Publication: Boca Ardiente: perfil de salud y manejo terapéutico con fotobiomodulación
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2021-07-06
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Universidad Complutense de Madrid
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Abstract
La boca ardiente es una entidad compleja de etiología multifactorial, con una fisiopatología poco conocida y sin tratamiento efectivo hasta la fecha. La Sociedad Internacional de Cefaleas, en su última clasificación, la define como aquella sensación intraoral de quemazón o disestesia, que recurre diariamente durante, al menos, 2 horas durante, al menos, 3 meses, sin lesiones clínicas evidentes. La gran variabilidad de definiciones y criterios diagnósticos de la entidad compromete la validez de los resultados en los estudios clínicos realizados, los hace menos reproducibles y contribuye a la confusión entre clínicos e investigadores. Revisando las diferentes clasificaciones publicadas, cabe pensar que la boca ardiente es una entidad neuropática, pero la falta de conocimiento de su fisiopatología obligan a encuadrarla como una entidad, por el momento, idiopática. La relación entre la boca ardiente y ciertas alteraciones en el estado de salud general de los pacientes y el estudio de diferentes comorbilidades ha sido objeto de estudio y discusión en los últimos años, al igual que las alteraciones en las analíticas de sangre, el consumo de medicamentos y el impacto en la calidad de vida del paciente. El incompleto conocimiento de la etiopatogenia de la boca ardiente explica la ausencia de tratamientos completamente efectivos. El clonazepam es, hasta el momento, la terapia más utilizada, pero los resultados no son aún aceptables para su uso generalizado y sus efectos adversos pueden conllevar la finalización prematura del tratamiento. La ausencia de efectos adversos es una de las características positivas de la fotobiomodulación con terapia láser de baja potencia, que ha emergido como una terapia a tener en cuenta en el manejo de patologías dolorosas, entre ellas la boca ardiente.
Objetivos: Los objetivos generales de esta memoria son valorar el estado de salud general de los pacientes con boca ardiente, comparándolo con un grupo control similar en edad y sexo (Estudio 1) y analizar el efecto de la fotobiomodulación en el manejo del dolor de estos pacientes (Estudio 2), estudiando su impacto en los diferentes aspectos asociados al dolor crónico (Estudio 3)...
Burning mouth is a complex entity of multifactorial etiology, with an unknown physiopathology and without a cure. The International Headache Society, in its latest classification, defines burning mouth as that intraoral sensation of burning or dysesthesia, which recurs daily for at least 2 hours and no less than 3 months, without obvious clinical injuries. The great variability of definitions, and diagnostic criteria of this entity compromises the validity of the results in the clinical studies carried out, making them less reproducible and contributing to confusion between clinicians and researchers. Reviewing the different published classifications, it is possible to think that burning mouth is a neuropathic entity, but the lack of knowledge about its physiopathology forces us to classify it as an idiopathic entity for the moment. The relationship between burning mouth and certain alterations in the general health status of patients, and the study of different comorbidities has been subject of study and discussion in recent years, the same happens with alterations in blood tests, consumption of medications, and the impact on the quality of life of the patients. An incomplete knowledge of the etiopathogenesis of the burning mouth explains the absence of completely effective treatments. Clonazepam is, thus far, the most widely used therapy, yet the results are not acceptable for its widespread use, and its adverse effects may cancel treatment. The absence of adverse effects is one of the positive characteristics of photobiomodulation with low-level laser therapy, which has emerged as an important option for the management of painful pathologies, including burning mouth. Objectives: The general objectives of this doctoral thesis are to assess the general health status of patients with burning mouth, compare it with a control group similar in age and sex (Study 1), and to analyze the effect of photobiomodulation on pain management in these patients (Study 2), studying their impact on the different aspects associated with chronic pain (Study 3)...
Burning mouth is a complex entity of multifactorial etiology, with an unknown physiopathology and without a cure. The International Headache Society, in its latest classification, defines burning mouth as that intraoral sensation of burning or dysesthesia, which recurs daily for at least 2 hours and no less than 3 months, without obvious clinical injuries. The great variability of definitions, and diagnostic criteria of this entity compromises the validity of the results in the clinical studies carried out, making them less reproducible and contributing to confusion between clinicians and researchers. Reviewing the different published classifications, it is possible to think that burning mouth is a neuropathic entity, but the lack of knowledge about its physiopathology forces us to classify it as an idiopathic entity for the moment. The relationship between burning mouth and certain alterations in the general health status of patients, and the study of different comorbidities has been subject of study and discussion in recent years, the same happens with alterations in blood tests, consumption of medications, and the impact on the quality of life of the patients. An incomplete knowledge of the etiopathogenesis of the burning mouth explains the absence of completely effective treatments. Clonazepam is, thus far, the most widely used therapy, yet the results are not acceptable for its widespread use, and its adverse effects may cancel treatment. The absence of adverse effects is one of the positive characteristics of photobiomodulation with low-level laser therapy, which has emerged as an important option for the management of painful pathologies, including burning mouth. Objectives: The general objectives of this doctoral thesis are to assess the general health status of patients with burning mouth, compare it with a control group similar in age and sex (Study 1), and to analyze the effect of photobiomodulation on pain management in these patients (Study 2), studying their impact on the different aspects associated with chronic pain (Study 3)...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Odontología, leída el 22 de Octubre de 2020. Tesis formato europeo (compendio de artículos)