• 대한한방내과학회지
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• 제41권4호
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• pp.624-643
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• 2020

Objectives: The aim of this study was to analyze the correlation between Ryodoraku and two pattern-identification questionnaires in patients with Burning Mouth Syndrome (BMS). Methods: The study participants were 30 patients with BMS who visited the Oral Diseases Clinic of Kyung Hee Oriental Medicine Hospital from June to November, 2019. The Ryodoraku test and two pattern-identification questionnaires were administered to all patients. Measurements included the average Ryodoraku score, which is called the Total Average (TA), and each score on the Ryodoraku point scale. The degree of Yin-deficiency, Qi-stagnation, and pain were assessed with the Yin-deficiency Questionnaire (YDQ), Qi-stagnation Questionnaire (QSQ), and Visual Analogue Scale (VAS), respectively. Results: The average TA score was 29.90. The LF5 (p=0.013) and RF5 (p=0.016) scores were lower than the TA scores, and the RH5 (p=0.020) and RH6 (p=0.006) scores were higher than the TA scores. A negative correlation was detected between the YDQ scores and the LH1 (r=-0.366, p=0.046), LH2 (r=-0.507, p=0.004), LH3 (r=-0.374, p=0.042), RH1 (r=-0.361, p=0.050), RH2 (r=-0.403, p=0.027) points. The LF5 (p=0.050) and RF2 (p=0.048) scores were lower in the patients with Qi-stagnation patients than without Qi-stagnation. Conclusions: Our results suggest that low TA and Ryodoraku scores on LF5 and RF5 and high Ryodoraku scores on RH5 and RH6 could be quantitative indicators for the diagnosis of BMS. The LH1, LH2, LH3, RH1, RH2, LF5, and RF2 scores could also be an indicators for diagnosis of Yin-deficiency and Qi-stagnation in patients with BMS.

• 대한한방내과학회지
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• 제39권3호
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• pp.363-371
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• 2018

Objective: The aim of this study was to investigate the clinical characteristics of patients showing fissured tongue (FT) with burning mouth syndrome (BMS). Methods: We reviewed the clinical records of 16 FT patients with BMS who visited the Oral Diseases Clinic of Kyung Hee University Korean Medicine Hospital from March 1, 2017 to February 28, 2018. The subjects were graded by FT classification and compared with each group on a numeral rating scale (NRS) of tongue pain, proportion of coated tongue, unstimulated salivary flow rate (USFR), Ryodoraku, and heart rate variability (HRV) results. Results: FT grade had no significant correlation with NRS of tongue pain and USFR. FT grade had a substantially significant positive correlation with BMI and LF/HF ratio in HRV. FT grade had a substantially significant negative correlation with proportion of coated tongue. The most frequent accompanying symptoms were xerostomia and insomnia. Conclusions: The results of this study suggest that FT has no correlation with tongue pain in BMS. Rather, FT seems to correlate with sympathetic function acceleration.

• 대한한방내과학회지
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• 제37권6호
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• pp.978-989
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• 2016

Objectives: This study evaluated the diagnostic values of measuring the number of fungiform papillae in patients with burning mouth syndrome (BMS). Methods: Seventy participants (35 BMS patients and 35 Healthy control) participated in this study. The number of fungiform papillae (FP) was measured on the anterior part of the tongue within an area of $9mm^2$ using a digital camera. The subjects were evaluated on their yin deficiency and blood stasis conditions using the Yin-Deficiency Questionnaire (YDQ) and Blood Stasis Questionnaire (BSQ). Moreover, the severities of subjective tongue pain in the BMS patients were assessed using Visual Analog Scale. Results: There were significant differences in the number of FP and the YDQ and BSQ scores between the two groups. The number of FP and the YDQ scores in the BMS group showed statistically significant correlations with the VAS score of tongue pain. In the bivariate logistic regression analysis, the factor that most strongly contributed to BMS was the number of FP. The optimal cut-off value of the number of fungiform papillae was calculated as 5.5 with 71.4% sensitivity and 82.9% specificity. There was no statistically significant correlation between the number of FP and the YDQ or BSQ score. Conclusions: According to these findings, measuring the number of FP could be a valuable evaluation indicator of BMS.

• Journal of Oral Medicine and Pain
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• 제39권3호
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• pp.96-99
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• 2014

Purpose: The objective of this retrospective pilot study was to evaluate the effectiveness of Gabapentin in patients with primary burning mouth syndrome (BMS). Methods: Ten subjects were diagnosed with primary BMS (8 women and 2 men). The mean age was 60.1 years. They had clinical examination to exclude local factors such as the presence of Candida species, xerostomia, lichen planus, etc. They also underwent hematological examination to exclude secondary BMS due to systemic disorders. Pain was assessed by patients on an 11-point numerical rating score system (0 to 10). Gabapentin was administered at a starting dose of 300 mg/day, slowly titrated up to maximum of 1,800 mg/day. All patients were treated for 4 weeks. Results: One half of the patients (n=5) obtained reduction in pain over the treatment period. Four patients reported no reduction in pain symptoms. One patient reported that symptoms were worsening. The average pain score before the treatment was 6.3 and after the treatment was 5.25. No significant relationship was detected between pretreatment and posttreatment pain score. Only one patient noted mild side effect (dizziness). Conclusions: This retrospective pilot study provides no preliminary evidence that Gabapentin has effect in the management of BMS. However, further research (well-designed, randomized, and controlled trial with large sample) would be needed to investigate the efficacy of Gabapentin in treatment of BMS.

• Journal of Oral Medicine and Pain
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• 제41권1호
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• pp.1-6
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• 2016

Purpose: To investigate the efficacy of pregabalin for patients with primary burning mouth syndrome (BMS) who are unresponsive to topical clonazepam therapy. Methods: By searching the clinical electronic records from the Department of Oral Medicine, Pusan National University Dental Hospital from 2012 to 2014, a retrospective analysis was performed on patients with primary BMS who were treated with topical clonazepam therapy during this period. Of the patients who were unresponsive to this therapy, 19 patients who were subsequently treated with pregabalin were included in the study. A pain assessment was performed using the 11-point numerical rating scale at first visit, following topical clonazepam therapy, and again after pregabalin therapy. The treatment outcomes were statistically analyzed using the Wilcoxon signed rank test. Results: Following additional pregabalin administration, the mean pain score was slightly reduced. A total of 7 patients reported a marked response (>50% pain reduction), and 3 patients reported a slight reduction in pain. Pain reduction following pregabalin therapy was statistically significant (p<0.05). Conclusions: Pregabalin has a slight therapeutic effect on patients with primary BMS. Therefore, we recommend pregabalin as an alternative drug for BMS patients who are unresponsive to topical clonazepam therapy.

• Journal of Oral Medicine and Pain
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• 제44권2호
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• pp.54-58
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• 2019

Purpose: The aim of this study is to evaluate the correlation between tongue pain and tenderness of tongue by digital palpation (DP) in Burning Mouth Syndrome (BMS) patients. Methods: One hundred thirty-four consecutive patients (60 BMS with tongue pain and 74 non-BMS) who attended the Department of Oral Medicine (Chosun University Dental Hospital, Gwangju, Korea) from January 2018 to December 2018 were included in this study. The examined sites were anterior, lateral (right and left) and central part of the tongue. The pain sites were reported by the patients and the tender points on DP test were recorded by the clinicians. DP test was performed by well-trained clinicians with palpation of the tongue with 0.5 kg pressure using the thumb and index finger. Obtained results for BMS and non-BMS group were compared using t-test (p<0.05). Results: 1. The BMS group had higher tender score on DP test of the tongue and there was a significant difference between the BMS and non-BMS groups. 2. The accuracy of the pain site and the tender point was shown to be 0.68 total (anterior 0.68; right lateral 0.69; left lateral 0.70; central 0.61). Conclusions: This study suggests that the tenderness to DP of the tongue could be related to the painsites in the BMS patients. Further study is needed to confirm the usefulness of DP test of the tongue to examine the BMS patients.

• Journal of Oral Medicine and Pain
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• 제44권1호
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• pp.25-30
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• 2019

Purpose: The exact causes of burning mouth syndrome (BMS) is unclear so far. There are many studies to elucidate the relation between oral disease and genetic predisposition. In this study, we first tried to investigate salivary exosomal genetic components that could play an important role for diagnosing and elucidating the progression of BMS. Methods: We compared salivary exosomal micro RNAs (miRNAs) of BMS Patients to those of control using next generation sequencing (NGS). Unstimulated whole saliva from 15 patients with BMS and 10 control subjects were divided into two sets. Isolated exosomes and their total RNAs were subject to NGS for the screening of miRNAs. Results: There were up-regulated 10 exosomal miRNAs (hsa-miR-1273h-5p, hsa-miR-1273a, hsa-miR-1304-3p, hsa-miR-4449, hsa-miR-1285-3p, hsa-miR-6802-5p, hsa-miR-1268a, hsa-miR-1273d, hsa-miR-1273f, and hsa-miR-423-5p) and down-regulated 18 exosomal miRNAs (hsa-miR-27b-3p, hsa-miR-16-5p, hsa-miR-186-5p, hsa-miR-142-3p, hsa-miR-141-3p, hsa-miR-150-5p, hsa-miR-374a-5p, hsa-miR-93-5p, hsa-miR-29c-3p, hsa-miR-29a-3p, hsa-miR-148a-3p, hsa-miR-22-3p, hsa-miR-27a-3p, hsa-miR-424-5p, hsa-miR-19b-3p, hsa-miR-99a-5p, hsa-miR-548d-3p, and hsa-miR-19a-3p) in BMS patients comparing with those of control subjects. Conclusions: We show that there are 28 differential expression of miRNAs between the patients with BMS and those of control subjects. The specific function of indicated miRNAs should be further elucidated.

• 대한한방내과학회지
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• 제43권1호
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• pp.53-67
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• 2022

Objectives: This study aimed to identify the characteristics of the heart rate variability (HRV) index in patients with burning mouth syndrome (BMS) and to evaluate the predictive value of HRV for Korean medical treatment responsiveness to tongue pain in BMS. Methods: Among BMS patients who visited the Oral Diseases Clinic of Kyung Hee University Korean Medicine Hospital from January 1, 2018, to May 31, 2021, we reviewed the clinical records of 217 women aged 50 years and over. HRV and unstimulated saliva flow rate (USFR) measurements were carried out, and all patients were asked to indicate their degree of tongue pain using the visual analog scale (VAS). The subjects were classified into subgroups according to the presence or absence of hyposalivation and VAS improvement, and each subgroup was compared using the HRV index. Logistic regression analysis was conducted to confirm whether cause-effect relationships were present between statistically significant values. Results: BMS patients had lower LF and HF than healthy people. Subgroup analysis demonstrated that there were some statistically significant differences in the HRV index according to salivation rate and degree of pain. In addition, as the LF/HF ratio increased, the pain improvement rate decreased after treatment. Conclusion: The autonomic nerve activity of BMS patients was lower than that of healthy people; however, autonomic balance was not impaired. In addition, tongue pain in BMS patients responded more favorably to Korean medical treatment when patients fell within a normal range of the LF/HF ratio, suggesting that autonomic imbalance could be used as one of the predictable factors in clinical practice.

• Journal of Oral Medicine and Pain
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• 제35권1호
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• pp.41-47
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• 2010

구강작열감증후군은 임상적 증상이나 검사실 소견없이 구강점막에 나타나는 작열감을 말하며 중년이후 폐경기 여성에게 높은 발생율을 보인다. 구강작열감증후군에서 보여지는 통증은 자발적이며 뚜렷한 악화요인을 보이고 있지 않다. 통증 유발과 관련해서 치과적 술식, 최근의 질환, 투약(항생제 요법)등을 포함하고 있으며, 작열감이 한 번 시작되면 수년간 지속된다. 대부분의 구강작열감 환자는 국소적 또는 전신적 요인을 가지고 있으며, 구강작열감증후군은 신경병리학적 활성화에서 기원되는 만성구강증상으로 고려할 수 있으며, 정신학적 원인에 대한 역할은 아직은 명확하지 않다. 구강작열감의 신경학적 측면에 대하여 연구가 증가하고 있고 이런 연구는 구강작열감에 중추신경계, 말초신경계가 관여함을 제시하고 있다. 그 중에 하나로 대두 되고 있는 것이 미각에서의 이상이 존재한다는 것이다. 구강작열감증후군에서 supertaster의 존재에 대해 언급하고 있으며, 이는 미각과 유해수용성 기전에 상호작용함을 제시하고 있다. 즉 중추신경계에서 미각과 구강 통증 감각이 연결되어 있고 이것은 구강작열감증후군에서 고삭신경, 설인신경수준에서 미각체계 변형에 의한 말초신경계와 중추신경계가 같이 상호 작용하여 구강작열감증후군을 발생시킴을 보여준다. 이에 본 저자는 만성구강통증으로 여겨지는 구강작열감증후군을 유발하는 요인과 병태 생리를 고찰하여 환자의 진단과 원인 지향적인 치료에 도움을 주고자 한다.

• Journal of Oral Medicine and Pain
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• 제42권4호
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• pp.102-108
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• 2017

Purpose: Many metal ions released from dental casting alloys have been reported to influence the intraoral symptoms of oral lichen planus (OLP) and burning mouth syndrome (BMS). The aim of this study was to investigate the relationship between salivary metal ion levels and the prosthetic duration as well as to evaluate the time-dependent morbid effects of metal ions in OLP and BMS patients. Methods: Three study groups consist of the following subjects respectively: 17 OLP patients, 12 BMS patients, and 12 patients without oral symptoms. The salivary concentrations of 13 metal ions (copper, cobalt, zinc, chromium, nickel, aluminum, silver, iron, titanium [Ti], platinum, tin, palladium, and gold) were measured by Laser Ablation Microprobe Inductively coupled Plasma Mass Spectrometry. Results: The Ti ions had statistically significant differences among the groups with a prosthetic duration of less than 5 years. There were no significant differences between all ion levels among the groups wearing dental cast alloys for over 5 years. In the BMS group, the level of Ti ions in patients with prosthetic restorations less than 5 years old were significantly high (p<0.05). Conclusions: In the BMS group, 3-60 months during which salivary Ti levels were higher were matched with the duration of burning symptoms ($15.6{\pm}17.1months$). Furthermore, Ti ions were statistically high in the oral cavity of BMS patients fitted with dental casting alloys for 5 years. These results suggest that Ti ions released from dental implants and oral prostheses could attribute to burning sensation of BMS.