The Effectiveness of Acupuncture versus Clonazepam in Patients with Burning Mouth Syndrome

Kvesić, Ante; Zavoreo, Iris; Kes, Vanja Bašić; Boras, Vanja Vučičević; Ciliga, Dubravka; Gabrić, Dragana; Vrdoljak, Danko Velimir

doi:10.1136/acupmed-2015-010759

Cited by 20 publications

(23 citation statements)

References 12 publications

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“…Two studies reported no significant differences in the impact on oral health after treatment or between groups (OHIP‐49) for topical treatment with aloe vera gel and clonazepam compared to low‐energy laser . The second study comparing clonazepam to acupuncture reported improved health status (SF‐36) for both interventions but no between‐group differences . Finally, one study showed significant improvement in oral health impact (OHIP‐14) for both virgin olive oil spray and placebo, but with no significant between‐group differences .…”

Section: Results Of the Systematic Review And Network Meta‐analysissupporting

confidence: 89%

“…Sixteen studies had high risk of bias (Figure ) and were excluded from analysis (Table ). The remaining 41 studies rated as medium or low risk of bias were included in the qualitative analysis for the individual groups: 15 studies on patients classified as TMD‐joint , nine on patients classified as TMD‐muscle and 17 on patients with BMS .…”

Section: Results Of the Systematic Review And Network Meta‐analysismentioning

confidence: 99%

“…Of the 12 studies that were excluded from the NMA, five showed no effect for interventions compared to placebo , whereas the remaining studies showed support for alpha lipoic acid and gabapentin , capsaicin , clonazepam , amisulpride and SSRIs (Table C).…”

Section: Results Of the Systematic Review And Network Meta‐analysismentioning

confidence: 99%

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Pharmacological treatment of oro‐facial pain – health technology assessment including a systematic review with network meta‐analysis

Häggman‐Henrikson

Alstergren

Davidson

et al. 2017

J of Oral Rehabilitation

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This health technology assessment evaluated the efficacy of pharmacological treatment in patients with oro-facial pain. Randomised controlled trials were included if they reported pharmacological treatment in patients ≥18 years with chronic (≥3 months) oro-facial pain. Patients were divided into subgroups: TMD-muscle [temporomandibular disorders (TMD) mainly associated with myalgia]; TMD-joint (TMD mainly associated with temporomandibular joint pain); and burning mouth syndrome (BMS). The primary outcome was pain intensity reduction after pharmacological treatment. The scientific quality of the evidence was rated according to GRADE. An electronic search in PubMed, Cochrane Library, and EMBASE from database inception to 1 March 2017 combined with a handsearch identified 1552 articles. After screening of abstracts, 178 articles were reviewed in full text and 57 studies met the inclusion criteria. After risk of bias assessment, 41 articles remained: 15 studies on 790 patients classified as TMD-joint, nine on 375 patients classified as TMD-muscle and 17 on 868 patients with BMS. Of these, eight studies on TMD-muscle, and five on BMS were included in separate network meta-analysis. The narrative synthesis suggests that NSAIDs as well as corticosteroid and hyaluronate injections are effective treatments for TMD-joint pain. The network meta-analysis showed that clonazepam and capsaicin reduced pain intensity in BMS, and the muscle relaxant cyclobenzaprine, for the TMD-muscle group. In conclusion, based on a limited number of studies, evidence provided with network meta-analysis showed that clonazepam and capsaicin are effective in treatment of BMS and that the muscle relaxant cyclobenzaprine has a positive treatment effect for TMD-muscle pain.

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Section: Results Of the Systematic Review And Network Meta‐analysissupporting

confidence: 89%

Section: Results Of the Systematic Review And Network Meta‐analysismentioning

confidence: 99%

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Pharmacological treatment of oro‐facial pain – health technology assessment including a systematic review with network meta‐analysis

Häggman‐Henrikson

Alstergren

Davidson

et al. 2017

J of Oral Rehabilitation

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“…In this systematic review, nearly 75% of the RCTs used an existing BMS definition to guide case selection (Cavalcanti & da Silveira, ; Femiano, ; Femiano & Scully, ; Gremeau‐Richard, Dubray, Aublet‐Cuvelier, Ughetto, & Woda, ; Gremeau‐Richard et al., ; Lopez‐Jornet, Camacho‐Alonso, & Andujar‐Mateos, ; Marino, Torretta, Capaccio, Pignataro, & Spadari, ; Petruzzi, Lauritano, De Benedittis, Baldoni, & Serpico, ; Sardella et al., , ; Spanemberg, Lopez Lopez, de Figueiredo, Cherubini, & Salum, ; Spanemberg et al., ), most commonly that by IASP (Cano‐Carrillo, Pons‐Fuster, & Lopez‐Jornet, ; Cavalcanti & da Silveira, ; Gremeau‐Richard et al., ; Jorgensen & Pedersen, ; Lopez‐Jornet et al., ; Marino et al., ; Palacios‐Sánchez, Moreno‐Lopez, Cerero‐Lapiedra, Llamas‐Martinez, & Esparza‐Gomez, ; Sardella et al., ; Silva, Siqueira, Teixeira, & Siqueira, ; Spanemberg et al., ; Umezaki et al., ) or IHS (Arduino et al., ; Carbone, Pentenero, Carrozzo, Ippolito, & Gandolfo, ; Jurisic Kvesic et al., ; Lopez‐Jornet, Camacho‐Alonso, & Leon‐Espinosa, ; López‐Jornet, Camacho‐Alonso, & Molino‐Pagan, ; Tammiala‐Salonen & Forssell, ; Valenzuela & Lopez‐Jornet, ; Valenzuela, Pons‐Fuster, & Lopez‐Jornet, ). However, the most current BMS definition by IASP and IHS differs (IASP, ; IHS, ).…”

Section: Discussionmentioning

confidence: 99%

World Workshop on Oral Medicine VII: Burning mouth syndrome: A systematic review of disease definitions and diagnostic criteria utilized in randomized clinical trials

et al. 2019

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Objective To conduct a systematic review analyzing disease definitions and diagnostic criteria used in randomized controlled trials (RCTs) involving burning mouth syndrome (BMS). Methods A systematic search conducted in PubMed, Web of Science, PsycINFO, Cochrane Database/Cochrane Central, and Google Scholar that included RCTs on BMS published between 1994 and 2017 was performed. Results Considerable variability in BMS disease definitions and diagnostic criteria used created substantial heterogeneity in the selection of participants and weakened the rigor of the 36 RCTs identified. The analyzed RCTs routinely under‐reported the methods used to rule in or out study participants and the number of individuals excluded from BMS RCTs. Conclusions Our findings indicate that a large proportion of participants enrolled in these studies may have had an underlying condition that could have explained their BMS symptoms. Thus, outcomes of therapeutic interventions from these BMS RCTs should be interpreted with caution due to heterogeneous disease definitions and diagnostic criteria. In order to improve the quality of clinical trials, future research should focus on establishing consensus for a single definition of BMS that includes specific inclusion and exclusion criteria that should be used to select study participants for clinical trials.

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“…Observational and interventional studies of clonazepam have evaluated topical administration of the drug (e.g., 0.5 mg clonazepam dissolved in the mouth for three minutes then spit out with remaining saliva up to four times daily), as well as once daily, low-dose systemic use [27][28][29][30][31][32][33][34][35][36]. With topical administration, clonazepam's action has a quick effect in reducing BMS symptoms (within 10 minutes) and is association with minimal adverse effects.…”

Section: Treatment Considerationsmentioning

confidence: 99%

Chronic Orofacial Pain: Burning Mouth Syndrome and Other Neuropathic Disorders

Tait¹,

Ferguson²,

Herndon³

2017

Pain Manage Med

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Chronic orofacial pain is a symptom associated with a wide range of neuropathic, neurovascular, idiopathic, and myofascial conditions that affect a significant proportion of the population. While the collective impact of the subset of the orofacial pain disorders involving neurogenic and idiopathic mechanisms is substantial, some of these are relatively uncommon. Hence, patients with these disorders can be vulnerable to misdiagnosis, sometimes for years, increasing the symptom burden and delaying effective treatment. This manuscript first reviews the decision tree to be followed in diagnosing any neuropathic pain condition, as well as the levels of evidence needed to make a diagnosis with each of several levels of confidence: definite, probable, or possible. It then examines the clinical literature related to the idiopathic and neurogenic conditions that can occasion chronic orofacial pain, including burning mouth syndrome, trigeminal neuralgia, glossopharyngeal neuralgia, post-herpetic neuralgia, and atypical odontalgia. Temporomandibular disorders also are examined as are other headache conditions, even though they are not neurologic conditions, because they are common and can mimic symptoms of the latter disorders. For each of these conditions, the paper reviews literature regarding incidence and prevalence, physiologic and other contributing factors, diagnostic signs and symptoms, and empirical evidence regarding treatments. Finally, in order to improve the quality and accuracy of clinical diagnosis, as well as the efficiency with which effective treatment is initiated and delivered, criteria are offered that can be instrumental in making a differential diagnosis.

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The Effectiveness of Acupuncture versus Clonazepam in Patients with Burning Mouth Syndrome

Abstract: Acupuncture and clonazepam are similarly effective for patients with BMS.

Cited by 20 publications

References 12 publications

Pharmacological treatment of oro‐facial pain – health technology assessment including a systematic review with network meta‐analysis

Pharmacological treatment of oro‐facial pain – health technology assessment including a systematic review with network meta‐analysis

World Workshop on Oral Medicine VII: Burning mouth syndrome: A systematic review of disease definitions and diagnostic criteria utilized in randomized clinical trials

Chronic Orofacial Pain: Burning Mouth Syndrome and Other Neuropathic Disorders

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