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Lasers in Medical Science May 2017The aim of this systematic review was to assess a potential benefit of laser use in the treatment of recurrent aphthous stomatitis (RAS). The primary outcome variables... (Meta-Analysis)
Meta-Analysis Review
The aim of this systematic review was to assess a potential benefit of laser use in the treatment of recurrent aphthous stomatitis (RAS). The primary outcome variables were pain relief, duration of wound healing and reduction in episode frequency. A PICO approach was used as a search strategy in Medline, Embase and Cochrane databases. After scanning and excluding titles, abstracts and full texts, 11 studies (ten RCTs and one non-randomised controlled trial) were included. Study selection and data extraction was done by two observers. Study participants varied between 7-90 for the laser and 5-90 for the control groups. Laser treatment included Nd:YAG laser ablation, CO laser applied through a transparent gel (non-ablative) and diode laser in a low-level laser treatment (LLLT) mode. Control groups had placebo, no therapy or topical corticosteroid treatment. Significant pain relief immediately after treatment was found in five out of six studies. Pain relief in the days following treatment was recorded in seven studies. The duration of RAS wound healing was also reduced in five studies. However, criteria of evaluation differed between the studies. The episode frequency was not evaluated as only one study addressed this outcome parameter, but did not discriminate between the study (LLLT) and control (corticosteroid) groups. Jadad scores (ranging from 0 to 5) for quality assessment of the included studies range between 0 and 2 (mean = 1.0) for studies analysing pain relief and between 0 and 3 (mean = 1.1) for studies evaluating wound healing. The use of lasers (CO laser, Nd:YAG laser and diode laser) to relieve symptoms and promote healing of RAS is a therapeutic option. More studies for laser applications are necessary to demonstrate superiority over topical pharmaceutical treatment and to recommend a specific laser type, wavelength, power output and applied energy (ablative versus photobiomodulation).
Topics: Humans; Laser Therapy; Lasers, Gas; Lasers, Semiconductor; Lasers, Solid-State; Pain; Recurrence; Stomatitis, Aphthous; Wound Healing
PubMed: 28345122
DOI: 10.1007/s10103-017-2184-z -
Stomatologija 2023To analyze the latest systemic and topical recurrent aphthous stomatitis (RAS) treatment methods that could help patients in their daily lives.
AIM
To analyze the latest systemic and topical recurrent aphthous stomatitis (RAS) treatment methods that could help patients in their daily lives.
MATERIAL AND METHODS
A systematic literature review was performed of randomized control trials in English identified in MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (Cochrane Library), Researchgate, published between 2018 and 2023. Studies had to be performed in vivo.
RESULTS
34 randomized clinical trials matched all criterias and were included in systematic literature review. A wide variety of topical and systemic agents are suggested for the treatment of RAS.
CONCLUSION
Topical medications can promote the healing time of ulcers and relieve the pain, but most of the time can not decrease the frequency of RAS relapse. However, for continuous RAS, treatment with systemic medication should be considered.
Topics: Humans; Stomatitis, Aphthous; Pain; Recurrence
PubMed: 37436177
DOI: No ID Found -
Medicina Oral, Patologia Oral Y Cirugia... Jan 2023Recurrent Aphtous Stomatitis (RAS) is the most common process affecting the oral mucosa. It is painful, multifactorial and generally recurrent. The aim of this...
BACKGROUND
Recurrent Aphtous Stomatitis (RAS) is the most common process affecting the oral mucosa. It is painful, multifactorial and generally recurrent. The aim of this systematic review is to know the last treatment approaches and their effectivity.
MATERIAL AND METHODS
we compared the outcome of different kind of treatments in terms of the improvement of the lesions, reduction of the size of those lesions and the time needed for their healing. Inclusion criteria were: clinical trials, articles written in English or Spanish and published less than 5 years ago.
RESULTS
we used the following keywords: "treatment", "aphtous stomatitis", "canker sores"; combined with Boolean operators AND y OR. We selected 28 articles for reading the whole text, and after applying the eligibility criteria, we selected 17 articles for our revision. Among all the treatments, we emphasize the barrier method based in compound of cellulose rubber and a calcium/sodium copolymer PVM/MA, with which the difference in the 3rd and 7th day was of -6,29 ± 0,14 points in the pain score. The treatment with insulin and chitosan gel, brought a pain suppression on the third day, with no reactivation of the pain during the whole study. The application of a film composed of polyurethane and sesame oil with chitosan, brought a reduction in the size of the lesions of 4,54 ± 2,84mm on the 6th day compared with the situation before the beginning of the treatment. The different kinds of laser, which produced a reduction in the pain score just at the beginning of the treatment up to 8,1 ± 1,6 points, and a reduction of the size of the lesions of 4,42 ± 1,02mm on the 7th day.
CONCLUSIONS
Besides the classic treatments for RAS, we have to take into account other treatment modalities, above all the different kinds of laser.
Topics: Humans; Chitosan; Stomatitis, Aphthous; Stomatitis; Mouth Mucosa; Pain
PubMed: 36173717
DOI: 10.4317/medoral.25604 -
Clinical Oral Investigations Nov 2023This meta-analysis was designed to provide new insights into the relationship between Helicobacter pylori (H. pylori) infection and recurrent aphthous stomatitis (RAS). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This meta-analysis was designed to provide new insights into the relationship between Helicobacter pylori (H. pylori) infection and recurrent aphthous stomatitis (RAS).
MATERIALS AND METHODS
We included and evaluated studies on H. pylori infection and RAS from PubMed, EMBASE, Cochrane Library, and Web of Science databases published up to January 31, 2023. The characteristics of these studies were collected, and the quality was evaluated by Newcastle-Ottawa Scale (NOS). The random effects model was used to calculate the pooled odds ratio (OR) and 95% confidence interval (CI). To further explore the sources of heterogeneity, meta-regression analysis and subgroup analyses were performed. Funnel plot, Egger's test, and Begg's test were used to assess publication bias.
RESULTS
In total, fifteen case-control studies with 1137 individuals (601 cases and 536 controls) were included. The H. pylori was found to be significantly associated with RAS (OR: 1.83 95% CI: 1.41-2.37, P = 0.001). In the subgroup analyses, studies that used PCR (OR: 2.03 95% CI: 1.31-3.15) or UBT (OR: 1.83 95% CI: 1.13-2.96) yielded a significant positive association, while a non-significant association (OR: 1.12 95% CI: 0.61-2.08) was found from studies that used ELISA method. Sensitivity analyses showed that the results were robust. No significant publication bias was found.
CONCLUSIONS
The current evidence does not rule out an association between H. pylori and RAS. The effect of H. pylori on RAS varies in detection methods and sources of sample. Large samples, multiple clinical studies, and improved methods are still needed to determine the exact effect of H. pylori on RAS.
CLINICAL SIGNIFICANCE
H. pylori infection may be a risk factor for the pathogenesis of RAS.
Topics: Humans; Stomatitis, Aphthous; Helicobacter pylori; Helicobacter Infections; Risk Factors
PubMed: 37798535
DOI: 10.1007/s00784-023-05273-y -
Medicina Oral, Patologia Oral Y Cirugia... Mar 2016Recurrent aphthous stomatitis (RAS) is a recurrent painful ulcerative disorder that commonly affects the oral mucosa. Local and systemic factors such as trauma, food... (Review)
Review
BACKGROUND
Recurrent aphthous stomatitis (RAS) is a recurrent painful ulcerative disorder that commonly affects the oral mucosa. Local and systemic factors such as trauma, food sensitivity, nutritional deficiencies, systemic conditions, immunological disorders and genetic polymorphisms are associated with the development of the disease. Helicobacter pylori (H. pylori) is a gram-negative, microaerophile bacteria, that colonizes the gastric mucosa and it was previously suggested to be involved in RAS development. In the present paper we reviewed all previous studies that investigated the association between RAS and H. pylori.
MATERIAL AND METHODS
A search in Pubmed (MEDLINE) databases was made of articles published up until July 2015 using the following keywords: Helicobacter Pylori or H. pylori and RAS or Recurrent aphthous stomatitis.
RESULTS
Fifteen experimental studies that addressed the relationship between infection with H. pylori and the presence of RAS and three reviews, including a systematic review and a meta-analysis were included in this review. The studies reviewed used different methods to assess this relationship, including PCR, nested PCR, culture, ELISA and urea breath test. A large variation in the number of patients included in each study, as well as inclusion criteria and laboratorial methods was observed. H. pylori can be detected in the oral mucosa or ulcerated lesion of some patients with RAS. The quality of the all studies included in this review was assessed using levels of evidence based on the University of Oxford's Center for Evidence Based Medicine Criteria.
CONCLUSIONS
Although the eradication of the infection may affect the clinical course of the oral lesions by undetermined mechanisms, RAS ulcers are not associated with the presence of the bacteria in the oral cavity and there is no evidence that H. pylori infection drives RAS development.
Topics: Helicobacter Infections; Helicobacter pylori; Humans; Recurrence; Stomatitis, Aphthous
PubMed: 26827061
DOI: 10.4317/medoral.20872 -
Cytokine Sep 2022The pathogenesis of recurrent aphthous stomatitis (RAS) is related to an increase of pro-inflammatory cytokine, namely tumor necrosis factor α (TNF-α). This cytokine... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The pathogenesis of recurrent aphthous stomatitis (RAS) is related to an increase of pro-inflammatory cytokine, namely tumor necrosis factor α (TNF-α). This cytokine plays an important role in the development of ulcer lesions, both in saliva, tissues and blood. This systematic review analyzed the differences of TNF-α in lesions, salivary and blood and can be used as a reliable method of diagnosis for RAS.
METHODS
A comprehensive search of PubMed, Scopus databases, Web of Science, Scielo, Google Scholar and Embase with keywords. The inclusion criteria were studies that assessed the saliva, serum, and RAS lesion, with the outcome reporting the mean of saliva, serum and tissue expression of TNF-α. The risk of bias was also assessed.
RESULT
Healthy individuals showed significantly lower TNF-α than RAS (SMD = -1.517, 95% CI [-2.25, -0.78]). Although there is a significant difference between sample (i.e., saliva, serum) and detection type (i.e., cytometry bead array, ELISA), both methods can detect a significant difference in TNF-α between healthy individuals and RAS patients.
CONCLUSIONS
The TNF-α is a useful diagnostic marker for RAS. We encourage saliva to detect changes in TNF-α during ulceration as it provides accuracy, reliability, and non-invasive procedure compared to a blood draw.
Topics: Humans; Recurrence; Reproducibility of Results; Stomatitis, Aphthous; Tumor Necrosis Factor-alpha; Ulcer
PubMed: 35728503
DOI: 10.1016/j.cyto.2022.155946 -
Cytokine May 2022Recurrent aphthous stomatitis (RAS) is one of the most common oral ulcerative diseases with unknown etiology. Identifying the genetic markers can improve medical care... (Meta-Analysis)
Meta-Analysis
Recurrent aphthous stomatitis (RAS) is one of the most common oral ulcerative diseases with unknown etiology. Identifying the genetic markers can improve medical care and prevention of RAS. Genetics variants inflammatory agents are associated with the risk of RAS. Thus, this meta-analysis aimed to investigate the genetic polymorphisms in RAS. Electronic literature search was carried out on Scopus, PubMed, and Web of Science (WOS). The references of relevant reviews were also manually checked. The observational studies till the end of 2020 were included. Odds ratio (OR) was estimated by fixed and random effect model. Seventeen polymorphisms in 23 studies were included in analysis. Pooled analysis performed for 12 polymorphisms (IL-2+166, IL-2-330, IL-4-590, IL-4 RA1902, IL-6-597, TNF-α-308, NLRP3(rs4612666, rs10754558), MMP2- rs2285053, MMP9- rs11697325, MMP9- rs3918242, MMP9- rs17576, IL-1a-889, IL-10-819, and IL-12+1188). The meta-analyses carried out for six polymorphisms (IL-1β-511, IL-1β+3954, IL-6-174, IL-10-592, IL-10-1082, and serotonin transporter). There were following significant results for IL-10, 819 in allelic:1.46(1.04-2.05) and homozygote: 1.61(1.08-2.39) models, serotonin Transporter in allelic:0.53(0.40-0.71), recessive:0.56(0.35-0.90), dominant:0.35(0.22-0.57) and homozygote:0.30(0.17-0.54) models. IL-1β-511 in dominant 0.69(0.50-0.95) and overdominant 0.73(0.55-0.96) models, IL-1β+3954 in allelic 1.25(1.05-1.50), homozygote 1.67(1.05-2.63) and dominant 1.26(1.01-1.57) models, IL-6-174 in dominant 2.24(1.36-3.67), IL-10-592 in homozygote 0.41(0.23-0.72) and dominant 0.55(0.33-0.93), IL-10-1082 in allelic 1.19(1.01-1.39) and dominant 1.29(1.02-1.64). In conclusion, serotonin transporter(L/S), IL-10-819(T/C), IL-10-592(C/A), IL-10-1082(G/A), IL-1β-511(C/T), IL-6-174(G/C), and IL-1β+3954 (T/C) polymorphisms are associated with susceptibility to RAS. These variants could be potential predictors of RAS and could be used for the developing clinically effective genetic panel for RAS.
Topics: Genetic Predisposition to Disease; Humans; Interleukin-10; Interleukin-2; Interleukin-4; Interleukin-6; Matrix Metalloproteinase 9; Polymorphism, Single Nucleotide; Serotonin Plasma Membrane Transport Proteins; Stomatitis, Aphthous
PubMed: 35313259
DOI: 10.1016/j.cyto.2022.155864 -
BMC Oral Health Dec 2023We performed this systematic review and meta-analysis to synthesize all studies that reported the level of oxidative and antioxidative markers in recurrent aphthous... (Meta-Analysis)
Meta-Analysis
BACKGROUND
We performed this systematic review and meta-analysis to synthesize all studies that reported the level of oxidative and antioxidative markers in recurrent aphthous stomatitis (RAS) patients compared to controls.
METHODS
We registered our study in PROSPERO (CRD42023431310). PubMed, ProQuest, Scopus, EMBASE, Google Scholar, and Web of Science were searched to find relevant publications up to June 5, 2023. The standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. We included 30 articles after multiple stags of screening.
RESULTS
We found that erythrocyte superoxide dismutase and Glutathione peroxidase activity were significantly lower in patients with RAS compared to healthy controls (SMD = - 1.00, 95%CI = -1.79 to -0.21, p = 0.013, and SMD = - 1.90, 95%CI = -3.43 to -0.38, p = 0.01, Respectively). However, there was not any difference between patients with RAS and healthy controls in erythrocyte Catalase (SMD = - 0.71, 95%CI = -1.56-0.14, p = 0.10). The total antioxidant status (TAS) level, in serum was significantly lower in patients than healthy controls (SMD = - 0.98, 95%CI = -1.57 to -0.39, p = 0.001). In addition, RAS patients had higher levels of serum Malondialdehyde (MDA), Serum total oxidant status, and serum oxidative stress index than healthy controls (SMD = 2.11, 95%CI = 1.43-2.79, p < 0.001, SMD = 1.53, 95%CI = 0.34-2.72, p = 0.01, and SMD = 1.25, 95%CI = 0.25-2.25, p = 0.014, Respectively); However, salivary MDA and TAS, and serum uric acid, vitamin E and C, and reduced glutathione levels of patients with RAS were not different from that of healthy controls.
CONCLUSIONS
The relationship between oxidative stress and RAS is well established in this meta-analysis. Although the molecular processes underlying the etiology of this pathology remain unknown, evidence indicating oxidative stress has a significant role in the pathogenesis of RAS has been revealed.
Topics: Humans; Antioxidants; Uric Acid; Stomatitis, Aphthous; Oxidative Stress
PubMed: 38042793
DOI: 10.1186/s12903-023-03636-1 -
Journal of Dentistry Oct 2017The aim of this systematic review was to compare the presence of enamel defects and aphthous stomatitis between celiac patients and healthy controls. (Review)
Review
OBJECTIVES
The aim of this systematic review was to compare the presence of enamel defects and aphthous stomatitis between celiac patients and healthy controls.
DATA SOURCES
A systematic review of articles selected from MEDLINE, EMBASE and Google Scholar was performed by two independent operators. Additional studies hand-searched and found in the principal dental and gastroenterology journals were included.
STUDY SELECTION
Only controlled studies on celiac patients compared to healthy subjects were included.
DATA EXTRACTION
Independent extraction of articles by 2 authors using predefined data fields, including study quality indicators.
DATA SYNTHESIS
In total, the celiac patients had greater frequency of enamel defects (odds ratio=5.69, 95%CI from 3.47 to 9.33, P<0.00001, I=90%, 30 studies). Considering only the children, the odds ratio was 5.63 (95%CI from 3.95 to 8.01, P<0.00001, I=65%, 24 studies), while in the adults the odds ratio was not significant (odds ratio=2.16, 95%CI from 0.95 to 4.88, P=0.06, I=40%, 3 studies). In total, the celiac patients had greater frequency of aphthous stomatitis (odds ratio=3.79, 95%CI from 2.67 to 5.39, P<0.00001, I=49%, 21 studies). Considering only the children, the odds ratio was 4.31 (95%CI from 3.03 to 6.13, P<0.00001, I=29%, 13 studies), while in the adults the odds ratio was 47.90 (95%CI from 6.29 to 364.57, P=0.0002, 1 study).
CONCLUSIONS
In children, celiac disease was associated with both enamel defects and aphthous stomatitis. The odds ratio estimates, however, should be interpreted with caution due to the high risk of bias showed by all the studies. In adults, the association between celiac disease and enamel defects or aphthous stomatitis was unclear because very few studies were performed on this population.
CLINICAL SIGNIFICANCE
The presence of enamel defects and/or aphthous stomatitis in a child affected by other typical or atypical symptoms of celiac disease represents an indication for further diagnostic exams for celiac disease.
Topics: Adolescent; Adult; Celiac Disease; Child; Databases, Factual; Dental Enamel; Dental Enamel Hypoplasia; Female; Healthy Volunteers; Humans; Male; Odds Ratio; Research Design; Stomatitis, Aphthous
PubMed: 28688949
DOI: 10.1016/j.jdent.2017.07.001 -
BMC Oral Health Mar 2024Recurrent Aphthous Stomatitis (RAS) known as recurrent aphthous ulcer is a common and painful ulcerations in oral cavity. It has been suggested that hematological... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Recurrent Aphthous Stomatitis (RAS) known as recurrent aphthous ulcer is a common and painful ulcerations in oral cavity. It has been suggested that hematological parameters seems to be considered as an etiologic factor. So, this meta-analysis and systematic review was aimed to examine the relationship between RAS and hematological parameters.
METHODS
Relevant studies were found using online international databases including Scopus, Science direct, Web of science (ISI), PubMed, and Google Scholar search engine between 2000 and October 2023. The quality of all papers was determined by NOS checklist. Heterogeneity between the results of primary studies was evaluated with I-square index and publication bias was performed by Egger's test and funnel plots. Also, sensitivity analysis was done to check the effect of each of the primary studies on the overall estimate. Also, the statistical analyses were done using Stata software Ver. 11.
RESULTS
By combining the results of primary studies, the standardized mean difference (SMD) of vitamin B12, ferritin, folic acid, hemoglobin, iron and zinc indices with a 95% confidence interval (CI) between the case (patients with RAS) and control (Healthy) groups were estimated -0.52(-0.89, -0.14), -0.20(-0.51, 0.11), -0.42(-0.95, 0.11), -0.58(-0.90, -0.27), 0.01(-0.12, 0.15), -0.33(-0.81, 0.14) respectively. The patients with vitamin B12, ferritin, folic acid, and iron deficiencies and reduced hemoglobin (Hb) level reported 2.93(2.28, 3.78), 2.50(1.48, 4.22), 1.51(0.53, 4.29), 1.46(0.70, 3.03), and 2.14(1.38, 3.32), times more susceptible to develop RAS than healthy individuals.
CONCLUSION
The results of the meta-analysis indicated that the SMD of vitamin B12 serum and Hb levels in the case group was 52%. Our result have also showed that the odds ratio of vitamin B12, ferritin deficiencies, and decreased Hb level in case group was 2.93, 2.50, and 2.14 times more than healthy group.
Topics: Humans; Stomatitis, Aphthous; Vitamin B 12 Deficiency; Folic Acid Deficiency; Folic Acid; Vitamin B 12; Hemoglobins; Ferritins
PubMed: 38493289
DOI: 10.1186/s12903-024-04072-5