{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T22:46:17Z","timestamp":1781563577894,"version":"3.54.5"},"reference-count":49,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Burning mouth syndrome (BMS) and oral lichen planus (OLP) are two chronic oral diseases\/disorders that continue to pose a challenge for conventional diagnosis and treatment. Both diseases do not occur in isolation but rather appear to reflect a broader interplay of psychological, neurological, endocrine, and immunological factors, i.e., complex disorders in interconnected biological and psychological systems. In BMS, patients often suffer from persistent burning sensations without visible lesions, which may be related to altered pain processing, emotional stress, and dysregulation in the brain regions responsible for interoception and perception. Although OLP is primarily characterised by immune-mediated mucosal damage, it often has significant psychological comorbidity, particularly in the erosive form. Common features such as cortisol imbalance, disturbed cytokine patterns, and high levels of anxiety and depression suggest that these conditions may be due to overlapping systemic disorders. It is no longer sufficient to focus only on the visible lesions or symptom relief. Understanding these diseases\/disorders through a more comprehensive psychoneuroendocrine immune system (PNEI) opens up new opportunities for early intervention, improved diagnostics, and more personalised therapeutic strategies that go beyond treating symptoms. Ultimately, these diseases\/disorders require a more integrated and patient-centred approach, where understanding the whole system is as important as treating its individual parts.<\/jats:p>","DOI":"10.3390\/medicina61081489","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T07:50:46Z","timestamp":1755676246000},"page":"1489","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Psychoneurobiological Aspects of Burning Mouth Syndrome and Oral Lichen Planus: A Narrative Review"],"prefix":"10.3390","volume":"61","author":[{"given":"Dora","family":"Marti\u0107","sequence":"first","affiliation":[{"name":"Department of Oral Medicine, Study of Dental Medicine, School of Medicine, University of Split, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2137-9665","authenticated-orcid":false,"given":"Ana","family":"Glavina","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine, Study of Dental Medicine, School of Medicine, University of Split, 21000 Split, Croatia"},{"name":"Department of Dental Medicine, University Hospital of Split, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7494-5742","authenticated-orcid":false,"given":"Liborija","family":"Lugovi\u0107-Mihi\u0107","sequence":"additional","affiliation":[{"name":"Department of Dermatovenereology, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia"},{"name":"School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5357-5890","authenticated-orcid":false,"given":"Maja","family":"Vilibi\u0107","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia"},{"name":"School of Medicine, Catholic University of Croatia, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3000605231218619","DOI":"10.1177\/03000605231218619","article-title":"Oral mucosal diseases and psychosocial factors: Progress in related neurobiological mechanisms","volume":"51","author":"Zhou","year":"2023","journal-title":"J. Int. Med. Res."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Dibello, V., Ballini, A., Lozupone, M., Custodero, C., Cantore, S., Sardone, R., Dibello, A., Santarcangelo, F., Barulli Kofler, B., and Petruzzi, M. (2023). Exploring the Association of Burning Mouth Syndrome with Depressive and Anxiety Disorders in Middle-Aged and Older Adults: A Systematic Review. J. Pers. Med., 13.","DOI":"10.3390\/jpm13061014"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Adamo, D., Calabria, E., Coppola, N., Muzio, L.L., Giuliani, M., Bizzoca, M.E., Azzi, L., Croveri, F., Colella, G., and Boschetti, C.E. (2021). Psychological profile and unexpected pain in oral lichen planus: A case-control multicenter SIPMO study. Oral Dis.","DOI":"10.1111\/odi.13787"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.oooo.2020.11.019","article-title":"The impact on quality of life in patients with burning mouth syndrome: A systematic review and meta-analysis","volume":"131","author":"Pereira","year":"2021","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1080\/08869634.2019.1681621","article-title":"Relevance of sleep, pain cognition, and psychological distress with regard to pain in patients with burning mouth syndrome","volume":"40","author":"Lee","year":"2022","journal-title":"Cranio"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1515\/sjpain-2020-0047","article-title":"Health-related quality of life in burning mouth syndrome\u2014A case-control study","volume":"20","author":"Jedel","year":"2020","journal-title":"Scand. J. Pain"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"813","DOI":"10.2340\/00015555-3094","article-title":"Usefulness of Psychiatric Intervention in a Joint Consultation for the Treatment of Burning Mouth Syndrome: A Monocentric Retrospective Study","volume":"99","author":"Chastaing","year":"2019","journal-title":"Acta Derm. Venereol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"E892","DOI":"10.1503\/cmaj.200309","article-title":"Oral lichen planus","volume":"192","author":"Hamour","year":"2020","journal-title":"CMAJ"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.jds.2021.06.007","article-title":"Estrogen-dependent regulation of transient receptor potential vanilloid 1 (TRPV1) and P2X purinoceptor 3 (P2X3): Implication in burning mouth syndrome","volume":"17","author":"Seol","year":"2022","journal-title":"J. Dent. Sci."},{"key":"ref_10","first-page":"e19","article-title":"Serological and psychological assessment of patients with oral lichen planus using serum cortisol levels and hads questionnaire-a case control study","volume":"27","author":"Chaitanya","year":"2020","journal-title":"J. Popul. Ther. Clin. Pharmacol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/j.tripleo.2009.06.022","article-title":"Salivary dehydroepiandrosterone (DHEA) levels in patients with the complaint of burning mouth: A case-control study","volume":"108","author":"Salum","year":"2009","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2600","DOI":"10.1111\/odi.14390","article-title":"Salivary biomarkers in burning mouth syndrome: A systematic review and meta-analysis","volume":"29","author":"Virto","year":"2023","journal-title":"Oral Dis."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Lavaee, F., Ranjbar, Z., Jalalian, M., and Amiri, M.A. (2021). Comparison of the sex hormones\u2019 serum level in women with recurrent aphthous stomatitis and healthy population: A cross-sectional study. BMC Oral Health, 21.","DOI":"10.1186\/s12903-021-01812-9"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1177\/0333102416646769","article-title":"Role of psychological factors in burning mouth syndrome: A systematic review and meta-analysis","volume":"37","author":"Galli","year":"2017","journal-title":"Cephalalgia"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Orliaguet, M., and Misery, L. (2021). Neuropathic and Psychogenic Components of Burning Mouth Syndrome: A Systematic Review. Biomolecules, 11.","DOI":"10.3390\/biom11081237"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1111\/jop.13526","article-title":"Salivary and serum biomarkers to evaluate psychological disorders in burning mouth syndrome: A systematic review and meta-analysis","volume":"53","author":"He","year":"2024","journal-title":"J. Oral Pathol. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1051\/mbcb\/2023024","article-title":"Salivary biomarkers and burning mouth syndrome: A systematic review and meta-analysis of the literature","volume":"29","author":"Kappes","year":"2023","journal-title":"J. Oral Med. Oral Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e12363","DOI":"10.1111\/jicd.12363","article-title":"Psychological disorders and oral lichen planus: A systematic review","volume":"9","author":"Cerqueira","year":"2018","journal-title":"J. Investig. Clin. Dent."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1111\/adj.12896","article-title":"Characteristics of the psychopathological status of oral lichen planus: A systematic review and meta-analysis","volume":"67","author":"Li","year":"2022","journal-title":"Aust. Dent. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1007\/s00784-021-04114-0","article-title":"Depression, anxiety, and stress in oral lichen planus: A systematic review and meta-analysis","volume":"26","author":"Warnakulasuriya","year":"2022","journal-title":"Clin. Oral Investig."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"599","DOI":"10.5114\/ada.2018.77611","article-title":"A systematic review and meta-analysis study of salivary and serum interleukin-8 levels in oral lichen planus","volume":"35","author":"Mozaffari","year":"2018","journal-title":"Postep. Dermatol Alergol"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Koopaie, M., Akhbari, P., Fatahzadeh, M., and Kolahdooz, S. (2024). Identification of common salivary miRNA in oral lichen planus and oral squamous cell carcinoma: Systematic review and meta-analysis. BMC Oral Health, 24.","DOI":"10.1186\/s12903-024-04986-0"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2734","DOI":"10.1111\/odi.14385","article-title":"Salivary biomarkers to evaluate psychological disorders in oral lichen planus: A systematic review with meta-analysis","volume":"29","author":"Pires","year":"2023","journal-title":"Oral Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1111\/odi.14127","article-title":"Autoimmune disorders in oral lichen planus: A systematic review and meta-analysis","volume":"29","author":"Warnakulasuriya","year":"2023","journal-title":"Oral Dis."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Yoshino, A., Otsuru, N., Doi, M., Maekawa, T., Sasaoka, T., and Yamawaki, S. (2022). Interoceptive accuracy is related to the psychological mechanisms of the burning mouth syndrome: A cross-sectional study. BMC Oral Health, 22.","DOI":"10.1186\/s12903-022-02316-w"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.1111\/joor.13028","article-title":"Psychophysical characterisation of burning mouth syndrome-A systematic review and meta-analysis","volume":"47","author":"Madariaga","year":"2020","journal-title":"J. Oral Rehabil."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"218","DOI":"10.11607\/ofph.2861","article-title":"Is Burning Mouth Syndrome a Neuropathic Pain Disorder? A Systematic Review","volume":"35","year":"2021","journal-title":"J. Oral Facial Pain Headache"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.cden.2019.12.009","article-title":"Neuropathic Pain and Burning Mouth Syndrome: An Overview and Current Update","volume":"64","author":"Dym","year":"2020","journal-title":"Dent. Clin. North Am."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1177\/03331024211036152","article-title":"A systematic review of treatment for patients with burning mouth syndrome","volume":"42","author":"Tan","year":"2022","journal-title":"Cephalalgia"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1111\/odi.12345","article-title":"Pathophysiology of primary burning mouth syndrome with special focus on taste dysfunction: A review","volume":"21","author":"Laine","year":"2015","journal-title":"Oral Dis."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Gait\u00e1n-Cepeda, L.A., Rivera-Reza, D.I., and Villanueva-Vilchis, M.D.C. (2023). Neuroticism and Psychological Stress in Patients Suffering Oral Lichen Planus: Research Evidence of Psycho-Stomatology?. Healthcare, 11.","DOI":"10.3390\/healthcare11121738"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Deng, X., Wang, Y., Jiang, L., Li, J., and Chen, Q. (2023). Updates on immunological mechanistic insights and targeting of the oral lichen planus microenvironment. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.1023213"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1111\/odi.12423","article-title":"Psychological disorders and oral lichen planus: Matched case-control study and literature review","volume":"22","author":"Pippi","year":"2016","journal-title":"Oral Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"177","DOI":"10.11607\/opfh.1326","article-title":"The application of neuropathic pain questionnaires in burning mouth syndrome patients","volume":"29","author":"Heo","year":"2015","journal-title":"J. Oral Facial Pain Headache"},{"key":"ref_35","first-page":"117","article-title":"Peripheral and central mechanisms of orofacial pain and their clinical correlates","volume":"71","author":"Sessle","year":"2005","journal-title":"Minerva Anestesiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"S80","DOI":"10.1016\/j.neuroimage.2007.03.054","article-title":"Brain imaging of neuropathic pain","volume":"37","author":"Moisset","year":"2007","journal-title":"Neuroimage"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Lon\u010dar-Brzak, B., Vidranski, V., Andabak-Rogulj, A., Vidovi\u0107-Juras, D., Todori\u0107-Laidlaw, I., Gabri\u0107, D., and \u0160krinjar, I. (2020). Salivary Hormones and Quality of Life in Female Postmenopausal Burning Mouth Patients-A Pilot Case\u2014Control Study. Dent. J., 8.","DOI":"10.3390\/dj8040111"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Rezazadeh, F., Lavaee, F., Dezhkameh, S., and Afshari, A. (2025). The serum evaluation of sex hormones including DHEAs, DHT, testosterone in oral lichen planus patients. Sci. Rep., 15.","DOI":"10.1038\/s41598-025-01750-4"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"445","DOI":"10.4103\/0019-5154.159625","article-title":"Role of Depression, Anxiety and Stress in Patients with Oral Lichen Planus: A Pilot Study","volume":"60","author":"Kalkur","year":"2015","journal-title":"Indian J. Dermatol."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Glavina, A., Lugovi\u0107-Mihi\u0107, L., Martinovi\u0107, D., Cigi\u0107, L., Tandara, L., Lukenda, M., Bio\u010dina-Lukenda, D., and \u0160upe-Domi\u0107, D. (2023). Association between Salivary Cortisol and \u03b1-Amylase with the Psychological Profile of Patients with Oral Lichen Planus and Burning Mouth Syndrome: A Case-Control Study. Biomedicines, 11.","DOI":"10.20944\/preprints202307.0650.v1"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1111\/joor.13110","article-title":"Oral health-related quality of life and associated factors in patients with burning mouth syndrome","volume":"48","author":"Choi","year":"2021","journal-title":"J. Oral Rehabil."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/1477-7525-9-57","article-title":"The impact of burning mouth syndrome on health-related quality of life. Health Qual","volume":"9","author":"Souza","year":"2011","journal-title":"Life Outcomes"},{"key":"ref_43","first-page":"e70419","article-title":"Evaluating the Impact of Different Treatments on the Quality of Life in Patients With Burning Mouth Syndrome: A Scoping Review","volume":"16","author":"Abreu","year":"2024","journal-title":"Cureus"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1007\/s40257-015-0170-4","article-title":"Primary Burning Mouth Syndrome: A Questionnaire Study of Neuropathic and Psychological Components","volume":"17","author":"Sevrain","year":"2016","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Chen, K., Qin, Y., Yan, L., Dong, Y., Lv, S., Xu, J., Kang, N., Luo, Z., Liu, Y., and Pu, J. (2025). Variations in salivary microbiota and metabolic phenotype related to oral lichen planus with psychiatric symptoms. BMC Oral Health, 25.","DOI":"10.1186\/s12903-025-06439-8"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1111\/ggi.12303","article-title":"Circadian rhythms variation of pain in burning mouth syndrome","volume":"15","author":"Pagan","year":"2015","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Zhao, H., Ran, S., Gan, K., Du, Y., and Li, W. (2023). Pain sensitivity and quality of life of patients with burning mouth syndrome: A preliminary study in a Chinese population. BMC Oral Health, 23.","DOI":"10.1186\/s12903-023-03689-2"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1111\/joor.13536","article-title":"Is burning mouth syndrome associated with stress? A meta-analysis","volume":"50","author":"Porporatti","year":"2023","journal-title":"J. Oral Rehabil."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2167","DOI":"10.1111\/odi.15249","article-title":"Is There a Correlation Between Quality of Life and Salivary Interleukin-6 in Patients with Oral Lichen Planus or Burning Mouth Syndrome?","volume":"31","author":"Glavina","year":"2025","journal-title":"Oral Dis."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/8\/1489\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:31:25Z","timestamp":1760034685000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/8\/1489"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,20]]},"references-count":49,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["medicina61081489"],"URL":"https:\/\/doi.org\/10.3390\/medicina61081489","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,20]]}}}