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Fulltext Classification, Epidemiology And Aetiology Of Oral Recurrent Aphtous Ulceration / Stomatitis

Zain, R.B.

Ann Dent, 1999;6(1):-.
MyJurnal

The most prevalent oral mucosal lesions are aphthous ulcerations commonly referred to as canker sores. The clinical characteristic of oral recurrent aphthous ulceration/stomatitis(ORAS) is well defined and can be partly described as an oval or rounded ulcer covered by a grey-white or yellowish fibrinous exudate and surrounded by an erythematous halo. There is intense or moderate pain and the ulcers heal in about 10 - 14 days for the more common type and more than 2 weeks for the severe type. Recurrence of the ulcers occurs at intervals within a year or over several years. Variations of ORAS described above have made studies on aetiology and treatment difficult to interpret due to differing descriptions of differing diseases with similar clinical signs and symptoms and possibly differing aetiologies. A classification that was considered useful as a working model for ORAS was formulated in 1978. While the classification of ORAS had been widely accepted since 1978, the cause for ORAS is still unknown and its aetiology in general remains unclear. However, its immunopathogenesis is now becoming more clearly defined.

Matched MeSH terms: Stomatitis, Aphthous
Oral recurrent aphthous ulcers/stomatitis: prevalence in Malaysia and an epidemiological update

Zain RB

J Oral Sci, 2000 Mar;42(1):15-9.
PMID: 10808270

One of the objectives of this short communication was to add to the literature on the prevalence of oral recurrent aphthous stomatitis (ORAS). This research is based on a total of 11,697 randomly selected Malaysian subjects with an age range of 25-115 years and a mean age of 44.5 +/- 13.9 years who were examined for oral mucosal lesions (ORAS). The prevalence of ORAS detected during the oral examination (average point prevalence) was found to be 0.5% (64 subjects). ORAS formed 5.7% of all lesions detected during the survey. The average point prevalence of ORAS was highest in the indigenous people of Sabah and Sarawak (1.2%), followed by the Chinese (0.7%), the Malays (0.5%) and the Indians (0.1%). This difference was statistically significant (p < 0.001). A review of the English literature on the prevalence of ORAS revealed different prevalence types used by different researchers, namely average point prevalence (APP), self reported life-time prevalence (SLP) and self reported two-year prevalence (STP). The other objective of this paper was to present the different types of prevalence that have been reported in the literature and to discuss the usefulness of such prevalence types in relation to using epidemiology in deriving certain possible etiological associations.

Matched MeSH terms: Stomatitis, Aphthous/ethnology; Stomatitis, Aphthous/epidemiology*
Fulltext Recurrent aphthous stomatitis

Ramanathan K, Ng KH, Chelvanayagam PI

Med J Malaysia, 1980 Mar;34(3):317-22.
PMID: 7412673

Despite the high prevalence of oral ulcers little is known about what causes them and how best they can be treated. Recurrent aphthous stomatitis (RAS) is a' chronic inflammatory disease characterized by painful recurring ulcerations of the oral mucosa. RAS can be clinically subdivided into four varieties viz - minor aphthous ulcer, major aphthous ulcer, herpetiform ulcers and Behcet's syndrome. A report on 134 patients with RAS is reported. Minor aphthous ulcer (63%) followed by major aphthous ulcer (29%) were the most frequent. A review of current research on RAS is summarized.
Study site: Department of Stomatology, Institute for Medical Research, Kuala Lumpur, Malaysia

Matched MeSH terms: Stomatitis, Aphthous/etiology; Stomatitis, Aphthous/pathology*
Fulltext Occurrence of Recurrent Aphthous Stomatitis (RAS) as a Rare Oral Manifestation in a Patient with Gilbert's Syndrome

Heboyan A, Avetisyan A, Skallevold HE, Rokaya D, Marla V, Vardanyan A

Case Rep Dent, 2021;2021:6648729.
PMID: 33953989 DOI: 10.1155/2021/6648729

Recurrent aphthous stomatitis is an ulcerative disease of the oral cavity and can occur in isolation or as a manifestation of many systemic diseases. It is a quite common entity and may hence often be overlooked as an isolated lesion. Gilbert's syndrome is a genetic disorder where a deficiency of an enzyme associated with the conjugation of bilirubin results in unconjugated hyperbilirubinemia. The disease is generally asymptomatic and is aggravated by certain trigger factors. No associated oral manifestations are known. In this case report, we discuss the concomitant presence of recurrent aphthous stomatitis in a patient of Gilbert's syndrome. The presence of such recurrent stomatitis may represent as an oral manifestation of Gilbert's syndrome. Early identification of these entities may improve the overall quality of life of the patient.

Matched MeSH terms: Stomatitis, Aphthous
Fulltext Management Of Oral Recurrent Aphthous Stomatitis (ORAS)

Khoo, S.P.

Ann Dent, 1999;6(1):-.
MyJurnal

Oral recurrent aphthous stomatitis is the most common oral mucosal disease. Despite much clinical and research attention, the causes remain incompletely understood. Treatment options include no treatment, treatment of associated systemic diseases, topical medications, systemic treatment and palliative treatments. The most effective treatments involve agents that suppress or modulate the immune function. Topical agents are preferred due to its limited side-effects. Adjunct pain control and prevention of secondary infections is sometimes necessary.

Matched MeSH terms: Stomatitis, Aphthous
Fulltext Lactic Acid Bacteria Is Beneficial For Oral Aphtous Ulcerations - A Preliminary Report

Hashim, B.Y., Rahman, R.A., Philip, K.

Ann Dent, 1999;6(1):-.
MyJurnal

Recurrent aphthous ulcers of the mouth are difficult to treat because of no known definite aetiology. This paper presents the use of lactic acid bacteria thought to modulate the host immune response to affect improvements in the disease. Twenty-five patients with the disease were treated with 6 lactic bacteria capsules (in the form of OMX capsules) daily for a period of six months, and their responses were evaluated. Seventeen patients (73.9%) became free of the disease six months later, while 6 (26.1 %) experienced very dramatic improvements. Two patients were lost to follow-up. It is concluded that lactic acid bacteria is beneficial in the treatment of recurrent aphthous ulcers of the mouth.

Matched MeSH terms: Stomatitis, Aphthous
Fulltext Anti-TNF Treatment for Extraintestinal Manifestations of Inflammatory Bowel Disease in the Swiss IBD Cohort Study

Vavricka SR, Gubler M, Gantenbein C, Spoerri M, Froehlich F, Seibold F, et al.

Inflamm Bowel Dis, 2017 07;23(7):1174-1181.
PMID: 28452862 DOI: 10.1097/MIB.0000000000001109

BACKGROUND: Extraintestinal manifestations (EIMs) in patients with inflammatory bowel disease (IBD) are frequently observed. Little is known about the efficacy of anti-tumor necrosis factor (TNF) in EIM management. We assessed the effect of 3 anti-TNF agents (infliximab, adalimumab, and certolizumab pegol) on EIM evolution.
METHODS: Data on 1249 patients from the Swiss IBD Cohort Study (SIBDCS) were analyzed. All EIMs were diagnosed by relevant specialists. Response was classified into improvement, stable disease, and clinical worsening based on the physician's interpretation.
RESULTS: Of the 366 patients with at least 1 EIM, 213 (58.2%) were ever treated with an anti-TNF. A total of 299 treatments were started for 355 EIMs. Patients with EIM were significantly more often treated with anti-TNF compared with those without EIM (58.2% versus 21.0%, P < 0.001). Infliximab was the most frequently used drug (63.2%). In more than 71.8%, a clinical response of the underlying EIM to anti-TNF therapy was observed. In 92 patients (43.2%), anti-TNF treatments were started for the purpose of treating EIM rather than IBD. Response rates to anti-TNF were generally good and best for psoriasis, aphthous stomatitis, uveitis, and peripheral arthritis. In 11 patients, 14 EIM occurred under anti-TNF treatment.
CONCLUSIONS: Anti-TNF was frequently used among patients with EIM. In more than 40%, anti-TNF treatments are started to treat EIM rather than IBD. Given the good response rates, anti-TNF seems to be a valuable option in the treatment of EIM, whereas appearance of EIM under anti-TNF does not seem to be a source of considerable concern.

Matched MeSH terms: Stomatitis, Aphthous/drug therapy*; Stomatitis, Aphthous/immunology; Stomatitis, Aphthous/pathology
Cardiovascular drugs-induced oral toxicities: A murky area to be revisited and illuminated

Balakumar P, Kavitha M, Nanditha S

Pharmacol Res, 2015 Dec;102:81-9.
PMID: 26409645 DOI: 10.1016/j.phrs.2015.09.007

Oral health is an imperative part of overall human health. Oral disorders are often unreported, but are highly troublesome to human health in a long-standing situation. A strong association exists between cardiovascular drugs and oral adverse effects. Indeed, several cardiovascular drugs employed clinically have been reported to cause oral adverse effects such as xerostomia, oral lichen planus, angioedema, aphthae, dysgeusia, gingival enlargement, scalded mouth syndrome, cheilitis, glossitis and so forth. Oral complications might in turn worsen the cardiovascular disease condition as some reports suggest an adverse correlation between periodontal oral disease pathogenesis and cardiovascular disease. These are certainly important to be understood for a better use of cardiovascular medicines and control of associated oral adverse effects. This review sheds lights on the oral adverse effects pertaining to the clinical use of cardiovascular drugs. Above and beyond, an adverse correlation between oral disease and cardiovascular disease has been discussed.

Matched MeSH terms: Stomatitis, Aphthous
Fulltext Therapeutic benefits of liquorice in dentistry

Sidhu P, Shankargouda S, Rath A, Hesarghatta Ramamurthy P, Fernandes B, Kumar Singh A

J Ayurveda Integr Med, 2018 11 01;11(1):82-88.
PMID: 30391123 DOI: 10.1016/j.jaim.2017.12.004

Oral health influences general well-being and quality of life. Oral diseases can be debilitating and are a major heath concern worldwide. Medicinal plants have been used for thousands of years for treating human diseases. Considering the emergence of multi-drug resistant pathogens and financial difficulties in developing countries, there is an urgent need for developing new antimicrobial compounds which are safe, efficient and cost effective. Liquorice also known as yashtimadhu, sweetwood or mulhatti is one such herbal remedy which has shown to have immense potential in treatment of orofacial diseases. Liquorice is rich in secondary metabolites which are used in cosmetics, foods, traditional and modern medicine. It has well known properties such as antiviral, glucocorticoid, anti-inflammatory, antioxidant, anti-ulcerative, anti-carcinogenic and many more. Liquorice extracts and liquorice bioactive ingredients such as glabridin, licoricidin, licorisoflavan A, licochalcone A, and glycyrrhizin have shown beneficial effects in preventing and treating oral diseases. This paper reviews the effects of liquorice and its constituents on oral diseases such as dental caries, periodontitis, gingivitis, candidiasis, recurrent aphthous ulcer and oral cancer and its use as a root canal medicament and summarizes the results of clinical trials that investigated the potential beneficial effects of liquorice and its constituents as a prevention and treatment modality in oral diseases. Clinical trials, case reports and review of literature evaluating the effect of liquorice on oral microorganisms and oral diseases are included. Literature pertaining to the effects of liquorice on systemic diseases have been excluded from this review of literature.

Matched MeSH terms: Stomatitis, Aphthous
Fulltext Evaluation of the salivary flow rate and ph in patients with recurrent oral ulcers

Mustafa Al-Ahmad, Basma Ezzat, Sukmasari S., Abdul Jabbar O.

International Medical Journal Malaysia, 2018;17(2):49-56.
MyJurnal

Introductions: Recurrent oral ulcers primarily effect mucosal surfaces and are among the most common chronic inflammatory diseases. Numerous studies to find the aetiopathogenesis have been conducted however the cause still remains unclear. Saliva is of utmostimportance for oral health maintenance. In current study, saliva was used as a diagnostic tool for comparison of salivary flow rate and pH in patients suffering from recurrent oral ulcers and control group. Materials and Methods: Saliva samples taken from 20 recurrent aphthous ulcer patients and 20 control (healthy) patients using a convient sampling method. Drooling method was used to collect unstimulated whole saliva sample. Pre-weighted specimen bottles were used and then weighed after sample collection on a graduated scale where as chair-side pH meter was used to determine the salivary pH. Independent t-test and Pearson’s correlation were performed. A p-value of less than 0.05 was considered statistically significance. Results: Positive correlation was found between the flow rate and pH in recurrent oral ulcer patients. Patients with recurrent oral ulcers had higher flow rate and pH compared to the control group. These effects were exaggerated in female patients with ulcers. Conclusions: Disturbances in salivary flow rate and pH were not significantly associated with recurrent oral ulcers.

Matched MeSH terms: Stomatitis, Aphthous
Acemannan, a polysaccharide extracted from Aloe vera, is effective in the treatment of oral aphthous ulceration

Bhalang K, Thunyakitpisal P, Rungsirisatean N

J Altern Complement Med, 2013 May;19(5):429-34.
PMID: 23240939 DOI: 10.1089/acm.2012.0164

The objective of this study was to elucidate the safety and effectiveness of acemannan, a polysaccharide extracted from Aloe vera, in the treatment of oral aphthous ulceration.

Matched MeSH terms: Stomatitis, Aphthous/drug therapy*
Extranodal NK/T-cell lymphoma mimicking Crohn's colitis

Wan Ahmad Kammal WS, Mohd Rose I, Md Zin RR, Raja Ali RA, Masir N

Malays J Pathol, 2019 Aug;41(2):195-199.
PMID: 31427556

INTRODUCTION: Extranodal NK/T cell lymphoma is a rare tumour, typically involving the upper aerodigestive tract. Even rarer is primary extranasal disease involving the skin, testis, soft tissue and gastrointestinal tract.
CASE REPORT: We report a case of a 46-year-old Chinese male who presented with six months history of abdominal pain, weight loss and rectal bleeding. Diagnostic colonoscopy revealed multiple aphthous ulcers within the ileo-caecal region and distal transverse colon, separated by normal mucosa, mimicking skip lesions of Crohn's colitis. Computer topography (CT) scan of the abdomen showed multiple circumferential thickenings involving predominantly the right colon. A clinical diagnosis of colonic Crohn's disease with possible perforation was made. An extended right hemicolectomy was performed due to uncontrolled rectal bleeding. Histopathology examination of the colon showed infiltration by malignant lymphoid cells associated with necrosis, angiocentricity and angiodestruction. Immunohistochemical studies confirmed T-cell monoclonality, presence of cytotoxic granules and Epstein-Barr virus (EBV) infection. A diagnosis of extranodal NK/T cell lymphoma of the colon was made.
DISCUSSION: These findings highlight that colonic NK/T cell lymphoma may clinically mimic other benign inflammatory lesions and should be one of the differential diagnoses in patients presenting with gastrointestinal lesions. The final diagnosis is only possible with appropriate histological and immunohistochemical studies.

Matched MeSH terms: Stomatitis, Aphthous