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Tratamento da síndrome de ardor bucal revisão narrativa de ensaios clínicos
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Introdução: A síndrome de Ardor Bucal enquadra-se na dor orofacial idiopática, sendo um diagnóstico por vezes difícil. O tratamento desta síndrome não reúne consenso, pela dificuldade em obter resultados favoráveis e que levem à remissão completa dos sintomas.
Esta revisão tem o objetivo de fazer um levantamento atualizado da literatura sobre os tratamentos disponíveis, a sua eficácia e efeitos secundários.
Metodologia: Ensaios clínicos aleatorizados e controlados sobre o tratamento da Síndrome de Ardor Bucal foram pesquisados nas bases de dados Pubmed e Cochrane Central Register of Controlled Trials (publicados até dezembro 2021). 41 artigos foram selecionados e analisados para a realização da presente dissertação de tese, num total de 2 009 doentes.
Resultados: Foram identificadas 23 diferentes tipologias de tratamento, sendo que o clonazepam, a capsaicina, o ácido alfa-lipóico, a terapia de laser e a psicoterapia de grupo apresentaram os melhores resultados na diminuição dos sintomas. A crocina, a catuama e a acupuntura mostraram resultados promissores. Quando outras terapias de primeira linha falham, a estimulação magnética transcraniana pré-frontal repetitiva pode ter uma resposta eficaz. Os efeitos secundários associados à maioria das terapias foram ligeiros a moderados, com uma diminuição ao longo do tempo.
Conclusão: Pelo carácter tendencialmente crónico desta síndrome, todos os tratamentos apresentam intrinsecamente um potencial efeito placebo. Deste modo, são necessários mais ensaios clínicos aleatorizados e controlados, com amostras maiores, que incluam o tratamento placebo nas suas comparações, e que utilizem as mesmas metodologias de investigação, por forma a determinar o tratamento mais adequado para a Síndrome de Ardor Bucal.
Introduction: Burning Mouth Syndrome is part of idiopathic orofacial pain, being sometimes a difficult diagnosis. There is no consensus on the treatment of this syndrome, due to the difficulty in obtaining favorable results and that lead to complete remission of symptoms. This review aims to provide an up-to-date survey of the literature on available treatments, their effectiveness and side effects. Methodology: Randomized controlled trials on the treatment of Burning Mouth Syndrome were searched in Pubmed and Cochrane Central Register of Controlled Trials databases (published until December 2021). 41 articles were selected and analyzed in order to perform this thesis, in a total of 2 009 patients. Results: 23 different types of treatment were identified, with clonazepam, capsaicin, alpha- lipoic acid, laser therapy and group psychotherapy showing the best results in reducing symptoms. Crocin, catuama and acupuncture showed promising results. When other first-line therapies fail, repetitive prefrontal transcranial magnetic stimulation may have an effective response. Side effects associated with most therapies were mild to moderate, with a decrease over time. Conclusion: Due to the chronic nature of this syndrome, all treatments intrinsically present a potential placebo effect. Thus, more randomized controlled trials are needed, with larger samples, that include placebo treatment in their comparisons, and use the same research methodologies, in order to determine the most appropriate treatment for Burning Mouth Syndrome.
Introduction: Burning Mouth Syndrome is part of idiopathic orofacial pain, being sometimes a difficult diagnosis. There is no consensus on the treatment of this syndrome, due to the difficulty in obtaining favorable results and that lead to complete remission of symptoms. This review aims to provide an up-to-date survey of the literature on available treatments, their effectiveness and side effects. Methodology: Randomized controlled trials on the treatment of Burning Mouth Syndrome were searched in Pubmed and Cochrane Central Register of Controlled Trials databases (published until December 2021). 41 articles were selected and analyzed in order to perform this thesis, in a total of 2 009 patients. Results: 23 different types of treatment were identified, with clonazepam, capsaicin, alpha- lipoic acid, laser therapy and group psychotherapy showing the best results in reducing symptoms. Crocin, catuama and acupuncture showed promising results. When other first-line therapies fail, repetitive prefrontal transcranial magnetic stimulation may have an effective response. Side effects associated with most therapies were mild to moderate, with a decrease over time. Conclusion: Due to the chronic nature of this syndrome, all treatments intrinsically present a potential placebo effect. Thus, more randomized controlled trials are needed, with larger samples, that include placebo treatment in their comparisons, and use the same research methodologies, in order to determine the most appropriate treatment for Burning Mouth Syndrome.
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Teses de mestrado - 2022 Saúde Oral