Dutrée-Meulenberg R O, Kozel M M, van Joost T
Department of Dermato-Venereology, Academic Hospital Dijkzigt, Erasmus University, Rotterdam, The Netherlands.
J Am Acad Dermatol. 1992 Jun;26(6):935-40. doi: 10.1016/0190-9622(92)70136-4.
The pathogenesis of the burning mouth syndrome (BMS) is not yet understood. Apart from psychologic factors, several etiologic "somatic" factors have been reported.
In 22 patients (19 women, 3 men, mean age 56 years) classified with BMS, clinical and laboratory investigations were performed, with particular emphasis on the role of contact hypersensitivity. Twenty of the 22 patients wore a complete or partial denture.
Besides clinical and laboratory investigations patch testing was performed with a standard routine series and a standardized denture-dental (acrylate and metal) series.
Folate, iron, pyridoxine deficiency, and Candida infections were found, but correction of the deficiency or treatment of the infection was of no benefit. Contact allergy to allergens used in the production of acrylate-based dentures was observed in six (27%) of the cases (all wore a denture); positive reactions were seen to N,N,-dimethyl-4-toluidine (3 cases), to 4-tolyldiethanolamine (2 cases), to benzoylperoxide (2 cases), and to oligotriacrylate (1 case). In six cases (27%) a possible relevant sensitization was seen to dental metals and in particular to gold chloride (four cases).
The possible role of local hypersensitivity reactions to denture or dental components as etiologic factors in BMS must be considered.
灼口综合征（BMS）的发病机制尚不清楚。除心理因素外，已有多种病因“躯体”因素的报道。
对22例诊断为BMS的患者（19例女性，3例男性，平均年龄56岁）进行临床和实验室检查，特别强调接触性过敏的作用。22例患者中有20例佩戴全口或局部义齿。
除临床和实验室检查外，还用标准常规系列和标准化义齿-牙科（丙烯酸酯和金属）系列进行斑贴试验。
发现叶酸、铁、维生素B6缺乏及念珠菌感染，但补充缺乏的营养素或治疗感染并无益处。6例（27%）患者（均佩戴义齿）对丙烯酸酯基义齿生产中使用的过敏原存在接触性过敏；对N，N-二甲基-4-甲苯胺（3例）、对4-甲苯基二乙醇胺（2例）、对过氧化苯甲酰（2例）和对低聚三丙烯酸酯（1例）出现阳性反应。6例（27%）患者对牙科金属尤其是氯化金（4例）可能存在相关致敏反应。
必须考虑局部对义齿或牙科部件的过敏反应作为BMS病因的可能作用。
