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Safari‐Faramani R, Salehi M, Ghambari Haji Shore S, Omidpanah N. Serum level of vitamin D in patients with recurrent aphthous stomatitis: A systematic review and meta-analysis of case control studies. Clin Exp Dent Res 2024; 10:e794. [PMID: 37786385 PMCID: PMC10860554 DOI: 10.1002/cre2.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/16/2023] [Accepted: 09/20/2023] [Indexed: 10/04/2023] Open
Abstract
OBJECTIVES Recurrent aphthous stomatitis (RAS) is an ulcerative condition with unknown etiology. The effect of vitamin D in the etiology of RAS is still a matter of controversy. In this study, we aimed at review the available evidence on the role of vitamin D deficiency in RAS etiology. MATERIAL AND METHODS PubMed, Cochrane Library for Systematic Reviews, ISI Web of Science, Scopus, and EmBase were systematically searched for evidence on RAS and vitamin D up to January 2020. Retrieved records were screened and assessed by two of the authors independently. Newcastle-Ottawa scale was used to assess the quality of individual studies. AMSTAR tool was used for assessing the quality of the study. RESULTS Eight studies including 383 healthy control and 352 patients with RAS were eligible for the meta-analysis. Serum vitamin D levels were significantly lower in RAS patients. The weighted mean difference was -7.90 (95% CI: -11.96 to -3.85). CONCLUSIONS The results highlighted the importance of vitamin D deficiency in the etiology of RAS. However, more studies are needed to reach a robust decision. The observed association between vitamin D and RAS is probably due to the effect of vitamin D on the immune system.
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Affiliation(s)
- Roya Safari‐Faramani
- Research Center for Environmental Determinants of Health, School of Public HealthKermanshah University of Medical SciencesKermanshahIran
| | - Mohsen Salehi
- Students Research CommitteeKermanshah University of Medical SciencesKermanshahIran
| | | | - Neda Omidpanah
- Department of Oral and Maxillofacial Medicine, School of DentistryKermanshah University of Medical SciencesKermanshahIran
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Assiri K, Hosmani J, Chalikkandy SN, Alkahtani AM, Alhanif RM, Alsarh SA, Patil S, Reda R, Testarelli L. Correlating Salivary Levels of Immunoglobin E and Human Eosinophil Cationic Protein in the Aseer Cohort with Recurrent Apthous Stomatitis. Int J Gen Med 2023; 16:2923-2931. [PMID: 37457753 PMCID: PMC10348369 DOI: 10.2147/ijgm.s410061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023] Open
Abstract
Background Repeated Aphthous Stomatitis (RAS) is the most prevalent inflammatory disorder of the oral mucosa, characterized by recurrent emergence of single or numerous painful ulcers. RAS usually affects healthy people without systemic illnesses. There is evidence linking atopy to the progression of this illness. Immunoglobulin E (IgE) and human eosinophil cationic protein (HECP) levels in the saliva of individuals with aphthous stomatitis were assessed as allergy-related indicators. Materials and Methods Sixty people were assessed for this study. 30 patients with RAS were included in the patient group, while 30 healthy individuals made up for the control group. Sixty participants' non-stimulated saliva was taken and IgE and HECP were evaluated using enzyme-linked immunosorbent assay (ELISA). Data were analyzed in SPSS 20 through the Mann-Whitney test and p<0.05 was considered significant. Results The salivary level of HECP was significantly (p 0.05) higher among cases (0.83 0.70) compared to controls (0.170 0.15), whereas the salivary level of IgE was not significantly (p = 0.41) higher among cases (35.60 11.19) compared to controls (67.42 18.34). Conclusion Even though this study found a positive correlation between elevated HECP levels and RAS, additional research with larger sample sizes is required to identify the biological mechanisms responsible for the observed associations and to include salivary HECP levels in the RAS patient's evaluation.
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Affiliation(s)
- Khalil Assiri
- Department of Diagnostic Dental Sciences, College of Dentistry, King Khalid University, Abha, 62529, Saudi Arabia
| | - Jagadish Hosmani
- Department of Diagnostic Dental Sciences, College of Dentistry, King Khalid University, Abha, 62529, Saudi Arabia
| | | | - Abdullah M Alkahtani
- Department of Microbiology and Clinical Parasitology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | | | - Shankargouda Patil
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, 84095, USA
| | - Rodolfo Reda
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, 00161, Italy
| | - Luca Testarelli
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, 00161, Italy
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Manoj MA, Jain A, Madtha SA, Cherian TM. Prevalence and risk factors of recurrent aphthous stomatitis among college students at Mangalore, India. PeerJ 2023; 11:e14998. [PMID: 37214085 PMCID: PMC10194064 DOI: 10.7717/peerj.14998] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 02/13/2023] [Indexed: 05/24/2023] Open
Abstract
Background Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal diseases affecting an approximate 25% of the world's population. Some common etiological factors are genetics, nutritional deficiencies, stress and immune dysfunction. There is currently no specific medication to treat the condition but RAS tends to heal by itself within a week or two. We aimed to explore about the prevalence and related risk factors of recurrent aphthous ulcers among college students aged 18-30 years who had been affected within the preceding six months prior to the study duration. Methods A questionnaire survey was conducted among 681 students from four colleges in Mangalore, Karnataka, India after obtaining the approval for the same from the respective colleges. Consenting participants returned a survey containing various questions. The collected data was then analyzed using descriptive statistics. The study was approved by the Institutional Ethics Committee. Results Of the 681 participants, 322 (47.2%) were affected with RAS in the past six months which included 131 (40.6%) males and 191 (59.3%) females. Single mouth ulcers were the most common presentation seen among the study participants (74.2%). Factors showing statistically significant association were: family history of RAS (P < 0.001), known diabetics (P < 0.001), history of smoking (P < 0.001), oral trauma (P < 0.001), history of wearing braces/dentures (P < 0.001) as well as those using toothpastes containing sodium lauryl sulphate (P < 0.001), stress and lack of sleep (P < 0.001). The most common form of medication used were topical agents (43.1%) (P < 0.001). Conclusions There was a statistically significant association between the occurrence of RAS and family history of RAS, diabetes, smoking, history of braces/dentures, oral trauma, sodium lauryl sulphate toothpastes, lack of sleep, stress, menstruation, consumption of particular foods and beverages. Further research is needed in this field to truly understand the prevalence and risk factors of RAS and to help in discovering a treatment modality for this condition.
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Affiliation(s)
- Matthew Antony Manoj
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Animesh Jain
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Saanchia Andria Madtha
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Tina Mary Cherian
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
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Liu Y, He M, Yin T, Zheng Z, Fang C, Peng S. Prevalence of recurrent aphthous stomatitis, oral submucosal fibrosis and oral leukoplakia in doctor/nurse and police officer population. BMC Oral Health 2022; 22:353. [PMID: 35974343 PMCID: PMC9382799 DOI: 10.1186/s12903-022-02382-0] [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: 05/02/2022] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The doctor/nurse and police officer population have some common typical characteristics of great professional pressure and night shift and past studies indicated oral mucosa lesions were closely associated with psychological factors and health-risking behaviors, however the prevalence of recurrent aphthous stomatitis (RAS) and the two commonly seen oral potentially malignant disorders of oral submucosal fibrosis (OSF) and oral leukoplakia in doctor/nurse and police officer in the Betel quid chewing city of Mainland China is unknown The cross-sectional study was to determine the prevalence differences of RAS, oral leukoplakia and OSF among doctor/nurse, police officer and non-doctor/nurse and non-police officer population aged 20-59 years. METHODS RAS, OSF and oral leukoplakia were examined in doctor/nurse group (male: 659, female: 2439), police officer group (male: 839, female: 262) and non-doctor/nurse and non-police officer group (male: 7576, female: 8129) from 2020-11-01 to 2021-08-31 in Health Management Center, Xiangya Hospital in Changsha city, Hunan province. RESULTS The prevalence rates of RAS, OSF, oral leukoplakia and oral leukoplakia combined with OSF in male and female non-doctor/nurse and non-police officer group are 8.32‰ and 10.83‰, 58.08‰ and 1.23‰, 11.75‰ and 0.25‰, 7.66‰ and 0.12‰ respectively. Compared with the non-doctor/nurse and non-police officer population, prevalence rates of RAS in male (24.27‰) and female (20.50‰) doctor/nurse population were significantly higher. Prevalence rates of OSF (21.24‰) and oral leukoplakia (3.03‰) in male doctor/nurse population were significantly less but prevalence rates of OSF (93.71‰), oral leukoplakia (20.17‰) and oral leukoplakia combined with OSF (15.42‰) for male police officer were significantly greater in comparison with male non-doctor/nurse and non-police officer group. OSF and oral leukoplakia prevalence rates were obvious lower for the female than the counterpart male group, but there were no significant differences of OSF and oral leukoplakia prevalence rates between the female non-doctor/nurse and non-police officer and female doctor/nurse group. Oral leukoplakia was not found in the female police officers. CONCLUSIONS Doctor/nurse population have higher prevalence of RAS. Male doctors/nurses have lower prevalence of OSF and oral leukoplakia, while male police officers have higher prevalence of OSF, oral leukoplakia and oral leukoplakia combined with OSF.
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Affiliation(s)
- Yundong Liu
- Health Management Center, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.
| | - Mi He
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China
| | - Tao Yin
- Changsha Health Vocational College, Changsha, 410605, Hunan, People's Republic of China
| | - Ziran Zheng
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China
| | - Changyun Fang
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.
| | - Shifang Peng
- Department of Infectious Diseases, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.
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5
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Yao H, Zhang Q, Song Q, Liu M, Tang G. Characteristics of Oral Mucosal Lesions and Their Association With Socioeconomic Status and Systemic Health: A Cross-Sectional Study of Consecutively Collected Oral Medicine Clinic Data in a Remote Rural Area of China. Front Public Health 2022; 10:897814. [PMID: 35677771 PMCID: PMC9168324 DOI: 10.3389/fpubh.2022.897814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 04/26/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives Epidemiological data of oral mucosal lesions (OMLs) are required to develop practical oral care policies. However, limited data are available for rural areas in China. We aimed to estimate the spectrum and frequency of OMLs and to identify their associated socioeconomic status (SES) and systemic health in a remote rural area in Yunnan, China. Methods We screened patients for OMLs in an oral medicine clinic in rural Yunnan, China, from August 2020 to February 2021. OMLs were documented. SES, including the highest education level achieved and the previous month's household income, as well as the patient's systemic health, including a history of smoking, alcohol use, and chronic disease, were obtained from the Medical History/Health Questionnaire Form and patient medical records. Results A total of 146 patients were found to have OMLs. The most frequent OML was aphthous ulcer (n = 41, 28.1%), followed by burning mouth syndrome (BMS) (n = 16, 11.0%), viral ulcer (n = 14, 9.6%), and oral lichen planus (OLP) (n = 9, 6.2%). In these patients, the most common chronic diseases were sleep apnea (n = 35, 24.0%), hypertension (n = 23, 15.8%), bronchitis (n = 16, 11.0%), reflux (including gastroesophageal reflux disease) (n = 12, 8.2%), and arthritis (n = 11, 7.5%). On adjusted regression, the patients without chronic diseases had a lower risk of BMS than those with chronic diseases [odds ratio (OR), 0.2; 95% confidence interval (CI), 0.03–0.9]. Age was an independent protective factor for viral ulcers (OR, 1.0; 95% CI, 0.9–1.0). Patients with low-income levels had a lower risk of OLP than those with high-income levels (OR, 0.2; 95% CI, 0.05–0.9). Conclusions Our oral medicine clinic data in remote Yunnan, China, showed the most frequent OML was aphthous ulcer, which was followed by BMS, viral ulcer, and OLP. Oral care policies should be prioritized among patients with aphthous ulcer. Preventive strategy of BMS should be targeted to people with chronic disease for health equalities. Therefore, an individualized strategy for interventions of OMLs might be optimal, based on the specific epidemiologic characteristics in rural settings.
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Affiliation(s)
- Hui Yao
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Qiongyue Zhang
- Department of Stomatology, The People's Hospital of Xiangyun Affiliated With Dali University, Yunnan, China
| | - Qianqian Song
- Department of Stomatology, The People's Hospital of Xiangyun Affiliated With Dali University, Yunnan, China
| | - Mingshan Liu
- Department of Stomatology, The People's Hospital of Xiangyun Affiliated With Dali University, Yunnan, China
- *Correspondence: Mingshan Liu
| | - Guoyao Tang
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Guoyao Tang
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6
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Kumar A, Kashyap D. Apthous ulcers: Its prevalence and distribution according to gender and site in different age groups-A descriptive study. THE SAINT'S INTERNATIONAL DENTAL JOURNAL 2022. [DOI: 10.4103/sidj.sidj_4_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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7
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Ryu HS, Lim NK, Padalhin AR, Abueva C, Park SY, Chung PS, Woo SH. Improved healing and macrophage polarization in oral ulcers treated with photobiomodulation (PBM). Lasers Surg Med 2021; 54:600-610. [PMID: 34913510 DOI: 10.1002/lsm.23510] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 11/25/2021] [Accepted: 12/01/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The effect of photobiomodulation (PBM) treatment on wound healing and macrophage polarization was investigated in vivo. Animal models of oral ulcers were simulated through chemically induced oral ulcers in rats. MATERIALS AND METHODS PBM treatment using an infrared pulsed laser was used to treat oral ulcers in the animal models. Twelve Sprague-Dawley rats were randomly divided into four groups depending on set absorbed energy: Group 1 (control), Group 2 (30 J), Group 3 (60 J), and Group 4 (100 J). Laser treatment was performed every other day for 8 days after ulcer confirmation. Parameters used were as follows: wavelength 808 nm, power output 50 mW, spot size 10 mm, frequency 10 Hz, and pulse duration 1 millisecond. Ulcers were measured to determine the effect of the treatments over time. Histology, immunostaining, and real-time polymerase chain reaction analyses were performed to evaluate the effect of PBM treatment on macrophage-related (IL-6/IL-10) and wound-healing-related (TNF-α/TGF-β/MMP-2) cytokine expression. RESULTS Histological examinations indicate that the PBM treatment stimulated a higher level of wound recovery after 8 days of treatment at 60 J absorbed energy compared to other treatment groups. Analyses of relative gene expression of proinflammatory, anti-inflammatory, and tissue remodeling cytokines indicate that the macrophages in the tissue samples were predominantly characterized as M2 subtypes (alternatively activated), which possibly accounts for the accelerated tissue repair in the animal model of oral ulcer. CONCLUSION This preliminary study stands as a proof of concept regarding the potential use of infrared laser PBM treatment for oral ulcers which have not been previously investigated upon. PBM treatment affects macrophage polarization and enhances wound healing. Further experimentation will be conducted to expand the understanding of how PBM treatment affects the healing mechanism of ulcers.
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Affiliation(s)
- Hyun Seok Ryu
- Interdisciplinary Program for Medical Laser, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Nam Kyu Lim
- Department of Plastic and Reconstructive Surgery, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Andrew Reyes Padalhin
- Beckman Laser Institute Korea, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Celine Abueva
- Beckman Laser Institute Korea, Dankook University College of Medicine, Cheonan, Republic of Korea.,Medical Laser Research Center, Dankook University, Cheonan, Republic of Korea
| | - So Young Park
- Beckman Laser Institute Korea, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Phil-Sang Chung
- Beckman Laser Institute Korea, Dankook University College of Medicine, Cheonan, Republic of Korea.,Medical Laser Research Center, Dankook University, Cheonan, Republic of Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Seung Hoon Woo
- Beckman Laser Institute Korea, Dankook University College of Medicine, Cheonan, Republic of Korea.,Medical Laser Research Center, Dankook University, Cheonan, Republic of Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Republic of Korea
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8
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Crosstalk between the oral microbiota, mucosal immunity, and the epithelial barrier regulates oral mucosal disease pathogenesis. Mucosal Immunol 2021; 14:1247-1258. [PMID: 34040155 DOI: 10.1038/s41385-021-00413-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 04/26/2021] [Accepted: 05/04/2021] [Indexed: 02/07/2023]
Abstract
Oral mucosal disease (OMD), which is also called soft tissue oral disease, is described as a series of disorders or conditions affecting the mucosa and soft tissue in the oral cavity. Its etiology is unclear, but emerging evidence has implicated the influence of the composition of the oral mucosa and saliva-resident microbiota. In turn, this dysbiosis effects the immune response balance and epithelial barrier function, followed by the occurrence and progression of OMD. In addition, oral microbial dysbiosis is diverse in different types of diseases and different disease progressions, suggesting that key causal pathogens may exist in various oral pathologies. This narrative literature review primarily discusses the most recent findings focusing on how microbial dysbiosis communicates with mucosal adaptive immune cells and the epithelial barrier in the context of five representative OMDs, including oral candidiasis (OC), oral lichen planus (OLP), recurrent aphthous ulcer (RAU), oral leukoplakia (OLK), and oral squamous cell carcinoma (OSCC), to provide new insight into the pathogenetic mechanisms of OMDs.
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Mazzoleni DS, Mazzoleni F, Mazzoleni LE, Francesconi CFDM, Milbradt TC, Uchoa DM, Birnfeld HR, Andrighetto LV, Ries SADS, Simon D, Talley NJ. Helicobacter pylori and other factors in recurrent aphthous stomatitis: A cross-sectional study. Oral Dis 2021; 28:390-397. [PMID: 33386646 DOI: 10.1111/odi.13765] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 11/03/2020] [Accepted: 12/19/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the role of Helicobacter pylori and other risk factors in recurrent aphthous stomatitis (RAS). METHODS Patients with functional dyspepsia responded to questionnaires regarding demographic and clinical data, anxiety and depression, and a specific RAS questionnaire. They underwent upper digestive endoscopy and H. pylori evaluation. RESULTS 476 patients were included and of the 372 evaluated for H. pylori, 65.6% were H. pylori-positive. RAS was reported by 32.6% (155/476). In the bivariate analysis of the 372 patients evaluated for gastric H. pylori status, positive subjects had a lower RAS prevalence (29.9%; 73/244) than H. pylori-negative (41.4%; 53/128) (p = .026). Smoking (p = .005) and older age (p = .034) were also associated with a lower prevalence, while female gender (p = .032) and lower income (p = .046) presented higher RAS prevalence. In the multivariate analysis, H. pylori infection (p = .017), smoking (p = .001), and older age (p = .013) were protective factors, while lower income (p = .030) and anxiety (p = .042) were risk factors. In the multivariate analysis of all patients, female gender, lower income, and more schooling years were risk factors. CONCLUSIONS An unexpected lower prevalence of RAS was found in H. pylori-positive patients. Smoking, sex, age, income, education, and anxiety were associated with RAS.
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Affiliation(s)
- Daniel Schebela Mazzoleni
- Graduate Program Sciences in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Mazzoleni
- Graduate Program Sciences in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Internal Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Luiz Edmundo Mazzoleni
- Graduate Program Sciences in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Gastroenterology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Carlos Fernando de Magalhães Francesconi
- Graduate Program Sciences in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Gastroenterology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Tobias Cancian Milbradt
- Graduate Program Sciences in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Clinical Research Unit, Hospital Ernesto Dornelles, Porto Alegre, Brazil
| | - Diego Mendonça Uchoa
- Department of Pathology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Luiza Vitelo Andrighetto
- Graduate Program Sciences in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Daniel Simon
- Human Molecular Genetics Laboratory, Universidade Luterana do Brasil, Canoas, Brazil
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Al-Maweri SA, Halboub E, Al-Sufyani G, Alqutaibi AY, Shamala A, Alsalhani A. Is vitamin D deficiency a risk factor for recurrent aphthous stomatitis? A systematic review and meta-analysis. Oral Dis 2020; 26:1116-1123. [PMID: 31493304 DOI: 10.1111/odi.13189] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 08/25/2019] [Accepted: 08/30/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES A few studies have associated vitamin D deficiency with the occurrence of recurrent aphthous stomatitis (RAS). Hence, the aim of the present systematic review and meta-analysis is to explore such a potential association. METHODS A comprehensive search of PubMed, Scopus, and Web of Science databases was conducted in June 2019. The inclusion criteria were (a) observational studies that assessed the relationship between vitamin D and RAS, and (b) the outcome measures reported quantitative vitamin D levels. Studies without control groups, case series, case reports, experimental studies, letter to editors, reviews, were excluded. The random effects model was conducted for meta-analyses using RevMan 5.3 software. RESULTS Five studies comprising 208 RAS patients and 241 healthy individuals were included. All studies except one reported significantly lower levels of vitamin D in RAS patients compared with the healthy individuals. The results of the pooled 5 studies revealed statistically significant lower levels of vitamin D in RAS patients (Mean Difference (MD) = -9.67 ng/ml, 95% CI = -15.68, -3.65; p ˂ .002). CONCLUSION The present meta-analysis suggests a significant association between low vitamin D levels and RAS. Further well-designed studies with adequate sample sizes are required to elucidate the role of vitamin D in pathogenesis of RAS.
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Affiliation(s)
- Sadeq Ali Al-Maweri
- Department of Oral Medicine and Diagnostic Sciences, AlFarabi Colleges of Dentistry and Nursing, Riyadh, Saudi Arabia
- Department of Oral Medicine, Faculty of Dentistry, Sana'a University, Sana'a, Yemen
| | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | | | | | - Anas Shamala
- Department of Biological and Preventive Sciences, College of Dentistry, University of Sciences and Technology, Sana'a, Yemen
| | - Anas Alsalhani
- Department of Oral Medicine and Diagnostic Sciences, AlFarabi Colleges of Dentistry and Nursing, Riyadh, Saudi Arabia
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11
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shirzaiy M, Sarabadani J. Recurrent Aphthous Stomatitis and Related Factors Among 12-17-Year-Old Students in Zahedan, Iran. JOURNAL OF RESEARCH IN DENTAL AND MAXILLOFACIAL SCIENCES 2020. [DOI: 10.29252/jrdms.5.1.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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12
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Vandana S, Kavitha B, Sivapathasundharam B. Salivary cortisol and dehydroepiandrosterone as oral biomarkers to determine stress in patients with recurrent aphthous stomatitis. J Oral Maxillofac Pathol 2019; 23:213-217. [PMID: 31516226 PMCID: PMC6714283 DOI: 10.4103/jomfp.jomfp_282_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Recurrent aphthous stomatitis (RAS) is one of the most common oral ulcerative diseases with a multifactorial etiology. Although psychological stress is an exacerbating factor, the role of salivary stress hormones, cortisol, and dehydroepiandrosterone (DHEA) in this oral disease has not been extensively reported. The study aimed to estimate and compare the salivary cortisol and DHEA levels in RAS patients and healthy control group with the aid of ELISA microplate reader. Subjects and Methods Sixty patients were enrolled in our study, which included 30 patients with clinically diagnosed RAS and 30 healthy controls. Two mL of unstimulated whole saliva was collected and salivary cortisol and DHEA levels were measured using ELISA kit, and the values were read by microplate ELISA reader and recorded in both groups. Results and Conclusion The mean salivary cortisol and DHEA levels were elevated in the RAS patients compared to the healthy controls and were statistically significant. Salivary cortisol and DHEA can serve as oral biomarkers to determine stress in patients with RAS. However, the present study necessitates further studies with larger sample size and an improved protocol to ascertain the actual role of these presumed oral biomarkers as well as anxiety and stress as triggers in the pathogenesis of RAS.
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Affiliation(s)
- S Vandana
- Department of Oral Pathology and Microbiology, Sri Ramachandra Dental College, Chennai, Tamil Nadu, India
| | - B Kavitha
- Department of Oral Pathology and Microbiology, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India
| | - B Sivapathasundharam
- Department of Oral Pathology and Microbiology, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India
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Soliman HA, Mostafaa D. Clinical Evaluation of 660 nm Diode Laser Therapy on the Pain, Size and Functional Disorders of Recurrent Aphthous Stomatitis. Open Access Maced J Med Sci 2019; 7:1516-1522. [PMID: 31198466 PMCID: PMC6542398 DOI: 10.3889/oamjms.2019.268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/03/2019] [Accepted: 05/04/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND: Minor recurrent aphthous stomatitis (MiRAS) is one of the most common, recurrent, and painful mucosal pathological condition. It is characterised by round or shallow oval ulcers, less than 10 mm in diameter, surrounded by a thin erythematous halo. It involves non-keratinized mucosa such as the labial and buccal mucosa, the ventral surface or borders of the tongue and the floor of the mouth, but it is uncommon to occur on the keratinised mucosa. It heals spontaneously within 10-14 days without scarring. There is no curative remedy to prevent its recurrence; also, available modalities only reduce the symptoms and severity of the lesion. AIM: Since these lesions may be extremely painful, we decided to estimate the pain-relieving and healing properties of low energy level laser therapy using diode laser 660 nm on MiRAS. MATERIAL AND METHODS: Twenty healthy patients suffering from minor aphthous ulcers were randomly selected from the Out-Patient Clinic of Oral Medicine Department, Faculty of Dentistry, Alexandria University. They were equally divided into two groups, study group who received 660 nm diode laser irradiation while the control group received placebo (sodium bicarbonate rinse). The visual analogue scale, size reduction, effectiveness indices and functional disorders were compared between the groups. RESULTS: Both groups presented a statistically significant difference from baseline to follow up periods. But, diode laser 660 nm treatment showed more remarkable improvements in reduction of healing time, pain and lesion size. CONCLUSION: We concluded that diode laser 660 nm should be further considered as an effective alternative therapeutic regimen to patients who suffer from recurrent aphthous stomatitis.
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Affiliation(s)
| | - Diana Mostafaa
- Faculty of Dentistry, Alexandria University, Alexandria, Egypt.,Department of Preventive Dental Sciences, Al Farabi Colleges, Riyadh, Saudi Arabia
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Hegde S, Ajila V, Babu S, Kumari S, Ullal H, Madiyal A. Evaluation of salivary tumour necrosis factor-alpha in patients with recurrent aphthous stomatitis. Eur Oral Res 2018; 52:157-161. [PMID: 30775720 DOI: 10.26650/eor.2018.543] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 04/09/2018] [Accepted: 05/10/2018] [Indexed: 11/20/2022] Open
Abstract
Purpose Present study was undertaken to evaluate and compare the salivary levels of tumour necrosis factor alpha (TNF-α) in subjects with RAS, traumatic ulcers (TUs) in the oral mucosa and in healthy controls. Materials and Methods Present study involved 90 participants of which 30 subjects were diagnosed with RAS, 30 subjects with TUs and 30 healthy controls grouped as group 1, group 2 and group 3 respectively. Unstimulated saliva was collected from the subjects through 'Spit Technique' and the estimation of TNF-α was done by enzyme linked immunosorbent assay. The data collected was statistically analysed. Results Salivary level of TNF-α was significantly higher in RAS patients than in patients with TUs and healthy controls. Difference between the Salivary TNF-α level in our study groups were statistically significant (p<0.001). Conclusion Present study suggests that saliva is a convenient and ideal medium for the detection of TNF-α. Statistically significant difference in the level of salivary TNF-α between the RAS and TUs subjects as well as controls suggests the significant contribution of TNF-α in pathogenesis of RAS.
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Affiliation(s)
- Shruthi Hegde
- Department of Oral Medicine and Radiology, A B Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, India
| | - Vidya Ajila
- Department of Oral Medicine and Radiology, A B Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, India
| | - Subhas Babu
- Department of Oral Medicine and Radiology, A B Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, India
| | - Suchetha Kumari
- Department of Biochemistry, K.S. Hegde Medical Academy, Nitte University, Mangalore, India
| | - Harshini Ullal
- Central research laboratory, K.S. Hegde Medical Academy, Nitte University, Mangalore, India
| | - Ananya Madiyal
- Department of Oral Medicine and Radiology, A B Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, India
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Systemic and environmental risk factors for recurrent aphthous stomatitis in a Polish cohort of patients. Postepy Dermatol Alergol 2018; 36:196-201. [PMID: 31320854 PMCID: PMC6627261 DOI: 10.5114/ada.2018.74638] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 02/02/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction Recurrent aphthous stomatitis (RAS) is a common oral mucosal disease without a clearly defined etiology. Aim To analyze the influence of systemic diseases, medications, smoking and a family history of RAS on the prevalence and the course of the condition in Polish patients with RAS. Material and methods Seventy-eight patients with RAS and 72 subjects without a history of RAS were enrolled in the study. All participants underwent a detailed oral examination and a full blood count. The results were statistically analyzed with Statistica 10 (StatSoft, Krakow, Poland) with Mann-Whitney, Kruskal-Wallis, χ2 and Fisher tests, with p < 0.05 considered as the significance level. Results The most common systemic conditions observed in patients with RAS were hypertension, allergies and anemia. Both HT and anemia were prevalent in the RAS group. A positive RAS family history occurred more frequently in the study group than in controls. However, no association was found between smoking and RAS prevalence, although a higher percentage of smokers was observed in the RAS subgroup with a low frequency of RAS episodes. Conclusions The potential role of hypertension and anemia as modifiers of the immune reaction in RAS has been implied in this study but confirmation of this association requires further studies on a larger sample of patients. However, there appears to be no correlation between smoking and the occurrence of RAS. The positive family history observed in this study in the majority of RAS patients confirms the genetic background of the condition.
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Xue Y, Liu J, Zhao W. A Comparison of Immunomodulatory Monotherapy and Combination Therapy for Recurrent Aphthous Stomatitis. INT J PHARMACOL 2018. [DOI: 10.3923/ijp.2018.377.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bao ZX, Shi J, Yang XW, Liu LX. Hematinic deficiencies in patients with recurrent aphthous stomatitis: variations by gender and age. Med Oral Patol Oral Cir Bucal 2018; 23:e161-e167. [PMID: 29476670 PMCID: PMC5911348 DOI: 10.4317/medoral.21885] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 12/26/2017] [Indexed: 11/26/2022] Open
Abstract
Background The aim of this study was to evaluate the association between hematinic deficiencies and recurrent aphthous stomatitis (RAS). Material and Methods 517 RAS patients and 187 healthy controls were enrolled in the present study. Hematinic deficiencies, including serum ferritin, folic acid, and vitamin B12 deficiencies were assessed for each participant. Gender and age were taken into account and the collected data were statistically analysed. Results Compared with the healthy controls, a significantly higher overall frequency of hematinic deficiencies was found in RAS patients (p<0.001). When gender and age were taken into account, significant differences in hematinic deficiencies were observed among RAS patients. Serum ferritin deficiency was much more common in young and middle-aged female RAS patients (age<60). Serum folate deficiency and serum vitamin B12 deficiency were both much more common in the young adult group of male RAS patients (21–40 years of age). Logistic regression analysis revealed that both gender and age have significant correlation with the presence of hematinic deficiencies in the RAS patients. Conclusions Significant variations in hematinic deficiencies were demonstrated in RAS patients across different genders and age groups. We suggest that further studies on the hematinic deficiencies of RAS patients should take into account the gender and age of participants. Key words:Recurrent aphthous stomatitis, hematinic deficiencies, gender, age.
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Affiliation(s)
- Z-X Bao
- Department of Gastroenterology and Hepatology, The First Clinical Hospital of Shanxi Medical University, Mailbox 427, 85 Jiefang South Road, Taiyuan, Shanxi Province, China 030001,
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Chaudhuri S, Dey S, Awasthi A, Bajpai RC. Does tobacco addiction relate to oral mucosal changes? An epidemiological study from North India. J Public Health (Oxf) 2017. [DOI: 10.1007/s10389-017-0787-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Baş Y, Seçkin HY, Kalkan G, Takcı Z, Önder Y, Çıtıl R, Demir S, Şahin Ş. Investigation of Behçet's Disease and Recurrent Aphthous Stomatitis Frequency: The Highest Prevalence in Turkey. Balkan Med J 2016; 33:390-5. [PMID: 27606133 DOI: 10.5152/balkanmedj.2016.15101] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 08/17/2015] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The Recurrent Aphthous Stomatitis (RAS) is the most frequently observed painful pathology of the oral mucosa in the society. It appears mostly in idiopathic form; however, it may also be related with systemic diseases like Behçet's Disease (BD). AIMS Determining the prevalence of RAS and BD in the Northern Anatolian Region, which is one of the important routes on the Antique Silk Road. STUDY DESIGN Cross-sectional study. METHODS Overall, 85 separate exemplification groups were formed to reflect the population density, and the demographic data of the region they represent. In the first stage, the individuals, who were selected in random order, were invited to a Family Physician Unit at a certain date and time. The dermatological examinations of the volunteering individuals were performed by only 3 dermatology specialists. In the second stage, those individuals who had symptoms of BD were invited to our hospital, and the Pathergy Test and eye examinations were performed. RESULTS The annual prevalence of RAS was determined as 10.84%. The annual prevalence was determined to be higher in women than in men (p=0.000). It was observed that the prevalence was at the peak level in the 3(rd) decade, and then decreased proportionally in the following decades (p=0.000). It was also observed that the aphtha recurrence decreased in the following decades (p=0.048). The Behçet's prevalence was found to be 0.60%. The prevalence in women was found to be higher than in men (0.86% female, 0.14% male; p=0.022). CONCLUSION While the RAS prevalence ratio was at an average value when compared with the other societies; the BD prevalence was found as the highest ratio in the world according to the literature.
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Affiliation(s)
- Yalçın Baş
- Department of Dermatology, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Havva Yıldız Seçkin
- Department of Dermatology, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Göknur Kalkan
- Department of Dermatology, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Zennure Takcı
- Department of Dermatology, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Yalçın Önder
- Department of Public Health, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Rıza Çıtıl
- Department of Public Health, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Selim Demir
- Department of Ophthalmology, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Şafak Şahin
- Department of Internal Medicine, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
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Vaillant L, Samimi M. [Aphthous ulcers and oral ulcerations]. Presse Med 2016; 45:215-26. [PMID: 26880080 DOI: 10.1016/j.lpm.2016.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 01/06/2016] [Indexed: 02/07/2023] Open
Abstract
Aphthous ulcers are painful ulcerations located on the mucous membrane, generally in the mouth, less often in the genital area. Three clinical forms of aphthous ulcers have been described: minor aphthous ulcers, herpetiform aphthous ulcers and major aphthous ulcers. Many other conditions presenting with oral bullous or vesiculous lesions orulcerations and erosions can be mistaken for aphthous ulcers. Currently, treatment of aphthous ulcers is palliative and symptomatic. Topical treatments (topical anesthetics, topical steroids and sucralfate) are the first line therapy. Recurrent aphthous stomatitis (RAS) is defined by the recurrence of oral aphthous ulcers at least 4 times per year. RAS is often idiopathic but can be associated with gastro-intestinal diseases (i.e. celiac disease, inflammatory bowel diseases), nutritional deficiencies (iron, folates...), immune disorders (HIV infection, neutropenia) and rare syndromes. Behçet's disease is a chronic, inflammatory, disease whose main clinical feature is recurrent bipolar aphthosis. Colchicine associated with topical treatments constitutes a suitable treatment of most RAS. Thalidomide is the most effective treatment of RAS but its use is limited by frequent adverse effects. Oral ulcers can be related to a wide range of conditions that constitute the differential diagnoses of aphthous ulcers. Oral ulcers are classified into three main groups: acute ulcers with abrupt onset and short duration, recurrent ulcers (mainly due to postherpetic erythema multiforme) and chronic ulcers (with slow onset and insidious progression). Acute oral ulcers are due to trauma, bacterial infections (including acute necrotizing ulcerative gingivitis), deep fungal infection, gastro-intestinal (namely inflammatory bowel disease) or systemic diseases. Chronic oral ulcers may be drug-induced, or due to benign or malignant tumors. Every oral solitary chronic ulcer should be biopsied to rule out squamous cell carcinoma. A solitary palatal ulcer can be related with necrotizing sialometaplasia.
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Affiliation(s)
- Loïc Vaillant
- CHRU de Tours, université François-Rabelais de Tours, hôpital Trousseau, Inserm U 930, service de dermatologie, 37044 Tours cedex 01, France.
| | - Mahtab Samimi
- CHRU de Tours, université François-Rabelais de Tours, hôpital Trousseau, Inra, service de dermatologie, 37044 Tours cedex 01, France
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Suresh KV, Shenai P, Chatra L, Ronad YAA, Bilahari N, Pramod RC, Kumar SP. Oral mucosal diseases in anxiety and depression patients: Hospital based observational study from south India. J Clin Exp Dent 2015; 7:e95-9. [PMID: 25810851 PMCID: PMC4368027 DOI: 10.4317/jced.51764] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 08/12/2014] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES The objective of this study was to evaluate the prevalence of different Oral Mucosal diseases in Anxiety and Depression patients. MATERIAL AND METHODS A hospital based observational Study was conducted in the department of Psychiatry and department of Oral Medicine and Radiology. Patients who were diagnosed with Anxiety or Depression by the psychiatrists using Hamilton Anxiety and Depression scale were subjected to complete oral examination to check for oral diseases like Oral Lichen Planus (OLP), Recurrent Aphthous Stomatitis (RAS), and Burning Mouth Syndrome (BMS). Equal number of control group subjects were also included. RESULTS In this study statistically significant increase in the oral diseases in patients with anxiety and depression than the control group was recorded. Oral diseases were significantly higher in anxiety patients (20.86%) than in depression (9.04%) and control group patients (5.17%). In anxiety patients, the prevalence of RAS was 12%, OLP was 5.7%, and BMS was 2.87%. In depression patients, the prevalence of RAS was 4.02%, OLP was 2.01% and BMS was 3.01%. In control group the prevalence was 2.2%, 1.33% and 1.62% in RAS, OLP and BMS respectively. RAS and OLP were significantly higher in the younger age group (18-49) and BMS was seen between the age group of 50-77 years in both study and control groups. CONCLUSIONS The results of the present study showed a positive association between psychological alterations and changes in the oral mucosa, particularly conditions like OLP, RAS and BMS. Thus psychogenic factors like anxiety and depression may act as a risk factor that could influence the initiation and development of oral mucosal diseases. Hence psychological management should be taken into consideration when treating patients with these oral diseases. Key words:Lichen planus, anxiety, depression, burning mouth syndrome, recurrent aphthous stomatitis.
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Affiliation(s)
- Kandagal V Suresh
- MDS, Senior lecturer, Department of Oral Medicine and Radiology, School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed University, Karad, Satara (District), Maharashtra (State), India
| | - Prashanth Shenai
- MDS, Senior Professor. Department of Oral Medicine and Radiology, Yenepoya Dental College and Hospital, Yenepoya university, Mangalore (District), Karnataka (State), India
| | - Laxmikanth Chatra
- Senior Professor and HOD. Department of Oral Medicine and Radiology, Yenepoya Dental College and Hospital, Yenepoya university, Mangalore (District), Karnataka (State), India
| | - Yusuf-Ahammed A Ronad
- MDS, Senior lecturer. Department of Orthodontics and Dentifacial Orthopaedics, School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed University, Karad, Satara (District), Maharashtra (State), India
| | - Naduvakattu Bilahari
- MDS, Senior lecturer. Department of Oral Medicine and Radiology, PSM College of Dental Science and Research, Thrisshur (District), Kerala, India
| | - Redder C Pramod
- MDS, Senior lecturer. Department of Oral pathology and microbiology, College of Dental Sciences, Davangere, Karanataka (State), India
| | - Sreeja P Kumar
- MDS, Senior lecturer. Department of Oral Medicine and Radiology, Amrita School of Dentistry, Kochi, Kerala (State), India
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Mohamed S, Janakiram C. Recurrent aphthous ulcers among tobacco users- hospital based study. J Clin Diagn Res 2015; 8:ZC64-LC66. [PMID: 25584320 DOI: 10.7860/jcdr/2014/10368.5145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 08/05/2014] [Indexed: 11/24/2022]
Abstract
CONTEXT Current evidence shows ambiguous relationship between tobacco use and the occurrence of aphthous. OBJECTIVES We studied the relationship between the occurrence of recurrent aphthous ulcers and various forms of tobacco usage. MATERIALS AND METHODS A hospital based case control study was carried out in a dental teaching hospital in Cochin, India. One hundred and two outpatient subjects (Males 56.9%) were identified having aphthous ulceration using Natha's diagnostic criteria and were classified as cases. One hundred and eight subjects (Males, 70.4%) with no aphthous ulceration were selected randomly as controls. Exposure ascertainment of tobacco usage was done by structured interview. RESULTS The adjusted odd ratio was found to be 0.41 (95% CI 0.19-0.87) for tobacco usage and occurrence of aphthous ulceration compared to non tobacco users. The odds ratio of 0.41 for tobacco usage infers that subjects using tobacco were 59% less likely to have aphthous ulcerations compared to nontobacco users. CONCLUSION The tobacco consumers have less frequency of aphthous ulceration compared non users.
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Affiliation(s)
- Shamaz Mohamed
- Associate Professor, Department of Public Health Dentistry, Amrita University , Edapally, Cochin, Kerala, India
| | - Chandrashekar Janakiram
- Professor, Department of Public Health Dentistry, Amrita University , Edapally, Cochin, Kerala, India
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Suresh KV, Ganiger CC, Ahammed YAR, Kumar MCD, Pramod RC, Nayak AG, Vibhute N. Psychosocial characteristics of oromucosal diseases in psychiatric patients: observational study from Indian dental college. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2014; 6:570-4. [PMID: 25535605 PMCID: PMC4264292 DOI: 10.4103/1947-2714.145471] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: Psychiatric diseases like anxiety, depression, schizophrenia and bipolar disorders can affect the mental and physical statuses of an individual. Aim: The study was to investigate the different oromucosal diseases (OMD) in psychiatric patients and to evaluate the correlation between these OMD to severity of anxiety and depression. Materials and Methods: A cross-sectional study was carried out during a six-month period. Patients reporting to psychiatry department with anxiety, depression, schizophrenia and bipolar disorder as diagnosed by an experienced psychiatrist, were subjected to complete oral examination by a skilled oral diagnostician to check for OMD like oral lichen planus (OLP), aphthous stomatitis (AS) and burning mouth syndrome (BMS). During the above mentioned time interval, 1320 patients with any of the above mentioned psychiatric diseases were included in this study. Of these, 278 had anxiety, 398 had depression, 295 had schizophrenia and 349 had bipolar disorder. Equal number of individuals reported to the Oral Medicine and Radiology department for routine oral screening with no mucosal diseases were included as control group. Results: In this study, statistically significant increase in the OMD of the psychiatric patients was recorded when compared with the control group. The OMD were significantly higher in patients with anxiety (20.86%) followed by patients with depression (9.04%), schizophrenia (7.7%), bipolar disorder (7.4%) and control group (5.17%), respectively. Most prevalent OMD in patients with anxiety was AS (12%) followed by OLP (5.7%), and BMS (2.87%) respectively. Patients with moderate to severe anxiety and depression showed significantly higher prevalence of these OMD compared to the ones with mild anxiety and depression. The AS and OLP were significantly more in the younger age group (18-49 year) and BMS was higher in 50-77 year age group in both the study and control groups. Conclusion: A positive association was established between psychological alterations and OMD. Emotional alterations may act as a precipitating factor that could influence the initiation and development of different OMD. Hence, better harmonization is essential between dentist and psychiatrists for comprehensive management of psychosomatic disorders of the oral mucosa.
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Affiliation(s)
- K V Suresh
- Department of Oral Medicine and Radiology, School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed University, Karad, Satara, Maharashtra, India
| | - Channamallappa C Ganiger
- Department of Orthodontics and Dentofacial Orthopaedics, School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed University, Karad, Satara, Maharashtra, India
| | - Yusuf A R Ahammed
- Department of Orthodontics and Dentofacial Orthopaedics, School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed University, Karad, Satara, Maharashtra, India
| | - Mounesh C D Kumar
- Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed University, Karad, Satara, Maharashtra, India
| | - R C Pramod
- Department of Oral Pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed University, Karad, Satara, Maharashtra, India
| | - Ajay G Nayak
- Department of Oral Medicine and Radiology, School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed University, Karad, Satara, Maharashtra, India
| | - Nupura Vibhute
- Department of Oral Pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed University, Karad, Satara, Maharashtra, India
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M K PD, D N S V R, Koppal S, Byatnal AR, Rukmangada T, Byatnal AA. Efficacy of rebamipide and levamisole in the treatment of patients with recurrent aphthous ulcer - a comparative study. J Clin Diagn Res 2014; 8:ZC119-22. [PMID: 25584301 DOI: 10.7860/jcdr/2014/10295.5202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 08/27/2014] [Indexed: 11/24/2022]
Abstract
UNLABELLED Context (Background): Recurrent aphthous stomatitis is an inflammatory condition of unknown aetiology characterized by painful recurrent, single or multiple ulcerations of the oral mucosa. AIMS To compare the efficacy of rebamipide, a gastro-protective agent and levamisole, an immunomodulating agent in the treatment of recurrent aphthous stomatitis. MATERIALS AND METHODS Hundred patients diagnosed with recurrent aphthous stomatitis were enrolled in the study. Fifty patients were assigned randomly to each of the two treatment groups. After the clinical diagnosis and ulcer measurement, a subjective evaluation of symptoms was done for each subject. Both the drugs were given orally at specified intervals. Ulcer measurements and subjective evaluations were made at day one. STATISTICAL ANALYSIS Analysis was done using various test like Mann Whitney and t-test. RESULTS AND CONCLUSION The overall results showed mean number of episodes whose values were not statistically significant (p=0.43), neither were the mean number of ulcers (p=0.75), or values for mean size of ulcers (p=0.91). However, the overall results suggested that efficacy of rebamipide is almost same as that of the efficacy of previously proved drug levamisole. The current study with a three months follow up, including patients with high scores of pain, aphthae count, ulcer size and frequency of occurrence showed better results in both the study groups. However, rebamipide is suggested to be well tolerated and may therefore be useful in the treatment and prevention of frequently recurrent aphthous ulcers not restricted to Behcet's disease.
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Affiliation(s)
- Parvathi Devi M K
- Reader, Department of Oral Medicine and Radiology, AMES Dental College and Hospital , Raichur, Karnataka, India
| | - Ramesh D N S V
- Professor, Department of Oral Medicine and Radiology, Pulla Reddy Dental College and Hospital , Kurnool, Andhrapradesh, India
| | - Shrinivas Koppal
- Professor, Department of Oral Medicine and Radiology, AMES Dental College and Hospital , Raichur, Karnataka, India
| | - Amit R Byatnal
- Assistant Professor, Department of Oral Medicine and Radiology, AMES Dental College and Hospital , Raichur, Karnataka, India
| | - Thriveni Rukmangada
- Professor and Head, Department of Oral Medicine and Radiology, AMES Dental College and Hospital , Raichur, Karnataka, India
| | - Aditi A Byatnal
- Private Consultant, Department of Oral and Maxillofacial Pathology, Hubli, Karnataka, India
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Altenburg A, El-Haj N, Micheli C, Puttkammer M, Abdel-Naser MB, Zouboulis CC. The treatment of chronic recurrent oral aphthous ulcers. DEUTSCHES ARZTEBLATT INTERNATIONAL 2014; 111:665-73. [PMID: 25346356 PMCID: PMC4215084 DOI: 10.3238/arztebl.2014.0665] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 06/18/2014] [Accepted: 06/18/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Chronic recurrent oral aphthous ulcers are the most common type of inflammatory efflorescence of the oral mucosa, with a prevalence of 2% to 10% in Caucasian populations. To treat them properly, physicians should know their clinical appearance and course, conditioning factors, underlying causes, and differential diagnosis. METHOD This review is based on pertinent articles that were retrieved by a selective search in PubMed and in the Cochrane Central Register of Controlled Trials. RESULTS Hard, acidic, and salty foods and toothpastes containing sodium lauryl sulfate should be avoided, along with alcohol and carbonated drinks. In Germany, the only drugs that have been approved to treat oral aphthous ulcers are corticosteroids, topical antiseptic/anti-inflammatory agents such as triclosan and diclofenac, and local anesthetics such as lidocaine. Antiseptic agents and local anesthetics should be tried first; if these are ineffective, topical cortico steroids should be used. In severe cases, local measures can be combined with systemic drugs, e.g., colchicine, pentoxifylline, or prednisolone. The efficacy of systemic treatment is debated. Other immunosuppressive agents should be given systemically only for refractory or particularly severe oral aphthous ulcers due to Adamantiades-Behçet disease. CONCLUSION The treatment of chronic recurrent oral aphthous ulcers is symptomatic, mainly with topically applied agents. It is tailored to the severity of the problem in the individual case, i.e., the frequency of ulcers, the intensity of pain, and the responsiveness of the lesions to treatment. Effective treatment relieves pain, lessens functional impairment, and lowers the frequency and severity of recurrences.
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Affiliation(s)
- Andreas Altenburg
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center
| | - Nadine El-Haj
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center
| | - Christiana Micheli
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center
| | | | - Mohammed Badawy Abdel-Naser
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center
- Department of Dermatology and Andrology, Faculty of Medicine, Ain Shams University, Cairo (Egypt)
| | - Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center
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One-Year Period Prevalence of Oral Aphthous Ulcers and Oral Health-Related Quality of Life in Patients with Behçet's Disease. GENETICS RESEARCH INTERNATIONAL 2014; 2014:930348. [PMID: 24734187 PMCID: PMC3966482 DOI: 10.1155/2014/930348] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 01/27/2014] [Indexed: 11/23/2022]
Abstract
The aim of this study was to investigate the 1-year period prevalence of oral aphthous ulcers (OAUs) and their association with oral health-related quality of life (OHQOL) in patients with Behçet's disease (BD) and in the general population. In this cross-sectional study, 675 patients with Behçet's disease (BD group) and 1,097 males and females in the Japanese general population (control group) completed both questionnaires on their OAU status during the prior year and the General Oral Health Assessment Index (GOHAI). In the BD group, 84% of patients reported experiencing an OAU during the previous year, and the mean number of OAUs/year was 13. In the control group, 31% of individuals experienced an OAU during the previous year, and the mean number of OAUs/year was one. Multivariate analysis indicated that both BD patients (OR, 6.2; 95% CI, 4.8–8.0) and controls (OR, 2.6; 95% CI, 2.0–3.5) who had OAUs at least twice per year were more likely to have GOHAI scores below the norm than were controls who had fewer than two OAUs per year. The association between HLA-B∗51 and OAUs remains unknown. The presence of OAUs has a negative effect on the OHQOL of patients with BD.
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Martori E, Ayuso-Montero R, Martinez-Gomis J, Viñas M, Peraire M. Risk factors for denture-related oral mucosal lesions in a geriatric population. J Prosthet Dent 2013; 111:273-9. [PMID: 24355508 DOI: 10.1016/j.prosdent.2013.07.015] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 07/12/2013] [Accepted: 07/21/2013] [Indexed: 02/06/2023]
Abstract
STATEMENT OF PROBLEM Denture-related mucosal lesions have been broadly studied. However, no consensus has been reached regarding the risk factors associated with these lesions, and few studies have used multivariable analysis to determine the relative significance of different risks. PURPOSE The purpose of this study was to determine the relationship between systemic, local, and denture factors on the risk of denture-related oral mucosal lesions in an elderly population by using multivariable analysis. MATERIAL AND METHODS Eighty-four elderly denture wearers recruited from geriatric residences and day care centers participated in this cross-sectional study. All data were obtained by means of a questionnaire-interview, a physical examination, and complementary tests. Bivariate relationship and multiple logistic regression analyses were performed (α=.05). RESULTS Angular cheilitis (34%), traumatic ulcers (15%), and denture stomatitis (14%) were the 3 most common lesions, and the prevalence of at least 1 denture-related mucosal lesion was 54%. The presence of denture stomatitis was related to low saliva pH, never having smoked, and regular sugar consumption. Angular cheilitis was associated with age, complete edentulism, the presence of oral Candida, a lack of denture stability, and a reduced occlusal vertical dimension. The presence of traumatic ulcers was related to a resorbed residual alveolar ridge. The presence of at least 1 lesion was associated with poor masticatory efficiency, being resident in a care facility, oral Candida, and a lack of denture stability. CONCLUSIONS Several systemic, local, and denture-related characteristics are independent risk factors for denture-related mucosal lesions in an elderly population.
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Affiliation(s)
- Elisenda Martori
- Assistant Professor, Department of Prosthodontics, University of Barcelona, Spain
| | - Raul Ayuso-Montero
- Assistant Professor, Department of Prosthodontics, University of Barcelona, Spain
| | - Jordi Martinez-Gomis
- Associate Professor, Department of Prosthodontics, University of Barcelona, Spain.
| | - Miguel Viñas
- Professor, Department of Pathology and Experimental Therapeutics, University of Barcelona, Spain
| | - Maria Peraire
- Professor, Department of Prosthodontics, University of Barcelona, Spain
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Slebioda Z, Szponar E, Kowalska A. Etiopathogenesis of recurrent aphthous stomatitis and the role of immunologic aspects: literature review. Arch Immunol Ther Exp (Warsz) 2013; 62:205-15. [PMID: 24217985 PMCID: PMC4024130 DOI: 10.1007/s00005-013-0261-y] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 10/28/2013] [Indexed: 12/31/2022]
Abstract
Recurrent aphthous stomatitis (RAS; recurrent aphthous ulcers; canker sores) belongs to the group of chronic, inflammatory, ulcerative diseases of the oral mucosa. Up to now, the etiopathogenesis of this condition remains unclear; it is, however, considered to be multifactorial. The results of currently performed studies indicate that genetically mediated disturbances of the innate and acquired immunity play an important role in the disease development. Factors that modify the immunologic response in RAS include: food allergies, vitamin and microelement deficiencies, hormonal and gastrointestinal disorders (e.g., celiac disease, Crohn’s disease, ulcerative colitis), some viral and bacterial infections, mechanical injuries and stress. In this paper, we presented the main etiopathogenetic factors of RAS with a special emphasis on the mechanisms of the immune response modification. Moreover, we discussed the crucial clinical symptoms and types of RAS together with epidemiologic data based on the current medical literature reports and our own observations.
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Affiliation(s)
- Zuzanna Slebioda
- Department of Oral Mucosa Diseases, University of Medical Sciences, Bukowska 70, 60-812, Poznan, Poland,
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Recurrent aphthous stomatitis: genetic aspects of etiology. Postepy Dermatol Alergol 2013; 30:96-102. [PMID: 24278055 PMCID: PMC3834687 DOI: 10.5114/pdia.2013.34158] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 09/03/2012] [Accepted: 09/23/2012] [Indexed: 11/17/2022] Open
Abstract
Recurrent aphthous stomatitis (RAS; recurrent aphthous ulcers - RAU; canker sores) is a chronic inflammatory, ulcerative condition of the oral mucosa. Its prevalence in the general population ranges between 5% and 20%, depending on the method and group studied. The etiopathogenesis of the disease is considered to be multifactorial, but remains still not fully understood. In patients with RAS, an enhanced immunologic response occurs to some trigger factors that may include: mechanical injury, stress or bacterial and viral antigens. Higher prevalence of aphthae in relatives may also indicate the genetic background of the condition. The inheritance of some specific gene polymorphisms, especially those encoding proinflammatory cytokines, which play a role in the formation of aphthous ulcer, may predispose family members to RAS. The purpose of this paper was to present the main clinical features of recurrent aphthous stomatitis, epidemiologic data and crucial etiopathogenetic factors with a special emphasis on genetic background of the condition.
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Abdullah MJ. Prevalence of recurrent aphthous ulceration experience in patients attending Piramird dental speciality in Sulaimani City. J Clin Exp Dent 2013; 5:e89-94. [PMID: 24455063 PMCID: PMC3892221 DOI: 10.4317/jced.51042] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 02/23/2013] [Indexed: 11/08/2022] Open
Abstract
Objective: The aim of this study is to report the prevalence and risk factors of recurrent aphthous ulceration (RAU) in patients attending Piramird dental speciality for seeking dental treatment.
Study design: A cross-sectional survey was carried out among patients (n=1100) who were visiting the department of oral medicine at Piramird dental speciality center in Sulaimani from December 2011-February 2012. The age range of the patients were between 10-79 years, with mean age of (34.27±14.14). 446 (44.6%) of participants were males and 554 (55.4%) were females, with male/female ratios of 0.80:1. All individuals had to answer specific questions including personal data (age, sex), level of education, occupation and smoking habit; etc. Additional questions were related to the risk factors that might be related to the condition. Chi Square test was used to analyze the data.
Result: The life time prevalence of RAU experience was 28.2% (n=282). It was highly significantly more common among females (31.76%) (p<0.004). The most commonly affected age group was 20-29 years (36.28%). The highest prevalence of RAU experience was seen among mere students (36.8%); Among non smokers there were highly significantly more patients with RAU experience (30%) than in heavy smoker patients (12.22%), (p=0.000). 34.4% of patients had family history of RAU. Lips and buccal mucosae were the commonest sites of ulcerations (73.10%), and the major risk factor was stress (43.3%).
Conclusion: This study has provided information about the epidemiologic aspects of recurrent aphthous ulceration, Based on the finding of this study, RAU is a common, recurrent painful oral ulceration. This study point to the importance of a thorough history taking to identify the patient’s main risk factors to get preventive measures, therefore treatment will be tailored for each patient accordingly. And the author concluded that stress was the major risk factor, thus, stress-management interventions suggested to be beneficial in reducing RAU recurrence episodes.
Key words:Recurrent aphthous ulceration, prevalence, stress.
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Affiliation(s)
- Mustafa J Abdullah
- B.D.S., M.Sc.Oral Medicine, Assistant lecturer in the Oral Medicine Clinic of the school of dentistry, University of Sulaimani, Kurdistan region, Iraq
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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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Lewkowicz N, Kur B, Kurnatowska A, Tchorzewski H, Lewkowicz P. Expression of Th1/Th2/Th3/Th17-Related Genes in Recurrent Aphthous Ulcers. Arch Immunol Ther Exp (Warsz) 2011; 59:399-406. [DOI: 10.1007/s00005-011-0134-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Accepted: 04/28/2011] [Indexed: 11/29/2022]
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Sina M, Toorchi M, Ghertasi Oskouei S. Update on prevalence of minor aphtha and the involved factors in tabriz, northwest iran. J Dent Res Dent Clin Dent Prospects 2011; 5:106-7. [PMID: 22991616 PMCID: PMC3442449 DOI: 10.5681/joddd.2011.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 05/12/2011] [Indexed: 11/17/2022] Open
Affiliation(s)
- Mahmood Sina
- Assistant professor, Department of Oral Pathology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Use of Lozenges Containing Lactobacillus brevis CD2 in Recurrent Aphthous Stomatitis: A Double-Blind Placebo-Controlled Trial. ACTA ACUST UNITED AC 2011. [DOI: 10.1155/2011/439425] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Recurrent aphthous stomatitis is a common disorder of the oral cavity, affecting mainly young people. It is characterized by small ulcers which can be very painful and generally heal spontaneously within 7–14 days. There is currently no therapy that can provide rapid healing.
This study evaluated the efficacy and rapidity of response of a lozenge containing Lactobacillus brevis CD2. 30 patients were randomized to take 4 lozenges a day of active product or placebo for 7 days. Signs and symptoms as well as laboratory parameters in the saliva were assessed at the start of the study and after 7 days of treatment.
The study demonstrated the efficacy and the rapidity of response of the Lactobacillus brevis CD2 lozenges in resolving the clinical signs and symptoms of aphthous stomatitis, with a significantly rapid improvement of pain. This is the first study confirming the efficacy of a probiotic product in this pathology.
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Sawair FA. Recurrent aphthous stomatitis: do we know what patients are using to treat the ulcers? J Altern Complement Med 2010; 16:651-5. [PMID: 20569032 DOI: 10.1089/acm.2009.0555] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The objectives of this study were to determine prevalence and types of treatments used by patients with recurrent aphthous stomatitis (RAS), and to study the sources of information about treatments used. METHODS The study was a cross-sectional survey. The participants were 530 students who had a history of RAS and were studying at the University of Jordan, Amman. RESULTS Of the 530 patients, 267 (50.4%) have attempted treatment of RAS. Of those who treated RAS, 86 (32.2%) have used alternative treatments (ATs). Topical anaesthetics/analgesics, antiseptic mouthwashes, and topical steroids represented 84.5% of the conventional medicines used. Of those who used ATs, 34 (39.5%) used tahini, 21 (24.4%) used salt/salt and warm water mouthrinse, and 7 (8.1%) used lemon/lemon salt. The tendency to treat RAS or not was not significantly affected by sociodemographic variables, but ATs were more significantly used by students living in rural areas. Relatives were the most frequently cited source of information about treatment (44.6%), followed by medical practitioners (22.9%), and only 9.4% sought treatment advice from dentists. Interestingly, 7% of the ATs were recommended by health care providers and 38.7% of the conventional treatments were recommended by non-health-care providers including 15 cases of topical steroids. CONCLUSIONS This survey revealed a high prevalence of ATs use among Jordanian patients with RAS. There is a need to educate patients with RAS on the treatment options available to reduce their distress and to improve their quality of life. Health care providers such as medical practitioners and pharmacists are frequently consulted by patients with oral lesions, so they should provide patients with better education in the diagnosis and treatment of oral diseases. Randomized clinical trials are needed to examine the potential usefulness of the commonly used ATs in this study such as tahini/sesame oil in the treatment of RAS.
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Affiliation(s)
- Faleh A Sawair
- Department of Oral and Maxillofacial Surgery, Oral Medicine, Oral Pathology and Periodontology, Faculty of Dentistry, University of Jordan, Amman, Jordan.
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Abstract
PURPOSE To study the effect of smoking on the prevalence of recurrent aphthous stomatitis (RAS) and to examine whether intensity and duration of smoking influence RAS lesions. SUBJECTS AND METHODS A cross-sectional survey was conducted on a random sample of 1000 students of The University of Jordan, Amman, between May and September 2008. Sociodemographic factors and details about smoking habits and RAS in last 12 months were collected. RESULTS Annual prevalence (AP) of RAS was 37.1%. Tobacco use was common among students: 30.2% were current smokers and 2.8% were exsmokers. AP was not significantly influenced by students' age, gender, marital status, college, and household income but was significantly affected by place of living (P = 0.02) and presence of chronic diseases (P = 0.03). No significant difference in AP of RAS was found between smokers and nonsmokers. Cigarette smokers who smoked heavily and for a longer period of time had significantly less AP of RAS when compared to moderate smokers and those who smoked for a shorter period of time. The protective effect of smoking was only noticed when there was heavy cigarette smoking (>20 cigarettes/day) (P = 0.021) or smoking for long periods of time (>5 years) (P = 0.009). Nevertheless, no significant associations were found between intensity or duration of smoking and clinical severity of RAS lesions. CONCLUSION The "protective effect" of smoking on RAS was dose- and time-dependent. When lesions are present, smoking had no effect on RAS severity.
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Affiliation(s)
- Faleh A Sawair
- Faculty of Dentistry, University of Jordan, Amman, Jordan.
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Compilato D, Carroccio A, Calvino F, Di Fede G, Campisi G. Haematological deficiencies in patients with recurrent aphthosis. J Eur Acad Dermatol Venereol 2009; 24:667-73. [DOI: 10.1111/j.1468-3083.2009.03482.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
There are many types of diseases associated with the oral cavity. As an adjunct to professional oral dental care, various drug delivery systems have been developed to improve the treatment or prevention of these diseases. In this manuscript, the current status of drug delivery strategies for these common orofacial diseases is reviewed. Biomineral-binding drug delivery and on-demand drug release are suggested to be considered in the future design of drug delivery systems for orofacial diseases. Apparently, this research field deserves much more attention from both pharmaceutical scientists and dental health professionals.
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Affiliation(s)
- Xin-Ming Liu
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE 68198-6025, USA
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41
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Pentenero M, Broccoletti R, Carbone M, Conrotto D, Gandolfo S. The prevalence of oral mucosal lesions in adults from the Turin area. Oral Dis 2008; 14:356-66. [DOI: 10.1111/j.1601-0825.2007.01391.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rodríguez M, Rubio JA, Sanchez R. Effectiveness of two oral pastes for the treatment of recurrent aphthous stomatitis. Oral Dis 2007; 13:490-4. [PMID: 17714352 DOI: 10.1111/j.1601-0825.2006.01327.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To compare the effectiveness of two topical medications to reduce the pain and size of recurrent minor aphthous ulcers. SETTING Ten Colombian Dental Faculties' clinics. DESIGN A double-blind randomized multi-centre clinical study. SUBJECTS Ninety-six patients complaining of at least five acute aphthous ulcers were randomized to two intervention groups. Sample size was calculated using an alpha error of 0.05 and beta of 0.20. MATERIALS AND METHODS Participants were randomly assigned to receive 5% amlexanox or a 0.05% clobetasol propionate magistral preparation. Observers at the participating institutions were previously trained to standardize clinical diagnosis and data recollection. Ulcer size and pain were measured on treatment days 0, 2 and 5. RESULTS No significant differences were found between the two groups studied in any of the studied variables at baseline. Both treatment medications significantly reduced pain magnitude and the index ulcer's size on days 2 and 5 compared with day 0 without adverse reactions (within groups differences). No statistical differences between groups of the study medications were found. CONCLUSION The two treatments applied had similar effectiveness as they both relieved pain and reduced the size of recurrent aphthous ulcers.
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Affiliation(s)
- M Rodríguez
- Facultad de Odontología, Universidad Nacional de Colombia, Bogotá, Colombia.
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Liu XM, Lee HT, Reinhardt RA, Marky LA, Wang D. Novel biomineral-binding cyclodextrins for controlled drug delivery in the oral cavity. J Control Release 2007; 122:54-62. [PMID: 17673326 DOI: 10.1016/j.jconrel.2007.06.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2007] [Revised: 06/15/2007] [Accepted: 06/20/2007] [Indexed: 12/30/2022]
Abstract
A biomineral-binding alendronate-beta-cyclodextrin conjugate (ALN-beta-CD, Fig. 1) was developed as a novel drug delivery system. "Click" chemistry was used in conjugation of alendronate (ALN) to beta-cyclodextrin (beta-CD). The delivery system shows very strong binding to hydroxyapatite (HA, main component of tooth enamel). Its ability in forming molecular inclusion complex with dexamethsone (Dex, model drug) was investigated independently with phase solubility experiments, isothermal titration calorimetry (ITC), Job plot and (1)H NMR. The stoichiometry of ALN-beta-CD/Dex molecular complex was determined as 1:1, and the binding constant of the complex obtained from ITC study is 3.8 x 10(3) M(-1), which is similar to the binding constant of beta-CD/Dex. In vitro data indicate that the ALN-beta-CD/Dex complex bound to HA could gradually release Dex upon repeated extraction with phosphate buffer saline (PBS). This novel drug delivery system may have great potential in improving treatment of diseases in the oral cavity.
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Affiliation(s)
- Xin-Ming Liu
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE 68198-6025, USA
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Chattopadhyay A, Chatterjee S. Risk indicators for recurrent aphthous ulcers among adults in the US. Community Dent Oral Epidemiol 2007; 35:152-9. [PMID: 17331156 DOI: 10.1111/j.1600-0528.2007.00329.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS Recurrent aphthous ulcers (RAU) in the oral cavity are painful, causing substantial morbidity in the US and elsewhere in the world. Despite this, there is a lack of population-based studies representative of the US national adult population to describe the epidemiology, and estimate the true disease burden and association with independent risk factors. Although several studies have investigated the role of various factors in RAU etiology, the epidemiology and etiology of RAU remain unclear. This study aims to establish the prevalence and describe the epidemiology of RAU in adults. METHODS Data from the Third National Health and Nutrition Examination Survey (NHANES III) were analyzed in SUDAAN using multivariable logistic regression, modeling RAU occurrences. RESULTS Overall, for all Americans regardless of age, prevalence of RAU was 1030 per 100,000 people (95% CI 830-1220). The prevalence of RAU among adults was 850 per 100,000 (95% CI 630-1070). The lower vestibule was the most commonly involved site. Multivariable analyses suggested that adjusted odds of RAU were greatest for those 17-29 years of age (adjusted OR 2.7; 95% CI 1.4-5.5), for men (adjusted OR 1.7; 95% CI 0.9-2.8), and for those with low serum insulin levels (OR 2.0; 95% CI 0.9-4.4). Never smokers had greater risk of RAU (OR 9.2, 95% CI 2.8-30.1) compared with those who smoked more than 10 cigarettes per day. CONCLUSION This study establishes the prevalence of RAU among adults in the US and demonstrates that whereas cigarette smoking is associated with lesser odds, low insulin levels might be independently associated with greater odds of RAU.
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Affiliation(s)
- Amit Chattopadhyay
- Department of Epidemiology, University of Kentucky College of Public Health, Lexington, KY, USA.
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Kalayciyan A, Orawa H, Fimmel S, Perschel FH, González JB, Fitzner RG, Orfanos CE, Zouboulis CC. Nicotine and biochanin A, but not cigarette smoke, induce anti-inflammatory effects on keratinocytes and endothelial cells in patients with Behçet's disease. J Invest Dermatol 2007; 127:81-9. [PMID: 17008886 DOI: 10.1038/sj.jid.5700492] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
During periods of smoking, patients with Behçet's disease have less oral aphthae than in abstinence. To elucidate this observation, human keratinocytes and dermal microvascular endothelial cells (HMEC-1) were incubated with serum of 20 patients with Behçet's disease and 20 healthy controls for 4 hours. Maximum non-toxic concentrations were determined and the cells were further treated with 6 microM nicotine, 3.3% cigarette smoke extract (CES), 100 microM biochanin A, and 6.25/12.5 microM pyrrolidine dithiocarbamate alone and in combinations for 24 hours. Serum IL-8 levels of patients were significantly lower than those of controls. However, after 4 hours incubation with patients' sera, IL-8 release by both cell types was markedly increased when compared with the corresponding serum levels. The levels of IL-6 and vascular endothelial growth factor (VEGF) release were after 4 hours similar with the corresponding levels in serum. IL-1 was not detected. Nicotine significantly decreased IL-8 and -6 release by HMEC-1 maintained in both patients' and controls' sera, but only IL-6 release by keratinocytes maintained in patients' sera. VEGF release by both cells was markedly increased after nicotine treatment in either serum. CES significantly decreased IL-8 release and increased production of VEGF in keratinocytes maintained in patients' serum. The phytoestrogen biochanin A alone and in combination with nicotine further decreased the secretion of IL-8, -6, and VEGF in all experimental settings. Our data support a specific anti-inflammatory effect of nicotine on keratinocytes and endothelial cells maintained in the serum of patients with Behçet's disease. Moreover, biochanin A is likely to exhibit similar and even more profound results than nicotine.
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Affiliation(s)
- Aylin Kalayciyan
- Department of Dermatology, Charité Universitaetsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
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Affiliation(s)
- Crispian Scully
- Eastman Dental Institute, University College London, London, United Kingdom.
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Abstract
OBJECTIVE To characterize the prevalence of geographic tongue (GT) among US adults. DESIGN Population-based case-control study. MAIN OUTCOME MEASURES The presence or absence of GT. SUBJECTS AND METHODS Data from 16 833 adults examined during The Third National Health and Nutrition Examination Survey, 1988-1994 (NHANES III), a study based on multistage probability sampling were analyzed using SAS-callable SUDAAN 9.0.1. RESULTS Geographic tongue point prevalence was 1.8% (95% CI: 1.4, 2.3). Multivariate logistic regression showed significant effects of race-ethnicity, with Whites (AOR = 1.8; 1.3, 2.5) and Blacks (AOR = 1.6; 1.2, 2.1) having greater odds of GT than Mexican-Americans; current corticosteroid therapy (AOR = 3.7; 1.54, 8.6). Cigarette smokers had lower GT prevalence (AOR = 0.4; 0.3, 0.6). Fissured tongue (FT) was strongly associated with GT among non-smokers: AOR = 17.5 (7.8, 39.5). We did not find significant associations with age, gender, oral contraceptive use, diabetes mellitus, allergy or atopy, psychological or dermatological conditions as previous research has suggested. CONCLUSIONS Geographic tongue was more prevalent among Whites and Blacks compared with Mexican-Americans, positively associated with FT, and inversely associated with cigarette smoking.
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Affiliation(s)
- J D Shulman
- Department of Public Health Sciences, Baylor College of Dentistry, The Texas A&M University System Health Science Center, Dallas, TX 75246, USA.
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Cherubini K, Lorandi CSA, Krapf SMR, de Sousa FR, Yurgel LS, Figueiredo MA, Salum FG. Association between recurrent aphthous stomatitis and salivary thiocyanate levels. J Oral Sci 2006; 48:153-6. [PMID: 17023748 DOI: 10.2334/josnusd.48.153] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The aim of this work was to investigate the association between recurrent aphthous stomatitis (RAS) and salivary thiocyanate levels. The sample comprised men and women of age ranging from 15 to 55 years, who were allocated to four groups: 28 patients in RAS active phase (group 1); 28 patients in RAS remission phase (group 2); 29 smokers (group 3); 26 non-smokers without RAS (group 4). Samples of whole saliva mechanically stimulated were collected, and thiocyanate levels were measured. The results were analyzed by ANOVA and paired t-test. Mean salivary thiocyanate values were 0.55 mM, 0.64 mM, 2.36 mM and 0.96 mM in groups 1 (active RAS), 2 (remission RAS), 3 (smokers) and 4 (control), respectively. There was no significant difference in thiocyanate levels when groups 1 and 2 were compared with group 4. Group 3 showed a significantly higher thiocyanate concentration when compared with groups 1, 2 and 4 (P < 0.05). There was no significant difference in thiocyanate levels between groups 1 and 2 (P > 0.05). It is therefore suggested that there is no association between RAS and salivary thiocyanate levels.
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Affiliation(s)
- Karen Cherubini
- Division of Stomatology and Prevention of Bucomaxillofacial Cancer, Hospital São Lucas-PUCRS, Rio Grande do Sul, Brazil.
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Abstract
Recurrent aphthous ulcer (RAU) is the most prevalent oral mucosal disease in humans, estimated to affect between 5% and 50% of the general population. The minor manifestation of the condition is the most common and is characterised by small, shallow, round or oval lesions that are surrounded by a raised erythematous halo and are covered by a grey-white pseudomembrane. Appropriate management of patients with this condition is largely symptomatic and should focus on reducing ulcer duration, relieving pain and reducing or preventing ulcer recurrence. Amlexanox is a novel anti-inflammatory and anti-allergic agent that has been evaluated for the treatment of RAU in a series of robust clinical trials. After a 100mg dose of 5% amlexanox topical paste, applied directly to the lesion, the maximum serum concentration of the drug was 120 ng/mL, which was achieved 2.4 hours after application. Steady-state concentrations were achieved within 1 week of starting four times daily dosing and there was no evidence of accumulation. In terms of efficacy, application of 5% amlexanox topical paste was shown to consistently and significantly accelerate complete ulcer healing and the time to resolution of pain across four large efficacy studies. Significantly more patients had completely healed ulcers from day 3 (compared with no treatment) and day 4 (compared with vehicle). Healing was mirrored by an improvement in pain: significantly more patients had complete resolution of pain from day 2 (compared with no treatment) and day 3 (compared with vehicle). Overall, amlexanox was well tolerated, with a low frequency of adverse effects. In the oral application studies, adverse effects that were considered by investigators to be potentially related to the study treatment occurred in 2.4% and 2.1% of 5% amlexanox and vehicle recipients, respectively. These effects were mainly local and were all classed as mild to moderate in severity, with the exception of one case of severe stinging in the vehicle treatment group. Furthermore, the incidence of dermal irritation and sensitisation was very low with amlexanox. These findings suggest that 5% amlexanox topical paste is a useful and well tolerated therapeutic option for the treatment of RAU.
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