Assessment of the oral microbiome in the development of recurrent oral aphthae in patients with gastrointestinal pathology

Chronic recurrent oral aphthae in residents living in an ecologically unfavourable region are characterized by a permanent course and prolonged recovery processes of regeneration of pathological elements of the oral mucosa. Using the microbiological method and modern test systems, it has been found that on the surface of aphthae an extremely diverse state of the oral microbiota is determined and its types are diverse. Trigger mechanisms have been determined. The role of representatives of various types of microorganisms - enterococci, staphylococci, streptococci, yeast-like fungi of the genus Candida (C. albicans) and obligate-anaerobes in the development of recurrent oral aphthae has been established. The data obtained can serve as an indication for the development of modern treatment and preventive measures regarding this category of patients.

Clinical evaluation of low-level laser treatment for recurring aphthous stomatitis.

OBJECTIVE: The aim of the present study was to assess the effect of low-level laser on the control of pain and the repair of recurring aphthous stomatitis (RAS). BACKGROUND: One of the most frequent pathologic conditions in the oral cavity is RAS. This multifactor immunologic inflammatory lesion causes patient discomfort, and treatment is controversial because of its unknown etiology. A number of treatment modalities have been proposed, but none is definitive. Low-level laser treatment (LLLT) has been used for lesions of an inflammatory nature, not as an inhibitor of the process, but for its modulating action and reparative effect on tissues. MATERIALS AND METHODS: Twenty patients with RAS were divided into one group treated with a topical corticoid agent (n = 5) and another group treated with laser (n = 15). Group I received conventional treatment with triamcinolone acetonide 4 times per day. The patients in Group II received laser treatment with an InGaA1P diode laser with wavelength of 670 nm, 50 mW, 3 J/cm(2) per point in daily sessions (once per day) on consecutive days. Both treatments were applied until the disappearance of the lesions. All patients were evaluated on a daily basis, and the following clinical parameters were determined during each session: pain intensity before and after treatment and clinical measurement of lesion size. RESULTS: The results revealed that 75% of the patients reported a reduction in pain in the same session after laser treatment, and total regression of the lesion occurred after 4 days. Total regression in the corticoid group was from 5 to 7 days. CONCLUSION: The use of LLLT under the conditions administered in the present study demonstrated analgesic and healing effects with regard to RAS.

[Levamisole does not prevent lesions of recurrent aphthous stomatitis: a double-blind placebo-controlled clinical trial]. / Levamisol não previne lesões de estomatite aftosa recorrente: um ensaio clínico randomizado, duplo-cego e controlado por placebo.

OBJECTIVE: to utilize a double-blind protocol to provide clarification about the safety and effectiveness of levamisole in the treatment of recurrent aphthous stomatitis. METHODS: Fourteen patients took a decreasing dose of oral levamisole for six months (initial dose 150mg three times a week) and ten others were placebo control patients. All were evaluated monthly. RESULTS: The number of crises had a tendency to decrease in both groups, but without a difference between groups. The number of lesions diminished significantly in the two groups, but upon comparison the difference was not significant. Duration of the lesions diminished significantly in the placebo, however when compared to the levamisole group, difference was not significant during treatment. The intensity of pain was significantly lower in the two groups, but upon comparison, pain was significantly lower in the placebo group. The final global evaluation showed improvement in 50% of patients of the levamisole group and in 70% of the placebo, without a significant difference between treatments. No difference in the frequency of collateral effects was observed between groups. CONCLUSIONS: Levamisole, as used in this protocol, is a safe drug. When compared with the placebo, levamisole is not effective in the prophylactic treatment of recurrent aphthous stomatitis. The placebo effect is important in diseases where emotional factors affect recurrence or expression of symptoms.

Prevalence of Behcet's syndrome in patients with recurrent aphthous ulcerations in Brazil.

Behcet's syndrome (BS) is a clinical entity characterized by the appearance of recurrent oral and genital ulcers, in addition to a broad spectrum of clinical manifestations. The aim of the present study is to evaluate the prevalence of BS in patients with recurrent aphthous ulcerations (RAU) and to test the hypothesis that BS could be under diagnosed in Brazil. This is a cross-sectional investigation of the prevalence of BS based on the International Study Group for Behcet's Disease (ISGBD) criteria in patients with RAU attended in a stomatology service. Three hundred and six patients were attended at the ambulatory clinic in the study period, but the standard questionnaire was applied to 50 (16.6%) patients, 29 men and 21 women, identified as having RAU. Only one patient met the ISGBD criteria presenting RAU of the minor and complex type, recurrent genital ulcers, cutaneous, articular, ocular, and vascular manifestations, hypoacusia and fever. Thus, a prevalence of 2% of BS was defined in this subgroup of patients. In the present study, the frequency of 2% of BS in patients with RAU demonstrates the need for further population-based studies to be developed in order to definitively establish the real prevalence of this condition.

Levamisol não previne lesões de estomatite aftosa recorrente: um ensaio clínico randomizado, duplo-cego e controlado por placebo / Levamisole does not prevent lesions of recurrent aphthous stomatitis: a double-blind placebo-controlled clinical trial

OBJETIVO: Avaliar a eficácia e a segurança do levamisol no tratamento profilático da afta recorrente, utilizando um protocolo de estudo duplo-cego. MÉTODOS: Quatorze pacientes receberam doses decrescentes de levamisol por via oral por seis meses (dose inicial de 150mg três vezes por semana). Dez pacientes receberam placebo. As avaliações foram mensais. RESULTADOS: Houve tendência à diminuição do número de crises nos dois grupos, mas sem diferenças entre ambos. O número de lesões diminuiu significantemente nos grupos levamisol e placebo, mas na comparação entre eles a diferença não foi significante. A duração das lesões diminuiu significantemente no grupo placebo, porém ao compará-lo com o grupo levamisol a diferença não foi significante durante todo o tratamento. A intensidade da dor foi significantemente menor nos dois grupos, mas ao compará-los a dor foi significantemente menor no grupo placebo. A avaliação global final mostrou melhora em 50 por cento dos pacientes do grupo levamisol e em 70 por cento do Placebo, sem diferença significante entre os dois tratamentos. Não foi observada diferença na frequência de efeitos colaterais entre os grupos. CONCLUSÃO: Levamisol, como usado nesse protocolo, é uma droga segura. Comparado ao placebo, levamisol não é efetivo no tratamento profilático da afta recorrente. O efeito placebo é importante em desordens nas quais fatores emocionais afetam a recorrência ou a expressão de sintomas.

OBJECTIVE: to utilize a double-blind protocol to provide clarification about the safety and effectiveness of levamisole in the treatment of recurrent aphthous stomatitis. METHODS: Fourteen patients took a decreasing dose of oral levamisole for six months (initial dose 150mg three times a week) and ten others were placebo control patients. All were evaluated monthly. RESULTS: The number of crises had a tendency to decrease in both groups, but without a difference between groups. The number of lesions diminished significantly in the two groups, but upon comparison the difference was not significant. Duration of the lesions diminished significantly in the placebo, however when compared to the levamisole group, difference was not significant during treatment. The intensity of pain was significantly lower in the two groups, but upon comparison, pain was significantly lower in the placebo group. The final global evaluation showed improvement in 50 percent of patients of the levamisole group and in 70 percent of the placebo, without a significant difference between treatments. No difference in the frequency of collateral effects was observed between groups. CONCLUSIONS: Levamisole, as used in this protocol, is a safe drug. When compared with the placebo, levamisole is not effective in the prophylactic treatment of recurrent aphthous stomatitis. The placebo effect is important in diseases where emotional factors affect recurrence or expression of symptoms.

Lesões da mucosa oral em pacientes idosos: um problema pouco enfatizado por médicos e pesqisadores / Oral mucosa lesions in elderlly inpatients: a problem little emphasized by doctors and researchers

Objetivos: Estimar a freqüência de lesões da mucosa oral em idosos internados nas várias especialidades de hospital geral, em Belo Horizonte, Minas Gerais; determinar com qual freqüência as lesões detectadas pelos pesquisadores haviam sido identificadas também pelos médicos responsáveis pelos pacientes estudados e veridicar a possível associação dessas lesões com sexo, tabagismo, etilismo, edentulismo e uso de próteses dentárias. Pacientes e métodos: Os pacientes foram selecionados de acordo com a idade (60 anos e mais), a partir do prontuário médico, de onde também se extraíram informações sobre o sexo, realização do exame da cavidade oral pelo médico assistente e sobre a detecção de lesões da mucosa oral pelo mesmo. O diagnóstico das lesões baseou-se nas suas características clínicas. Resultados: Foram avaliados 198 pacientes, com idade média de 75 anos, sendo 116 do sexo feminino e 82 masculino. Foram detectadas lesões nas cavidades orais de 69 pacientes (34,8 por cento). Em apenas 13 pacientes (6,6 por cento) as lesões haviam sido detectadas também pelo médico assistente. As lesões mais freqüentemente encontradas foram candidíase (23 por cento), epulis fissuratum (11 por cento), hiperplasia inflamatória (11 por cento), afta recorrente (10 por cento), papiloma (10 por cento), queilite angular (7 por cento) e leucoplasia (3 por cento). Em relação à associação das lesões com sexo, tabagismo, etilismo, edentulismo e uso de prótese, encontrou-se que o uso de prótese esteve associado com maior número de lesões, especificamente, com hiperplasia inflamatória. Conclusões: Os dados ora apresentados são comparáveis aos observados em outros estudos, mas, diferentemente daqueles, demonstram o pequeno interesse dos médicos pelo exame da cavidade oral dos seus pacientes. Ressaltamos, portanto, a importância deste trabalho, cujos resultados alertam para a necessidade da realização do exame da cavidade oral por todos os profissionais que cuidam de pacientes idosos.

Aims: To estimate the prevalence of oral mucosa lesions in elderly inpatients admitted to different specialities of a general hospital, its possible association with gender, smoking habit, alcohol use, edentulis and dental prosthesis anda how often these lesions go unrecognizes. Patients and methods: The case notes of all patients 60 years of age and older of both sexes were analyzes in order to identify whether the oral cavity was examined by the responsible doctor and what kind of oral mucosa lesions were detected. Results: A total of 198 patients (median age: 75 years) (116 females; 82 males) were evaluated. Oral cavity lesions were detected in 69 patients (34,8 percent). In only 13 patients (6,6 percent) lesions were recognized by the responsible doctor. The most frequently found lesions were: candidiasis (23 percent), epulis fissuratum (11 percent), inflammatory hyperplasia (11 percent), recurrente aphthous ulcer (10 percent), papilloma (10 percent), angular chelilitis (7 percent) and leucoplakia (3 percent). The use of dental prosthesis was associated with a greater number of lesions specifically inflammatory hyperplasia. Conclusions: The prevalence and type of oral mucosa lesions found in our study is similar to other studies. Nevertheless, is was clear that routine examination of the oral cavity was not performed regularly. It's highlighted the importance of routine examination of elderly oral cavity.

Localização anatômica da ulceração aftosa recorrente [UAR] e estudo da prevalência da hiperplasia fibrosa inflamatória [HFI] em pacientes que fazem uso de prótese total mucossuportada / Anatomical localization of recurrent aphthous ulceration [rau] and a study of the prevalence of inflammatory fibrous hyperplasia [IFH] in pacients that use a full mucus supported dental plate

Os autores discutem a importancia da epidemiologia das doenças da cavidade bucal e relatam o envolvimento anatômico de 71 pacientes com ulceração aftosa recorrente e a prevalência de hiperplasia fibrosa inflamatória em 36 pacientes usuários de prótese total mucossuportada