60ª Reunião Anual da SBPC

D. Ciências da Saúde - 4. Odontologia - 10. Odontologia


Talita Wandeur1
Antonio Adilson Soares de Lima1
Luciana Reis de Azevedo Alanis1
Sérgio Adriane Bezerra de Moura2
Ana Miryam Costa de Medeiros3
Maria Ângela Naval Machado1

1. Department of Stomatology, Pontifícia Universidade Católica do Paraná /PUCPR
2. Department of Anatomy, Universidade Estadual da Paraíba/ UEPB
3. Department of Oral Medicine, Universidade Federal do Rio Grande do Norte/UFRN

Burning Mouth Syndrome (BMS) is a clinic condition characterized by sensation of episodic pain in the healthy oral mucosa. Pain is a moderate to severe burning sensation, affecting mainly the lateral borders and the tip of the tongue, and may persist for years. The other BMS clinical signs related in literature are dysgeusia and xerostomia. The etiology of the BMS is poorly understood. Some different local, systemic, and psychological factors have been associated to the BMS. This condition affects 3,7% of the general population and its prevalence is significantly higher in females. Therefore, this syndrome appears to be most prevalent in postmenopausal women. A correct clinical history associated with a careful examination of the oral mucosa may be sufficient to arrive at an initial diagnosis of BMS. Multiple approaches to treatment have been described in the literature. Despite the fact that a voluminous amount has been published in this field, an investigation about the oral mucosa behavior in BMS patients is still lacking. The purpose of this study was to analyze the effect of BMS on the oral epithelium, where the patient refers burning sensation. Thus, both nuclear (NA), and cytoplasmic area (CA) and nucleus-to-cytoplasm area ratio (NA/CA) were measured.

The experimental protocol was approved by Committee of Ethics in Research. Twenty adult BMS patients (experimental group) and 20 healthy individuals (control group) were diagnosed for BMS at the UFRN (Natal, RN/Brazil) and PUCPR (Curitiba, PR/ Brazil). Exfoliated cells from clinically normal oral mucosa were obtained by oral liquid-based exfoliative cytology. The cells collection was realized where the BMS patients were feeling the burning sensation, and the control group, in jugal mucosa. The mouth was rinsed to remove debris in the oral cavity. The squamous epithelial cells were collected using cytobrush and kit Universal Collection Medium of DNA-Citoliq (Digene). An aliquot was filtered through Filtrogene, placed in Prepgene press attached to glass slides and fixed in absolute alcohol. Smears were stained with Papanicolaou stain. Each slide was assessed using the light microscopy. Fifty cells images were captured for digitalizing camera at x400 magnification and were measured by Image-Pro Plus analysis system. The nuclear (NA) and cytoplasmic (CA) areas were obtained by drawing around areas the nuclear and cell boundaries using the digitizer cursor. All data were tabulated and significant statistical differences between groups were examined using two sample t test (P < 0.01).

The mean age for females patients in the experimental and control group was 57.1 years (37-80). Mean values of NA for experimental and control groups were, respectively, 67.52µm² and 55.64m2. CA showed the following mean values:1258.0m2 (experimental) and 2069.0m2 (control). NA/CA for the experimental group was 0.07, besides the control group was 0.03. Using a t test, a highly significant increase in NA and reduction in CA for experimental group (P<0.01). Nucleus/cytoplasm area ratio was higher in experimental group than control. The integrity of the mucosa is important for the maintenance of oral health. Clinic alterations can be associated with epithelial changes. In BMS patients the oral mucosa is clinically normal. This study revealed a highly increase in NA and NA/CA ratio and a reduction in CA in BMS. These findings can be attributed to the changes that are produced by epithelium differentiation cells. Clinically, oral mucosa in older people exhibits a surface dry and thinner than younger individuals becoming delicate and atrophic. Atrophy occurs in the epithelium, some nerve endings can become exposed to physical and chemical agents. Thus, this thinner and less keratinized epithelium contribute to the greater sensibility reported as burning in the oral mucosa of BMS.

In summary, the results observed in this study might contribute to the general understanding of the changes in cellular pattern of the oral mucosa in BMS patients. Meanwhile, additional studies should be performed to elucidate the real mechanisms involved in the oral mucosa changes induced by this disease. This study revealed that oral mucosa of BMS patients exhibited significant changes on the oral epithelial cells, principally, in the keratinization process of the oral mucosa where the symptoms of pain and discomfort occur.


Trabalho de Iniciação Científica

Palavras-chave:  Burning mouth syndrome, Exfoliative cytology, Oral mucosa

E-mail para contato: tali_wandeur@hotmail.com