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Kareem DS, Al-Ameri LMH, Alalawi AS. Impact of Photobiomodulation on IL1β and TGFβ-1 concentrations in patients with aphthous stomatitis. Lasers Med Sci 2024; 39:176. [PMID: 38976032 DOI: 10.1007/s10103-024-04130-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 07/02/2024] [Indexed: 07/09/2024]
Abstract
Laser therapy has shown effectiveness in promoting wound healing by influencing various physiological factors such as blood flow, cytokines, histamine, nerve signals, lymphocyte function, tissue oxygenation, and cell growth. This study aims to evaluate the therapeutic efficacy of Photobiomodulation (PBM) treatment, by using diode laser, in modifying the levels of interleukin-1 beta (IL1β) and transforming growth factor beta-1 (TGFβ-1) in patients diagnosed with aphthous stomatitis. A before-after interventional design was conducted over 10 months with 20 subjects. Data on demographic details and serum concentrations of IL1β and TGFβ-1 were collected pre-treatment and on Days 3 and 7 post-treatments. The intervention involved a single session of four 30-second applications of a QuickLase dual-wavelength laser operating at 980 nm. Results show significant reductions in IL1β and TGFβ-1 levels after 7 days of treatment, indicating a time-dependent effect of PBM therapy on these inflammatory markers. The findings suggest that PBM therapy holds promise as an intervention for reducing inflammation associated with aphthous stomatitis.
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Affiliation(s)
- Dalia Saleem Kareem
- Medical and Biological applications Branch Institute of Laser for Postgraduate Studies, University of Baghdad, Baghdad, Iraq.
| | - Layla M H Al-Ameri
- Medical and Biological applications Branch Institute of Laser for Postgraduate Studies, University of Baghdad, Baghdad, Iraq
| | - Ammar Saleh Alalawi
- Laser/Dentistry (oral surgery), Al-Emamein Al-Kadhimein Madical City, Baghdad, Iraq
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2
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Muacevic A, Adler JR. Evaluation of Vitamin D Levels in Pediatric Patients With Recurrent Aphthous Stomatitis. Cureus 2022; 14:e32064. [PMID: 36600845 PMCID: PMC9800943 DOI: 10.7759/cureus.32064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Recurrent aphthous stomatitis is one of the most common oral mucosal diseases. It is characterized by recurrent painful attacks. Its etiology is unknown. Vitamin D (vit D) is a steroid vitamin with immunomodulatory and anti-inflammatory effects. It is thought that oral cavity diseases may occur in vitamin D deficiency. This study aimed to investigate vit D levels in pediatric patients with recurrent aphthous stomatitis. METHODS In this retrospective study, 86 children with recurrent aphthous stomatitis and 71 age-matched healthy children were included in the study. The 25-hydroxyvitamin D levels examined with the enzyme immune assay were recorded for both groups. RESULTS Serum vit D level was 12±4.5 ng/ml in the group with aphthous stomatitis and 31±7 ng/ml in the healthy group. A statistically significant difference was found in vit D levels between the two groups (p<0.001). CONCLUSIONS Vit D levels were significantly low in children with recurrent aphthous stomatitis. Our findings suggest that low vit D levels may be associated with recurrent aphthous stomatitis.
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Recurrent Aphthous Stomatitis – An Overview. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2022. [DOI: 10.2478/sjecr-2021-0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Recurrent aphthous ulcers are common painful mucosal conditions affecting the oral cavity. Despite their high prevalence and knowledge of many etiological factors, the exact mechanism of disease is still not fully understood. There are three different clinical forms of recurrent aphthous stomatitis and the therapy differs depending on it.
The aim of this article is to provide an overview of current knowledge about the possible causes and treatment of recurrent aphthous stomatitis. We discuss its pathogenesis which is currently the least explained in the literature. This review offers scientists and clinicians useful information about clinical presentation, diagnosis, predisposing aetiological factors and recent trends in the management of recurrent aphthous stomatitis.
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Arroyo GP, Lofters A, Clarkson E. Pharmacological Management of Common Soft Tissue Lesions of the Oral Cavity. Oral Maxillofac Surg Clin North Am 2021; 34:99-114. [PMID: 34728147 DOI: 10.1016/j.coms.2021.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Soft tissue lesions commonly seen in the oral cavity tend to overlap in their onset, presentation, and location making it difficult to appreciate their etiology. In some instances, common oral soft tissue lesions can create confusion due to similar clinical appearance or unusual presentation; therefore, proper diagnosis of the lesion is key in pharmacologic management. In ulcerative conditions, topical steroids can decrease the symptoms and improve healing time, but do not affect the recurrence rate. Always be suspicious of soft tissue lesions that are nonresolving or recurrent lesions as they may warrant further investigation to rule out malignancy or associated systemic conditions. This article discusses key clinical presentations and the proper topical and systemic pharmacologic treatments.
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Affiliation(s)
- Guillermo Puig Arroyo
- Department of Oral and Maxillofacial Surgery, Woodhull Medical Center, 760 Broadway, Room 2C319, Brooklyn, NY 11206, USA.
| | - Ashley Lofters
- Department of Oral and Maxillofacial Surgery, Woodhull Medical Center, 760 Broadway, Room 2C319, Brooklyn, NY 11206, USA.
| | - Earl Clarkson
- Department of Oral and Maxillofacial Surgery, Woodhull Medical Center, 760 Broadway, Room 2C319, Brooklyn, NY 11206, USA
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Turan Ç, Metin N, Utlu Z, Tezcan D. Mean platelet volume as a predictor in the differentiation of Behçet's disease from recurrent aphthous stomatitis - A single centre, prospective, case-control study. Int J Clin Pract 2021; 75:e14866. [PMID: 34519145 DOI: 10.1111/ijcp.14866] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/10/2021] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Recurrent oral ulcers (ROUs) are the most common disorder of the oral cavity in the community. The most challenging issue for the clinician to deal with in the diagnosis is to distinguish whether ROUs are associated with primarily Behçet's disease (BD). We aimed to investigate whether hemogram parameters contribute to reinforce BD suspicion in the differential diagnosis of recurrent aphthous stomatitis (RAS) and BD. METHODS A total of 260 participants were recruited from the dermatology department in this single-centre, prospective, case-control study. Participants meeting eligibility criteria were divided into three groups as healthy control (n = 90), RAS (n = 97) and mucocutaneous BD (n = 73). The mean platelet volume (MPV), red cell distribution width (RDW), haemoglobin, neutrophils, monocyte, lymphocytes and platelet counts were evaluated with the complete blood count. Furthermore, the neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio and platelet/lymphocyte ratio were calculated. Erythrocyte sedimentation rate (ESR) and C-reactive protein were recorded. The contribution of hemogram parameters to the differentiation of BD from RAS was analysed. RESULTS The healthy control, RAS and BD groups were matched in terms of mean age (29.3 ± 5.8, 28.7 ± 5.6 and 29.9 ± 6.8 years; respectively) and sex distribution (women/men rate: 1.4, 1.6 and 1.7; respectively). ESR, neutrophil count and NLR were significantly higher in BD patients. (P = .032, P = .010, P = .019; respectively). MPV is significantly decreased in BD patients than in healthy control and RAS patients (P < .001). Decreased MPV (≤10 fL) and increased RDW (≥13.0%) were useful in predicting BD in patients evaluated with complaints of ROUs (OR = 9.98, 95% CI: [4.65-21.42], P < .001 and OR = 2.23, 95% CI: [1.14-3.36], P = .019, respectively). CONCLUSIONS Decreased MPV may be predictive for BD in selected patients with ROUs. We consider that more attention is required in terms of BD especially if MPV ≤10.0 fL.
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Affiliation(s)
- Çağrı Turan
- Department of Dermatology and Venereology, The Republic of Turkey, Health Sciences University Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Nurcan Metin
- Department of Dermatology and Venereology, The Republic of Turkey, Health Sciences University Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Zeynep Utlu
- Department of Dermatology and Venereology, The Republic of Turkey, Health Sciences University Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Dilek Tezcan
- Department of Rheumatology, The Republic of Turkey, Selçuk University Faculty of Medicine, Selcuklu, Konya, Turkey
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Srivastava A, Gc S, Pathak S, Ingle E, Kumari A, Shivakumar S, Pg NK, Singh AK. Evidence-based effectiveness of herbal treatment modality for recurrent aphthous ulcers - A systematic review and meta-analysis. Natl J Maxillofac Surg 2021; 12:303-310. [PMID: 35153423 PMCID: PMC8820316 DOI: 10.4103/njms.njms_249_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/16/2020] [Accepted: 01/28/2021] [Indexed: 11/07/2022] Open
Abstract
Recurrent Apthous Ulcers (RAU) has affected mankind through time immemorial. It is the most commonly prevalent oral mucosal lesion manifesting as painful ulcers involving non – keratinised oral mucosa. This review was done to assess herbal intervention in RAU patients for outcomes of ulcer size and pain intensity. Literature search of published articles in Medline, Scopus, Ovid and Journal of Web upto August 2020 were reviewed for the pre-described outcomes. Revman 5.4 software was used for study analysis. Total 9 articles were finally chosen for qualitative analysis. Meta analytic comparison demonstrated the ulcer reduction (CI = -2.22 to – 0.09; p <0.001) and pain intensity (CI = -4.60 to – 0.08; p <0.001) was reduced in the herbal group as compared to the controls. A definite evidence of herbal intervention was noted in alleviating RAU signs and symptoms.
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Affiliation(s)
- Adit Srivastava
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - ShivaKumar Gc
- Department of Oral Medicine and Radiology, Peoples College of Dental Sciences, Bhanpur, Bhopal, Madhya Pradesh, India
| | - Swarnasmita Pathak
- Department of Oral Medicine and Radiology, Regional Dental College, Guwahati, Assam, India
| | - Ekta Ingle
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
| | - Anjali Kumari
- Department of Oral Medicine and Radiology, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India
| | - Sahana Shivakumar
- Department of Public Health Dentistry, Peoples College of Dental Sciences, Bhanpur, Bhopal, Madhya Pradesh, India
| | - Navin Kumar Pg
- Department of Public Health Dentistry, Faculty of Dental Sciences, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Akhilesh Kumar Singh
- Department of Oral and Maxillofacial Surgery, IMS, BHU, Varanasi, Uttar Pradesh, India
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Owlia MB, Mirzadeh M, Mehrpoor G. Penicillin in oral aphthosis, new insight for an old drug: A randomized, double-blind, controlled clinical trial. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2020; 25:95. [PMID: 33273940 PMCID: PMC7698373 DOI: 10.4103/jrms.jrms_748_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 04/25/2020] [Accepted: 06/17/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Oral aphthosis is a painful ulceration of mucus membranes characterized by round or oval lesions with central necrosis and erythematous haloes. Due to unknown etiology, treatment is highly controversial and based mainly on individual experience. The aim of this study was to investigate the safety and efficacy of topical penicillin 6.3.3 for the treatment of recurrent aphthous stomatitis. MATERIALS AND METHODS This randomized, double-blind, controlled clinical trial was done in Shahid Sadoughi Hospital Clinic in Yazd (2011-2012). Fifty patients aged 15-45 with recurrent oral aphthosis were randomly divided into two groups. After obtaining informed consents, patients in the case and control groups were treated (four times/day for a week), respectively, by topical penicillin 6.3.3 powder and placebo in similar vial. The patients who had acute-onset oral aphthae (≤48 h of appearance) with diameter ≥5 mm were included. History of sensitivity to β-lactam antibiotics and cephalosporin; spontaneous recovery during <5 days in previous episodes; concurrent systemic, infectious, or any autoimmune disorders; history of taking drugs (local or systemic) from 2 weeks prior to presentation; alcohol or drug abuse; smoking cigarette or tobacco; and poor compliance were exclusion criteria. Patients were examined in days 0, 3, 6, and 8. The main outcome measure was reduction in the median pain. Burning, pain, erythema, and inflammation were recorded as complications. RESULTS Of 25 patients receiving penicillin, 13 were female and 12 were male. Regarding the pain score (mean difference = 1.6 vs. 0.88, P = 0.012) and size of aphthus (mean difference = 9.43 vs. 1.24, P = 0.008), patients who received penicillin had significantly better results than the placebo group on day 8 after the treatment. The mean duration to healing was 3 days for penicillin group and 6 days for placebo group (P = 0.016). No topical or systemic adverse effects were observed. CONCLUSION Our study showed a dramatic response to topical penicillin with respect to placebo. Hence, it seems that penicillin could be a safe and effective option in managing oral aphthosis.
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Affiliation(s)
- Mohammad Bagher Owlia
- Department of Internal Medicine, Division of Rheumatology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahboobeh Mirzadeh
- Department of Internal Medicine, Division of Rheumatology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Golbarg Mehrpoor
- Department of Internal Medicine, Division of Rheumatology, Alborz University of Medical Sciences, Karaj, Iran
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Ekinci A, Demir E, Ekinci H. Serum prolidase and oxidative stress levels in patients with recurrent aphthous stomatitis: a prospective, controlled study. Indian J Dermatol Venereol Leprol 2020; 86:18-23. [DOI: 10.4103/ijdvl.ijdvl_20_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Garlapati K, Rallabandi M, Shalini S. An update on investigations of autoimmune diseases affecting orofacial region. J Immunoassay Immunochem 2019; 41:1-19. [PMID: 31645179 DOI: 10.1080/15321819.2019.1680387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Autoimmune diseases are better diagnosed currently with advances in cellular immunology, molecular biology, and genetics. Clinical diagnosis of systemic and organ specific autoimmune diseases is a challenging task for the Oral physicians and the development of chairside investigation methods has not only saved the time but also cost factor. To understand patient's immune status, the clinical chair side diagnostic aids along with laboratory testing methods are necessary. Laboratory investigations have great importance in detecting, confirming and analyzing the severity, and predicting the prognosis of the autoimmune disease. This article aims to list out the diagnostic methods to diagnose autoimmune conditions and focuses on various diagnostic methods to effectively evaluate autoimmune disease of orofacial region.
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Affiliation(s)
- Komali Garlapati
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, PMVIDS, Hyderabad, India
| | - Mayuri Rallabandi
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, India
| | - Srinivas Shalini
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, PMVIDS, Hyderabad, India
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Nalbantoğlu B, Nalbantoğlu A. Vitamin D Levels in Children With Recurrent Aphthous Stomatitis. EAR, NOSE & THROAT JOURNAL 2019; 99:460-463. [PMID: 31631677 DOI: 10.1177/0145561319882783] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Recurrent aphthous stomatitis is one of the most prevalent oral mucosa diseases and the etiology is unclear. As a potent anti-inflammatory and immunomodulating agent, vitamin D can significantly affect oral cavity homeostasis. However, to the best of our knowledge, no study has been conducted in pediatric population on the potential role of vitamin D in recurrent aphthous stomatitis to date. The aim of the present study is to determine the vitamin D status in recurrent aphthous stomatitis in children. METHODS This study is conducted retrospectively. Seventy-two patients with minor recurrent aphthous stomatitis and 70 age-matched healthy controls included in the study. 25-Hydroxyvitamin D levels were measured in all patients using enzyme immunoassay. RESULTS Serum vitamin D levels were 16.4 (8.6) ng/mL in patient group and 23.1 (11.5) ng/mL in healthy controls. There was a statistically significant difference between the groups in terms of serum vitamin D levels (P = .002). There was no significant correlation between serum vitamin D levels and the severity of the recurrent aphthous stomatitis (r = 0.54, P = .76). CONCLUSIONS Our study showed a significant difference in vitamin D levels between patients with recurrent aphthous stomatitis and the healthy control group. We also found no correlation between vitamin D status and the severity of the disease.
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Affiliation(s)
- Burçin Nalbantoğlu
- Faculty of Medicine, Department of Pediatrics, Namik Kemal University, Tekirdag, Turkey
| | - Ayşin Nalbantoğlu
- Faculty of Medicine, Department of Pediatrics, Namik Kemal University, Tekirdag, Turkey
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Öztekin A, Öztekin C. Vitamin D levels in patients with recurrent aphthous stomatitis. BMC Oral Health 2018; 18:186. [PMID: 30413195 PMCID: PMC6230238 DOI: 10.1186/s12903-018-0653-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 10/29/2018] [Indexed: 01/08/2023] Open
Abstract
Background Lower serum vitamin D levels, a major public health problem worldwide, has been found to be associated with various infectious diseases, cancers, autoimmune and dermatological diseases. The serum levels of vitamin D in patients with recurrent aphthous stomatitis are not clear. We investigated the vitamin D levels in patients with recurrent aphthous stomatitis. Methods Forty patients with recurrent aphthous stomatitis (Group I) and 70 healthy controls (Group II) included in the study. The characteristics of aphthous lesions (duration of disease and remission, frequency, diameter and number of the lesions) and demographics of the participants were recorded. Serum 25-hydroxycholecalciferol levels were measured using electrochemiluminescence binding method. Results There was no statistically significant difference between the groups in terms of age (p = 0.06) and sex (p = 0.4). Other baseline characteristics were not significantly different between the groups (p > 0.05 for all). The mean diameter of aphthous lesions was 0.5 (0.4–0.6) cm and the mean number of lesions was 2.2 ± 1.5. Serum vitamin D levels were 11 ± 7.04 ng/ml in Group I and 16.4 ± 10.19 ng/ml in Group II. Serum vitamin D levels were significantly lower in patients with recurrent aphthous stomatitis (p = 0.004). Conclusions The present study showed lower vitamin D levels in patients with recurrent aphthous stomatitis compared to healthy controls.
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Affiliation(s)
- Aynure Öztekin
- Department of Dermatology, Hitit University Medical School, Çorum, Turkey.
| | - Coşkun Öztekin
- Department of Family Medicine, Hitit University Medical School, Çorum, Turkey
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Akerzoul N, Chbicheb S. Low laser therapy as an effective treatment of recurrent aphtous ulcers: a clinical case reporting two locations. Pan Afr Med J 2018; 30:205. [PMID: 30574224 PMCID: PMC6294968 DOI: 10.11604/pamj.2018.30.205.15779] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 06/22/2018] [Indexed: 11/11/2022] Open
Abstract
Apthous ulcers, commonly referred to as canker sores, are the most common ulcerative lesions of the oral mucosa. These are usually painful and are associated with redness and occasional bleeding from the affected area(s). Low Level Laser Therapy (LLLT) has shown excellent results in relieving the pain and complete remission of the oral ulcers. Through a clinical case, we report two locations of oral ulcers treated successfully with diode laser.
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Affiliation(s)
- Narjiss Akerzoul
- Department of Oral Surgery, Faculty of Dentistry, Mohamed V University, Rabat, Morocco
| | - Saliha Chbicheb
- Department of Oral Surgery, Faculty of Dentistry, Mohamed V University, Rabat, Morocco
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Morikawa S, Ouchi T, Asoda S, Horie N, Tsunoda K, Kawana H, Nakagawa T. Treatment of severe generalized chronic periodontitis in a patient with Behçet's disease: A case report. J Int Med Res 2018; 46:2037-2045. [PMID: 29557228 PMCID: PMC5991237 DOI: 10.1177/0300060518762267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Behçet’s disease is a systemic disorder of unknown etiology. It involves multiple organ systems and is characterized by recurring episodes of oral ulcers as well as ocular, genital, and skin lesions. Oral ulcers can affect tooth brushing and impair proper oral hygiene. As a result, a dental biofilm accumulates, and the condition of the teeth and periodontal tissue deteriorates. The aim of this case report is to highlight the efficacy of periodontal treatment for patients with Behçet’s disease. A 51-year-old man with Behçet’s disease presented with generalized severe periodontitis. After basic treatment of the periodontal tissues, periodontal surgery was performed at several sites with bony defects. However, the patient developed severe stomatitis in the oral mucosa and gingiva after periodontal surgery. Administration of the antimicrobial agent cefdinir had little effect on recovery; however, subsequent administration of sitafloxacin resulted in significant improvement of the stomatitis. This case demonstrates that periodontal therapy is very useful for alleviating the oral signs and symptoms of Behçet’s disease. Systemic antibiotic treatment with sitafloxacin (but not cefdinir) and mechanical debridement were effective in preventing the recurrence of aphthous ulcer outbreaks after periodontal surgery.
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Affiliation(s)
- Satoru Morikawa
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Takehito Ouchi
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Seiji Asoda
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Nobuyuki Horie
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Kazuyuki Tsunoda
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Hiromasa Kawana
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Taneaki Nakagawa
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
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Volle G, Fraison JB, Gobert D, Goulenok T, Dhote R, Fain O, Gonzalez-Chiappe S, Lhote F, Papo T, Thuillier A, Rivière S, Mahr A. Dietary and Nondietary Triggers of Oral Ulcer Recurrences in Behçet's Disease. Arthritis Care Res (Hoboken) 2017; 69:1429-1436. [PMID: 27863145 DOI: 10.1002/acr.23155] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 11/01/2016] [Accepted: 11/15/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The nature and impact of food and other external triggers in recurrences of Behçet's disease (BD)-related oral ulcers (OUs) remain unknown. This survey investigated dietary and nondietary triggers of BD-related OU recurrences. METHODS Patients with BD who were followed in 7 French hospital departments completed a self-administered patient questionnaire. General and specific dietary triggering factors were sought in open questions. The questionnaire also included closed questions, notably to evaluate the effect of 6 general triggering situations and 24 selected foods. The results were expressed as number (percentage) of positive responses. RESULTS Among the 101 questionnaires distributed, 81 were usable. Among the 81 patients, 96% fulfilled the International Criteria for Behçet's Disease classification criteria, and 53% qualified their OU recurrences during the previous 12 months as very discomforting or discomforting. For the 6 general situations suggested, 50 patients (62%) declared ≥1 as a "sure" trigger of OU recurrences. In both open and closed questions, the most frequent triggers were fatigue/stress (37-47% of patients) and food (32-35%). Among the 24 suggested foods, nuts (48%), pineapple (42%), peanuts (32%), Emmental cheese (30%), almonds (23%), lemons (22%), and other cheeses (21%) were the most frequently reported. The corresponding open question gave consistent findings but with lower frequencies. CONCLUSION Most patients can identify triggers of recurring BD-related OUs, with fatigue/stress and food representing the most frequent triggers. The management of OU must consider such external factors. The histamine-rich or -liberating properties of the commonly cited OU-triggering foods suggest a hyperreactivity mechanism.
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Affiliation(s)
- Geoffroy Volle
- Hospital Saint-Louis, University Paris Diderot, Paris, France
| | - Jean-Baptiste Fraison
- Hospital Saint-Louis, University Paris Diderot, Paris, and Hospital Jean Verdier, University Leonard de Vinci, Bondy, France
| | - Delphine Gobert
- Hospital Saint Antoine, University Pierre et Marie Curie, Paris, France
| | | | - Robin Dhote
- Hospital Avicenne, University Leonard de Vinci, Bobigny, France
| | - Olivier Fain
- Hospital Saint Antoine, University Pierre et Marie Curie, Paris, France
| | | | | | - Thomas Papo
- Hospital Bichat, University Paris Diderot, Paris, France
| | | | - Sophie Rivière
- Hospital Saint-Eloi, University Montpellier, Montpellier, France
| | - Alfred Mahr
- Hospital Saint-Louis, University Paris Diderot, and Sorbonne Paris Cité Research Center UMR 1153, Inserm, Paris, France
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15
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Efficacy and safety of Chinese patent medicines in the treatment of recurrent aphthous stomatitis. J Am Dent Assoc 2017; 148:17-25. [DOI: 10.1016/j.adaj.2016.08.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 08/12/2016] [Accepted: 08/31/2016] [Indexed: 11/19/2022]
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16
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Short-Term Efficacy of Pudilan Keyanning Toothpaste in Treatment of Minor Recurrent Aphthous Ulcers. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:9125327. [PMID: 27965713 PMCID: PMC5124687 DOI: 10.1155/2016/9125327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 09/18/2016] [Accepted: 10/12/2016] [Indexed: 01/23/2023]
Abstract
Aim. To examine the potential of Pudilan Keyanning toothpaste (PKT) to treat minor aphthous ulcers (MiAU). Method. A double-blind clinical trial was conducted in which 80 volunteers were randomly assigned to the PKT group (N = 40) or the control group (N = 40). The control group used a placebo toothpaste containing no Pudilan extract. At baseline, after 3 days, and after 6 days the following parameters were recorded for the target ulcers: healing rate, healing period, pain (visual analogue scale, VAS), areas of the target ulcerated lesions, degree of exudation, and hyperemia. Results. At the end of the study, the healing rate in the PKT group was 80%, compared to 50% in the control group (p < 0.05). At day 6, the VAS scores, ulcer area, degree of exudation, and hyperemia were significantly different between the two groups, with better performance observed in the PKT group (p < 0.05). Conclusion. PKT toothpaste appears to promote effective healing of MiAU.
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Abstract
The oral ulcerations caused by aphtous lesions, herpetic lesions, candidiasis, ulcerative lichen planus, mucous membrane pemphigoid, and pemphigus vulgaris are managed in a step-up approach that can involve topical, intarlesional, and systemic pharmacologic management. This article reviews the common treatment agents, modalities, and dosages. The emphasis is on local pharmacologic therapies, yet systemic conditions that often present with such oral lesions are briefly reviewed, along with the appropriate management.
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Affiliation(s)
- Mihai Radulescu
- Oral Maxillofacial Surgery, Woodhull Medical Center, 760 Broadway, Brooklyn, NY 11206, USA.
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Gavanji S, Larki B, Bakhtari A. WITHDRAWN: The effect of extract of Punica granatum var. pleniflora for treatment of minor recurrent aphthous stomatitis. Integr Med Res 2016. [DOI: 10.1016/j.imr.2014.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Li CL, Huang HL, Wang WC, Hua H. Efficacy and safety of topical herbal medicine treatment on recurrent aphthous stomatitis: a systemic review. Drug Des Devel Ther 2015; 10:107-15. [PMID: 26770058 PMCID: PMC4706126 DOI: 10.2147/dddt.s96589] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
This study aimed to evaluate the efficacy and safety of topical treatment with natural herbal medicines on recurrent aphthous stomatitis (RAS). Nine electronic databases were searched to identify the randomized controlled trials and clinical controlled trials that reported the potential effect of natural herbal medicines on RAS published in Chinese or English. Ulcer size and duration, and remission of pain were assessed as main outcome measures. The methodological quality of the studies was evaluated using the Cochrane Handbook for Systemic Review of Interventions and Rev Man software. Thirteen trials with a total of 1,515 patients were included in the present analysis, which showed that topical treatment with natural herbal medicines seemed to benefit RAS patients by reducing ulcer size, shortening ulcer duration, and relieving pain without severe side effects. In conclusion, there is some evidence of the efficacy of topically applied natural herbal medicines with regards to improved RAS outcome measures and fewer side effects. However, given the limitations of this study, the evidence remains insufficient. Well-designed and high-quality randomized controlled trials are required for further exploration.
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Affiliation(s)
- Chun-Lei Li
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, People’s Republic of China
| | - He-Long Huang
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, People’s Republic of China
| | - Wan-Chun Wang
- Department of Oral Medicine, Qingdao Stomatological Hospital, Qingdao, People’s Republic of China
| | - Hong Hua
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, People’s Republic of China
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Montgomery-Cranny JA, Wallace A, Rogers HJ, Hughes SC, Hegarty AM, Zaitoun H. Management of Recurrent Aphthous Stomatitis in Children. ACTA ACUST UNITED AC 2015; 42:564-6, 569-72. [PMID: 26506812 DOI: 10.12968/denu.2015.42.6.564] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Recurrent oral ulceration is common and may present in childhood. Causes of recurrent oral ulceration are numerous and there may be an association with underlying systemic disease. Recurrent aphthous stomatitis (RAS) is the most common underlying diagnosis in children. The discomfort of oral ulcers can impact negatively on quality of life of a child, interfering with eating, speaking and may result in missed school days. The role of the general dental practitioner is to identify patients who can be treated with simple measures in primary dental care and those who require assessment and treatment in secondary care. Management may include topical agents for symptomatic relief, topical corticosteroids and, in severe recalcitrant cases, systemic agents may be necessary.
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Babaee N, Baradaran M, Mohamadi H, Nooribayat S. Therapeutic effects of Zataria Multiflora essential oil on recurrent oral aphthous lesion. Dent Res J (Isfahan) 2015; 12:456-60. [PMID: 26604960 PMCID: PMC4630710 DOI: 10.4103/1735-3327.166218] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Aphthous lesions are one of the most common diseases of the oral cavity. They can cause severe pain, and there is no definite treatment. The purpose of this study was to determine the efficacy of Zataria multiflora (ZM, a thyme-like plant) essential oil for the control and treatment of aphthous lesions. MATERIALS AND METHODS This Triple blind clinical trial study was performed on 28 patients who were divided into two groups (eight men and six women in each group) and given ZM or placebo (control). The healing time, pain intensity, and aphthous zone diameter were recorded for each patient and followed for 6-month. Data were analyzed using Mann-Whitney and Friedman tests (P < 0.05). RESULTS After 6-month of follow-up, 4 patients in the placebo group and 6 patients in the ZM group suffered from recurrent aphthous lesions. The average complete healing time and duration of burning sensation were significantly lower in the ZM group (P < 0.05). Significant difference was observed between the two groups with regard to the diameter of lesions and halo of the lesions (P < 0.05). CONCLUSION Within the limitations of this study, ZM shortened the healing period compared to placebo.
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Affiliation(s)
- Neda Babaee
- Department of Oral Medicine, School of Dentistry, Babol University of Medical Sciences, Babol, Iran
| | - Mahmoud Baradaran
- Department of Pharmacology, Babol University of Medical Sciences, Babol, Iran
| | - Hossein Mohamadi
- Department of General dentist, Babol University of Medical Sciences, Babol, Iran
| | - Shaghayegh Nooribayat
- Department of Peridontics/Member of Research Committee, School of Dentistry, Babol University of Medical Sciences, Babol, Iran
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Liu HL, Chiu SC. The Effectiveness of Vitamin B12 for Relieving Pain in Aphthous Ulcers: A Randomized, Double-blind, Placebo-controlled Trial. Pain Manag Nurs 2015; 16:182-7. [PMID: 26025792 DOI: 10.1016/j.pmn.2014.06.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 06/08/2014] [Accepted: 06/09/2014] [Indexed: 12/31/2022]
Affiliation(s)
- Hsin-Li Liu
- Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Shu-Chin Chiu
- Feng-Yuan Hospital Department of Health, Taichung, Taiwan.
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Hamishehkar H, Nokhodchi A, Ghanbarzadeh S, Kouhsoltani M. Triamcinolone Acetonide Oromucoadhesive Paste for Treatment of Aphthous Stomatitis. Adv Pharm Bull 2015; 5:277-82. [PMID: 26236668 PMCID: PMC4517075 DOI: 10.15171/apb.2015.038] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Revised: 10/10/2014] [Accepted: 10/12/2014] [Indexed: 12/11/2022] Open
Abstract
PURPOSE The aim of this study was to prepare the optimized oral paste formulation of Triamcinolone acetonide intended to be used in aphtous stomatitis. METHODS Plastibases were prepared using mineral oil and polyethylene (95:5). Oral paste formulations were prepared with different mixtures of three hydrocolloids solids, including gelatin, pectin and sodium carboxymethylcellulose, with different ratios, as well as Plastibase. Long-term and short-term stability of prepared formulations were studied in the case of color and consistency of pastes. Franz diffusion cell and dialysis membrane were employed for release study. Release data were fitted in the kinetic models to find out the mechanism of drug release. RESULTS Formulation containing 60% plastibase, 3.3% pectin, 6.6% gelatin and 30% carboxymethylcellulose showed desired durability of adhesion, spreadability and rheology property in healthy volunteers and was compared with reference formulation (Adcortyl(®)) in the case of release profile. Although, optimized formulation and Adcortyl followed the Higuchi and first order release kinetics respectively, optimized formulation showed similar release profile to reference formulation. CONCLUSION Optimized oral paste formulation of Triamcinolone Acetonide showed similar characteristics with reference formulation and could be used as an effective drug delivery system for the treatment of recurrent aphthous stomatitis.
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Affiliation(s)
- Hamed Hamishehkar
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Nokhodchi
- Medway School of Pharmacy, Universities of Kent and Greenwich, Central Ave., Chatham Maritime, Kent ME4 4TB, United Kingdom
| | - Saeed Ghanbarzadeh
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Kouhsoltani
- Dental and Periodontal Research Center and Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Bidoki AZ, Harsini S, Sadr M, Soltani S, Mohammadzadeh M, Najafi S, Rezaei N. NLRP3
gene polymorphisms in Iranian patients with recurrent aphthous stomatitis. J Oral Pathol Med 2015; 45:136-40. [DOI: 10.1111/jop.12332] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2015] [Indexed: 02/03/2023]
Affiliation(s)
- Alireza Zare Bidoki
- Molecular Immunology Research Center; Tehran University of Medical Sciences; Tehran Iran
- Department of Immunology; School of Medicine; Tehran University of Medical Sciences; Tehran Iran
| | - Sara Harsini
- Research Center for Immunodeficiencies; Children's Medical Center; Tehran University of Medical Sciences; Tehran Iran
| | - Maryam Sadr
- Molecular Immunology Research Center; Tehran University of Medical Sciences; Tehran Iran
- Department of Immunology; School of Medicine; Tehran University of Medical Sciences; Tehran Iran
| | - Samaneh Soltani
- Molecular Immunology Research Center; Tehran University of Medical Sciences; Tehran Iran
- Department of Immunology; School of Medicine; Tehran University of Medical Sciences; Tehran Iran
| | - Mahsa Mohammadzadeh
- Dental Research Center; School of Dentistry; Tehran University of Medical Sciences; Tehran Iran
| | - Shamsolmoulouk Najafi
- Dental Research Center; School of Dentistry; Tehran University of Medical Sciences; Tehran Iran
| | - Nima Rezaei
- Molecular Immunology Research Center; Tehran University of Medical Sciences; Tehran Iran
- Department of Immunology; School of Medicine; Tehran University of Medical Sciences; Tehran Iran
- Research Center for Immunodeficiencies; Children's Medical Center; Tehran University of Medical Sciences; Tehran Iran
- Universal Scientific Education and Research Network (USERN); Tehran Iran
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Kalpana R, Thubashini M, Sundharam BS. Detection of salivary interleukin-2 in recurrent aphthous stomatitis. J Oral Maxillofac Pathol 2015; 18:361-4. [PMID: 25948989 PMCID: PMC4409179 DOI: 10.4103/0973-029x.151313] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 12/30/2014] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The present study was undertaken to estimate and compare salivary interleukin-2 (IL-2) levels in patients with recurrent aphthous stomatitis, among healthy controls and their variation with age and sex. STUDY DESIGN Saliva was collected from 60 patients within the age range of 16-60 years which included 30 patients (17 Females and 13 Males) with recurrent aphthous stomatitis and healthy control group consisted of 30 participants (18 Females and 12 Males). IL-2 estimation was done in both the groups using enzyme linked immunosorbent assay (ELISA). Statistical analysis of the data was done using Independent 't' test. RESULTS The results showed increased salivary IL-2 levels in patients with recurrent aphthous stomatitis compared to the healthy controls. The IL-2 levels were also increased in patients with the age group of 16-30 years compared to other age groups. Similar increase of IL-2 was also seen in female patients. CONCLUSION Age related and sex related alterations of IL-2 in recurrent aphthous stomatitis patients were observed.
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Affiliation(s)
- R Kalpana
- Department of Oral and Maxillofacial Pathology, Rathnavel Subramaniam Educational Trust RVS Dental College and Hospital, Kannampalayam, Sulur, Coimbatore, India
| | - M Thubashini
- Department of Oral and Maxillofacial Pathology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - B Sivapatha Sundharam
- Department of Oral and Maxillofacial Pathology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
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Low-level laser therapy in the treatment of recurrent aphthous ulcers: a systematic review. ScientificWorldJournal 2015; 2015:150412. [PMID: 25879049 PMCID: PMC4386290 DOI: 10.1155/2015/150412] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 10/31/2014] [Indexed: 11/23/2022] Open
Abstract
Recurrent aphthous ulcers (RAUs) are the most common lesion found in the oral cavity. There is no definitive cure for RAUs and current treatments are aimed at minimizing symptoms. Since low-level laser therapy (LLLT) modulates inflammatory responses, and promotes pain reduction and cellular biostimulation, LLLT can be suggested as an alternative treatment for RAUs. The literature concerning the potential of LLLT in the treatment of RAUs was evaluated. A systematic literature review identified 22 publications, of which only 2 studies were adopted. The eligibility criteria consisted of randomized controlled trials (RCTs). Both RCTs achieved significant results concerning LLLT and pain-level reductions and reduced healing times. Despite the variance in irradiation conditions applied in both studies, very similar wavelengths were adopted. There is accordingly strong evidence that wavelength plays an important role in RAU treatment. Taking into account the different parameters applied by selected RCTs, it is not possible to suggest that a specific protocol should be used. However, in light of the significant results found in both studies, LLLT can be suggested as an alternative for RAU treatment. Additional RCTs should be performed in order to reach a clinical protocol and better understand the application of LLLT in RAU treatment.
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Ghalayani P, Zolfaghary B, Farhad AR, Tavangar A, Soleymani B. The efficacy of Punica granatum extract in the management of recurrent aphthous stomatitis. J Res Pharm Pract 2014; 2:88-92. [PMID: 24991610 PMCID: PMC4076909 DOI: 10.4103/2279-042x.117389] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective: Recurrent aphthous stomatitis (RAS) is a common, painful ulcerative disorder of the oral cavity with unknown etiology. No documented cure exists and topical application of medications aims to reduce pain associated with this condition. The aim of this study was to evaluate the efficacy of Punica granatum (PG) extract on the clinical management of RAS. Methods: A total of 40 patients with RAS participated in this randomized, double-blind, and placebo-controlled study. During three episodes of RAS, the efficacy of topical PG gel (10%) was evaluated. Patients were randomly assigned to use placebo gel or PG gel daily. The time of pain elimination and the time of complete healing were recorded and the pain degree was assessed and recorded by each patients in different time intervals including: Before using the oral gel (day 0), and on days 1, 3, 5, 7 after using the product. Data were analyzed using the repeated measures ANOVA, paired and independent t-test. Findings: Mean time of pain elimination showed a significant difference (P < 0.001) between PG group (3.4 ± 1.09) and placebo group (5.9 ± 0.6). The mean duration of complete healing also showed a significant difference (P < 0.001) between PG group (5.3 ± 0.81) and placebo group (8.6 ± 0.99). The visual analog scale score in PG group was significantly less than the placebo group in all time intervals (day 1 to day 7) (P < 0.001). Conclusion: The findings of this study revealed that PG extract in the form of oral gel (10%) may be beneficial in reducing RAS pain and has a positive effect in reducing the overall time period of complete healing. It was concluded that PG is an effective herbal medicine for the management of RAS.
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Affiliation(s)
- Parichehr Ghalayani
- Department of Oral Medicine and Torabinejad Dental Research Center, Isfahan University of Medical Science, Isfahan, Iran
| | - Behzad Zolfaghary
- Depatment of Pharmacognosy, Isfahan University of Medical Science, Isfahan, Iran
| | - Ali Reza Farhad
- Department of Endodontics and Torabinejad Dental Research Center, Isfahan University of Medical Science, Isfahan, Iran
| | - Atefeh Tavangar
- Department of Oral Medicine and Torabinejad Dental Research Center, Isfahan University of Medical Science, Isfahan, Iran
| | - Bahram Soleymani
- Department of Health, Islamic Azad University, Najafabad Branch, Isfahan, Iran
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Deshmukh RA, Bagewadi AS. Comparison of effectiveness of curcumin with triamcinolone acetonide in the gel form in treatment of minor recurrent aphthous stomatitis: A randomized clinical trial. Int J Pharm Investig 2014; 4:138-41. [PMID: 25126527 PMCID: PMC4131385 DOI: 10.4103/2230-973x.138346] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Recurrent aphthous stomatitis (RAS) is an unfortunately most common disease occurring in oral cavity. Although the lesion is usually self-limited, its painful presentation, high frequency of occurrence, and multifactorial etiology leads to significant morbidity. So, an efficient therapeutic strategy is needed to provide relief to the patients. AIM To assess and compare the efficacy of Curcumin with Triamcinolone acetonide in the gel form in treatment of minor RAS. MATERIALS AND METHODS As a randomized clinical trial, 60 patients of either sex with clinically diagnosed RAS were randomly divided into 2 groups-Curcumin gel group (Group I) and Triamcinolone Acetonide gel group (Group II). Patients in either group were asked to apply the gel three times a day on each ulcer. Assessment of efficacy of gel was done on the basis of time required for regression in pain, size, and number of the ulcers. RESULTS The results showed significant difference in size, pain, number, and duration of ulcers in Group I and Group II within a period of 7 days. However, no significant difference was noted in both the groups in the treatment of RAS. To evaluate the efficacy, Mann-Whitney U test was used and statistical analysis was done using Statistical Package for the Social Sciences (SPSS) 19 software. CONCLUSION Curcumin has strong antioxidant, with anti-inflammatory, immunomodulatory and analgesic properties, which according to the results obtained from the present study, can be used as an effective alternative to steroids in treatment of RAS.
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Affiliation(s)
- Radha A. Deshmukh
- Department of Oral Medicine and Radiology, Karnataka Lingayat Education Society's, Vishwanath Katti Institute of Dental Sciences, Karnatak Lingayat Education University, Belgaum, Karnataka, India
| | - Anjana S. Bagewadi
- Department of Oral Medicine and Radiology, Karnataka Lingayat Education Society's, Vishwanath Katti Institute of Dental Sciences, Karnatak Lingayat Education University, Belgaum, Karnataka, India
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Vijayabala GS, Kalappanavar AN, Annigeri RG, Sudarshan R, Shettar SS. Single application of topical doxycycline hyclate in the management of recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 116:440-6. [PMID: 24035110 DOI: 10.1016/j.oooo.2013.06.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 06/08/2013] [Accepted: 06/14/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Although tetracyclines are used for topical therapy in recurrent aphthous stomatitis (RAS) patients, there are few clinical trials that have used doxycycline. Hence, we evaluated the therapeutic efficacy of topical doxycycline hyclate in RAS. STUDY DESIGN A single-blinded placebo-controlled trial comprising 50 RAS subjects divided into group A and group B with 25 subjects in each group was performed. Patients in group A received topical application of crushed doxycycline hyclate tablet with denture adhesive and few drops of saline solution once at the initial visit. Group B received placebo similarly. Treatment response was assessed by measures of pain reduction, ulcer duration, and adhesive retention time. Data were analyzed using the Student t test. RESULTS Participants treated with doxycycline hyclate had significantly less pain by day 1 (P < .001) and healed faster (P < .001) compared with placebo. CONCLUSION A single application of doxycycline hyclate decreased pain and speeded recovery.
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Affiliation(s)
- G Sree Vijayabala
- Assistant Professor, Department of Dentistry, ESIC Medical College & PGIMSR, KK Nagar, Chennai, Tamilnadu, India.
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Gavanji S, Larki B, Bakhtari A. The effect of extract of Punica granatum var. pleniflora for treatment of minor recurrent aphthous stomatitis. Integr Med Res 2014; 3:83-90. [PMID: 28664082 PMCID: PMC5481717 DOI: 10.1016/j.imr.2014.03.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 02/14/2014] [Accepted: 03/06/2014] [Indexed: 12/02/2022] Open
Abstract
Background Herbal drugs are considered alternative agents and have been used for several years around the world. Recurrent aphthous stomatitis (RAS) is one of the most common problems recognized by dentists and skin specialists. This problem is characterized by recurring, painful, small oral mucosal ulcers with a round or oval aspect that mostly appear in keratinized mucosa, cheeks, and on the surface of the mouth under the tongue. Methods In our experiment, the alcoholic and water extracts of Punica granatum var. pleniflora, P. granatum var. Sweet Alak, and P. granatum var. Saveh Black were tested on minor RAS. The study was carried out using the double-blind method. The study population consisted of 210 participants, of whom 69 were females (32%) and 141 were males (68%). In addition to checking several factors, the pain and the degree of the participant's satisfaction had been determined based on visual analog scale. Data analysis was done in the form of a nonparametric method using Kruskal–Wallis test and SPSS version 20 software. Results The results show that the alcoholic and water extracts of P. granatum var. pleniflora have a meaningful therapeutic effect on minor RAS. Results from the antioxidant activity and its relation to total phenolics show that P. granatum var. pleniflora and P. granatum var. Sweet Alak are rich in phenols. Conclusion The water and alcoholic extracts of P. granatum varpleniflora decreased the entire time of complete treatment, and the treatment was meaningfully satisfactory for patients who participated in this experiment.
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Affiliation(s)
- Shahin Gavanji
- Young Researchers and Elite Club, Khorasgan Branch, Islamic Azad University, Khorasgan, Isfahan, Iran
| | - Behrouz Larki
- Department of Plant protection, Khorasgan (Isfahan) Branch, Islamic Azad University, Isfahan, Iran
| | - Azizollah Bakhtari
- Department of Animal Science, Isfahan University of Technology, Isfahan, Iran
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Aggarwal H, Singh MP, Nahar P, Mathur H, GV S. Efficacy of low-level laser therapy in treatment of recurrent aphthous ulcers - a sham controlled, split mouth follow up study. J Clin Diagn Res 2014; 8:218-21. [PMID: 24701539 PMCID: PMC3972568 DOI: 10.7860/jcdr/2014/7639.4064] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 12/19/2013] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Apthous ulcers, commonly referred to as canker sores, are the most common ulcerative lesions of the oral mucosa. These are usually painful and are associated with redness, and occasional bleeding from the affected area(s). The aims of treatment are to reduce pain and healing time. AIMS To assess clinically the efficacy of Low-level laser therapy (LLLT) on recurrent aphthous ulcers for reduction of pain, lesion size, and healing time and to compare the results with those of a sham control group. SETTINGS AND DESIGN A total of 30 patients who presented with two separate aphthous ulcers were included in the study. Each lesion was randomly allotted to either the active treatment group or the sham control group. MATERIALS AND METHODS Lesions which were included in the active group were treated with LLLT in a single sitting, which was divided into four sessions. Lesions in the sham control group were subjected to similar treatment without activating the LASER unit. Each patient was evaluated for pain, lesion size, and complete healing at the following intervals; immediately post LLLT and one day, two days, and three days follow up. Statistical Analysis : The Student's t-test was used for statistical evaluation of the data. RESULTS Complete resolution of the ulcers in the active group was 3.05 ± 1.10 days as compared to 8.90 ± 2.45 days in the sham control group. Immediately, post the LLLT application, complete pain relief was observed in 28 of the 30 patients of the active group. CONCLUSION LLLT was effective in relieving pain and reducing the healing time during the treatment of aphthous ulcers.
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Affiliation(s)
- Hersheal Aggarwal
- Private Practitioner, Department of Oral Medicine and Radiology, Pacific Dental College and Hospital, Udaipur, Rajasthan, India
| | - Mohit Pal Singh
- Professor and HOD, Department of Oral Medicine and Radiology, Pacific Dental College and Hospital, Udaipur, Rajasthan, India
| | - Prashant Nahar
- Professor, Department of Oral Medicine and Radiology, Pacific Dental College and Hospital, Udaipur, Rajasthan, India
| | - Hemant Mathur
- Senior Lecturer, Department of Oral Medicine and Radiology, Pacific Dental College and Hospital, Udaipur, Rajasthan, India
| | - Sowmya GV
- Senior Lecturer, Department of Oral Medicine and Radiology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
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Bilgili SG, Ozkol H, Takci Z, Ozkol HU, Karadag AS, Aslan M. Assessment of the serum paraoxonase activity and oxidant/antioxidant status in patients with recurrent aphthous stomatitis. Int J Dermatol 2013; 52:1259-64. [PMID: 23834345 DOI: 10.1111/ijd.12084] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVES Several studies have indicated that recurrent aphthous stomatitis (RAS) is associated with oxidative stress. The aim of this study was to investigate serum paraoxonase (PON) activity and oxidant/antioxidant status in patients with RAS. DESIGN AND METHODS Thirty-one patients with RAS and 31 healthy controls were enrolled. Serum PON1 and arylesterase activities, total antioxidant capacity, total oxidant status, and oxidative stress index were determined. RESULTS Serum total antioxidant capacity levels, PON1, and arylesterase activities were significantly lower in RAS than controls (P < 0.001), while total oxidant status levels and oxidative stress index were significantly higher (P < 0.001). PON1 activity had a significant correlation with high-density lipoprotein cholesterol only (r = 0.482, P < 0.05), while there were no correlations with other lipids (P > 0.05) in patients with RAS. CONCLUSIONS Our results indicate that RAS is associated with decreased PON1 activity and increased oxidative stress that plays a crucial role in the pathogenesis of RAS. Further studies on a larger number of patients are needed to verify these results.
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Affiliation(s)
- Serap Gunes Bilgili
- Departments of, Dermatology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey
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Shilpashree HS, Sarapur S. Evaluation of salivary immunoglobulin A levels in tobacco smokers and patients with recurrent aphthous ulcers. J Nat Sci Biol Med 2012; 3:177-81. [PMID: 23225981 PMCID: PMC3510913 DOI: 10.4103/0976-9668.101907] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objectives: The aim of the present study was to analyze the influence of smoking on the salivary immunoglobulin response in smokers and to evaluate the salivary immunoglobulin A in patients with recurrent aphthous ulcers. Materials and Methods: The study included total of 80 subjects, of whom 40 were having history of chronic smoking habit, 20 were clinically diagnosed cases of recurrent aphthous ulcer and 20 were in the control group. Sample of unstimulated saliva was collected, centrifuged and analyzed for the level of salivary immunoglobulin A with turbidimetric immunoassay. For all the tests, a P- value of < 0.05 was considered for statistical significance. Results: The mean salivary immunoglobulin A level in control group was 0.20 Grams/litre and in smokers the mean salivary immunoglobulin A level was 0.13 Grams / Litre. In patients with recurrent aphthous ulcers mean salivary immunoglobulin A level was 0.31 Grams / Litre. The mean salivary immunoglobulin A levels showed a decreasing trend from controls to smokers. These results were highly significant for values between control groups to smokers. Conclusion: The mean salivary immunoglobulin A levels demonstrated a progressive decrease from controls to smokers. This investigative procedure although non-specific, can be used as a diagnostic marker in smokers and patients with recurrent aphthous ulcers.
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Affiliation(s)
- H S Shilpashree
- Department of Oral Medicine and Radiology, RKDF Dental College and Research Center, Bhopal 462 026, Madhya Pradesh, India
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Tezel A, Kara C, Balkaya V, Orbak R. An evaluation of different treatments for recurrent aphthous stomatitis and patient perceptions: Nd:YAG laser versus medication. Photomed Laser Surg 2010; 27:101-6. [PMID: 18687056 DOI: 10.1089/pho.2008.2274] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The aim of this randomized controlled clinical trial was to determine the anxiety levels of patients with recurrent aphthous stomatitis (RAS) prior to therapy with the Nd:YAG laser or medication, and to compare the effects of these different treatment methods on the degree of post-treatment pain, discomfort, and functional complications (eating and speech) experienced. MATERIALS AND METHODS Twenty patients with RAS-related oral problems were included in the study. Levels of pre- and post-treatment pain and functional complications were assessed at patient visits on days 1, 4, and 7. RESULTS The results indicated that patients treated with the Nd:YAG laser had less post-treatment pain and fewer functional complications, and reported immediate relief of pain and faster healing (p +/- 0.05). However, only after 5 d was there a significant reduction in the pain levels of the patients treated with medication. CONCLUSION Our results suggest that the Nd:YAG laser has better patient acceptance, shorter treatment time, and lower rates of pain and post-treatment adverse events among patients with RAS.
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Affiliation(s)
- Adnan Tezel
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
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Morelli V, Calmet E, Jhingade V. Alternative Therapies for Common Dermatologic Disorders, Part 2. Prim Care 2010; 37:285-96. [DOI: 10.1016/j.pop.2010.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Han RP, Hwu YJ, Peng NH, Tseng KY, Pai LW, Chiu SC. Effectiveness of Vitamin B12 on Recurrent Aphthous Stomatitis in long term care: a Systematic Review. JBI LIBRARY OF SYSTEMATIC REVIEWS 2010; 8:1-15. [PMID: 27820363 DOI: 10.11124/01938924-201008341-00015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Ruo-Ping Han
- 1. Central Taiwan University of Science and Technology. 2. A Collaborating Centre of the Joanna Briggs Institute, National Yang-Ming University, Taipei, Taiwan 3. Feng-Yuan Hospital Department of Health
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Arabaci T, Kara C, Çiçek Y. Relationship between periodontal parameters and Behçet’s disease and evaluation of different treatments for oral recurrent aphthous stomatitis. J Periodontal Res 2009; 44:718-25. [DOI: 10.1111/j.1600-0765.2008.01183.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Yardim-Akaydin S, Sepici A, Ozkan Y, Simşek B, Sepici V. Evaluation of allantoin levels as a new marker of oxidative stress in Behçet's disease. Scand J Rheumatol 2009; 35:61-4. [PMID: 16467045 DOI: 10.1080/03009740510026878] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The increased production of reactive oxygen species (ROS) from activated neutrophils in Behçet's disease (BD) and recurrent aphthous stomatitis (RAS) may result in increased oxidative stress. Uric acid can react rapidly with neutrophil-derived ROS to form allantoin. The purpose of the study was to evaluate the serum levels of allantoin as a new marker of oxidative stress in BD compared with malondialdehyde (MDA) levels as a well-known marker. Blood samples were obtained from 23 BD patients, 22 RAS patients as positive controls, and 21 healthy controls. When compared to the healthy controls, we found higher allantoin and MDA levels in the BD patients and higher MDA levels in the RAS patients. Serum ascorbic acid levels in the BD patients were significantly lower than in the controls. Increased allantoin and MDA levels suggest the possible involvement of free radicals in BD. As allantoin is only a product of uric acid oxidation by reactive oxygen and nitrogen species, it may also be used as a marker of oxidative stress in BD.
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Affiliation(s)
- S Yardim-Akaydin
- Department of Biochemistry, Faculty of Pharmacy, Gazi University, Etiler, Ankara, Turkey.
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Correlation between histocompatibility antigens and recurrent aphthous stomatitis in the brazilian population. Braz J Otorhinolaryngol 2009. [PMID: 19649495 PMCID: PMC9445898 DOI: 10.1016/s1808-8694(15)30662-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Recurrent aphthous stomatitis is a common oral mucosa disorder that affects 20% of the world's population, characterized by recurring painful ulcers in the mouth. The diagnosis is primarily based on the patient's clinical history. Inheritance may pose as a risk factor for the disease; however, the studies available are inconclusive as to the results attained, and they vary according to the population studied. Aim to typify class I and class II HLA molecules and to assess how frequent these molecules are present in the Brazilian population with Recurrent Aphthous Stomatitis, compared to healthy controls. Materials and Methods In this prospective, cross-sectional and investigative study, thirty one patients with diagnostic hypothesis of recurrent aphthous stomatitis were seen from February of 2004 to May of 2006. We obtained the DNA from those patients who matched the inclusion criteria and typified their HLA by PCR. Results In those patients with Recurrent Minor Aphthous Stomatitis we found statistically significant occurrences of HLA-A33 and HLA-B35. Conclusion HLA-A33 and HLA-B35 may be associated with recurrent minor aphthous stomatitis in the Brazilian's population.
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Wilhelmsen NSW, Weber R, Miziara ID. The role of immunofluorescence in the physiopathology and differential diagnosis of recurrent aphthous stomatitis. Braz J Otorhinolaryngol 2008; 74:331-6. [PMID: 18661004 PMCID: PMC9442135 DOI: 10.1016/s1808-8694(15)30564-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2006] [Accepted: 02/12/2007] [Indexed: 10/31/2022] Open
Abstract
UNLABELLED Recurrent aphthous stomatitis (RAS) is a disease characterized by the periodic appearance of aphthous lesions on the oral mucosa, of which etiology and physiopathology are not well explained. Recent studies with direct immunofluorescence show controversial results. Some reveal that the basic disorder is associated with humoral immunity, while others point to changes in cellular immunity. Atypical forms of aphthous stomatitis may have its differential diagnosis carried out with vesicobullous diseases, such as pemphigus vulgaris. AIM Check the presence of immunocomplexes in the mucosa of patients with aphthous stomatitis and the usefulness of the differential diagnosis method with bullous skin diseases. MATERIALS AND METHODS 23 patients with aphthous stomatitis were prospectively included in the study. There were all submitted to mucosa biopsy under local anesthesia for the removal of two fragments. One of these was sent to histology and, the other to direct immunofluorescence. RESULTS The 23 samples from the histology exam revealed an ulcerated inflammatory process. The samples referred to immunofluorescence resulted negative and only one showed the presence of complement in the basal membrane. CONCLUSION Based on our results, we conclude that the patients with RAS do not show deposits of immunocomplexes in their oral cavity mucosa and immunofluorescence is useful in the differential diagnosis between this disease and bullous skin diseases.
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Corticoides tópicos en la estomatitis aftosa recurrente. Revisión sistemática. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2008. [DOI: 10.1016/s0001-6519(08)73314-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Karaca S, Seyhan M, Senol M, Harputluoglu MM, Ozcan A. The effect of gastric Helicobacter pylori eradication on recurrent aphthous stomatitis. Int J Dermatol 2008; 47:615-7. [PMID: 18477159 DOI: 10.1111/j.1365-4632.2008.03667.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Helicobacter pylori (H. pylori) has been suggested to be associated with recurrent aphthous stomatitis (RAS) as well as many other diseases. METHODS We conducted a prospective study on a total of 23 patients with RAS to investigate the relationship between H. pylori and RAS as well as the effect of eradication therapy on the recurrence. All patients underwent endoscopic examination and gastric biopsy. The biopsy materials were examined histopathologically whether they contained H. pylori or not. The density of H. pylori was also noted. The patients with H. pylori infection were followed up for up to 1 year after starting the eradication therapy. RESULTS Gastric mucosal H. pylori colonization was + in 39%, ++ in 39%, +++ in 9%, and - in 13% of the patients, respectively. There were statistically significant decreases in the recurrence rate and amelioration time of RAS by eradication therapy. There were no significant correlations among the intensity of H. pylori with the recurrence rate, number, diameter, and amelioration time of the lesions in 1-year follow-up. CONCLUSIONS We concluded that eradication of H. pylori may have reducing effects on the recurrence and amelioration period of the RAS.
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Affiliation(s)
- Semsettin Karaca
- Department of Dermatology, School of Medicine, Inonu University, Malatya, Turkey
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Wilhelmsen NSW, Weber R, Miziara ID. O papel da imunofluorescência direta na fisiopatologia e no diagnóstico diferencial da estomatite aftóide recorrente. ACTA ACUST UNITED AC 2008. [DOI: 10.1590/s0034-72992008000300004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A estomatite aftóide recorrente é doença caracterizada por aparecimento periódico de aftas na mucosa oral, cuja etiologia e fisiopatologia não estão bem explicadas. Estudos recentes com imunofluorescência direta mostram resultados controversos. Alguns revelam que o distúrbio básico está relacionado à imunidade humoral, enquanto outros apontam alterações da imunidade celular. Formas atípicas de estomatite aftóide podem fazer diagnóstico diferencial com doenças vésico-bolhosas como pênfigo vulgar. OBJETIVO: Verificar a presença de imunecomplexos na mucosa de pacientes com estomatite aftóide e utilidade do método no diagnóstico diferencial com dermatopatias bolhosas. CASUÍSTICA E MÉTODO: 23 pacientes portadores de estomatite aftóide, de modo prospectivo, foram incluídos no estudo. Todos foram submetidos à biópsia de mucosa sob anestesia local para retirada de dois fragmentos. Um deles foi enviado para exame histológico e, outro, para ser realizada a imunofluorescência direta. RESULTADOS: As 23 amostras no exame histológico revelaram processo inflamatório inespecífico ulcerado. As amostras enviadas para imunofluorescência resultaram negativas e apenas uma revelou presença de complemento em membrana basal. CONCLUSÃO: Baseado em nossos resultados, concluímos que pacientes portadores de EAR não apresentam depósitos de imunecomplexos na mucosa da cavidade bucal e a imunofluorescência é útil no diagnóstico diferencial entre a doença e dermatopatias bolhosas.
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Shemer A, Amichai B, Trau H, Nathansohn N, Mizrahi B, Domb AJ. Efficacy of a mucoadhesive patch compared with an oral solution for treatment of aphthous stomatitis. Drugs R D 2008; 9:29-35. [PMID: 18095751 DOI: 10.2165/00126839-200809010-00003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the efficacy and tolerability of a mucoadhesive patch compared with a pain-relieving oral solution for the treatment of aphthous stomatitis. METHODS Patients with active aphthous stomatitis were randomly treated either once a day with a mucoadhesive patch containing citrus oil and magnesium salts (n = 26) or three times a day with an oral solution containing benzocaine and compound benzoin tincture (n = 22). All patients were instructed to apply the medication until pain had resolved, and completed a questionnaire detailing multiple clinical parameters followed by an evaluation of the treatment. RESULTS The mucoadhesive patch was found to be more effective than the oral solution in terms of healing time (mean +/- SD: 36.0 +/- 22.8 hours vs 134.7 +/- 57.7, p < 0.001) and pain intensity after 12 and 24 hours (3.7 +/- 2.8 vs 6.3 +/- 2.6, p = 0.003, and 2.3 +/- 2.7 vs 5.7 +/- 2.5, p < 0.001, respectively). Local adverse effects 1 hour after treatment were significantly (p < 0.01) less frequent among the mucoadhesive patch patients compared with the oral solution patients. CONCLUSIONS The mucoadhesive patch was found to be significantly more effective and better tolerated than the oral solution in the treatment of aphthous stomatitis.
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Affiliation(s)
- Avner Shemer
- Department of Dermatology, C. Sheba Medical Center, Ramat-Gan, Israel
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Scully C, Porter S. Oral mucosal disease: Recurrent aphthous stomatitis. Br J Oral Maxillofac Surg 2008; 46:198-206. [PMID: 17850936 DOI: 10.1016/j.bjoms.2007.07.201] [Citation(s) in RCA: 221] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2007] [Indexed: 11/28/2022]
Abstract
Recurrent aphthous stomatitis (RAS; aphthae; canker sores) is common worldwide. Characterised by multiple, recurrent, small, round, or ovoid ulcers with circumscribed margins, erythematous haloes, and yellow or grey floors, it usually presents first in childhood or adolescence. Its aetiology and pathogenesis is not entirely clear, but there is genetic predisposition, with strong associations with interleukin genotypes, and sometimes a family history. Diagnosis is on clinical grounds alone, and must be differentiated from other causes of recurrent ulceration, particularly Behçet disease - a systemic disorder in which aphthous-like ulcers are associated with genital ulceration, and eye disease (particularly posterior uveitis). Management remains unsatisfactory, as topical corticosteroids and most other treatments only reduce the severity of the ulceration, but do not stop recurrence.
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Affiliation(s)
- Crispian Scully
- University College London, Eastman Dental Institute, London, UK.
| | - Stephen Porter
- University College London, Eastman Dental Institute, London, UK
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Quijano D, Rodríguez M. Topical Corticosteroids in Recurrent Aphthous Stomatitis. Systematic Review. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2008. [DOI: 10.1016/s2173-5735(08)70242-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Altenburg A, Abdel-Naser MB, Seeber H, Abdallah M, Zouboulis CC. Practical aspects of management of recurrent aphthous stomatitis. J Eur Acad Dermatol Venereol 2007; 21:1019-26. [PMID: 17714120 DOI: 10.1111/j.1468-3083.2007.02393.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Treatment of recurrent aphthous stomatitis (RAS) remains, to date, empirical and non-specific. The main goals of therapy are to minimize pain and functional disabilities as well as decrease inflammatory reactions and frequency of recurrences. Locally, symptomatically acting modalities are the standard treatment in simple cases of RAS. Examples include topical anaesthetics and analgesics, antiseptic and anti-phlogistic preparations, topical steroids as cream, paste or lotions, antacids like sucralfate, chemically stable tetracycline suspension, medicated toothpaste containing the enzymes amyloglucosidase and glucoseoxidase in addition to the well-known silver nitrate application. Dietary management supports the treatment. In more severe cases, topical therapies are again very useful in decreasing the healing time but fail to decrease the interval between attacks. Systemic immunomodulatory agents, like colchicine, pentoxifylline, prednisolone, dapsone, levamisol, thalidomide, azathioprine, methotrexate, cyclosporin A, interferon alpha and tumour necrosis factor (TNF) antagonists, are helpful in resistant cases of major RAS or aphthosis with systemic involvement.
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Affiliation(s)
- A Altenburg
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Dessau, Germany
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Gurel A, Altinyazar HC, Unalacak M, Armutcu F, Koca R. Purine catabolic enzymes and nitric oxide in patients with recurrent aphthous ulceration. Oral Dis 2007; 13:570-4. [DOI: 10.1111/j.1601-0825.2006.01338.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Abstract
INTRODUCTION Recurrent aphthous ulcers are common lesions of the oral mucosa of which the etiology is unknown. This study aimed to estimate the bacterial diversity in the lesions and in control mucosa in pooled samples using a culture-independent molecular approach. METHODS Samples were collected from ten healthy individuals and ten individuals with a clinical history of recurrent aphthous ulcers. After DNA extraction, the 16S ribosomal RNA bacterial gene was amplified by polymerase chain reaction with universal primers; amplicons were cloned, sequenced and matched to the GenBank database. RESULTS A total of 535 clones were analyzed, defining 95 bacterial species. We identified 62 putative novel phylotypes. In recurrent aphthous ulcer lesions 57 phylotypes were detected, of which 11 were known species. Control samples had 38 phylotypes, five of which were already known. Only three species or phylotypes were abundant and common to both groups (Gemella haemolysans, Streptococcus mitis strain 209 and Streptococcus pneumoniae R6). One genus was found only in recurrent aphthous ulcer samples (Prevotella) corresponding to 16% of all lesion-derived clones. CONCLUSION The microbiota found in recurrent aphthous ulcers and in the control groups diverged markedly and the rich variety of genera found can provide a new starting point for individual qualitative and quantitative analyses of bacteria associated with this oral condition.
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Affiliation(s)
- L Marchini
- Laboratory of Molecular Genetics and Genomics, University of Vale do Paraíba, São José dos Campos, São Paulo, Brazil
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