Abstract Burning mouth syndrome (BMS) is a condition characterized by painful symptoms of the oral mucosa, despite the absence of any clinical signs. Its etiology is unknown, and there is still no effective treatment to date. Current evidence has shown neuropathic impairment in BMS patients. Neuropathic pain can be related to the dysfunction of voltage-gated sodium channels, considering that these receptors regulate the induction of action potentials in nociceptive neurons. This study evaluated the gene expression of voltage-gated sodium channels Na v 1.7, Na v 1.8 and Na v 1.9 in these patients. The gene expressions of these channels were assessed by real time RT-PCR analysis of fresh-frozen tongue biopsies in a case-control study composed of 12 patients with BMS, and 5 healthy control patients, proportionally matched by sex and age, and analyzed using the 2^(-Delta Delta CT) method. There was no statistically significant difference between the analyzed groups, despite the increase in Na v 1.7 (fold-change = 3.13, p = 0.52) and decrease in Na v 1.9 (fold-change = 0.45, p = 0.36) gene expression in the BMS group. The Na v 1.8 gene was not expressed in any of the samples analyzed. Although the gene expression in the voltage-gated sodium channels in BMS under study seems to be comparable with that of the normal oral mucosa, the functionality of these channels in BMS has not yet been identified, thus suggesting that further research is needed to better understand these voltage-gated sodium channels.

Abstract Oral leukoplakia is a potentially malignant disorder, defined as a white plaque that cannot be diagnosed as another known disease or disorder, and has an increased risk of malignancy. The aim of the present study was to evaluate the results of CO2 laser treatment in a well-defined cohort of patients with oral leukoplakia in order to identify the occurrence of clinical outcomes of relapse, resolution, or malignancy after treatment. The study group comprised 37 patients. Before treatment, clinical photographs and incisional biopsies were obtained in all cases. In addition, the post-treatment results were documented using photographs. Evaluation of treatment results was performed by an independent researcher who had not performed the surgery. The minimum, maximum, and mean values of continuous variables were calculated. Statistically significant relationships were tested using the Cox regression analysis. A survival curve was constructed according to the Kaplan–Meier method to analyze the malignant transformation and recurrence of oral leukoplakia. The clinical outcomes analyzed were resolution, recurrence, and malignancy. The mean follow-up period was 36 months (range, 6–239 months). In 13/37 patients, leukoplakia recurred between 6 and 93 months (mean, 38.2 months). In 8/37 patients, a malignant transformation occurred (mean, 50.6 months). In 16/37 patients, lesion resolution occurred. No risk factor was statistically significant for malignancy or recurrence of lesions. The treatment of the lesions by CO2 laser was efficient in the removal of the lesions; however, it did not avoid the clinical outcomes of recurrence or malignancy.

Abstract: In Brazil, there are 15,500 incident cases of oral cancer (OC) yearly, and early diagnosis is the main factor for a better prognosis. The objective of this study was to analyze the interval between the first symptoms, diagnosis, and treatment commencement in patients with malignant neoplasms in the oral cavity, lips, and oropharynx diagnosed between 2012–2018. Epidemiological data, duration, history of lesion, biopsy, and diagnosis were obtained from the medical records of these patients, who were then contacted via phone and interviewed about their oncological treatment. The results were analyzed and expressed as mean, median, and SD. Of 184 patients, most were men, white, 50–69 years old, smokers, and alcoholics. The longest interval was between the first symptoms and first evaluation (a mean of 275 days). The interval between the first appointment and the result of the biopsy was shorter (13 days). Among the 85 patients interviewed, the interval between the diagnosis, the first appointment at the oncological clinic and treatment commencement was 55 days (mean) for patients using private-sector health care, and 96 days (mean) for patients using public health care. The interval was twice as long in the public health system compared with the private sector, which highlights the inequality of access to health care in Brazil. Delay in seeking health care after the appearance of the first symptoms remains a major problem.

Resumo Introdução A Síndrome de Ardência Bucal (SAB) é uma condição caracterizada pelo sintoma de ardência na mucosa oral na ausência de qualquer sinal clínico. Sua etiologia ainda é desconhecida e, até o momento, não dispõe de tratamento efetivo. Objetivo Avaliar o perfil do paciente portador de SAB, as terapias instituídas e seus resultados em estudo retrospectivo. Material e método Foram coletados os dados clínicos e terapêuticos dos prontuários de pacientes diagnosticados com SAB, no período de janeiro de 2013 a abril de 2015, no Ambulatório da Disciplina de Estomatologia Clínica da Faculdade de Odontologia da Universidade de São Paulo. Os critérios para o diagnóstico utilizados se basearam nos estabelecidos pela International Headache Society em 2013 e foram observadas as terapêuticas empregadas e seus resultados. Resultado Doze pacientes foram diagnosticadas com SAB neste período, todas do sexo feminino, média de idade 61,18 anos, e a principal região acometida pelo sintoma de ardor foi o ápice de língua. O tempo de duração deste sintoma variou de 6 meses a 25 anos. As terapias utilizadas para o controle de sintomas da SAB foram capsaicina, clonazepan tópico, laserterapia e homeopatia. Dentre as terapias instituídas, a capsaicina apresentou efeito imediato na redução dos sintomas. Conclusão O presente estudo demonstrou que os desafios que circundam a obtenção de um tratamento efetivo para a SAB são diversos e estão principalmente relacionados ao desconhecimento da etiopatogenia da doença. O perfil demográfico dos pacientes aqui estudados foi semelhante ao descrito na literatura disponível, entretanto, as variáveis representadas por sintomas secundários (história médica, níveis de ansiedade e depressão) podem constituir fatores modificadores da resposta terapêutica e da própria etiopatogenia da doença.

Abstract Introduction Burning Mouth Syndrome (BMS) is a condition characterized by burning symptom of the oral mucosa in the absence of clinical signs. Its etiology is still unknown and, and to date there is no effective treatment. Purpose The aim of this study was to evaluate patients with BMS profile and the therapies results in a retrospective study. Material and method Clinical and therapeutic data were collected from records of patients with BMS diagnosed between January 2013 to April 2015 at the Clinic of Stomatology Clinic, Faculdade de Odontologia of Universidade de São Paulo, according to the criteria established by the International Headache Society in 2013. The therapies used for BMS control were also evaluated. Result Twelve patients were diagnosed with BMS at this period. All of them were women with a mean age of 61.18 years and the apex of the tongue was the most common affected site and the duration of the burning sensation ranged from 6 months to 25 years. Many therapies were prescribed for BMS control, such as topical capsaicin, topical clonazepan, low level laser therapy and homeopathy. Among the established therapies, capsaicin has immediate effect in reducing symptoms. Conclusion The present study showed that the challenges towards an effective treatment for BMS are varied and are mainly related to the lack knowing of the pathogenesis of this disease. The demographic profile of patients studied here was similar to that described in the available literature, however, the variables represented by secondary symptoms (medical history, anxiety and depression levels) may be modifying factors of therapeutic response and the pathogenesis of the disease itself.

Abstract The aim of this study was to assess the effectiveness of low intensity laser therapy in patients with Burning Mouth Syndrome (BMS). Thirty BMS subjects were randomized into two groups – Laser (LG) and Placebo (CG). Seven patients dropped out, leaving 13 patients in LG and 10 patients in CG. Each patient received 4 irradiations (laser or placebo) twice a week, for two consecutive weeks (blinded to the type of irradiation received). Infrared laser (AsGaAI) irradiations were applied to the affected mucosa in scanning mode, wavelength of 790 nm, output power of 20 mW and fluence of 6 J/cm2. A visual analogue scale (VAS) was used to assess the therapeutic effect before and after each irradiation, and at all the control time periods: 7, 14, 30, 60 and 90 days after the last irradiation. One researcher delivered irradiation and another recorded the results. Both researchers were blinded, the first to the results, and the second to the type of radiation applied. The results were categorized according to the percentage of symptom level variation, and showed a statistically better response in LG in only two categories of the control checkpoints (p=0.02; Fisher’s Exact Test). According to the protocol used in this study, low intensity laser therapy is as beneficial to patients with BMS as placebo treatment, indicating a great emotional component of involvement in BMS symptomatology. Nevertheless, there were positive results in some statistical analyses, thus encouraging further research in BMS laser therapy with other irradiation parameters.

INTRODUCTION AND OBJECTIVES: Recurrent aphthous stomatitis (RAS) is the most common type of ulcerative disease of the oral mucosa. Despite its worldwide occurrence and the extensive amount of research that has been devoted to the subject, the etiology of RAS remains unclear. Nevertheless, several hereditary, nutritional, infectious and psychological factors have been associated with RAS. The aim of this case-control study was to assess the influence of psychological stress on the manifestation of RAS. METHOD: Fifty patients were enrolled in the trial. Twenty-five RAS patients constituted the study group and another 25 non-RAS patients who were similarly matched for sex, age and socioeconomic status constituted the control group. Each patient was evaluated in terms of the four domains of stress (emotional, physical, social and cognitive) using an internationally validated questionnaire, which was comprised of 59 items and measured the frequency and intensity of stress symptoms. The RAS group was interviewed during an active RAS episode. Completed questionnaires were submitted to proper analytical software and interpreted by an expert psychologist. RESULTS: There was a higher level of psychological stress among RAS group patients when compared to the control group (P < 0.05). CONCLUSION: Psychological stress may play a role in the manifestation of RAS; it may serve as a trigger or a modifying factor rather than being a cause of the disease.