Both physiological and psychological aspects of BMS need to be actively investigated by clinicians to successfully manage these patients. The physiological and psychological aspects are not mutually exclusive. The DN4i and the HADS are easy-to-use tools and could be used in an initial assessment of BMS patients.
The aim of this study was to take stock of current anatomic and physiologic knowledge of the human temporo-mandibular joint. Though the lateral pterygoid m. plays an essential role in joint movements, we believe that the small deep portion of the masseter and temporalis have a supplementary action in guiding the articular disc forward. The embryologists have demonstrated joint movements in the two-month embryo and at this stage there already exists a triple attachment of the temporalis, pterygoid and masseter to the disc.
Background: Patients with burning mouth syndrome (BMS) are frequently treated with antidepressants. Selective serotonin reuptake inhibitors (SSRIs) are increasingly used. Nonetheless, few studies have examined the effects of SSRIs in BMS. Objective: We performed a retrospective study to confirm the need for a prospective study on this topic in the future. Patients and Methods: 51 patients suffering from primary BMS were included in this study. Results: The frequency of side effects due to SSRIs was low, with mainly digestive side effects. Treatment with SSRIs was more efficient in patients reporting a psychogenic origin for their symptoms. Antidepressants were more frequently stopped when patients did not declare such an origin. Conclusions: SSRIs appear to be effective and well tolerated. Declaring a psychogenic component may be considered as a potentiating or predictive factor for the efficacy of treatment with SSRIs. These results should be confirmed by a prospective randomised study.
RÉSUMÉLes kératokystes des maxillaires sont connus pour leur relative agressivité et leur forte propension à la réci-dive. Il existe deux types histologiques, l'un parakératosique, l'autre orthokératosique, le taux de récidive est de 42,6 % pour le premier type et de 2,26 % pour le second. Le taux de récidive varie également suivant l'atteinte unique ou multiple. Les patients présentant de multiples kératokystes ont un taux de récidive de 35 % contre 10 % dans l'atteinte unique. Si la transformation maligne ou améloblastique est exceptionnelle (2%), elle ne doit jamais être négligée dans la conduite opératoire et le suivi thérapeutique.L'exposé de deux cas cliniques, l'un entrant dans le cadre d'une naevomatose baso-cellulaire ou syndrome de GorlinGoltz et l'autre étant une localisation maxillaire isolée, nous permet de faire part de notre démarche chirurgicale conservatrice décidée après un examen clinique et radiographique. La tomodensitométrie est l'élé-ment indispensable à l'approche diagnostique, la décision chirurgicale et le suivi post-opératoire.
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