Valoración de las diferentesopciones de tratamientoen el manejo clínico delSíndrome de Boca Ardiente(SBA) / ASSESSMENT OF THE DIFFERENT TREATMENT OPTIONS IN THE CLINICAL MANAGEMENT OF BURNING MOUTH SYNDROME (BMS)

Introducción: El Síndrome de Boca Ardiente (SBA), cuya definición y fisiopatología continúan siendo un tema de debate actual, tampoco cuenta con unas pautas universalmente aceptadas para su tratamiento. Por ello, el objetivo del presente trabajo es presentar una valoración de los distintos tratamientos para el manejo clínico de los pacientes con SBA en base a la evidencia científica disponible, para que se valore su aplicación en cada caso concreto. Material y métodos: Se realizó una búsqueda en las bases de datos de PubMed (MEDLINE) y The Cochrane Library (Wiley) sobre los distintos tratamientos del SBA. Con los datos obtenidos respecto a la efectividad de cada modalidad terapéutica y los efectos adversos que produce, se han elaborado tres diferentes líneas de tratamiento. Resultados: En la primera línea de tratamiento encontramos los chicles, la LLLT (terapia con láser de baja potencia, en inglés), el protector lingual, la psicoterapia, clonazepam tópico, ALA (ácido alfa-lipoico, en inglés) y la Catauma. Conclusión: Hacen falta más investigaciones que brinden una orientación suficiente a los clínicos sobre las modalidades terapéuticas efectivas y que permitan establecer una correcta estrategia en el manejo del SBA (AU)

Introduction: The definition and pathophysiology of Burning Mouth Syndrome (BMS) remain a subject of ongoing debate, and there are no universally accepted guidelines for its treatment. Therefore, the objective of this paper is to present an assessment of the different treatments for the clinical management of patients with BMS on the basis of the available scientific evidence, so that their application in each specific case can be assessed. Material and methods: A search was carried out in the PubMed (MEDLINE) and The Cochrane Library (Wiley) databases on the different treatments for BMS. With the data obtained regarding the effectiveness of each therapeutic modality and the adverse effects it produces, three different lines of treatment have been developed. Results: The first line of treatment includes chewing gum, LLLT (low level laser therapy), tongue guard, psychotherapy, topical clonazepam, ALA (alpha lipoic acid) and Catauma. Conclusion: Further research is required to provide sufficient guidance to clinicians on effective therapeutic modalities and to establish a correct strategy in the management of BMS (AU)

Medication related to pigmentation of oral mucosa.

BACKGROUND: The diagnosis of oral melanotic lesions is, more often than not, challenging in the clinical practice due to the fact that there are several reasons which may cause an increase in pigmentation on localized or generalized areas. Among these, medication stands out. MATERIAL AND METHODS: In this work, we have carried out a review in the reference pharma database: Micromedex® followed by a review of the scientific published literature to analyse coincidences and possible discrepancies. RESULTS: Our findings show that there are several prescription drugs that can cause pigmented lesions in the oral mucosa. This must be known by clinicians in order to properly diagnose pigmented lesions. We have identified a set of 21 medicaments which cause these lesions, some of which are used frequently in the clinic, such as Metronidazole, Amitriptyline, conjugated oestrogens and Chlorhexidine gluconate. We also found discrepancies with the data published in specialized literature, some of which wasn't reflected in the Summary of Product Characteristics. CONCLUSIONS: Our work highlights the importance of the proper communication of adverse drug reactions (ADR) by health professionals in order to provide thorough and accurate information and diagnosis.

Oral and dental health status in patients with eating disorders in Madrid, Spain.

BACKGROUND: The aim of the present study was to describe and compare the oral and dental health status of two groups, one diagnosed with eating disorders (EDs), and another group without this pathology, assessing the following oral manifestations: dental alterations, periodontal disorders, soft tissue disorders, non-stimulated salivary flow, and oral pH. MATERIAL AND METHODS: This comparative transversal epidemiological study included 179 participants, of whom 59 were diagnosed with EDs (Eating Disorder Group: EDG) and 120 had no antecedents of EDs (No Eating Disorder Group: NEDG). All patients fulfilled the following inclusion criteria: women aged over 18 years, diagnosed with an ED by a specialist, patients who had undergone at least 1 year monitoring by the Clinical Nutrition Unit, and had not received any periodontal treatment during the previous 6 months. Both groups were homogeneous in terms of sex, age, education, and socioeconomic level. Oral exploration was performed, registering clinical variables, as well as sociodemographic and socioeconomic data, oral hygiene habits, and smoking. Statistical significance was established as p<0.05 (confidence level > 95%). RESULTS: The dental erosion (DE) was the most significative feature of dental alterations. The degree of DE was significantly greater in the EDG (p<0.001). A significant association between soft tissue lesions and EDs was found (p<0.001) A notable difference in non-stimulated salivary flow was found between the groups (p<0.001). No significant differences between the groups were found for periodontal status, dental caries, or oral hygiene practices. CONCLUSIONS: On the basis of the results obtained, it is necessary to carry out oral/dental examination as soon as an ED is diagnosed with regular check-ups thereafter.

Prevalence of oral side effects of chemotherapy and its relationship with periodontal risk: a cross sectional study.

PURPOSE: To determine the prevalence of professionally reported oral side effects of chemotherapy and the self-reported oral side effects and whether both prevalences could be related to the periodontal risk of the patients. METHODS: A cross-sectional study with patients undergoing chemotherapy treatment was carried out. Demographic, oral hygiene habits, and cancer-related data were collected while the patient was receiving the chemotherapy infusion. Patient's oral status, measured according to the oral-assessment guide for patients in hospital environments, patient-related outcomes (PROMs), measured by a visual analogue scale, and patient's periodontal risk were analyzed using validated questionnaires. Data was reported in means and standard deviations (SD) in quantitative variables and in counts, prevalence, and 95% confidence intervals (CI) in qualitative variables. ANOVA test and chi-squared tests were used to compare oral side effects among different periodontal risk groups. RESULTS: Three hundred sixty-nine patients were included in the study. The prevalence of professionally reported oral side effects was 86.99% (95% confidence interval CI 83.54%; 90.44%). The prevalence of self-reported oral side effects was 89.70% (95% CI 86.59; 92.82). The most common oral side effects were xerostomia (73.4%), dysgeusia (61.8%), and dry lips (54.2%). More oral alterations were found in patients with worse periodontal risk (p < 0.001). CONCLUSIONS: The prevalence of oral side effects (professional or self-reported) is higher than 85% in patients undergoing chemotherapy. This prevalence increases as the risk of developing periodontal disease does.

Alpha lipoic acid efficacy in burning mouth syndrome. A controlled clinical tria

BACKGROUND: A double-blind placebo-controlled trial was conducted in order to evaluate the efficacy of alpha lipoic acid (ALA) and determine the statistical significance of the outcome variables. Burning mouth syndrome (BMS) is defined as an oral burning sensation in the absence of clinical signs which could justify the syndrome. Recent studies suggest the existence of neurological factors as a possible cause of the disease. MATERIAL AND METHODS: 60 patients with BMS, in two groups: case group with 600 mg/day and placebo as control group; with follow up of 2 months. RESULTS: 64% of ALA patients reported some level of improvement, with a level of maintenance of 68.75% one month after treatment. 27.6% of the placebo group also demonstrated some reduction in BMS symptoms. CONCLUSIONS: Long-term evolution and the intensity of symptoms are variables that reduce the probability of improvement with ALA treatment

No disponible

Malignización del liquen plano oral / Oral lichen planus malignancy

La complicación más importante del Liquen Plano Oral (LPO), es el desarrollo de un carcinoma oral de células escamosas (COCE). Desde 1910 en que se comunicó el primer caso en una paciente con LP, se han publicado numerosos casos, y series de casos de malignización, que nos aportan cifras que varían entre el 0 y el 12,5%de LPO malignizados, con periodos de seguimiento también muy variables, que oscilan entre 0,5 y 20 años. Pero estos estudios han sido refutados por un grupo de autores, que se cuestionan los criterios diagnósticos utilizados. Por todo ello, el potencial maligno del liquen plano oral, es un tema actualmente muy controvertido en Medicina Oral. Se realiza una revisión crítica de la literatura más actual sobre los conceptos clave, implicados en esta controversia (AU)

The most important complication of oral lichen planus (OLP), is the development of oral squamous cellcarcinoma (OSCC).From 1910 when was reported the first case in a woman suffered OLP, many cases and cases series have been reported with values from 0 to 12,5%, and with follow-up ranking from 0,5 to 20 years. But many of this cases not had been accepted by some authors who disagree with the diagnostic criteria employed. By all previously cited, the cancerization of OLP is a very controversial topic in Oral Medicine. It has been performed a critical review of the recent literature about it (AU)

Progressive bulbar palsy: a case report diagnosed by lingual symptoms.

The aim of this report is to show a case of Progressive Bulbar Palsy (PBP), diagnosed by oral medicine specialists, from oral symptoms of the disease. We have found no more than two published cases of PBP diagnosed by lingual alterations. We have followed the patient for almost four years, which is remarkable considering that the normal survival period for these patients is up to three years. We would like to emphasize the role of general dentists in the diagnosis of systemic conditions based on an oral examination that should include the oro-facial muscles.

Técnicas de obtención de tejido en Medicina y Patología Oral (I): Biopsia con bisturí. Biopsia con "punch" / Obtaining tissue techniques in oral medicine and pathology scalpel and biopsy technique with punch

En el presente artículo se ha realizado una revisión sobre las diferentes técnicas de obtención de tejido en Medicina y Patología oral. Se analiza los propósitos de la biopsia, los criterios para su realización y sus diferentes tipos. Se describen en detalle las dos formas de biopsia más comúnmente realizadas en mucosa oral: técnica de biopsia mediante bisturí frío y técnica mediante "punch" (AU)

No disponible

Anorexia y Bulimia: ¿Qué ve el odontólogo? / Anorexia and Bulimia: What the dentist see?

El objetivo del trabajo es llamar la atención del odontólogo acerca de la importancia que tiene su función en el diagnóstico precoz de enfermedades como la anorexia y la bulimia. Debido al aumento de la prevalencia de este tipo de trastornos, es fundamental que estos profesionales tengan unas nociones básicas sobre ambas patologías. Se han revisado ambos conceptos, sus manifestaciones orales y las correspondientes medidas a tomar, ya que con relativa frecuencia pueden aparecer en la consulta y no ser reconocidas por el profesional (AU)

No disponible

Lesiones blancas bucales en el paciente geriátrico / White oral lesions in geriatric people

Las lesiones blancas de la cavidad bucal son frecuentes en los pacientes geriátricos. Un correcto diagnóstico y una actitud terapéutica acertada en estas enfermedades son fundamentales para poder descartar procesos considerados precancerosos e incluso cáncer oral. Las lesiones blancas más prevalentes en este grupo de pacientes son las queratosis irritativas (leucoplasia), las candidiasis y el liquen plano. En este revisión exponemos los principales datos clínicopatológicos de estas enfermedades (AU)

Risk of oral cancer associated with tobacco smoking, alcohol consumption and oral hygiene: a case-control study in Madrid, Spain.

Oral cancer is a disease whose principal etiological factors are tobacco and alcohol consumption, which if controlled could help avoid many tumors. However, consumption has continued to grow for years. We have studied the risk of the principal factors established in the development of oral cancer and the influence of the oral hygiene level on the appearance of these tumors. Seventy-five cases of oral cancer and 150 controls from the Madrid community were interviewed on tobacco and alcohol consumption habits and their oral hygiene level. The Odds Ratio (OR) for consumption of 6-20 cigarettes/day is 3.1 and 7.96 for more than 20 cigarettes/day. When more than 50 g of alcohol/day is consumed the risk results in an OR of 5.3. Daily brushing is a protective factor (OR, 0.41). In conclusion, the most important risk factor for developing oral cancer is tobacco consumption followed by alcohol consumption.

[Lichen planus of the oral mucosa in the clinical course of chronic active hepatitis. Presentation of two cases]. / Liquen plano de la mucosa oral en el curso clínico de hepatitis crónica activa. Presentación de dos casos.

Two cases of oral lichen planus associated with chronic active hepatitis are presented. One of them it was also associated with achrosclerosis. A review of the literature is done, and it is suggested the possibility that oral lichen planus play a role of diagnostic importance in hepatic pathology.