Alessia Ruggieri

Burning mouth syndrome: is acupuncture a therapeutic possibility?

Background Burning mouth syndrome is a chronic pathology of unknown ethiopathogenesis. The aim of this study was to evaluate whether acupuncture can produce a reduction of the burning sensation by influencing the oral microcirculation.Methods Thirty patients (10 male and 20 female; mean age ± SD = 65.4 ± 2.17) and 30 healthy subjects (10 male and 20 female; mean age ± SD = 62.06 ± 6.72) were recruited for the study. The patients were treated with acupunctural techniques based on traditional Chinese medicine. Microcirculation was observed in vivo using videocapillaroscopy at three different times: t0) in the absence of acupuncture; t1) 1 minute after the insertion of the needles; and t2) 5 minutes after the insertion of the needles and following their stimulation.Results The capillaroscopic observation revealed a significant increase of the capillary tortuousness and density, a reduction of the arborescence and a reduction of burning sensation in such patients.Conclusion The study shows that acupuncture influences oral microcirculation, resulting in a significant variation of the vascular pattern to which is associated a significant reduction of the burning sensation after three weeks of therapy. Such reduction of the burning sensation has been permanent for the 18 months following the acupuncture therapy. Acupuncture appears a valid therapeutic choice in the management of such patients.

Periodontal Disease and Sjögren Syndrome: A Possible Correlation?

Sjögren syndrome (SS) is a chronic autoimmune rheumatic disease characterized by a progressive lymphocytic infiltration of exocrine glands, especially salivary and lachrymal ones, leading to xerostomia, parotid gland enlargement, and xerophthalmia. The aim of this study is to describe the capillaroscopic pattern of the interdental papilla in patients with SS and to evaluate a possible correlation with periodontal disease. Methods: A total of 25 patients affected by SS and 25 healthy controls were examined. The patients with conditions that compromise microcirculation, such as diabetes, hypertension, hyperlipidemia, or some pharmacological treatments, were not included in the study. All the patients were nonsmokers. Periodontal capillaroscopy has been used to investigate the features of microcirculation. Visibility, course, tortuosity, as well as the possible presence of microhemorrhage, the average caliber of the capillary loops, and the number of visible capillary loops per square millimeter were evaluated for each patient. Results: The results show evident alterations to the capillaries and a typical conformation of the interdental papilla microcirculation in patients with SS; it was possible to observe a reduced caliber of capillaries, as well as a greater number and tortuosity of capillary loops. Conclusion: This study shows that capillary alterations to patients with SS occur in gingival microcirculation.

Evaluation of labial microvessels in Sjogren syndrome: A videocapillaroscopic study

UNLABELLED Sjögrens syndrome (SS) is a chronic autoimmune rheumatic disease characterized by a progressive lymphocytic infiltration of exocrine glands, especially salivary and lachrymal ones, leading to xerostomia, parotid gland enlargement, and xerophtalmia. SS may occur alone (primary) or in association with almost any of the autoimmune rheumatic diseases (secondary), the most frequent being rheumatoid arthritis. The aim of this study is to describe the capillaroscopic pattern of the labial mucosa in patients with SS. METHODS A total of 20 patients affected by SS and 20 healthy controls were examined. The patients with conditions that compromise microcirculation, such as diabetes, hypertension, hyperlipidemia or some pharmacological treatments, were not included in the study. All the patients were non-smokers. Labial capillaroscopy has been used to investigate the features of microcirculation. Visibility, course, tortuosity, as well as the possible presence of microhemorrhage, the average calibre of the capillary loops and the number of visible capillary loops per square millimetre were evaluated for each patient. RESULTS The results show evident alterations in the capillaries and a typical conformation of the labial microcirculation in SS patients. CONCLUSION Labial microcirculation alterations occur in SS patients. The study of the microcirculation in autoimmune pathology such as SS could provide new understanding on the dynamics of the pathology and could help to complete the diagnosis.

Correlation of " in vivo" microcirculation and degeneration of the basal cells of the epithelium in lingual lichen planus

BACKGROUND Oral lichen planus is an inflammatory chronic disease with an autimmune pathogenesis and unknown etiology that affects oral mucosa, with or without the involvement of the skin and other mucous membranes. The principal histological characteristics are the degeneration of the basal cell layer and the abnormal infiltration of inflammatory cells into the subepithelial layer of connective tissue. OBJECTIVES This study is aimed to appraise if lingual lichen planus (LLP) is sustained by alteration of the oral microcirculation and if this abnormal vascularisation increases the degeneration of basal keratinocytes and the disruption of the basement membrane. MATERIALS AND METHODS Fifteen patients with a histological diagnosis of LLP with higher degree of degeneration of the basement membrane, fifteen LLP patients with lower degree of basement membrane (BM) degeneration and fifteen healthy patients were included in the study. The microcirculation of the left margin of the lingual mucosa of all the patients and subjects was analysed with the videocapillaroscopy. The following parameters were analyzed on each capillaroscopic image: c0 apillary loop length, loop diameter, and capillary density. The results obtained by videocapillaroscopy software were subjected to statistical analysis using Mann Whitney U-test (P < 0.001). Statistical analysis was performed using PAST software, v. 1.53. RESULTS Capillary density, loop length, and total diameter showed statistically significant differences between LLP patients with histologically lower degree of BM degeneration and healthy subjects and a meaningful significant difference between LLP patients with higher degree of BM degeneration. CONCLUSIONS A remarkable increase in capillary density was showed by videocapillaroscopic exam. The increased value of the density could be associated with angiogenesis mechanism and it could be an indicator of the evolutionary condition of LLP. Videocapillaroscopy may be useful for the evaluation of the evolution or regression of the disease.

The effect of acupuncture on oral microcirculation in healthy volunteers: an exploratory study.

Background Acupuncture is a therapeutic technique currently used in the treatment of many pathologies. The aim of this study is to evaluate the potential effect of acupuncture on “in vivo” variations in oral microcirculation in healthy subjects. Methods An exploratory study was conducted on 40 healthy subjects: 20 cases (mean 55.90, SD 16.04) and 20 controls (mean 51, SD 11.91). Videocapillaroscopy was used to detect variations in oral microcirculation. This method permits an accurate and non-invasive in vivo study of the capillaries of the oral mucous. The site selected for this pilot study is the lower lip since it is the simplest to investigate and is more readily accessible. Assessments were carried out in three phases: t0 before the application of the needles; t1 one minute after the application; t2 five minutes after the application; similar time points were used for the control group. Data were compared using the Mann-Whitney test. Results The study showed characteristic changes in oral microcirculation induced by acupuncture. The tortuousness of capillary loops and in the diameter of the afferent loop changed significantly (p<0.05) over time in the acupuncture group but not in the controls. Conclusions The findings lend support to our expectation that acupuncture may generate significant variations in oral microcirculation in healthy adults. Further research is needed to confirm these findings and evaluate the therapeutic role of acupuncture in oral pathologies.