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灼口综合征的诊断与管理挑战:文献综述

Challenges of Diagnosis and Management of Burning Mouth Syndrome: A Literature Review.

作者信息

Almeida Nara Lígia Martins, Oliveira Gabriela Moraes, Santos Carlos Ferreira, Lara Vanessa Soares, Cardoso Camila Lopes

机构信息

Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo (USP), Bauru, 17012-901, Brazil.

Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP), Bauru, 17012-900, Brazil.

出版信息

Curr Aging Sci. 2025;18(2):102-119. doi: 10.2174/0118746098279205240812113353.

Abstract

BACKGROUND

Burning Mouth Syndrome (BMS) is defined as an idiopathic orofacial pain with recurrent intraoral burning. It mainly affects middle-aged women in peri- or post-menopause and the elderly, without any identifiable causative lesions and with or without somatosensory alterations. BMS has a complex pathogenesis involving psychogenic factors and deregulated peripheral and central pain, and there is no standard treatment protocol, making its diagnosis and management challenges.

OBJECTIVE

This study was to carry out a review literature on BMS, addressing its identification and therapeutic possibilities.

METHODS

Review articles and randomized controlled clinical studies whose full text was available, published between 2017 and 2022 in national and international journals, from PubMed and SCIELO databases, WHO manuals and books, were collected. As a search strategy, the keywords "burning mouth syndrome", "treatment" and "diagnosis" were used, totaling 42 papers. Of these, after applying the exclusion criteria, 34 articles were selected.

RESULTS

Studies indicate that a comprehensive and thorough anamnesis is essential to exclude secondary factors leading to the correct diagnosis of BMS. In addition, a comprehensive anamnesis directs the best management considering a combination of neuropathic and palliative therapies, which aim to control, eliminate and/or minimize painful symptoms, treating the patient in an individualized way and not the disease itself, since this pathology has no cure.

CONCLUSION

Considering the impact of BMS on quality of life, further studies are needed to expand diagnostic and treatment strategies, aiming to complement existing pharmacological and non-pharmacological treatments, observing the influence that biopsychosocial and neurophysiological mechanisms have on this syndrome.

摘要

背景

灼口综合征(BMS)被定义为一种伴有复发性口腔内烧灼感的特发性口面部疼痛。它主要影响围绝经期或绝经后以及老年的中年女性,没有任何可识别的致病病变,且伴有或不伴有躯体感觉改变。BMS的发病机制复杂,涉及心理因素以及外周和中枢疼痛调节异常,并且没有标准的治疗方案,这使得其诊断和管理具有挑战性。

目的

本研究旨在对BMS进行文献综述,探讨其识别方法和治疗可能性。

方法

收集2017年至2022年期间在国家和国际期刊上发表的、来自PubMed和SCIELO数据库、世界卫生组织手册和书籍的全文可获取的综述文章和随机对照临床研究。作为检索策略,使用了关键词“灼口综合征”“治疗”和“诊断”,共检索到42篇论文。其中,在应用排除标准后,选择了34篇文章。

结果

研究表明,全面而彻底的病史采集对于排除导致BMS正确诊断的次要因素至关重要。此外,全面的病史采集指导最佳管理方案,考虑到神经病理性和姑息性治疗的结合,旨在控制、消除和/或最小化疼痛症状,以个体化方式治疗患者而非疾病本身,因为这种病症无法治愈。

结论

考虑到BMS对生活质量的影响,需要进一步研究以扩展诊断和治疗策略,旨在补充现有的药物和非药物治疗,观察生物心理社会和神经生理机制对该综合征的影响。

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