Tânia Mara Pimenta Amaral

Psychiatric disorders in burning mouth syndrome.

BACKGROUND Prevalence of psychiatric disorders in burning mouth syndrome (BMS) is high, but their role in the pathogenesis of BMS remains unclear. OBJECTIVE The authors aimed to assess the frequency of psychiatric disorders and the severity of psychopathology in BMS. METHODS Thirty BMS patients and thirty-one controls underwent a psychiatric evaluation which included a structured interview (MINI-Plus) and five psychometric scales. A Visual Analogue Scale (VAS) was used to measure the intensity of burning sensation. RESULTS Patients with BMS showed a higher frequency of current major depressive disorder, past major depressive disorder, generalized anxiety disorder, hypochondria and cancerophobia (p<0.05). In BMS patients, generalized anxiety disorder was significantly associated with current major depression and social phobia (p<0.05). As expected, cancerophobia was significantly associated with hypochondria (p<0.05). Patients with BMS had higher scores in Hamilton Rating Scale for Depression (HRSD), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI) and Dutch Fatigue Scale (DUFS) (p<0.05). CONCLUSION BMS patients may have a particular psychological and/or psychiatric profile. Psychometric scales might be useful in screening psychiatric disorders, as well as for assessment of treatment outcomes. In the presence of clinical relevant psychiatric symptoms, patients must be treated appropriately.

Burning Mouth Syndrome: A Therapeutic Approach Involving Mechanical Salivary Stimulation

Objective.— The study aimed to evaluate the effects of salivary stimulation therapy on the salivary flow, quality of saliva, and symptoms in patients with burning mouth syndrome (BMS).

The association of openness personality trait with stress-related salivary biomarkers in burning mouth syndrome.

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.

Effect of salivary stimulation therapies on salivary flow and chemotherapy-induced mucositis: a preliminary study

OBJECTIVE The objective of this study was to evaluate the effect of salivary stimulation therapies on the salivary flow, oral mucositis, and salivary cytokine levels in patients receiving allogeneic hematopoietic stem cell transplantation. STUDY DESIGN Thirty-five eligible patients were randomized into 4 groups: control, mechanical sialogogue, transcutaneous electrical nerve stimulation (TENS) sialogogue, and combined mechanical/electrical sialogogue. Saliva was collected from patients before transplantation and at days 3, 7, and 14 after transplantation. The volume was measured and salivary cytokines were assessed using enzyme-linked immunosorbent assay. RESULTS By day 14, resting and stimulated salivary flow levels were diminished. Resting salivary flow rates decreased the most in the control and mechanical groups. In contrast, TENS alone or in combination with mechanical stimulatory therapy benefited the patients. TENS-treated patients showed increase in resting salivary flow. Also, the groups treated with TENS had fewer patients affected by grades 3 and 4 mucositis, and less mucositis was associated with better patient survival (P = .027). CONCLUSIONS TENS-associated salivary stimulation therapies minimized the reduction of salivary flow and prevented severe chemotherapy-induced oral mucositis.

Classifications of mandibular canal branching: A review of literature

AIM To gather existing radiographic classifications of mandibular canals branching, considering the criteria on which these were based. METHODS The search for studies on mandibular canals based on imaging exams included literature reviews, epidemiological studies of prevalence, descriptive studies, or case reports. An electronic search in the MEDLINE (OvidSP), PubMed, EMBASE (OvidSP), Web of Science (Thompson Reuters), and Scopus (Elsevier) databases was performed, as well as a manual evaluation of the references of the selected articles. Combinations of key words were placed in each database. No restrictions were imposed regarding the year of publication or language. References collected in duplicate were removed by the authors. A table was drawn up, containing the included studies and respective interest data. RESULTS Six classifications of mandibular canals branching were selected for the present literature review. Four were based on two-dimensional radiographic exams, and two were performed based on three-dimensional tomographic exams. Three-dimensional classifications were determined based on the analysis found in the least number of exams, comparatively to two-dimensional studies. The prevalence of mandibular canal branching varied from 0% to 38.75% in the works based on two-dimensional exams, while those found in three-dimensional exams ranged from 15.6% to 65%. The studies were mostly referred to branches that began in the mandibular ramus. Just one classification considered the branches that began in the mandibular body region. CONCLUSION Three-dimensional exams appear to be the best method to view mandibular canal branching. Further studies are warranted to determine its true prevalence and questions concerning to associations.