Danica VIDOVIĆ JURAS

Ivana Canjuga

Vanja VUČIĆEVIĆ BORAS

Vlaho Brailo

Hrčak - Portal of scientific journals of Croatia

www.ascro.hr141Acta Stomatol Croat. 2011;45(2):141.PISMO UREDNIKULETTER TO THE EDITORVanja VuËiÊevic Boras, Ivana Canjuga, Vlaho Brailo, Danica Vidović JurasUčinak	lokalne	primjene	hijaluronske	kiseline	kod	pacijenata	sa	sindromom	pekućih	ustaThe Effect of Topical Hyaluronic Acid in Patients with Burning Mouth SyndromeACTASTOMATOLOGICACROATICAwww.ascro.hrZavod za oralnu medicinu Stomatološkog fakulteta Sveučilišta u Zagrebu, HrvatskaDepartment of oral medicine, School of Dentistry, University of Zagreb, Gunduliceva 5, Zagreb, CroatiaDragi uredniče,U literaturi postoje podatci koji pokazuju djelotvornost 0,2-postotne hijaluronske kiseline (HK) u liječenju određe-nih oralnih bolesti, poput rekurentnih aftoznih ulceracija i oralnog lihen-planusa zbog njezinih protuupalnih i drugih svojstava (1). Osim toga, HK je hidroskopna makromole-kula i njezine su otopine jako osmozne. Kad je riječ o  ko-ži i sluznici usne šupljine, to je svojstvo možda odgovorno za kontroliranje hidracije tkiva, posebice u slučaju upale ili od-govora na oštećenje tkiva (2). Sindrom pekućih usta (SPU-a) još je enigma, kako za bolesnika tako i za liječnika, iako je ta tema obrađena u mnogobrojnim člancima. Nažalost, nema učinkovitog liječenja toga sindroma (3). Zbog toga je devet-naestero bolesnika koji pate od sindroma pekućih usta detalj-no klinički pregledano i obavljena su hematološka ispitivanja koja su uključivala kompletnu krvnu sliku, željezo i feritin te im je dijagnoza SPU-a određena na temelju kriterija Scale i njegovih suradnika (4). Bolesnicima sa SPU-om propisan je HK u obliku gela (Gengigel®, Ricerfarma, Italija) i morali su ga  stavljati na jezik tri puta na dan. Nakon godinu dana tele-fonski smo intervjuirali bolesnike te smo povratne informa-cije dobili od njih dvanaestero. Četvero bolesnika imalo je potpunu remisiju SPU-a, nakon jednomjesečnog korištenja HK. Dvoje je izjavilo da im se osjećaj pečenja smanjio, a še-stero su rekli da HK uopće nije utjecao na njihove simptome. Možda primjena HK smanjuje neugodu jer barijerno, odno-sno protektivno štiti oralnu sluznicu od podražaja iz usne šu-pljine. S druge strane, kompletna rezolucija SPU-a, odnosno smanjenje intenziteta pečenja može se pripisati placebo-učin-ku, što bi trebalo istražiti u budućim istraživanjima. Ipak, mi smo bili sretni jer neki bolesnici više nisu imali SPU, bez ob-zira na to koji se mehanizam nalazio u podlozi.Dear Editor,it has been reported that 0.2% hyaluronic acid (HA) might be beneficial in certain oral diseases such as recurrent aphthous ulcers and oral lichen planus due to its anti-inflam-matory and other properties (1). Furthermore, HA is a hy-groscopic macromolecule and solutions are highly osmotic. In the skin and perhaps on the oral mucosa, this property is likely to be relevant in controlling tissue hydration dur-ing periods of change such as the inflammatory process or response to tissue injury (2). Burning mouth syndrome is a still enigmatic condition for the patient and the doctor albe-it extensive literature reports could be found. Unfortunately there is no effective treatment for BMS (3). In 19 patients with burning mouth syndrome a thor-ough clinical examination was performed as well as hemato-logical investigation which involved complete blood count, iron, feritin and the BMS diagnosis was established accord-ing to the Scala et al.(4). HA was prescribed in the form of gel (Gengigel®, Ricerfarma, Italy) to be applied three times a day. After one year the participants were interviewed by the telephone. Out of 19 participants, we could reach only 12. In four patients complete BMS remission was reported after HA has been used for one month. In two patients the burn-ing symptoms were reduced but were still present and in six patients burning symptoms were unaffected by use of HA, i.e. HA was not useful in BMS symptoms. It is possible that immediate application reduces discomfort and this is pure-ly a barrier or protective mechanism from stimuli arising in the oral environment. On the other hand, complete remis-sion of BMS might be solely attributed to the placebo effect which remains to be elucidated in further studies. However, we were satisfied as some patients were free of symptoms no matter what caused BMS remission.References1. Nolan A, Baillie C, Badminton J, Rudralingham M, Seymour RA. The efficacy of topical hyaluronic acid in the management of recurrent aphthous ulceration. J Oral Pathol Med. 2006 Sep; 35(8): 461–5.2. Culp LA, Murray BA, Rollins BJ. Fibronectin and proteoglycans as determinants cell-substratum adhesion.J Supramol Struct. 1979; 11(3): 401–27.3. Minguez-Sanz MP, Salort-Llorca C, Silvestre-Donat FJ. Etiology of burning mouth syndrome: A review and update. Med Oral Patol Oral Cir Bucal. 2011 Mar1;16(2):e144-8.4. Scala A, Checchi L, Montevecchi M, Marini I, Giamberardino MA. Update on burning mouth syndrome: overview and patient man-agement. Crit Rev Oral Biol Med. 2003;14(4):275-91.

The Effect of Topical Hyaluronic Acid in Patients with Burning Mouth Syndrome

Abstract

Similar works

Full text

Available Versions

Hrčak - Portal of scientific journals of Croatia

HRČAK - Portal of Croatian Scientific and Professional Journals