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Journal of Molecular Medicine (Berlin,... Apr 2024Recurrent aphthous stomatitis (RAS) is a chronic and recurrent inflammatory disease of the mouth. It is characterised by the appearance of painful ulcers in the oral... (Review)
Review
Recurrent aphthous stomatitis (RAS) is a chronic and recurrent inflammatory disease of the mouth. It is characterised by the appearance of painful ulcers in the oral mucosa. RAS is believed to be a multifactorial disease with genetic predisposition, environmental factors and alterations in the immune system. Oxidative stress, caused by an imbalance between free radicals and the antioxidant system, also appears to be involved in the pathogenesis of RAS. Several risk factors, such as smoking, iron and vitamin deficiency and anxiety, may contribute to the development of the disease. Understanding the underlying mechanisms may help in the prevention and treatment of RAS. We searched PubMed, Scopus and Web of Science databases for articles on oxidative stress in patients with RAS from 2000 to 2023. Studies analysing oxidant and antioxidant levels in the blood and saliva of RAS patients and healthy controls were selected. Of 170 potentially eligible articles, 24 met the inclusion criteria: 11 studies on blood samples, 6 on salivary samples and 7 on both blood and salivary samples. Multiple oxidative and antioxidant markers were assessed in blood and saliva samples. Overall, statistically significant differences were found between RAS patients and healthy controls for most markers. In addition, increased oxidative DNA damage was observed in patients with RAS. Patients with RAS show elevated levels of oxidative stress compared to healthy controls, with a significant increase in oxidative markers and a significant decrease in antioxidant defences in saliva and blood samples.
Topics: Humans; Stomatitis, Aphthous; Antioxidants; Oxidative Stress; Iron
PubMed: 38376817
DOI: 10.1007/s00109-024-02434-8 -
Journal of Trace Elements in Medicine... Dec 2021Recurrent aphthous stomatitis (RAS) is a very common oral ulcerative disease with no definitive cure. Growing evidence suggests a significant association between zinc...
BACKGROUND
Recurrent aphthous stomatitis (RAS) is a very common oral ulcerative disease with no definitive cure. Growing evidence suggests a significant association between zinc deficiency and RAS.
OBJECTIVES
To assess the efficacy of systemic zinc supplementations in the prevention and management of RAS.
METHODS
Five databases were searched for all English and Chinese studies published up to November 2020. All clinical trials that assessed the efficacy of zinc supplementations in the management and/or prevention of RAS were included.
RESULTS
Seven clinical trials comprising 482 RAS patients (250 in zinc group) fulfilled the inclusion criteria. The follow-up period ranged from three months to one year. Five studies showed significantly better efficacy of zinc in reducing the recurrence rates of RAS, whereas two studies did not report any significant differences compared to the controls. Four studies reported on signs/symptoms of RAS, three of which showed superior outcomes in favour of zinc, while one study reported comparable results.
CONCLUSION
Zinc supplementation seems to be efficacious in the management and prevention of RAS. However, further clinical trials with standardized methodologies and adequate follow-up periods are required to confirm the efficacy of zinc supplementations.
Topics: Asian People; Dietary Supplements; Humans; Recurrence; Stomatitis, Aphthous; Zinc
PubMed: 34146924
DOI: 10.1016/j.jtemb.2021.126811 -
The Journal of Dermatological Treatment May 2022Recurrent aphthous stomatitis (RAS) is the most common ulcerative lesion of the oral mucosa. The management of RAS is quite challenging with no definitive cure. (Review)
Review
BACKGROUND
Recurrent aphthous stomatitis (RAS) is the most common ulcerative lesion of the oral mucosa. The management of RAS is quite challenging with no definitive cure.
OBJECTIVE
The present systematic review aimed to summarize the available evidence regarding the efficacy of curcumin in the management of RAS.
METHODS
PubMed, Scopus and Web of Science databases were searched in June 2020 for all relevant studies. Clinical trials that assessed the efficacy of curcumin for the management of RAS were included. The primary outcomes were pain and/or clinical improvement.
RESULTS
Eight studies involving 439 subjects were included. The efficacy of curcumin was compared with 1% triamcinolone in four studies, glycerin vehicle in one study, placebo in one study, and honey in one study. Overall, the included studies reported a good efficacy of curcumin in reducing pain and ulcers size in patients with RAS. Four studies found curcumin as effective as triamcinolone in relieving signs and symptoms of RAS. Three studies reported superior results with curcumin as compared with control groups.
CONCLUSION
The limited available evidence suggests that curcumin have potential benefits in alleviating pain and accelerating healing in patients with RAS. Further well-designed clinical trials with standardized curcumin formulations are highly recommended.
Topics: Curcumin; Humans; Pain; Stomatitis, Aphthous; Triamcinolone
PubMed: 32893718
DOI: 10.1080/09546634.2020.1819529 -
European Journal of Pediatrics Oct 2020In previously healthy subjects, vulvar ulcers are mostly caused by sexually transmitted microorganisms. Lipschütz's acute vulvar ulceration, first reported in 1912, is...
In previously healthy subjects, vulvar ulcers are mostly caused by sexually transmitted microorganisms. Lipschütz's acute vulvar ulceration, first reported in 1912, is a non-sexually acquired condition characterized by sudden onset of a few genital ulcers. We systematically review presentation, underlying causes, and disease duration of Lipschütz's ulceration. A comprehensive source of Excerpta Medica, National Library of Medicine, and Web of Science databases was performed. Reports including cases of apparently previously healthy females affected by Lipschütz's ulceration were selected. A predefined database was used to extract data on demographics, history, clinical and microbiological findings, and treatment.The search disclosed 158 cases. Almost 90% of cases were ≤ 20 years of age and sexually inactive. Lesions were usually one to about three, painful, ≥ 10 mm large, well-delimited, with a fibrinous and necrotic center and a symmetric distribution. Voiding disorders and enlarged inguinal lymph nodes were observed in a large subset of cases. Canker sores were noted in 10% of patients. Lipschütz's vulvar ulceration occurred concomitantly with an infectious disease in 139 cases. Infectious mononucleosis syndrome (N = 40) was the most frequently detected well-defined infection, followed by mycoplasma species infections (N = 11). The disease resolved after ≤ 3 weeks.Conclusions: Lipschütz's ulceration mainly affects both sexually inactive and, less frequently, sexually active subjects ≤ 20 years of age, presents with ≤ 3 vulvar ulcers, resolves without recurrences within 3 weeks and is temporarily associated with an infection, most frequently a flu-like illness or an infectious mononucleosis syndrome. What is Known: • Lipschütz's acute vulvar ulceration is a non-sexually acquired condition, which is characterized by a sudden onset of a few necrotic and painful genital ulcers. • The condition tends to resolve spontaneously and is usually triggered by an infection. What is New: • The condition mainly affects subjects ≤ 20 years of age, tends to resolve within 3 weeks, and is usually temporarily associated with a flu-like illness or an infectious mononucleosis syndrome. • Systemic corticosteroids do not reduce disease duration.
Topics: Diagnosis, Differential; Female; Humans; Infant, Newborn; Recurrence; Stomatitis, Aphthous; Ulcer; Vulvar Diseases
PubMed: 32296983
DOI: 10.1007/s00431-020-03647-y -
Archives of Oral Biology Sep 2021This study aimed to investigate that these bacteria counts in the oral cavity were modulated by the recurrent aphthous stomatitis (RAS) status according to age and... (Meta-Analysis)
Meta-Analysis Review
Quantitative changes of Veillonella, Streptococcus, and Neisseria in the oral cavity of patients with recurrent aphthous stomatitis: A systematic review and meta-analysis.
OBJECTIVE
This study aimed to investigate that these bacteria counts in the oral cavity were modulated by the recurrent aphthous stomatitis (RAS) status according to age and ethnicity with a systematic review and meta-analysis.
DESIGN
The relevant case-control studies were searched in the literature database in English, Korean, and Chinese until June 2020 using keywords, and the literature was screened and collated for Review Manager analysis. Sensitivity analysis and quality check of the included literature were conducted.
RESULTS
From the selection process, oral bacteria counts were measured by polymerase chain reaction (PCR) in 8 studies and next-generation sequencing in 4 studies. Healthy control, ulcerative phases of RAS (UC-RAS), non-ulcerative phases of RAS (Non-UC-RAS) groups included 442, 473, and 386 participants in a total of 12 studies. For PCR detection, mean differences (95 % confidence intervals) of Veillonella and Streptococcus counts between the healthy-control and RAS groups were -1.91 (-2.41 ∼ -1.41) and -1.34 (-1.85 ∼ -0.83)(P < 0.0001). The bacteria count results by "Next-generation" sequencing (NGS) and PCR methods were similar. Significantly lower Veillonella and Streptococcus counts were observed in the UC-RAS group than in the non-UC-RAS group (P < 0.0001). Veillonella and Streptococcus count differences between RAS and controls aged ≥30 years were greater than those aged <30 years. At the species level, the prevalence of RAS had a negative relation with Veillonella dispar count.
CONCLUSIONS
Counts of Veillonella and Streptococcus are strongly correlated with the recovery and progression of RAS, especially in middle-aged patients. Adjustment of oral microbiota should be considered in the treatment of RAS.
Topics: Humans; Middle Aged; Neisseria; Stomatitis, Aphthous; Streptococcus; Veillonella
PubMed: 34167010
DOI: 10.1016/j.archoralbio.2021.105198 -
Journal of the American Dental... Jan 2017Recurrent aphthous stomatitis (RAS) is the most common chronic oral mucosal condition of the oral cavity. Investigators in clinical trials have evaluated the... (Review)
Review
BACKGROUND
Recurrent aphthous stomatitis (RAS) is the most common chronic oral mucosal condition of the oral cavity. Investigators in clinical trials have evaluated the effectiveness of Chinese patent medicines in the treatment of RAS. However, the results are conflicting rather than conclusive. To evaluate the efficacy and safety of Chinese patent medicines for the treatment of RAS, the authors conducted a systematic review.
TYPES OF STUDIES REVIEWED
The authors searched 9 electronic databases to identify randomized controlled trials (RCTs) or potential clinical controlled trials (CCTs), published in any language, in which the investigators compared Chinese patent medicines with vitamin tablets or placebos for the treatment of RAS.
RESULTS
The authors included 11 RCTs and 1 CCT in the review. Results showed that Chinese patent medicines were beneficial for patients with RAS in relieving ulcer pain and reducing the duration and frequency of attacks. The reported adverse effects of Chinese patent medicines included stomachache, abdominal distention, diarrhea, mild nausea, and gastrointestinal discomfort, which were either self-limiting or could be relieved by treatment cessation.
CONCLUSIONS AND PRACTICAL IMPLICATIONS
Chinese patent medicines may be effective for treatment of RAS by means of relieving pain and reducing ulcer size and episode duration and frequency.
Topics: Drugs, Chinese Herbal; Humans; Recurrence; Stomatitis, Aphthous; Treatment Outcome
PubMed: 28062049
DOI: 10.1016/j.adaj.2016.08.025 -
Oral Diseases Sep 2020A few studies have associated vitamin D deficiency with the occurrence of recurrent aphthous stomatitis (RAS). Hence, the aim of the present systematic review and... (Review)
Review
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.
PubMed: 31493304
DOI: 10.1111/odi.13189 -
Frontiers in Nutrition 2023Growing evidence suggests a significant association between vitamin D deficiency and RAS. Hence, the present meta-analysis and trial sequential analysis sought to...
BACKGROUND
Growing evidence suggests a significant association between vitamin D deficiency and RAS. Hence, the present meta-analysis and trial sequential analysis sought to investigate the potential association between low serum vitamin D levels and RAS.
METHODS
PubMed, Scopus, Embase, and Web of Science were comprehensively searched on December 1, 2022 to retrieve all relevant studies. The grey literature was also searched via ProQuest. All case-control studies on the association between vitamin D and RAS were considered. The quality appraisal of the included studies was done using Newcastle-Ottawa scale. RevMan 5.0 and trial sequential analysis (TSA) programs were used for analyses.
RESULTS
A total of 14 case-control studies with 1468 subjects (721 RAS patients and 747 controls) were included. The pooled data revealed a significant association between low serum levels of vitamin D and the risk of RAS (mean difference = - 8.73, 95% CI: - 12.02 to - 5.44, I = 94%, P < 0.00001). Additionally, TSA findings indicated that the current studies surpassed the required information size, confirming that the differences were reliable.
CONCLUSION
The available evidence suggests that Vitamin D deficiency may have a role in the pathogenesis of RAS. Therefore, evaluation of vitamin D should be considered in RAS patients. Additionally, the results support the possibility of using vitamin D supplements in the management of RAS patients with inadequate serum levels of vitamin D. Future interventional studies are required to evaluate the benefits of vitamin D replacement in prevention and treatment of RAS.
PubMed: 37426194
DOI: 10.3389/fnut.2023.1132191 -
Vojnosanitetski Pregled Aug 2015Recurrent aphthous stomatitis (RAS) is defined as multifactor immunologic inflammatory lesions in the oral cavity, characterized by painful, recurrent single/multiple,... (Review)
Review
BACKGROUND/AIM
Recurrent aphthous stomatitis (RAS) is defined as multifactor immunologic inflammatory lesions in the oral cavity, characterized by painful, recurrent single/multiple, shallow, round or ovoid ulcerations of mucosal tissues. To date, a considerable number of RAS treatment protocols have been suggested, but since the etiology of RAS is idiopathic, these treatment options have symptomatic rather than curative or preventive effect. Recently, it has been suggested that laser therapy could be successfully used as an efficient treatment approach in therapy of RAS. Therefore, the aim of this review was to estimate the effects of laser therapy in treatment of RAS analyzing results of clinical studies published in peer reviewed journals.
METHODS
The studies published until 31 December 2013 were obtained from the Medline/PubMed, Science Direct and Cochrane Library of the Cochrane Collaboration (CENTRAL) online databases, using following search terms and key words: "laser" AND "recurrent aphthous stomatitis", "laser" AND "aphthous", and "laser" AND "aphthae". In total 4 original research articles met the all required inclusion/exclusion criteria, and were used for this review. The main outcome measures assessed were: a reduction of pain associated with RAS and a reduction in episode duration (faster RAS healing).
RESULTS
The assessed literature demonstrates the benefits of laser therapy mainly due to immediate analgesia and ability to speed up a RAS healing process.
CONCLUSION
Even thoughthe assessed literature suggests beneficial outcomes of laser therapy in treatment of RAS, these results should be interpreted with caution. The issues related to the study designs and different sets of laser irradiation parameters of a limited number of available studies with the same treatment outcomes prevent us from making definite conclusions.
Topics: Humans; Low-Level Light Therapy; Stomatitis, Aphthous
PubMed: 26495699
DOI: 10.2298/vsp140410028p -
BMJ Clinical Evidence Feb 2015Most people with recurrent aphthous ulcers develop a few ulcers less than 10 mm in diameter that heal after 7 to 10 days without scarring. The causes are unknown but... (Review)
Review
INTRODUCTION
Most people with recurrent aphthous ulcers develop a few ulcers less than 10 mm in diameter that heal after 7 to 10 days without scarring. The causes are unknown but local physical trauma may trigger ulcers in susceptible people. In 10% of sufferers, lesions are more than 10 mm in diameter and can cause scarring.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of selected topical treatments for recurrent idiopathic aphthous ulcers? We searched: Medline, Embase, The Cochrane Library, and other important databases up to December 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found nine studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: analgesics (local), corticosteroids (topical), tetracycline antibiotic mouthwash, and topical antiseptic agents (chlorhexidine and similar agents).
Topics: Adrenal Cortex Hormones; Analgesics; Anti-Infective Agents, Local; Humans; Mouthwashes; Stomatitis, Aphthous; Tetracycline; Treatment Outcome
PubMed: 25720501
DOI: No ID Found