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Previous issue date: 2015-03-30Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPESConselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPqBurning mouth syndrome (BMS) is a complex disease characterized mainly by
symptoms of burning, pain or itching in the oral mucosa without apparent clinical
alterations. The literature was reviewed in the first manuscript, emphasizing BMS
characteristics, etiology and therapeutics. Low-level laser therapy (LLLT) has been
widely used in oral disorders because of its analgesic, anti-inflammatory and tissue
repair effects. Thereby, in the second manuscript we reviewed the applicability and
protocols of LLLT in the management of lichen planus, xerostomia, recurrent
aphthous stomatitis, herpes labialis, oral mucositis and BMS. Controlled trials
investigating the effects of LLLT on BMS are still rare. The present randomized,
placebo-controlled study aimed to clinically assess the effect of LLLT in the treatment
of patients with BMS, and to investigate the impact of such therapy in the quality of
life of these individuals. The sample consisted of 78 BMS patients who were
randomly assigned into three laser groups and one control group (n=19), which was
treated with sham LLLT. Laser groups were treated with the following parameters:
IR1w group, n=20 (830 nm, 100 mW, 5 J, 176 J/cm2, 50 s, weekly LLLT sessions, ten
sessions); IR3w group, n=20 (830 nm, 100 mW, 5 J, 176 J/cm2, 50 s, three weekly
LLLT sessions, nine sessions); red laser group, n=19 (685 nm, 35 mW, 2 J, 72 J/cm2,
58 s, three weekly LLLT sessions, nine sessions). Symptoms were assessed at
initial, at the end of the treatment and eight weeks later using visual analogue scale
and visual numeric scale. Quality of life related to oral health was assessed through
the Oral Health Impact Profile (OHIP-14). Statistical analysis was carried out using
repeated measures ANOVA followed by the Tukey test. There was a significant
reduction in the symptoms in all groups at the end of the treatment, which was maintained in the follow-up. The scores of the IR1w and IR3w laser groups were
significantly lower in comparision to the control group. On the other hand, there was
no significant difference between Red laser group and control group. There was also
a decrease in the OHIP-14 scores in the four groups. The scores of the IR3w laser
group differed significantly from those of the control group, showing that LLLT had a
positive impact on the quality of life related to oral health. Based on the results of this
study it is possible to conclude that infrared LLLT, in the parameters used, reduces
the BMS symptoms and can be an alternative therapeutic for this disorder.A s?ndrome da ard?ncia bucal (SAB) ? uma doen?a de etiopatogenia desconhecida,
caracterizada pela sensa??o de queima??o e ard?ncia na mucosa bucal, que se
apresenta clinicamente normal. No primeiro artigo desta tese foi realizada uma
revis?o da literatura com ?nfase nas caracter?sticas da SAB, etiologia e terap?utica.
Uma vez que a terapia laser de baixa pot?ncia (LLLT) tem sido amplamente utilizada
em enfermidades bucais devido aos seus efeitos analg?sicos, biomoduladores e
antiinflamat?rios, no segundo artigo foram revisados a aplicabilidade e os protocolos
da LLLT no manejo do l?quen plano, xerostomia, ulcera??o aftosa recorrente, herpes
labial, mucosite e SAB. Ensaios cl?nicos controlados investigando o efeito da LLLT
na SAB s?o ainda escassos; portanto, o presente estudo cl?nico randomizado e
controlado teve como objetivos avaliar o efeito da LLLT nos sintomas da SAB, bem
como, o impacto desta terapia na qualidade de vida relacionada ? sa?de bucal dos
pacientes. A amostra foi constitu?da por 78 pacientes com SAB, distribu?dos em tr?s
grupos laser e um grupo-controle (n=19), no qual foi empregada sham LLLT. Os
seguintes protocolos de LLLT foram empregados nos grupos-laser: grupo IR1w,
n=20 (830 nm, 100 mW, 5 J, 176 J/cm2, 50 s, uma sess?o semanal, total de 10
sess?es); IR3w, n=20 (830 nm, 100 mW, 5 J, 176 J/cm2, 50 s, tr?s sess?es por
semana, total de nove sess?es); laser vermelho, n=19 (685 nm, 35 mW, 2 J, 72
J/cm2, 58 s, tr?s sess?es por semana, total de nove sess?es). Os sintomas foram
avaliados por meio de escala visual num?rica e escala visual anal?gica no in?cio e
fim do tratamento, e oito semanas ap?s. Para avalia??o da qualidade de vida
relacionada ? sa?de bucal foi usado o instrumento Oral Health Impact Profile (OHIP-
14). Os dados foram analisados por meio do teste ANOVA de medidas repetidas, seguido pelo teste de Tukey. Houve redu??o significativa dos sintomas ao final do
tratamento em todos os grupos, o que se manteve no acompanhamento de oito
semanas. Os escores dos grupos laser IR1w e IR3w foram significativamente
inferiores aos do grupo-controle. Por outro lado, n?o houve diferen?a significativa
entre o grupo laser vermelho e o grupo-controle. Houve tamb?m redu??o
significativa nos escores do OHIP-14 nos quatro grupos, entretanto, somente o
grupo laser IR3w apresentou diferen?a significativa em rela??o ao grupo-controle,
mostrando que o tratamento teve impacto positivo na qualidade de vida relacionada
? sa?de bucal. Com base nos resultados, pode-se concluir que a LLLT no
comprimento de onda infravermelho e nos par?metros utilizados neste estudo, reduz
os sintomas da SAB e pode ser uma alternativa terap?utica no tratamento desta
doen?a
