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Revista Cientifica Odontologica... 2023Recurrent Aphthous Stomatitis, also known as aphthous ulcers or simply aphthous, is considered the most common of oral mucosal lesions.
INTRODUCTION
Recurrent Aphthous Stomatitis, also known as aphthous ulcers or simply aphthous, is considered the most common of oral mucosal lesions.
OBJECTIVE
To describe the prevalence of recurrent aphthous stomatitis.
METHODS
Descriptive, cross-sectional and prospective study. 847 patients who attended the Family Medical Office No. 28, San Francisco comunity, Manzanillo, from July 1, 2021 to June 30, 2022, Cuba, were evaluated. A calibrated and trained assistant investigator evaluated the following variables: Clinical classification of recurrent aphthous stomatitis (minor aphthosis, major aphthosis, or aphthosis herpetiformis), lesion pain intensity, lesion location, and risk factors (viral infection), bacterial infection, immunological alterations, psychosomatic alterations, oral trauma, gastrointestinal alterations, endocrine factors, allergic conditions, heredity, blood and nutritional deficiencies, smoking), age group, sex, race, and duration of the lesion.
RESULTS
Aphthous stomatitis occurred in 30.46%, with greater frequency in the age group 30 - 39 years (24.42%). Minor aphthosis was the most frequent with 91.09%. The duration of the lesion of 10 to 12 days predominated with 37.60%, the most frequent location corresponded to the edge and tip of the tongue with 32.94% and the most representative pain intensity was mild with a total of 63.18%. The highest frequency among the risk factors corresponded to psychosomatic alterations with 100%.
CONCLUSIONS
Recurrent Aphthous Stomatitis had a prevalence greater than 30% with a predominance of the female sex and young adults. Minor Aphtosis and a stay time of more than 10 days were the most frequent. The most common location is the tongue and bottom of the vestibular sulcus with the possible existence of a relationship between the mobile parts of the mouth. Stress, the main risk factor, exacerbated by Covid-19.
PubMed: 38312464
DOI: 10.21142/2523-2754-1104-2023-172 -
Cureus Dec 2023Aphthous stomatitis, with frequent and painful aphthous ulcers (also called canker sores or simply oral ulcers) on the non-keratinized oral mucous membranes, is often a...
Aphthous stomatitis, with frequent and painful aphthous ulcers (also called canker sores or simply oral ulcers) on the non-keratinized oral mucous membranes, is often a cutaneous complication in kidney transplant recipients. Mycophenolate mofetil is a drug that is part of an immunosuppressive regimen in kidney transplant recipients, along with corticosteroids and calcineurin inhibitors. Mycophenolate mofetil, the triggering agent for mouth ulcers in kidney transplant recipients, has been communicated in scientific literature. Herein, we report a case of multiple painful oral ulcerations secondary to mycophenolate mofetil in a 23-year-old female kidney transplant recipient. The oral ulcers resolved immediately after discontinuation of the mycophenolate mofetil. Withdrawal of mycophenolate mofetil or switching to other medicine must be considered when a patient with a kidney transplant history complains of oral ulcers and a negative workup for other etiologies.
PubMed: 38249270
DOI: 10.7759/cureus.50811 -
Dentistry Journal Jan 2024The systematic review assessed the efficacy and safety of propolis for treating recurrent aphthous stomatitis (RAS). The review adopted the PICO framework to examine the... (Review)
Review
The systematic review assessed the efficacy and safety of propolis for treating recurrent aphthous stomatitis (RAS). The review adopted the PICO framework to examine the effects of topical and systemic propolis on RAS while also comparing it to established treatments, placebos, or no treatment. The main focus was on the healing time, pain levels, adverse effects, the likelihood of ulcer recurrence, and accompanying symptoms such as redness. The team included randomised controlled trials (RCTs) and quasi-randomised trials, excluding case reports and studies on oral ulcers other than RAS. In May 2022, the review team comprehensively searched nine databases and trial registries following the PRISMA guidelines. The protocol was registered in the PROSPERO database under the registration number CRD42022327123. Two review authors conducted a comprehensive and autonomous search for pertinent papers and extracted essential data. Where data permitted, the team utilised Review Manager 5 to conduct a random-effects meta-analysis, assessing the risk of bias and heterogeneity of the included studies. Where possible, the GRADE Pro programme was used to assess the certainty of the evidence for all the outcomes. This review included 10 RCTs, comprising 825 participants aged between 18 and 69 years. Seven studies evaluated the efficacy and safety of propolis when applied topically, all of which used different formulations, concentrations, and carriers. The remaining three studies assessed systemic administration in tablet form. The duration of investigations ranged from 5 days to 3 years. The review team classified two studies as having an overall 'high risk' of bias, while the remaining studies were categorised as having an overall 'uncertain risk'. The overall certainty of the evidence was 'very low'. The results indicate that topical and systemic propolis may decrease the duration of healing, alleviate pain, and reduce redness in patients with RAS compared to a placebo. However, the certainty of the evidence is very low. These may be due to the high risk of bias, substantial heterogeneity, and limited sample sizes in the included studies. For these reasons, the results of this review should be interpreted with caution. Nevertheless, the limited number of adverse effects observed suggests that propolis may have a favourable safety profile when used for a short period in treating RAS.
PubMed: 38248221
DOI: 10.3390/dj12010013 -
Journal of Ethnopharmacology Apr 2024Kaempferia galanga L. is one of the important medicinal plants and has been used in Thailand for treating inflammation and wound.
ETHNOPHARMACOLOGICAL RELEVANCE
Kaempferia galanga L. is one of the important medicinal plants and has been used in Thailand for treating inflammation and wound.
AIM OF THE STUDY
This study aimed to investigate the efficacy of the compound from K. galanga on wound healing and anti-inflammatory activities and develop a new product in gel form to maximize the benefits of this plant.
MATERIALS AND METHOD
The mouth gel containing kaempulchraol K (KG2) was prepared by using 1.5% carbopol 934 as a gelling agent. Formulations of mouth gel containing KG2 at 0.10%, 0.25%, and 0.50% w/w were evaluated for color, smell, pH values, viscosity, and separation. Also, the chemical and biological stabilities of mouth gel containing KG2 were evaluated by heating-cooling test. The anti-inflammatory activity was tested against RAW 264.7 cells nitric oxide (NO) production and wound healing assay was performed using human gingival fibroblasts (HGF).
RESULTS
Compound KG2 exhibited anti-NO production with an IC value of 66.8 μM and the wound healing activity of compound KG2 showed cell viability in the range of 90.9-111.4%. In addition, compound KG2 at a concentration of 3 μM induced the highest proportion of cell migration on day 3 at 90.2 ± 2.4%. The mouth gel containing KG2 both before and after the heating-cooling test exhibited good consistency, with pH values in the range of 6.64-6.71 (before) and 6.63-6.68 (after). Meanwhile, the viscosity was 81,700-96,700 cP (before) and 78,300-93,300 cP (after). For the chemical stability test of the active ingredient of mouth gel, the compound showed good stability after mixing with the gel base. The mouth gel exhibited anti-inflammation with IC values > 1000 μg/ml both before and after accelerating conditions. The wound healing activity of mouth gel containing KG2 (0.50% w/w) showed the highest % cell viability at 128.6% (before) and 123.8% (after). For cell migration, the result suggested that the mouth gel containing KG2 at 0.10%, 0.25%, and 0.50% w/w (3 μg/ml) on day 3 enhanced cell migration higher than that of the positive controls both before (85.0-96.8%) and after (and 84.4-94.3%) the accelerating conditions.
CONCLUSION
The present study shows that mouth gel containing 0.50% KG2 is the most appropriate with good physical, chemical, and biological stabilities and might be one of the alternative sources for treatment of mouth ulcers (oral stomatitis) derived from aphthous ulcers, chemotherapy, and radiotherapy treatments.
Topics: Humans; Alpinia; Rhizome; Plant Extracts; Wound Healing; Anti-Inflammatory Agents; Zingiberaceae; Gels; Mouth
PubMed: 38219883
DOI: 10.1016/j.jep.2024.117762 -
Medicine Jan 2024Recurrent aphthous stomatitis (RAS) is common in clinical practice and imposes both physical and psychological distress on patients. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Recurrent aphthous stomatitis (RAS) is common in clinical practice and imposes both physical and psychological distress on patients.
OBJECTIVE
This study aimed to evaluate the clinical effectiveness of fire needle therapy for the treatment of RAS, providing a basis for clinical decision-making.
METHODS
Eight databases, in both Chinese and English, were searched from their inception until December 2022. All randomized controlled trials (RCTs) that utilized fire needle therapy, either alone or combined with other treatments for RAS, were considered. Data evaluation and extraction were conducted independently by 2 authors.
RESULTS
The revised Cochrane Risk of Bias Version 2 tool was employed to assess the risk of bias in the included RCTs. A meta-analysis was conducted using Review Manager 5.4 and Stata 15.0. Nine RCTs involving 1469 patients were selected for inclusion. The meta-analysis revealed that, compared to a non-fire-needle control group (primarily utilizing vitamin and transfer factor treatments), fire needle therapy for RAS significantly improved the total effective rate (relative risk = 1.25, 95% confidence interval [CI] [1.14, 1.36], P < .00001), reduced the visual analogue scale score (mean difference = -1.68, 95% CI [-1.82, -1.53], P < .0001), diminished the Traditional Chinese Medicine symptom score (standardized mean difference = -1.20, 95% CI [-1.76, -0.65], P < .0001), and shortened the healing time (mean difference = -1.66, 95% CI [-2.73, -0.59], P = .002). Notably, there was no significant difference in the recurrence rate between the groups (relative risk = -0.18, 95% CI [-0.36, 0.01], P = .06). Further subgroup analysis on total efficacy rate was performed based on variables such as experimental group intervention, control group intervention, and duration of therapy to explore potential sources of heterogeneity.
CONCLUSION
Fire needle therapy appears to be a clinically effective treatment for RAS, offering benefits such as pain alleviation, symptom improvement based on the Traditional Chinese Medicine parameters, and faster recovery. Nonetheless, the overall quality of the RCTs available raises concerns. Future research, involving high-quality RCTs, is essential to confirm the clinical efficacy and safety of this treatment. Registration number: PROSPERO (CRD42023387973).
Topics: Humans; Medicine, Chinese Traditional; Needles; Stomatitis, Aphthous
PubMed: 38215116
DOI: 10.1097/MD.0000000000036817 -
Cancers Dec 2023It has been 24 years since rapamycin (sirolimus) was approved to mitigate solid organ transplant rejection and 16 years since mTOR (mammalian/mechanistic target of...
It has been 24 years since rapamycin (sirolimus) was approved to mitigate solid organ transplant rejection and 16 years since mTOR (mammalian/mechanistic target of rapamycin) inhibitors reached patients as a cancer therapy. While the clinical benefits of mTOR inhibitors (mTORi) are robust, so too are their toxicities. Among the most common issues is the development of ulcers of the oral mucosa (mTOR-inhibitor associated stomatitis; mIAS). These lesions are distinct from those of other anti-cancer agents, occur with regularity, and impact patient outcomes. mIAS' pathogenesis has been the subject of speculation, and its similar presentation to recurrent aphthous stomatitis (RAS) has led to the hypothesis that it might serve as a surrogate to better understand RAS. Based on a review of the literature, the current manuscript provides a hypothesis regarding the mechanisms by which mTORis uniquely initiate mucosal injury and an explanation for the observation that steroids (also an immunosuppressive) are effective in its treatment through a non-immunologic mechanism. Unexplained unique features of mIAS are discussed in this review in the context of future investigation.
PubMed: 38201496
DOI: 10.3390/cancers16010068 -
The Journal of International Medical... Dec 2023The aetiology of oral mucosal diseases, such as recurrent aphthous ulcer (RAU), oral lichen planus (OLP) and burning mouth syndrome (BMS), involves many factors, and it... (Review)
Review
The aetiology of oral mucosal diseases, such as recurrent aphthous ulcer (RAU), oral lichen planus (OLP) and burning mouth syndrome (BMS), involves many factors, and it remains difficult for clinicians to effectively relieve disease symptoms and formulate coping strategies. With the rapid development of psychology, the role of mental and psychological factors in RAU, OLP and BMS has gradually attracted researchers attention, but the specific mechanism has not been completely determined. This narrative review describes the potential neurobiological mechanism of oral mucosal diseases and detailed psychological factors after introducing relevant research into psychological factors and oral mucosal diseases. Future research strategies and innovations needed to understand and treat oral mucosal diseases and psychological factors, as well as how to prevent oral mucosal diseases by regulation of the neuroendocrine system, are also discussed.
Topics: Humans; Mouth Diseases; Stomatitis, Aphthous; Lichen Planus, Oral; Burning Mouth Syndrome
PubMed: 38150546
DOI: 10.1177/03000605231218619 -
Frontiers in Immunology 2023Periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome (PFAPA) is the most frequent periodic fever syndrome in children. Its pathogenesis is still... (Clinical Trial)
Clinical Trial
INTRODUCTION
Periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome (PFAPA) is the most frequent periodic fever syndrome in children. Its pathogenesis is still unknown, but some disease-modifying factors were observed. Several medications were tested for the long-term prophylaxis of inflammatory flares; however, none are standardly used.
METHODS
This prospective clinical trial enrolled 142 children (71 girls, 50%) meeting diagnostic criteria for PFAPA syndrome. We analysed selected clinical characteristics and compared laboratory parameters during the flare and attack-free period (at least two weeks after the attack). Moreover, we assessed the possible therapeutic effect of ketotifen on the duration of attack free-periods and clinical picture.
RESULTS
The mean age of patients was 6.81 ± 3.03 years and the mean age of onset of symptoms was 2.31 ± 2.02 years. No significant differences were observed between genders.We recorded a positive family history for PFAPA in 31.69% of patients. Attacks lasted for 2.8 ± 1.2 days, with intervals between attacks of 4 ± 1 weeks. We administered ketotifen in 111 (77.8%) patients, and a positive effect was observed in 86 (77.5%) of patients. We observed prolonged attack-free intervals in patients treated with ketotifen (14.7 ± 8.9 days in comparison with 4.4 ± 1.9 days before the treatment; p<0.001). The used dose of ketotifen was 0.08 ± 0.01 mg/kg/day. Mild side effects were observed in four patients (restlessness, irritability, agitation and constipation).
DISCUSSION
Our data supports the use of ketotifen for long-term prophylaxis in children with PFAPA syndrome with positive effects on the attenuation of disease activity and the prolongation of attack-free periods. Further well-designed studies should confirm the preliminary data.
Topics: Child; Humans; Male; Female; Child, Preschool; Infant; Ketotifen; Stomatitis, Aphthous; Pharyngitis; Lymphadenitis; Lymphadenopathy; Syndrome; Anti-Inflammatory Agents
PubMed: 38143757
DOI: 10.3389/fimmu.2023.1302875 -
Cureus Nov 2023Introduction Recurrent aphthous stomatitis (RAS) is a common ulcer of idiopathic etiology but is recurrent, causing painful ulcers in the non-keratinized mucosa. The...
Introduction Recurrent aphthous stomatitis (RAS) is a common ulcer of idiopathic etiology but is recurrent, causing painful ulcers in the non-keratinized mucosa. The disease is commonly seen in people aged 10-40 years. The etiology of RAS has yet to be well established, but several risk factors that lead to the development of RAS have been proven in the literature. With an unknown etiology, developing a definitive cure and maintaining disease remission remains challenging. An epidemiological survey will shed some light on the disease's prevalence, which could provide insights into disease management. This study aimed to study the prevalence of aphthous stomatitis among the patients visiting the dental outpatient services of a dental college in South India. The objectives were to discover the different subtypes of aphthous stomatitis and the age predominance of the type of ulcer. Materials and methods The data was collected from the case records of Saveetha Dental College and Hospitals, Chennai, India, dated from June 2019 to June 2023. The age and gender of the patients with RAS were recorded. The details collected were systematically arranged in an Excel sheet (Microsoft Corporation, Redmond, Washington, United States) and further analyzed using IBM SPSS Statistics for Windows, Version 24.0 (Released 2016; IBM Corp., Armonk, New York, United States) and chi-square tests were run to check for statistical significance. Results A total of 1,44,056 patients visited the Dental OPD during the study period. Of these, 1115 patients had RAS. When the data was analyzed, there was a three-fold increase in the occurrence of RAS during the coronavirus disease 2019 (COVID-19) pandemic, which was statistically significant (p=0.043). The most commonly affected age group was 26-40 years. Among the clinical variants of RAS, it was found that 82.5% of RAS patients had a minor variant of aphthous stomatitis. Conclusion This study shows the prevalence of different types of aphthous stomatitis, wherein we noticed that the minor clinical variant was the most common, followed by the major variant. The lesions were more commonly seen in women. However, the age group most commonly affected was 26-40 years.
PubMed: 38143711
DOI: 10.7759/cureus.49288 -
Dental and Medical Problems 2023Diet and eating habits significantly affect health and quality of life. Various diets and food eliminations can lead to nutritional deficiencies and malnutrition. This... (Review)
Review
Diet and eating habits significantly affect health and quality of life. Various diets and food eliminations can lead to nutritional deficiencies and malnutrition. This article discusses the relationship between nutrition, nutritional deficiencies, and the condition of the periodontium and oral mucosa. An analysis of PubMed materials was conducted to assess the impact of nutrition on the condition of the oral mucosa and periodontium. We also considered dietary habits such as vegetarianism, the ketogenic diet, the Paleo diet, the Mediterranean diet, the Western diet, and intermittent fasting. Vitamin deficiencies, both watersoluble and fat-soluble, as well as macroand microelements, can manifest in the oral cavity, among others, as gingivitis and bleeding, recurrent aphthous stomatitis, enamel hypomineralization, cheilitis, angular cheilitis, halitosis, glossitis, lingual papillae atrophy, and stomatitis. Malnutrition does not cause periodontal disease, but it increases the risk of its occurrence and accelerates disease progression. Inadequate nutrition, combined with other predisposing factors, may contribute to an increased risk of oral cancer and the development of leukoplakia.
Topics: Humans; Mouth Mucosa; Cheilitis; Quality of Life; Periodontium; Malnutrition
PubMed: 38133993
DOI: 10.17219/dmp/156466