低亜鉛血症を伴うBurning Mouth Syndrome 患者の臨床的検討

Burning mouth syndrome

北海道歯学会

北海道歯学雑誌

[Purpose] Burning mouth syndrome (BMS), also known as glossodynia, presents as a burning sensation in the oral cavity. Pathologically, BMS can be classified into primary and secondary types. Primary BMS occurs without dental or medical causes and has been reported to respond to certain drug therapi es. However, secondary BMS develops as a result of local and systemic factors. Some studies have investigated the diagnosis and treatment of primary BMS, but few have targeted secondary BMS. Therefore, in this study, single zinc therapy was administered to patients with glossodynia and hypozincemia, and the effects of replacement therapy, changes in serum zinc level, and duration of effect were retrospectively observed and investigated. [Subjects] Forty-nine patients who were suspected as secondary BMS due to zinc deficiency and treated with zinc replacement therapy were selected from the medical records of o utpatients who visited the Department of Oral Medicine at Hokkaido University Hospital between 2014 and 2020. [Methods] The survey content taken from the medical records included a retrospective review of age, sex, illness period, treatment period, drugs used, rate of improvement with zinc replacement therapy, time until the onset of the effect, and changes in serum zinc levels. The therapeutic effect was determined with the clinical global impression of improvement (CGI-I) score, rated on a 7-point scale: “1: Very much improved”, “2: Much improved”, “3: Minimally improved”, “4: No change”, “5: Minimally worse”, “6: Much worse” and“ 7: Very much worse”. CGI scores of 1 and 2 were considered to denote improvement. [Results] The target patient’s average age was 69 years, and females accounted for more than 85 % of the cohort. The average illness period was 15 months. For the zinc replacement therapy, 23 participants used zinc acetate dihydrate (Nobelzin® ) and 26 participants used polaprezinc (Promac® ). Thirty-four cases reported improvement (approximately 69 %), and the time until the improvement was 45 days. A higher improvement rate of 90 % was observed in patients with zinc deficiency of less than 60 μg/dL. [Conclusion] Zinc replacement therapy is a promising treatment option for patients with glossodynia accompanied with hypozincemia.