evaluate its role in diagnosis and/or response to treatment.
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Affiliation(s)
- María Fernández-Agra
- Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - José González-Serrano
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Miguel de Pedro
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
- Department of Clinical Dentistry, Faculty of Biomedical Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Leire Virto
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, School of Dentistry, Complutense University, Madrid, Spain
| | | | - Elena Ibáñez-Prieto
- Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Gonzalo Hernández
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Rosa María López-Pintor
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
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Moreau C, El Habnouni C, Lecron JC, Morel F, Delwail A, Le Gall-Ianotto C, Le Garrec R, Misery L, Piver E, Vaillant L, Lefevre A, Emond P, Blasco H, Samimi M. Salivary metabolome indicates a shift in tyrosine metabolism in patients with burning mouth syndrome: a prospective case-control study. Pain 2023; 164:e144-e156. [PMID: 35916738 DOI: 10.1097/j.pain.0000000000002733] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 05/31/2022] [Indexed: 11/25/2022]
Abstract
ABSTRACT The pathophysiology of primary burning mouth syndrome (BMS) remains controversial. Targeted analyses or "omics" approach of saliva provide diagnostic or pathophysiological biomarkers. This pilot study's primary objective was to explore the pathophysiology of BMS through a comparative analysis of the salivary metabolome among 26 BMS female cases and 25 age- and sex-matched control subjects. Secondary objectives included comparative analyses of inflammatory cytokines, neuroinflammatory markers, and steroid hormones among cases and control subjects, and among BMS patients according to their clinical characteristics. Salivary metabolome, neuroinflammatory markers, cytokines, and steroids were, respectively, analysed by liquid chromatography coupled with mass spectrometry, ELISA and protease activity assay, and multiparametric Luminex method. Among the 166 detected metabolites, univariate analysis did not find any discriminant metabolite between groups. Supervised multivariate analysis divided patients into 2 groups with an accuracy of 60% but did not allow significant discrimination (permutation test, P = 0.35). Among the metabolites contributing to the model, 3 belonging to the tyrosine pathway ( l -dopa, l -tyrosine, and tyramine) were involved in the discrimination between cases and control subjects, and among BMS patients according to their levels of pain. Among the detectable molecules, levels of cytokines, steroid hormones, and neuroinflammatory markers did not differ between cases and control subjects and were not associated with characteristics of BMS patients. These results do not support the involvement of steroid hormones, inflammatory cytokines, or inflammatory neurogenic mediators in the pathophysiology of pain in BMS, whereas the observed shift in tyrosine metabolism may indicate an adaptative response to chronic pain or an impaired dopaminergic transmission.
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Affiliation(s)
- Charlotte Moreau
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
| | - Chakib El Habnouni
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
| | - Jean-Claude Lecron
- Laboratory Inflammation, Tissus Epithéliaux et Cytokines, Poitiers University and Immunology/inflammation Laboratory, Poitiers University Hospital, Poitiers, France
| | - Franck Morel
- Laboratory Inflammation, Tissus Epithéliaux et Cytokines, Poitiers University and Immunology/inflammation Laboratory, Poitiers University Hospital, Poitiers, France
| | - Adriana Delwail
- ImageUP, Plate-forme d'Imagerie and Laboratoire Signalisation et Transport Ioniques Membranaires ERL CNRS 7003/EA 7349, Poitiers University, Poitiers, France
| | | | - Raphaele Le Garrec
- Univ Brest, LIEN (Laboratoire Interactions Epithelium Neurones), Brest, France
| | - Laurent Misery
- Univ Brest, LIEN (Laboratoire Interactions Epithelium Neurones), Brest, France
| | - Eric Piver
- Department of Biochemistry and Molecular Biology, University Hospital of Tours, Tours Cedex, France
- Inserm UMR 1259-Morphogenèse et antigénicité du VIH et des virus des hépatites (MAVIVH)
| | - Loïc Vaillant
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
| | | | - Patrick Emond
- UMR 1253 iBrain, Université de Tours, Inserm, Tours, France
- Department of In Vitro Nuclear Medicine, University Hospital of Tours, Tours Cedex, France
| | - Hélène Blasco
- Department of Biochemistry and Molecular Biology, University Hospital of Tours, Tours Cedex, France
- UMR 1253 iBrain, Université de Tours, Inserm, Tours, France
| | - Mahtab Samimi
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
- BIP, 1282 INRA University of Tours, Tours, France
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Aitken-Saavedra J, Tarquinio SB, Kinalski M, Haubman D, Martins MW, Vasconcelos AC. Salivary characteristics in burning mouth syndrome: a systematic review. Minerva Dent Oral Sci 2022; 71:233-241. [PMID: 35920290 DOI: 10.23736/s2724-6329.22.04647-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Compare through case-control studies, the salivary characteristics of patients with and without BMS. EVIDENCE ACQUISITION Searches in Embase, PubMed, Web of Science, Scopus, Cochrane, and BIREME were conducted for the identification of case-controls studies reported. EVIDENCE SYNTHESIS Thirty-three studies were included, of which 26 articles evaluated OSB, 17 SRF, and 7 SE. Nineteen organic biomarkers showed higher levels in BMS patients, the two most indicated being α-amylase and cortisol. Ten organic biomarkers, including Tumor Necrosis Factor-alpha (TNF-α) and IL-6, showed lower levels in BMS patients. Regarding salivary flow rate (SFR), five articles indicated that BMS patients have less unstimulated SFR (uSRF)Two articles indicate that stimulated SFR (sSRF) is lower in BMS patients nevertheless, but eight did not show differences. Sialochemical analysis revealed that sodium (Na), chloride (Cl), potassium (K), sodium (Na), and calcium (Ca), showed higher levels in BMS patients according to three studies, but two studies did not establish any differences. Two study established that BMS patients have lower Mg salivary levels. CONCLUSIONS Qualitative salivary characteristics suggest that BMS has neuropathic, inflammatory, emotional, immune, and hormonal involvements. BMS can be associated with changes in salivary biomarkers of inflammation and oxidative stress, is related to anxiety and degree of pain.
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Affiliation(s)
- Juan Aitken-Saavedra
- Department of Oral Pathology and Medicine, Faculty of Dentistry, University of Chile, Santiago, Chile
- School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Sandra B Tarquinio
- Diagnostic Center for Oral Diseases, Federal University of Pelotas, Pelotas, Brazil
| | - Matheus Kinalski
- Faculty of Dentistry, Community University of Chapecó, Chapecó, Brazil
| | - Daniela Haubman
- School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | | | - Ana C Vasconcelos
- Diagnostic Center for Oral Diseases, Federal University of Pelotas, Pelotas, Brazil -
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Nosratzehi T. Burning mouth syndrome: a review of therapeutic approach. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 19:83-90. [PMID: 34881535 DOI: 10.1515/jcim-2021-0434] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 11/15/2021] [Indexed: 01/03/2023]
Abstract
Burning mouth syndrome (BMS) is described by an intense burning sensation of the tongue or other oral areas without a clear etiopathology. The diagnosis of BMS is challenging due to variations of manifestations. The management of BMS is complicated due to the complex etiology of the disease. Many medications and treatment methods have been recommended for BMS management, but no one confirmed as the standard method. In this study, the therapeutic approaches of BMS were evaluated. The data of the article was obtained from PubMed/MEDLINE, Cochrane Library, and Web of Science. The following terms including "burning mouth syndrome", "therapy", and "treatment" were used for search in the databases. A wide range of articles about the therapeutic approach of BMS was searched and reviewed. Pharmacological and non-pharmacological approaches have been used for BMS management. Pharmacological treatments are including Capsaicin, Clonazepam, Low-dose aripiprazole, Alpha-lipoic acid, Duloxetine, Amitriptyline, Gabapentin, and Pregabalin, and ultra-micronized palmitoylethanolamide. Non-pharmacological therapies for BMS are cognitive therapy, Electroconvulsive therapy, Laser therapy, Acupuncture and auriculotherapy, Transcranial Magnetic Stimulation (rTMS), Salivary Mechanical Stimulation, and Botulinum Toxin. A detailed assessment of the etiology and pathophysiology of BMS, and having information about novel therapeutic interventions are essential for the management of BMS.
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Affiliation(s)
- Tahereh Nosratzehi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Oral and Dental Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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Petrović M, Kesić L, Šavikin K, Miladinović B, Obradović R, Bojović M, Stojković B, Stojanović S, Jovanović M, Kitić D. Can the chokeberry juice be used as additional therapy for burning mouth syndrome in menopausal women? Health Care Women Int 2021; 43:1234-1246. [PMID: 34846271 DOI: 10.1080/07399332.2021.2007247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The researchers' aims were to evaluate the effects of chokeberry juice in the treatment of burning mouth syndrome (BMS) and oral discomfort in menopausal women. The following validated scales and questionnaires were used before and after treatment: questionnaire used for selection of research participants with xerostomia, the xerostomia inventory, Visual Analogue Scale (VAS), localization of pain before and after treatment, short-form McGill pain questionnaire. There was statistically significant decrease in number of research participants who felt pain after therapeutic procedure (p < 0.05). Chokeberry juice, as additional therapy for BMS, reduced intensity of characteristic types of pain sensations and oral dryness feeling.
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Affiliation(s)
- Milica Petrović
- Department of Dentistry, Faculty of Medicine, University of Niš, Niš, Serbia
| | - Ljiljana Kesić
- Department of Dentistry, Faculty of Medicine, University of Niš, Niš, Serbia
| | - Katarina Šavikin
- Institute for Medicinal Plants Research "Josif Pančić'", Belgrade, Serbia
| | - Bojana Miladinović
- Department of Pharmacy, Faculty of Medicine, University of Niš, Niš, Serbia
| | - Radmila Obradović
- Department of Dentistry, Faculty of Medicine, University of Niš, Niš, Serbia
| | - Marija Bojović
- Department of Dentistry, Faculty of Medicine, University of Niš, Niš, Serbia
| | | | - Simona Stojanović
- Department of Dentistry, Faculty of Medicine, University of Niš, Niš, Serbia
| | - Marija Jovanović
- Department of Dentistry, Faculty of Medicine, University of Niš, Niš, Serbia
| | - Dušanka Kitić
- Department of Pharmacy, Faculty of Medicine, University of Niš, Niš, Serbia
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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] [MESH Headings] [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.
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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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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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Paudel D, Morikawa T, Yoshida K, Uehara O, Giri S, Neopane P, Khurelchuluun A, Hiraki D, Sato J, Abiko Y. Chronic stress-induced elevation of IL-1β in the saliva and submandibular glands of mice. Med Mol Morphol 2020; 53:238-243. [PMID: 32253605 DOI: 10.1007/s00795-020-00250-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 03/27/2020] [Indexed: 12/16/2022]
Abstract
Psychological stress is involved in the development of various oral diseases. Alterations in the levels of cytokines in the saliva of patients with stress-related oral diseases have been reported. However, the inconsistencies in the results of these studies might be attributed to differences in the local and systemic factors in the oral cavities of the patients. We examined the effect of chronic stress on three major inflammatory cytokines Interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α in the saliva and salivary glands of chronically stressed mice. Six-week-old C57BL/6 J mice were randomly divided into a control and a stress group. The mice in stress group were exposed to 4 h of stress daily for 10 days and subsequently saliva, as well as the submandibular glands, were collected from both groups. The expression levels of cytokines in the saliva were examined by enzyme-linked immunosorbent assay. The submandibular glands were subjected to histopathological and mRNA expression analyses. IL-1β was significantly elevated in saliva of the chronic stressed mice. Furthermore, the mRNA expression levels of both IL-1β and IL-6 were significantly elevated in the submandibular gland of chronic stressed mice. IL-1β may be a potential salivary biomarker in response to chronic stress in mice.
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Affiliation(s)
- Durga Paudel
- Division of Oral Medicine and Pathology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Tetsuro Morikawa
- Division of Oral Medicine and Pathology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Koki Yoshida
- Division of Oral Medicine and Pathology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Osamu Uehara
- Division of Disease Control and Molecular Epidemiology, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Sarita Giri
- Division of Periodontology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Puja Neopane
- Division of Oral Medicine and Pathology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Ariuntsetseg Khurelchuluun
- Division of Oral Medicine and Pathology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Daichi Hiraki
- Division of Oral Medicine and Pathology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Jun Sato
- Division of Oral Medicine and Pathology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Yoshihiro Abiko
- Division of Oral Medicine and Pathology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan.
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Pereira SR, Tello Velasquez J, Duggan S, Ivanisevic B, McKenna JP, McCreary C, Downer EJ. Recent advances in the understanding of the aetiology and therapeutic strategies in burning mouth syndrome: Focus on the actions of cannabinoids. Eur J Neurosci 2020; 55:1032-1050. [DOI: 10.1111/ejn.14712] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/06/2020] [Accepted: 02/20/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Sónia R. Pereira
- Discipline of Physiology School of Medicine Trinity Biomedical Sciences Institute Trinity College Dublin Dublin 2 Ireland
| | - Johana Tello Velasquez
- Discipline of Physiology School of Medicine Trinity Biomedical Sciences Institute Trinity College Dublin Dublin 2 Ireland
| | - Sarah Duggan
- Discipline of Physiology School of Medicine Trinity Biomedical Sciences Institute Trinity College Dublin Dublin 2 Ireland
| | - Bojana Ivanisevic
- Cork University Dental School and Hospital University College Cork Cork Ireland
| | - Joseph P. McKenna
- Cork University Dental School and Hospital University College Cork Cork Ireland
| | - Christine McCreary
- Cork University Dental School and Hospital University College Cork Cork Ireland
| | - Eric J. Downer
- Discipline of Physiology School of Medicine Trinity Biomedical Sciences Institute Trinity College Dublin Dublin 2 Ireland
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12
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13
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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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15
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Kishore J, Shaikh F, Mirza S, Raffat MA, Ikram S, Akram Z. Cytokine levels and their role in the etiopathogenesis of Burning Mouth Syndrome: A systematic review. Cephalalgia 2019; 39:1586-1594. [DOI: 10.1177/0333102419854052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Introduction Burning Mouth Syndrome is characterized by variable symptoms that include pain, burning and paraguesia in an otherwise healthy-appearing oral mucosa. Although the etiopathogenesis of Burning Mouth Syndrome is unknown, some studies provide evidence of subclinical inflammation leading to disrupted cytokine levels. Aim To investigate the expression of cytokines and role in the etiopathogenesis of Burning Mouth Syndrome. Methods Online databases (MEDLINE and EMBASE) were searched from November 1986 to November 2018 for case control/cross-sectional studies comparing the levels of cytokines in patients with Burning Mouth Syndrome and healthy controls. Results A total of eight studies were included in the current review. Four studies were of high and four studies were of moderate quality. Seven studies evaluated IL-6, out of which four showed comparable results, two showed higher levels and one study reported lower levels in Burning Mouth Syndrome patients compared to controls. Four studies assessed IL-2, out of which two reported comparable results whereas one study reported higher levels and one study reported lower levels in Burning Mouth Syndrome patients compared to controls. IL-10 levels were measured in three studies that reported no significant differences in the levels between Burning Mouth Syndrome and healthy controls. Discussion and conclusion The etiopathogenesis of Burning Mouth Syndrome is multifactorial. Studies have provided scientific evidence that inflammation plays a key role in Burning Mouth Syndrome pathogenesis. However, whether up-regulation or down-regulation of specific cytokines contribute to the etiopathogenesis of Burning Mouth Syndrome remains debatable. Further high-quality studies with larger sample size and assessing a wider array of cytokines are warranted in order to obtain strong conclusions.
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Affiliation(s)
- Jaimala Kishore
- Department of Oral Pathology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | - Fouzia Shaikh
- Department of General Pathology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | - Sana Mirza
- Department of Oral Pathology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | | | - Sana Ikram
- Department of Oral Biology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | - Zohaib Akram
- Department of Periodontology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
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16
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Cabras T, Manconi B, Castagnola M, Sanna MT, Arba M, Acharya S, Ekström J, Carlén A, Messana I. Proteomics of the acid-soluble fraction of whole and major gland saliva in burning mouth syndrome patients. Arch Oral Biol 2018; 98:148-155. [PMID: 30496935 DOI: 10.1016/j.archoralbio.2018.11.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 11/15/2018] [Accepted: 11/19/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE In the present study the salivary proteome of burning mouth syndrome patients and healthy subjects was characterized by a top-down proteomic approach and compared to highlight possible qualitative and quantitative differences that may give suggestions about the causes of this pathology which are still unknown. MATERIALS AND METHODS Resting and stimulated whole saliva, stimulated parotid and submandibular/sublingual saliva samples were collected from burning mouth syndrome patients (n = 16) and age- and gender-matched healthy subjects (n = 14). An equal volume of 0.2% trifluoroacetic acid was added to each sample immediately after collection and the supernatants were analysed by liquid chromatography coupled to electrospray-ionisation mass spectrometry. Proteins and peptides were quantified using a label-free approach measuring the extracted ion current peak areas of the main salivary proteins and peptides. RESULTS The quantitation of the main salivary proteins and peptides revealed a higher concentration of cystatin SN in resting saliva of burning mouth syndrome patients with respect to healthy controls and no other conspicuous changes. CONCLUSIONS The reported data showed that the salivary protein profile was not affected, in composition and relative abundance, by the burning mouth syndrome, except for the cystatin SN, a protein up-regulated in several pathological conditions, that might be considered potentially indicative of the disease.
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Affiliation(s)
- Tiziana Cabras
- Department of Life and Environmental Sciences, Biomedical Section, University of Cagliari, 09042, Monserrato, CA, Italy.
| | - Barbara Manconi
- Department of Life and Environmental Sciences, Biomedical Section, University of Cagliari, 09042, Monserrato, CA, Italy
| | - Massimo Castagnola
- Institute of Chemistry of the Molecular Recognition - CNR, L.go F. Vito 1, 00168, Rome, Italy; Institute of Biochemistry and Clinical Biochemistry, Università Cattolica del Sacro Cuore and/or Department of Laboratory Diagnostic and Infectious Diseases, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, L.go F. Vito 1, 00168, Rome, Italy
| | - Maria Teresa Sanna
- Department of Life and Environmental Sciences, Biomedical Section, University of Cagliari, 09042, Monserrato, CA, Italy
| | - Morena Arba
- Department of Life and Environmental Sciences, Biomedical Section, University of Cagliari, 09042, Monserrato, CA, Italy
| | - Shikha Acharya
- Department of Oral Microbiology and Immunology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Box 431, SE-405 30 Göteborg, Sweden
| | - Jörgen Ekström
- Department of Pharmacology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Box 431, SE-405 30 Göteborg, Sweden
| | - Anette Carlén
- Department of Oral Microbiology and Immunology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Box 431, SE-405 30 Göteborg, Sweden
| | - Irene Messana
- Institute of Chemistry of the Molecular Recognition - CNR, L.go F. Vito 1, 00168, Rome, Italy
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17
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Wang DK, Liao GQ. [Relationship between interleukins in the saliva and oral cavity cancer]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2018; 36:325-330. [PMID: 29984937 DOI: 10.7518/hxkq.2018.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Saliva is being attached great importance for its application in illness diagnosis and have more advantage on the diagnose in oral cavity cancer (OCC). Studies have showed that interleukin (IL) in the saliva could be used as a potential biomarker for OCC diagnosis. Moreover, they have a close connection with tumor genesis, invasion, and metastasis in OCC. Therefore, we reviewed research progress on the relationship between salivary interleukins and OCC.
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Affiliation(s)
- Di-Kan Wang
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
| | - Gui-Qing Liao
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
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18
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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: 22] [Impact Index Per Article: 3.7] [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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19
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Barry A, O'Halloran KD, McKenna JP, McCreary C, Downer EJ. Plasma IL-8 signature correlates with pain and depressive symptomatology in patients with burning mouth syndrome: Results from a pilot study. J Oral Pathol Med 2017; 47:158-165. [DOI: 10.1111/jop.12666] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Alison Barry
- Department of Physiology; University College Cork; Cork Ireland
| | | | - Joseph P. McKenna
- Cork University Dental School and Hospital; University College Cork; Cork Ireland
| | - Christine McCreary
- Cork University Dental School and Hospital; University College Cork; Cork Ireland
| | - Eric J. Downer
- Discipline of Physiology; School of Medicine; Trinity Biomedical Sciences Institute; Trinity College Dublin; University of Dublin; Dublin Ireland
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20
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Hassona Y, Scully C. Salivary changes in oral mucosal diseases. Periodontol 2000 2017; 70:111-27. [PMID: 26662486 DOI: 10.1111/prd.12102] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2015] [Indexed: 12/17/2022]
Abstract
Saliva is a unique biological fluid that can be easily collected and analyzed with low cost and low morbidity. Therefore, there is a growing attention for using salivary biomarkers in the diagnosis and monitoring of disease progress and response to treatment. Salivary changes have been described in relation to oral mucosal diseases. This article discusses the causes and consequences of salivary hypofunction and presents a review of the literature related to changes in salivary parameters in various oral mucosal diseases and in systemic diseases with possible oral mucosal involvement.
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21
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Is it Sjögren's syndrome or burning mouth syndrome? Distinct pathoses with similar oral symptoms. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:482-495. [PMID: 28283095 DOI: 10.1016/j.oooo.2017.01.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 01/10/2017] [Accepted: 01/12/2017] [Indexed: 12/17/2022]
Abstract
Sjögren's syndrome (SS) and burning mouth syndrome (BMS) typically occur in postmenopausal women. Although these conditions have significantly different etiopathogeneses, patients with SS or BMS often present with analogous oral complaints. The similarities between the two conditions have led to considerable confusion on the part of medical and dental practitioners, and those with BMS or SS often wait years to receive a diagnosis. Therefore, it is imperative for clinicians to understand the characteristic subjective and objective features of each disease and how these can be used to distinguish them. This review will discuss the proposed etiology, clinical manifestations, histopathology, diagnostic criteria, and patient management of SS and BMS. We also identify key differences between the two pathoses that aid in establishing the correct diagnosis. Recognition of the defining features of each condition will lead to reduced time to diagnosis and improved patient management for these poorly understood conditions.
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Abstract
Burning mouth syndrome (BMS) is a chronic pain condition. It has been described by the International Headache Society as "an intra-oral burning or dysesthetic sensation, recurring daily for more than 2 h/day for more than 3 months, without clinically evident causative lesions." BMS is frequently seen in women in the peri-menopausal and menopausal age group in an average female/male ratio of 7:1. The site most commonly affected is the anterior two-thirds of the tongue. The patient may also report taste alterations and oral dryness along with the burning. The etiopathogenesis is complex and is not well-comprehended. The more accepted theories point toward a neuropathic etiology, but the gustatory system has also been implicated in this condition. BMS is frequently mismanaged, partly because it is not well-known among healthcare providers. Diagnosis of BMS is made after other local and systemic causes of burning have been ruled out as then; the oral burning is the disease itself. The management of BMS still remains a challenge. Benzodiazepines have been used in clinical practice as the first-line medication in the pharmacological management of BMS. Nonpharmacological management includes cognitive behavioral therapy and complementary and alternative medicine (CAM). The aim of this review is to familiarize healthcare providers with the diagnosis, pathogenesis, and general characteristics of primary BMS while updating them with the current treatment options to better manage this group of patients.
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Affiliation(s)
- Cibele Nasri-Heir
- Department of Diagnostic Sciences, Center for Temporomandibular Disorders and Orofacial Pain, Rutgers School of Dental Medicine, Rutgers, The State University, Newark, New Jersey 07101-1709, USA
| | - Julyana Gomes Zagury
- Department of Diagnostic Sciences, Center for Temporomandibular Disorders and Orofacial Pain, Rutgers School of Dental Medicine, Rutgers, The State University, Newark, New Jersey 07101-1709, USA
| | - Davis Thomas
- Department of Diagnostic Sciences, Center for Temporomandibular Disorders and Orofacial Pain, Rutgers School of Dental Medicine, Rutgers, The State University, Newark, New Jersey 07101-1709, USA
| | - Sowmya Ananthan
- Department of Diagnostic Sciences, Center for Temporomandibular Disorders and Orofacial Pain, Rutgers School of Dental Medicine, Rutgers, The State University, Newark, New Jersey 07101-1709, USA
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23
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Kalpana R, Thubashini M, Sundharam BS. Detection of salivary interleukin-2 in recurrent aphthous stomatitis. J Oral Maxillofac Pathol 2015; 18:361-4. [PMID: 25948989 PMCID: PMC4409179 DOI: 10.4103/0973-029x.151313] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 12/30/2014] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The present study was undertaken to estimate and compare salivary interleukin-2 (IL-2) levels in patients with recurrent aphthous stomatitis, among healthy controls and their variation with age and sex. STUDY DESIGN Saliva was collected from 60 patients within the age range of 16-60 years which included 30 patients (17 Females and 13 Males) with recurrent aphthous stomatitis and healthy control group consisted of 30 participants (18 Females and 12 Males). IL-2 estimation was done in both the groups using enzyme linked immunosorbent assay (ELISA). Statistical analysis of the data was done using Independent 't' test. RESULTS The results showed increased salivary IL-2 levels in patients with recurrent aphthous stomatitis compared to the healthy controls. The IL-2 levels were also increased in patients with the age group of 16-30 years compared to other age groups. Similar increase of IL-2 was also seen in female patients. CONCLUSION Age related and sex related alterations of IL-2 in recurrent aphthous stomatitis patients were observed.
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Affiliation(s)
- R Kalpana
- Department of Oral and Maxillofacial Pathology, Rathnavel Subramaniam Educational Trust RVS Dental College and Hospital, Kannampalayam, Sulur, Coimbatore, India
| | - M Thubashini
- Department of Oral and Maxillofacial Pathology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - B Sivapatha Sundharam
- Department of Oral and Maxillofacial Pathology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
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24
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de Souza FTA, Kummer A, Silva MLV, Amaral TMP, Abdo EN, Abreu MHNG, Silva TA, Teixeira AL. The association of openness personality trait with stress-related salivary biomarkers in burning mouth syndrome. Neuroimmunomodulation 2015; 22:250-5. [PMID: 25322841 DOI: 10.1159/000367714] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 08/20/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Burning mouth syndrome (BMS) is a chronic disorder defined as a burning sensation in the oral mucosa without evidence of pathological findings. Its pathophysiology is largely unknown, but psychiatric disorders and personality traits have been implicated. OBJECTIVE This study investigated whether there is any association between salivary biomarkers and personality traits in BMS patients. METHODS It was a cross-sectional, controlled study that evaluated 30 individuals with BMS and 32 controls. All subjects were assessed with a structured psychiatric interview (Mini International Neuropsychiatric Interview) and the Big Five inventory. Salivary levels of brain-derived neurotrophic factor (BDNF), neural growth factor, tumor necrosis factor-α, interleukin (IL)-6, IL-10 and cortisol were determined. RESULTS We found that BMS patients exhibited more traits of neuroticism and lower openness than controls. Openness showed a moderate and negative correlation with cortisol, BDNF and IL-6. CONCLUSION Personality traits are associated with salivary biomarkers in BMS.
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Affiliation(s)
- Fabrício T A de Souza
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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25
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Forssell H, Jääskeläinen S, List T, Svensson P, Baad-Hansen L. An update on pathophysiological mechanisms related to idiopathic oro-facial pain conditions with implications for management. J Oral Rehabil 2014; 42:300-22. [DOI: 10.1111/joor.12256] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2014] [Indexed: 01/03/2023]
Affiliation(s)
- H. Forssell
- Department of Oral and Maxillofacial Surgery; Institute of Dentistry; University of Turku; Turku Finland
| | - S. Jääskeläinen
- Department of Clinical Neurophysiology; University of Turku and Turku University Hospital; Turku Finland
| | - T. List
- Department of Orofacial Pain and Jaw Function; Faculty of Odontology; Malmö University; Malmö Denmark
- Department of Rehabilitation Medicine; Skåne University Hospital; Lund Denmark
- Scandinavian Center for Orofacial Neuroscience (SCON); Aarhus University; Aarhus Denmark
| | - P. Svensson
- Scandinavian Center for Orofacial Neuroscience (SCON); Aarhus University; Aarhus Denmark
- Section of Clinical Oral Physiology; Department of Dentistry; HEALTH; Aarhus University; Aarhus Denmark
| | - L. Baad-Hansen
- Scandinavian Center for Orofacial Neuroscience (SCON); Aarhus University; Aarhus Denmark
- Section of Clinical Oral Physiology; Department of Dentistry; HEALTH; Aarhus University; Aarhus Denmark
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26
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[Burning mouth syndrome: diagnostic and therapeutic keys]. Med Clin (Barc) 2014; 142:370-4. [PMID: 24315745 DOI: 10.1016/j.medcli.2013.09.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 09/12/2013] [Indexed: 11/21/2022]
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27
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Molony RD, Rice JM, Yuk JS, Shetty V, Dey D, Lawrence DA, Lynes MA. Mining the salivary proteome with grating-coupled surface plasmon resonance imaging and surface plasmon coupled emission microarrays. ACTA ACUST UNITED AC 2013; Chapter 18:Unit 18.16.1-19. [PMID: 22896008 DOI: 10.1002/0471140856.tx1816s53] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Biological indicators have numerous and widespread utility in personalized medicine, but the measurement of these indicators also poses many technological and practical challenges. Blood/plasma has typically been used as the sample source with which to measure these indicators, but the invasiveness associated with sample procurement has led to increased interest in saliva as an attractive alternative. However, there are unique issues associated with the measurement of saliva biomarkers. These issues are compounded by the imperfect correlation between saliva and plasma with respect to biomarker profiles. In this manuscript, we address the technical challenges associated with saliva biomarker quantification. We describe a high-content microarray assay that employs both grating-coupled surface plasmon resonance imaging and surface plasmon-coupled emission modalities in a highly sensitive assay with a large dynamic range. This powerful approach provides the tools to map the proteome of saliva, which in turn should greatly enhance the utility of salivary biomarker profiles in personalized medicine.
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Affiliation(s)
- Ryan D Molony
- Department of Molecular and Cell Biology, University of Connecticut, Storrs, Connecticut, USA
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28
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Detection and quantitation of forty eight cytokines, chemokines, growth factors and nine acute phase proteins in healthy human plasma, saliva and urine. J Proteomics 2012; 75:4802-19. [DOI: 10.1016/j.jprot.2012.05.018] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 04/24/2012] [Accepted: 05/05/2012] [Indexed: 12/22/2022]
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Abstract
The aetiology of BMS remains an enigma, however novel evidence suggests a neuropathic basis, which may explain concomitant vulvodynia in some patients.The constant high level spontaneous chronic pain in BMS has significant functional and psychological repercussions for these patients.Cognitive behavioural therapy remains the sole evidence based management of this condition, whilst some patients respond to treatment with Tricyclic antidepressants, SSRIs or SNRIs, compliance with medication remains an issue due to pharma side effects.Increasing evidence suggests that there may be 3 subgroups that should be managed differently.
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Affiliation(s)
- Tara Renton
- Professor in Oral Surgery, Kings College Dental Institute, Kings College Hospital, London SE5 9RS
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de Souza FTA, Amaral TMP, dos Santos TPM, Abdo EN, Aguiar MCF, Teixeira AL, Kummer AM, Abreu MHNG, Silva TA. Burning Mouth Syndrome: A Therapeutic Approach Involving Mechanical Salivary Stimulation. Headache 2011; 52:1026-34. [DOI: 10.1111/j.1526-4610.2011.02037.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Borelli V, Marchioli A, Di Taranto R, Romano M, Chiandussi S, Di Lenarda R, Biasotto M, Zabucchi G. Neuropeptides in saliva of subjects with burning mouth syndrome: a pilot study. Oral Dis 2010; 16:365-74. [DOI: 10.1111/j.1601-0825.2009.01648.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Suh KI, Kim YK, Kho HS. Salivary levels of IL-1β, IL-6, IL-8, and TNF-α in patients with burning mouth syndrome. Arch Oral Biol 2009; 54:797-802. [DOI: 10.1016/j.archoralbio.2009.05.007] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Revised: 05/10/2009] [Accepted: 05/16/2009] [Indexed: 11/30/2022]
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Chen Q, Xia J, Lin M, Zhou H, Li B. Serum interleukin-6 in patients with burning mouth syndrome and relationship with depression and perceived pain. Mediators Inflamm 2008; 2007:45327. [PMID: 17641729 PMCID: PMC1906709 DOI: 10.1155/2007/45327] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2007] [Accepted: 02/26/2007] [Indexed: 11/17/2022] Open
Abstract
Objective. To examine alteration of serum interleukin-6 and its clinical significance in burning mouth syndrome (BMS) patients.
Methods. 48 BMS patients and 31 healthy controls participated in the study. Serum interleukin-6 was measured by means of ELISA. Hamilton rating scale of depression (HRSD) and visual analogue scale (VAS) were used to quantitiate depressive status and pain levels of subjects, respectively.
Results. 15 (31%) patients displayed substantial depressive symptoms (HRSD ≧ 16). HRSD scores of patients were significantly higher than controls and positively correlated to their VAS values (P = .002). Serum interleukin-6 in patients was much lower than controls and negatively correlated to their VAS values (P = .011). However, no significant relations were found between interleukin-6 and HRSD scores (P = .317).
Conclusions. Serum interleukin-6 in patients with burning mouth syndrome is decreased and negatively correlated to chronic pain. Both psychological and neuropathic disorders might act as precipitating factors in BMS etiopathogenesis.
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Affiliation(s)
- Qianming Chen
- Department of Oral Medicine, West China College of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Juan Xia
- Department of Oral Medicine, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong 510055, China
- *Juan Xia:
| | - Mei Lin
- Department of Oral Medicine, West China College of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Hongmei Zhou
- Department of Oral Medicine, West China College of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Bingqi Li
- Department of Oral Medicine, West China College of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
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Pršo IB, Kocjan W, Šimić H, Brumini G, Pezelj-Ribarić S, Borčić J, Ferreri S, Karlović IM. Tumor necrosis factor-alpha and interleukin 6 in human periapical lesions. Mediators Inflamm 2006; 2007:38210. [PMID: 17497030 PMCID: PMC1804300 DOI: 10.1155/2007/38210] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2006] [Revised: 11/06/2006] [Accepted: 11/08/2006] [Indexed: 11/17/2022] Open
Abstract
AIM The aim of this study was to evaluate the presence of the cytokines tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) in human periapical lesions. SUBJECTS AND METHODS Samples were obtained from three groups of teeth: symptomatic teeth, asymptomatic lesions, and uninflamed periradicular tissues as a control. RESULTS TNF-alpha levels were significantly increased in symptomatic lesions compared to control. Group with asymptomatic lesions had significantly higher concentrations compared to control. There were no significant differences in TNF-alpha levels between symptomatic and asymptomatic lesions. In group with symptomatic lesions, IL-6 levels were significantly higher than in group with asymptomatic lesions. The IL-6 levels in symptomatic group also showed significantly higher concentration in comparison with control group. In asymptomatic group, the IL-6 level had significantly higher concentrations compared to control. CONCLUSION These results indicate that symptomatic lesions represent an immunologically active stage of disease, and asymptomatic lesions are the point from which the process advances toward healing.
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Affiliation(s)
- Ivana Brekalo Pršo
- Department of Dentistry, Medical Faculty, University of Rijeka, HR 51000 Rijeka, Croatia
| | - Willy Kocjan
- Department of Dentistry, Medical Faculty, University of Rijeka, HR 51000 Rijeka, Croatia
| | - Hrvoje Šimić
- Department of Histology, Medical Faculty, University of Rijeka, HR 51000 Rijeka, Croatia
| | - Gordana Brumini
- Department of Informatics, Medical Faculty, University of Rijeka, HR 51000 Rijeka, Croatia
| | - Sonja Pezelj-Ribarić
- Department of Dentistry, Medical Faculty, University of Rijeka, HR 51000 Rijeka, Croatia
- *Sonja Pezelj-Ribarić:
| | - Josipa Borčić
- Department of Dentistry, Medical Faculty, University of Rijeka, HR 51000 Rijeka, Croatia
| | - Silvio Ferreri
- Department of Dentistry, Medical Faculty, University of Rijeka, HR 51000 Rijeka, Croatia
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