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Case Report : Treatment of Burning mouth Syndrome Using a Removable Anti-Nociceptive Appliance

가철성 유해자극차단장치를 이용한 구강작열감증후군의 치료 증례

  • Roh, Byung-Yoon (Department of Oral medicine, School of Dentistry, Chosun University) ;
  • Ahn, Jong-Mo (Department of Oral medicine, School of Dentistry, Chosun University) ;
  • Yoon, Chang-Lyuk (Department of Oral medicine, School of Dentistry, Chosun University) ;
  • Ryu, Ji-Won (Department of Oral medicine, School of Dentistry, Chosun University)
  • 노병윤 (조선대학교 치의학전문대학원 구강내과학교실) ;
  • 안종모 (조선대학교 치의학전문대학원 구강내과학교실) ;
  • 윤창륙 (조선대학교 치의학전문대학원 구강내과학교실) ;
  • 유지원 (조선대학교 치의학전문대학원 구강내과학교실)
  • Received : 2011.12.20
  • Accepted : 2011.02.13
  • Published : 2012.03.30

Abstract

Burning mouth syndrome(BMS) refers to a chronic orofacial pain disorder usually unaccompanied by mucosal lesions or other clinical signs. Tongue(anterior and lateral border) is found to be the most common site for the burning sensations in the oral cavity, and various oral sites may be affected including hard palate and lips. The etiology of this disorder remains poorly understood, but the various factors might be related with the pathogenesis of the BMS. These factors have been devided into local, systemic and psychological. Recently, there have been increasing reports that the pain of BMS may be neuropathic in origin. The complex and multifactorial etiology of BMS necessitates multidisciplinary approach for the management of these patients. Recently, several studies have reported that oral parafunctional habits could be related the pathogenesis of BMS, and tried to control the symptom of BMS with various methods. We reported the cases who had the symptom of burning mouth syndrome with removable anti-nociceptive appliance in the lower dentition.

구강작열감증후군(Burning Mouth Syndrome: BMS)은 특기할 임상적인 증상 없이, 구강 내에 나타나는 병적인 작열감 또는 통증을 지칭한다. 구강작열감증후군은 주로 혀 전방 그리고 측방에 증상이 나타나며, 경구개 전방, 입술 등의 다른 구강점막에도 나타나는 것으로 보고되고 있다. 구강작열감증후군의 원인은 분명하게 밝혀져 있지 않으며, 여러 가지 요인들이 작용하는 것으로 알려져 있다. 감염과 외상 같은 국소적 요인, 내분비 변화, 당뇨, 영양결핍(비타민, 아연 등), 철분 또는 엽산 결핍과 관련된 빈혈과 같은 전신적인 요인 등이 영향을 미치는 것으로 알려져 있고, 불안, 우울, 암공포증과 같은 심리적 요인 또한 영향을 미치는 것으로 알려져 있다. 최근의 연구는 구강작열감증후군이 신경학적 병변에 의한 신경병변성 통증의 특성을 나타냄을 보고하고 있다. 구강작열감증후군의 치료는 알려진 원인이 분명하지 않기 때문에 치료 또한 여러 각도로 시행되고 있다. 그 중, clonazepam의 국소적 적용, capsaicin, alpha lipoic acid 투여 등의 약물요법이 주로 이루어지며, 저주파 에너지 레이저 조사, 침술요법과 같은 치료법도 보고되고 있다. 최근의 몇몇 연구들은 혀를 국소적 자극요인으로부터 보호하여 구강작열감증후군의 증상을 완화시킨 사례들을 보고하고 있다. 본 연구는 구강작열감증후군 증상을 보이는 환자에게 하악 치아에 가철성 유해자극차단장치를 장착하여 증상이 개선된 증례를 소개하고, 구강 이상악습관과 구강작열감증후군의 연관성 및 이에 대한 치료법을 소개하고자 한다.

Keywords

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