Martić Dora, Glavina Ana, Lugović-Mihić Liborija, Vilibić Maja
Department of Oral Medicine, Study of Dental Medicine, School of Medicine, University of Split, 21000 Split, Croatia.
Department of Dental Medicine, University Hospital of Split, 21000 Split, Croatia.
Medicina (Kaunas). 2025 Aug 20;61(8):1489. doi: 10.3390/medicina61081489.
Burning mouth syndrome (BMS) and oral lichen planus (OLP) are two chronic oral diseases/disorders that continue to pose a challenge for conventional diagnosis and treatment. Both diseases do not occur in isolation but rather appear to reflect a broader interplay of psychological, neurological, endocrine, and immunological factors, i.e., complex disorders in interconnected biological and psychological systems. In BMS, patients often suffer from persistent burning sensations without visible lesions, which may be related to altered pain processing, emotional stress, and dysregulation in the brain regions responsible for interoception and perception. Although OLP is primarily characterised by immune-mediated mucosal damage, it often has significant psychological comorbidity, particularly in the erosive form. Common features such as cortisol imbalance, disturbed cytokine patterns, and high levels of anxiety and depression suggest that these conditions may be due to overlapping systemic disorders. It is no longer sufficient to focus only on the visible lesions or symptom relief. Understanding these diseases/disorders through a more comprehensive psychoneuroendocrine immune system (PNEI) opens up new opportunities for early intervention, improved diagnostics, and more personalised therapeutic strategies that go beyond treating symptoms. Ultimately, these diseases/disorders require a more integrated and patient-centred approach, where understanding the whole system is as important as treating its individual parts.
灼口综合征（BMS）和口腔扁平苔藓（OLP）是两种慢性口腔疾病/病症，它们在传统诊断和治疗方面仍然构成挑战。这两种疾病并非孤立发生，而是似乎反映了心理、神经、内分泌和免疫因素之间更广泛的相互作用，即相互关联的生物和心理系统中的复杂病症。在灼口综合征中，患者常遭受持续的灼痛但无可见病变，这可能与疼痛处理改变、情绪压力以及负责内感受和感知的脑区调节异常有关。虽然口腔扁平苔藓主要以免疫介导的黏膜损伤为特征，但它通常有明显的心理合并症，尤其是糜烂型。诸如皮质醇失衡、细胞因子模式紊乱以及焦虑和抑郁水平高等共同特征表明，这些病症可能归因于重叠的全身性疾病。仅关注可见病变或症状缓解已不再足够。通过更全面的心理神经内分泌免疫系统（PNEI）来理解这些疾病/病症，为早期干预、改进诊断以及超越症状治疗的更个性化治疗策略开辟了新机会。最终，这些疾病/病症需要一种更综合且以患者为中心的方法，其中理解整个系统与治疗其各个部分同样重要。
