Burning mouth syndrome: a review and update.

Burning mouth syndrome (BMS) is mainly found in middle aged or elderly women and is characterized by intense burning or itching sensation of the tongue or other regions of the oral mucosa. It can be accompanied by xerostomia and dysgeusia. The syndrome generally manifests spontaneously, and the discomfort is typically of a continuous nature but increases in intensity during the evening and at night. Although BMS classically has been attributed to a range of factors, in recent years evidence has been obtained relating it peripheral (sensory C and/or trigeminal nerve fibers) or central neuropathic disturbances (involving the nigrostriatal dopaminergic system). The differential diagnosis requires the exclusion of oral mucosal lesions or blood test alterations that can produce burning mouth sensation. Patient management is based on the avoidance of causes of oral irritation and the provision of psychological support. Drug treatment for burning sensation in primary BMS of peripheral origin can consist of topical clonazepam, while central type BMS appears to improve with the use of antidepressants such as duloxetine, antiseizure drugs such as gabapentin, or amisulpride.

TITLE: Sindrome de boca ardiente: revision y puesta al dia.El sindrome de boca ardiente (SBA) es un cuadro clinico que padecen mayoritariamente mujeres de edad media o avanzada. Se caracteriza por una sensacion muy molesta de ardor o escozor sobre la lengua o en otras zonas de la mucosa bucal. Puede estar acompañado de xerostomia y de disgeusia. Se suele presentar de forma espontanea y tiene un perfil clinico muy caracteristico. Las molestias son continuas, pero aumentan hacia la tarde-noche. Aunque clasicamente se habia atribuido a multiples factores, en los ultimos años hay evidencia para relacionarlo con una disfuncion neuropatica de tipo periferico (fibras C sensitivas o trigeminales) o de tipo central (sistema dopaminergico nigroestriado). En el diagnostico hay que descartar lesiones objetivables en la mucosa oral o alteraciones en la analitica sanguinea que puedan ser causa de ardor bucal. El manejo de los pacientes se basa en evitar focos irritativos orales y soporte psicologico. Para el tratamiento farmacologico del ardor en el SBA primario de causa periferica, se puede administrar clonacepam de uso topico, y pacientes con SBA de tipo central parecen mejorar con el uso de antidepresivos del tipo de la duloxetina, anticonvulsionantes como la gabapentina, o la amisulprida.

Síndrome de boca ardiente: revisión y puesta al día / Burning mouth syndrome: a review and update

El síndrome de boca ardiente (SBA) es un cuadro clínico que padecen mayoritariamente mujeres de edad media o avanzada. Se caracteriza por una sensación muy molesta de ardor o escozor sobre la lengua o en otras zonas de la mucosa bucal. Puede estar acompañado de xerostomía y de disgeusia. Se suele presentar de forma espontánea y tiene un perfil clínico muy característico. Las molestias son continuas, pero aumentan hacia la tarde-noche. Aunque clásicamente se había atribuido a múltiples factores, en los últimos años hay evidencia para relacionarlo con una disfunción neuropática de tipo periférico (fibras C sensitivas o trigeminales) o de tipo central (sistema dopaminérgico nigroestriado). En el diagnóstico hay que descartar lesiones objetivables en la mucosa oral o alteraciones en la analítica sanguínea que puedan ser causa de ardor bucal. El manejo de los pacientes se basa en evitar focos irritativos orales y soporte psicológico. Para el tratamiento farmacológico del ardor en el SBA primario de causa periférica, se puede administrar clonacepam de uso tópico, y pacientes con SBA de tipo central parecen mejorar con el uso de antidepresivos del tipo de la duloxetina, anticonvulsionantes como la gabapentina, o la amisulprida (AU)

Burning mouth syndrome (BMS) is mainly found in middle aged or elderly women and is characterized by intense burning or itching sensation of the tongue or other regions of the oral mucosa. It can be accompanied by xerostomia and dysgeusia. The syndrome generally manifests spontaneously, and the discomfort is typically of a continuous nature but increases in intensity during the evening and at night. Although BMS classically has been attributed to a range of factors, in recent years evidence has been obtained relating it peripheral (sensory C and/or trigeminal nerve fibers) or central neuropathic disturbances (involving the nigrostriatal dopaminergic system). The differential diagnosis requires the exclusion of oral mucosal lesions or blood test alterations that can produce burning mouth sensation. Patient management is based on the avoidance of causes of oral irritation and the provision of psychological support. Drug treatment for burning sensation in primary BMS of peripheral origin can consist of topical clonazepam, while central type BMS appears to improve with the use of antidepressants such as duloxetine, antiseizure drugs such as gabapentin, or amisulpride (AU)

Influence of the crown-implant connection on the preservation of peri-implant bone: a retrospective multifactorial analysis.

PURPOSE: Control over marginal bone loss (MBL) and its progression is critical for preserving peri-implant tissue health. A moderate MBL over the first year has conventionally been associated with clinical success. However, different implants are associated with distinct amounts of MBL during their first functional year. Therefore, this study evaluated the MBL in pristine maxillary bone around implants with different types of implant-abutment connections and sought to determine the effect of other clinical factors on this tissue response. MATERIALS AND METHODS: Two hundred forty-six implants were placed in 101 patients with a mean age of 54.43 years. The MBL around two different types of implants (internal versus external prosthetic connection) was evaluated at 6 and 18 months after loading. Different variables were recorded to analyze their influence on radiographic parameters using a complex samples general linear model. RESULTS: At 18 months, MBL ranged from 0 to 3.56 mm; less than 1 mm was lost around 46.3% (mesial) and 40.2% (distal) of the implants, while no bone was lost around 19.5% (mesial) and 19.9% (distal). The MBL was significantly higher around external than internal connections (0.714 vs 0.516 mm/year, respectively). Age, smoking habit, and connection type were directly related to mesial and distal MBL at 6 and 18 months postloading. CONCLUSION: Implant design is a key factor in peri-implant MBL. Age and smoking also play major roles in maintaining the stability of peri-implant bone.

Marginal bone loss in implants placed in grafted maxillary sinus.

PURPOSE: The purpose of this study is to evaluate the vertical and horizontal graft bone resorption (GR) in grafted maxillary sinuses and the marginal bone loss (MBL) around implants placed in the sinuses with different prosthetic connections and to determine the effect of other clinical factors on these tissue responses at 6 and 18 months postloading. MATERIAL AND METHOD: A total of 254 implants were placed in 150 grafted maxillary sinuses of 101 patients (51.5% female) with mean age of 52.2 years (range, 32-82 years). GR and MBL measurements were made in implants placed with two different prosthetic connections (internal and external) at 6 and 18 months postloading. The complex samples general linear model was used to analyze the influence of patient age, gender, smoking habit, history of periodontal disease, implantation timing (simultaneous vs deferred), and prosthetic abutment length on radiographic GR and MBL values. RESULTS: At 18 months postloading, the MBL ranged from 0 mm to 5.89 mm; less than 1 mm was lost around 49.0% (mesial) and 44.3% (distal) of the implants, while no bone was lost around 32.9% (mesial) and 26.7% (distal). The GR was significantly affected by smoking, remnant alveolar bone height, graft length, graft height, gender, and age, and it significantly decreased over time. The MBL was influenced by the type of connection, implantation timing, and prosthetic abutment length. The MBL was greater with longer postloading interval and higher patient age and in smokers. CONCLUSION: Resorption of grafts that combine autogenous cortical bone with anorganic bovine bone is dependent on the anatomic features of the sinus and is not affected by the time elapsed after the first 6 months. The MBL in implants placed in these grafted areas is time dependent and mainly related to potentially modifiable clinical decisions and patient habits.

Changes in general and oral health-related quality of life in immediate or conventionally loaded dental implants: a nonrandomized clinical trial.

PURPOSE: To evaluate changes in the general and oral health-related quality of life (using the European Quality of Life indicator and the Oral Health Impact Profile-49 [OHIP-49], respectively) of patients treated with conventionally or immediately loaded implants. MATERIALS AND METHODS: This clinical trial consisted of a clinical oral examination and a questionnaire-based interview carried out before and after both surgery and definitive prosthetic rehabilitation in a consecutive sample of patients requiring dental implants. According to the clinical diagnosis and patient preference, patients were assigned to the immediate loading group (IL group; n = 29) or the conventional loading group (CL group; n = 75). The change summary scores and effect sizes were calculated in the intermediate stage and at the final follow-up, taking baseline scores as reference. RESULTS: The oral health-related quality of life and oral satisfaction after implant therapy were significantly better than at baseline, with an even greater benefit when the implants were loaded immediately than when prosthetic rehabilitation was delayed. However, there were no significant differences in between-group comparisons in the ratings of general health status. The effect size for the OHIP-49 exceeded the threshold value of 0.8 for the domains functional limitation, pain/discomfort, and psychological discomfort in both groups and also for physical disability and psychological disability in the IL group. CONCLUSIONS: A gradual improvement in oral well-being scores, but not in those of general well-being, were observed for both groups from the intermediate stage to the final evaluation. This benefit was markedly greater for the IL group.

Resting position of the head and malocclusion in a group of patients with cerebral palsy.

UNLABELLED: Cerebral palsy are found as a result of these disorders, along with associated neuromuscular functional alterations that affect the resting position of the head. In this context, the resting position of the head could be responsible for several skeletal and dental occlusal disorders among patients with cerebral palsy. OBJECTIVE: To assess the presence of malocclusions in patients with cerebral palsy, define the most frequent types of malocclusions, and evaluate how the resting position of the head may be implicated in the development of such malocclusions. STUDY DESIGN: Forty-four patients aged between 12-55 years (18 males and 26 females) were studied. Occlusal conditions, the Dental Aesthetic Index (DAI), changes in the resting position of the head, and breathing and swallowing functions were assessed. RESULTS: Orthodontic treatment was required by 70.8% of the patients, the most frequent malocclusions being molar class II, open bite and high overjet. These individuals showed altered breathing and swallowing functions, as well as habit and postural disorders. The resting position of the head, especially the hyperextended presentation, was significantly correlated to high DAI scores. CONCLUSIONS: The results obtained suggest that patients with cerebral palsy are more susceptible to present malocclusions, particularly molar class II malocclusion, increased open bite, and high overjet. Such alterations in turn are more common in patients with a hyperextended position of the head. Key words:Cerebral palsy, malocclusion, head position, disabled patients.

Training adults and children with an autism spectrum disorder to be compliant with a clinical dental assessment using a TEACCH-based approach.

The specific neuropsychological and sensory profile found in persons with autism spectrum disorders complicate dental procedures and as a result of this, most are treated under general anesthesia or unnecessary sedation. The main goal of the present study was to evaluate the effectiveness of a short treatment and education of autistic and related communication-handicapped children-based intervention program (five sessions) to facilitate a 10-component oral assessment in children (n = 38, aged 4-9 years) and adults (n = 34, aged 19-41) with autism spectrum disorder (with or without associated intellectual disability). The assessment ranges from entering into the examination room to the evaluation of the dental occlusion. There were statistically significant differences in the number of components reached and in compliance before and after the training program.

Presence of fibronectin peptides in saliva of patients with Sjögren’s Syndrome: A potential indicator of salivary gland destruction

Objective: The purpose of this preliminary study was to monitor the degree of destruction of salivary glands inSjögren disease by the detection of fibronectin peptides in patients’ saliva. Study design: The sample consisted of10 subjects divided in 2 groups, one with Sjögren disease and a control group. Saliva samples were submitted to aninmunodetection analysis. In addition, non pathological salivary glands, obtained from 2 subjects who underwentminor oral surgery, were incubated with leukocyte homogenates and analysed to compare the obtained fragments.Results: The inmunodetection analysis of Sjögren saliva revealed multiple protein bands, including fibronectin,that were not present in saliva from healthy individuals. The inmunostained bands varied depending on the courseof the disease, showing more fibronectin fragments in an active phase . Furthermore, results obtained from thenon-pathological glands incubated with leukocyte homogenates were similar to those revealed in saliva from Sjögrenpatients. Conclusion: The presence of fibronectin peptides in Sjögren patients’ saliva can constitute a methodto monitor activity in Sjögren’s disease (AU)

No disponible

Type 1 diabetes mellitus and periodontal disease: Relationship to different clinical variables

Objective: This study is designed to evaluate the frequency of periodontal disease in a group of patients with type 1 diabetes mellitus and how this relates with diabetes metabolic control, duration of diabetes, and presence of diabetic complications.
Methods: A comparison was made of periodontal parameters (plaque index, bleeding index, pocket depth and attachment loss) in a group of diabetic patients (n=90) versus a group of non-diabetics (n=90). Logistic regression analysis was performed to evaluate relationship between periodontal parameters and degree of metabolic control, the duration of the disease, and the appearance of complications. Results: Diabetics had greater bleeding index (p<0.01), deeper periodontal pockets (p<0.01) and more periodontal attachment loss (p<0.01) than non-diabetics. Deficient metabolic control and presence of diabetic complication were associated with higher bleeding index and pocket depth (p≤0.02). Conclusions: Patients with type 1 diabetes appear to show increased periodontal disease susceptibility, particularly those with poorer metabolic control or with diabetic complications (AU)

Type 1 diabetes mellitus and periodontal disease: relationship to different clinical variables.

OBJECTIVE: This study is designed to evaluate the frequency of periodontal disease in a group of patients with type 1 diabetes mellitus and how this relates with diabetes metabolic control, duration of diabetes, and presence of diabetic complications. METHODS: A comparison was made of periodontal parameters (plaque index, bleeding index, pocket depth and attachment loss) in a group of diabetic patients (n=90) versus a group of non-diabetics (n=90). Logistic regression analysis was performed to evaluate relationship between periodontal parameters and degree of metabolic control, the duration of the disease, and the appearance of complications. RESULTS: Diabetics had greater bleeding index (p< 0.01), deeper periodontal pockets (p< 0.01) and more periodontal attachment loss (p< 0.01) than non-diabetics. Deficient metabolic control and presence of diabetic complication were associated with higher bleeding index and pocket depth (p

Presence of fibronectin peptides in saliva of patients with Sjögren's syndrome: a potential indicator of salivary gland destruction.

OBJECTIVE: The purpose of this preliminary study was to monitor the degree of destruction of salivary glands in Sjögren disease by the detection of fibronectin peptides in patients' saliva. STUDY DESIGN: The sample consisted of 10 subjects divided in 2 groups, one with Sjögren disease and a control group. Saliva samples were submitted to an inmunodetection analysis. In addition, non pathological salivary glands, obtained from 2 subjects who underwent minor oral surgery, were incubated with leukocyte homogenates and analysed to compare the obtained fragments. RESULTS: The inmunodetection analysis of Sjögren saliva revealed multiple protein bands, including fibronectin, that were not present in saliva from healthy individuals. The inmunostained bands varied depending on the course of the disease, showing more fibronectin fragments in an active phase. Furthermore, results obtained from the non-pathological glands incubated with leukocyte homogenates were similar to those revealed in saliva from Sjögren patients. CONCLUSION: The presence of fibronectin peptides in Sjögren patients' saliva can constitute a method to monitor activity in Sjögren's disease.

Materiales hemostáticos en cirugía oral / No disponible

El paciente con riesgo de sangrado alto representa un problema a la hora de realizar cualquier tratamiento quirúrgico bucal. En este trabajo revisamos los mecanismos básicos de la hemostasia, así como las pruebas principales de laboratorio para controlarla. También se presentan los principales métodos y materiales para evitar el sangrado a nivel local y su utilización en la clínica odontológica (AU)

The patient with high risk of bleeding can be a problem to perform any surgical dental treatment. In this work, we review the basic mechanisms of hemostasis and also the main laboratory tests to control it. Otherwise, the main materials and methods to prevent the bleeding at local areas are also exposed, as well as their uses in dentistry (AU)