Recurrent Aphthous Stomatitis Patients Research Articles

Manifestations and Treatment of Hypovitaminosis in Oral Diseases: A Systematic Review

This review’s objective is to examine the findings from various studies on oral signs and symptoms related to vitamin deficiency. In October 2023, two electronic databases (Scopus and PubMed) were searched for published scientific articles following PRISMA principles. Articles eligible for inclusion in this review had to be published in English between 2017 and 2023, be original studies, and involve human subjects. Fifteen studies were included in this review: three examining oral symptoms of vitamin B12 deficiency; one assessing vitamin B complex and vitamin E for recurrent oral ulcers; one investigating serum vitamin D levels in recurrent aphthous stomatitis patients; three exploring hypovitaminosis effects on dental caries; two measuring blood serum vitamin D levels; one evaluating vitamin B12 hypovitaminosis; three investigating hypovitaminosis as indicative of gingival disease; one focusing on vitamin deficiencies and enamel developmental abnormalities; one assessing vitamin deficiencies in oral cancer patients; one examining vitamin K as an oral anticoagulant and its role in perioperative hemorrhage; and one evaluating vitamin effects on burning mouth syndrome. Despite some limitations, evidence suggests a correlation between vitamin deficiencies and oral symptoms. This systematic review was registered in the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) database (202430039).

Natural and Synthetic Drugs Approached for the Treatment of Recurrent Aphthous Stomatitis Over the Last Decade.

Recurrent aphthous stomatitis (RAS) refers to a sore and frequently recurring inflammation of the oral tissues, distinguished by the presence of small ulcers that cause significant discomfort and cannot be attributed to any underlying disease. Different treatments have been used for RAS. This review aims to provide a comprehensive overview of the treatment options over the past decade for recurrent aphthous stomatitis (RAS), encompassing both natural and synthetic treatments. It will utilize clinical efficacy studies conducted in vivo and in vitro, along with a focus on the pharmaceutical approach through advancements in drug delivery development. We conducted a thorough literature search from 2013 to 2023 in prominent databases such as PubMed, Scopus, and Cochrane, utilizing appropriate keywords of recurrent aphthous stomatitis, and treatment. A total of 53 clinical trials with 3022 patients were included, with 35 using natural materials in their research and a total of 16 articles discussing RAS treatment using synthetic materials. All the clinical trials showed that natural and synthetic medicines seemed to benefit RAS patients by reducing pain score, ulcer size, and number of ulcers and shortening the healing duration.

Association of IL-1β 542 T>A gene polymorphism with Recurrent Aphthous Stomatitis in Erbil City population.

Recurrent Aphthous stomatitis (RAS) is common oral mucosal condition. The pathophysiology of RAS is affected by a variety of variables, including microbial, genetic, immunological and local and systemic diseases. Interleukin IL-1β, a cytokine that promotes inflammation, has been found in high concentrations in the circulation of RAS. The goal of current investigation was to determine whether RAS is connected with polymorphisms of the IL-1β 542 T>A gene. A total of 60 RAS patients and 30 controls were included in the study. Biochemical investigations for determining (vitamin D, vitamin B12 and zinc) were done and genotypes of IL-1B gene polymorphisms were determined using polymerase chain reaction (PCR) and sequencing. The mean age of the participants was 30.83 ± 1.466 years (range 16 to 50). There was no significant association of SNP IL-1β 542T>A polymorphism with RAS diseases compared to controls, in both parameters such as sex (p-value=0.495) and age groups (p-value=0.6253). There was significant difference in the occurrence of both A and T alleles between RAS patients and controls (p-value=0.0058). The mean vitamin D in both genotypes TA and TT differed significantly (p-value=0.007) but in genotype AA there was no significant difference. Significant difference was observed in zinc concentration between patients and controls (p-value=0.0031). The findings of current investigation indicate that there is a specific IL-1β 542 T>A gene variation that is associated to the pathogenesis of RAS. Allele A was related to the risk of RAS in Erbil city population.

Systematic review and meta-analysis of oxidative stress and antioxidant markers in recurrent aphthous stomatitis

BackgroundWe 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.MethodsWe 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.ResultsWe 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.ConclusionsThe 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.

Identification and Functional Analysis of Serum Specific miRNAs in Recurrent Aphthous Stomatitis Patients with Excess-heat or Yin-deficiency

Identification and Functional Analysis of Serum Specific miRNAs in Recurrent Aphthous Stomatitis Patients with Excess-heat or Yin-deficiency

Effects of honey-lemon spray on recurrent aphthous stomatitis comparing to Triamcinolone ointment

Recurrent aphthous stomatitis (RAS) is recurrent and painful diseases of the oral mucosa that can be very painful and annoying despite their small size. There is no definitive cure for this disease and the usual treatments are mainly based on pain control. The aim of this study was to investigate the effect of honey-lemon spray (mucotin) in the treatment of recurrent aphthous stomatitis. Methods: This study is a randomized controlled clinical trial conducted in 2020 at Zahedan University of Medical Sciences on 46 RAS patients. The participants were randomly assigned to the intervention (mucotin) or control groups (Triamcinolone ointment) equally (23 patients in each group). Patients were evaluated for the severity of pain and ulcer size. Evaluations were performed on days 0, 2, 7 of the treatment using VAS. Data were analyzed using ANOVA statistical test. Results: The inner aspect of the lower lip was the most common site of RAS in the participants (48.8%) and the lowest site went for hard palate (2.4%). Four items including pain, burning sensation, necrosis area, and erythematous area were evaluated in both groups. There was no significant difference in all parameters before the treatment period (day 0). The mean pain score, burning sensation, necrosis, erythematous areas were not different in days 0, 2 and 7 between groups respectively (p=0.849, p=0.105, p=0.917, p=0.442). Conclusion: Honey-lemon spray (Mucotin) and topical corticosteroid have similar effects in RAS treating, So Mucotin can be used as the first line of treatment for RAS lesions. This herbal medicine has no side effects.

Prevalence of Aphthous Stomatitis: A Cross-Sectional Epidemiological Study.

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 of1,44,056 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.

Cardiovascular diseases, risk factors, and ulcer relapse in older adults with aphthous stomatitis.

To test the hypothesis that cardiovascular diseases and risk factors are associated with ulcer relapse in after-retirement patients with recurrent aphthous stomatitis. This retrospective cohort study analyzed the data of 40 minor recurrent aphthous stomatitis patients aged 55-75 years, admitted to Oral Medicine Clinic at one university hospital in China between 2016 and 2018. The diagnosis of minor recurrent aphthous stomatitis was made based on the history and manifestation of oral ulcers. The ulcer relapse was evaluated after a 5-week anti-inflammatory treatment, and the history of systemic diseases was collected. cardiovascular disease/metabolic risk referred to the presence of any cardiovascular diseases and metabolic cardiovascular disease risks. Associations among cardiovascular diseases, risk factors, and ulcer relapse were evaluated. The mean age of 40 patients with minor recurrent aphthous stomatitis was 62.4 years (SD 5.1), and 60% were women. The ulcer relapse rate was 37.5% (95% CI, 0.242-0.530). The proportion of cardiovascular disease/metabolic risk was higher in the relapse group than in the no-relapse group after 5-week anti-inflammatory treatment (Fisher's exact test, p = 0.041). According to this single-center experience, older patients with cardiovascular disease/metabolic risk may be more prone to oral ulcer recurrence. Nevertheless, larger prospective studies are needed to confirm our findings.

Effectiveness of Zhibai Dihuang pill (Chinese herbal formula) in combination with western drugs in the treatment of recurrent aphthous stomatitis: A systematic review and meta-analysis.

The pain caused by recurrent aphthous stomatitis (RAS) and the recurrent nature of RAS lead to diminished quality of life for RAS patients. An alternative treatment for RAS is the oral administration of the Chinese herbal medicine Zhibai Dihuang pill (ZBDHP). Our study aims to investigate the clinical efficacy of ZBDHP when used in combination with Western medicine (WM) for the treatment of RAS and its effectiveness in preventing the recurrence of RAS. Following the PRISMA 2020 guidelines, we conducted a literature search on 7 electronic databases according to predefined criteria. The methodological quality of randomized controlled trials (RCTs) was evaluated based on the Cochrane Handbook, and data analysis was performed using RevMan 5.3 software. A meta-analysis which included 7 studies and 669 participants in total was carried out in this study. The quantitative analysis revealed that the combined treatment of ZBDHP and WM has witnessed significantly improved overall clinical efficacy (RR = 1.20, 95% CI [1.12, 1.28], P < .05), reduced recurrence rate (RR = 0.24, 95% CI [0.13, 0.45], P < .05), decreased ulcer area (MD = -0.75, 95% CI [-0.91, -0.59], P < .05), and reduced pain visual simulation score (MD = -0.42, 95% CI [-0.52, -0.33], P < .05). No significant heterogeneity was observed among the studies. Qualitative analysis showed that the combination therapy significantly reduced serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 and interleukin-10, shortened ulcer healing time and pain disappearance time, with no adverse effects observed. It was found that the combination of ZBDHP and WM is more effective in treating RAS than the use of WM alone, which thus provides clinicians with a more optimal treatment option. However, due to limitations in the methodological quality of the included original studies and the small sample size, we hold the opinion that more rigorous and scientific clinical trials are needed to further evaluate the efficacy of ZBDHP in treating RAS.

Serum level of vitamin D in patients with recurrent aphthous stomatitis: A systematic review and meta-analysis of case control studies.

Recurrent aphthous stomatitis (RAS) is an ulcerative condition with unknown etiology. The effect of vitamin D in the etiology of RAS is still a matter of controversy. In this study, we aimed at review the available evidence on the role of vitamin D deficiency in RAS etiology. PubMed, Cochrane Library for Systematic Reviews, ISI Web of Science, Scopus, and EmBase were systematically searched for evidence on RAS and vitamin D up to January 2020. Retrieved records were screened and assessed by two of the authors independently. Newcastle-Ottawa scale was used to assess the quality of individual studies. AMSTAR tool was used for assessing the quality of the study. Eight studies including 383 healthy control and 352 patients with RAS were eligible for the meta-analysis. Serum vitamin D levels were significantly lower in RAS patients. The weighted mean difference was -7.90 (95% CI: -11.96 to -3.85). The results highlighted the importance of vitamin D deficiency in the etiology of RAS. However, more studies are needed to reach a robust decision. The observed association between vitamin D and RAS is probably due to the effect of vitamin D on the immune system.

Expression of Salivary Ceramide Synthase 1 (CERS1) in Recurrent Aphthous Stomatitis (RAS): A Cross-Sectional Institutional Study.

Background The increased rate of apoptosis is one of the major causes of ulcer formation. A variety of factors can influence the rate of apoptosis. Ceramide (CER) is one such factor that has been proposed to play a role in signaling apoptosis induced by extracellular agents. Recurrent aphthous stomatitis (RAS) is a common condition that initially presents in children or adolescents. Multiple recurrent small, round, or ovoid ulcers with erythematous haloes and circumscribed margins are its characteristic features. Its pathogenesis is still a mystery. Ceramide synthase 1 (CERS1) aids in the production of C18 CER. Although the role of CERS1 in aphthous is well understood, its possible intricate role in pathogenesis remains unknown. Aim To evaluate the expression of salivary CERS1 in patients with RAS and healthy individuals. Materials and methods 30 patients were included in the present study. Ethical clearance for this study was obtained, and there were no gender or age limits for enrollment. After obtaining informed consent, 30 salivary samples were collected from patients with RAS (n=15) and from healthy individuals (n=15). Enzyme-linked immunosorbent assay (ELISA) was performed using the CERS1 kit by MyBioSource Inc (San Diego, USA) and the results were recorded. The Chi-square test and Independent t-test were used for statistical analysis with SPSS v23.0 (IBM, Chicago, USA) with a significant p-value of <0.05. Results CERS1 expression was identified in the saliva of all participants. There was a decrease in the salivary CERS1 level in RAS patients (7.6 +/- 2.0 pg/ml) when compared to healthy individuals (8.3 +/- 1.8 pg/ml) but it did not achieve statistical significance. Conclusion We found that salivary CERS1 levels decreased in RAS patients. More research is required to understand CERS1's pathogenetic role.

Evaluation of Mean Platelet Volume in Patients of Recurrent Aphthous Stomatitis

One of the most prevalent conditions affecting the oral mucosa is recurrent aphthous stomatitis (RAS), which is characterized by uncomfortable ulcerations on the movable or non-keratinized oral mucosa. Objective: To compare mean platelet volume (MPV) in patients of recurrent aphthous stomatitis (RAS) versus healthy control. Methods: This non-probability sampling case-control research included 56 RAS patients and 56 healthy controls. Patients who presented for dental treatment and have RAS in oral cavity were included. Patients with systemic inflammatory illnesses, autoimmune diseases like pemphigus, or infectious diseases like herpes who attended for dental treatment and exhibited RAS in the oral cavity were excluded. The healthy control group had no mouth ulcers or blood problems. A Student t-test compared MPV between cases and controls based on age, gender, and MPV. Results: The mean age of the participants was 29.35 ± 8.28 years, with 57 (50.89%) females and 55 (49.11%) males. The mean MPV in the RAS group (8.86 ± 0.33) was significantly higher (p &lt; 0.001) than in the control group (6.95 ± 0.2). The univariable model coefficient of 1.91 (95% CI = 1.81-2.01, p &lt; 0.001) indicates that the RAS group had a significantly higher MPV than the Control group. For gender, males had a lower MPV compared to females (β = -0.36), but it was not statistically significant (p = 0.056). Conclusions: RAS patients have higher platelet activity indicated by higher mean platelet volume (MPV) than healthy controls.

Salivary cortisol and alpha amylase enzyme levels in different phases of minor recurrent aphthous stomatitis

Objectives: Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal lesions and stress is one of the major factors implicated in its causation. The aim of the present work is to measure the stress biomarkers, salivary cortisol (SC) and salivary alpha amylase (SAA), in the different phases of RAS. Patients and Methods: The study included 69 subjects of whom 38 patients served as the study group who suffered from minor RAS and one to three active minor oral ulcers of &lt;48 h duration. The remaining 31 healthy subjects served as controls. Unstimulated salivary samples were collected twice from the study group; during the ulcerative phase of RAS and after complete healing has occurred, and only once from the controls. Concentrations of SC, and SAA enzyme were assessed by Enzyme-linked Immunosorbent Assay (ELISA). Results: There was a significant increase of SC and SAA in both the ulcerative and the post-healing phases in comparison to the control group. The ulcerative phase had higher but insignificant levels of both biomarkers when compared to the post-healing phase. There was a significant correlation between both biomarkers in the post-healing but not in the ulcerative phase. Conclusion: RAS patients have significantly higher levels of both stress biomarkers (SC and SAA) in the ulcerative and in the post-healing phases when compared to controls.

&lt;strong&gt; Correlation between presence of bacillus species and OHI-s in recurrent aphthous stomatitis patients &lt;/strong&gt;

ABSTRACTIntroduction: The approximate prevalence of Recurrent Aphthous Stomatitis (RAS) was 45.42% at Gusti Hasan Aman Dental Hospital Banjarmasin. Bacillus sp. is a bacterium that can form spores that can be transmitted through air, dust, water and food. Poor oral conditions will increase the possibility of bacterial contamination, especially for ulcers found in RAS. This study aimed to analyzed correlation between the presence of Bacillus species and OHI-S in the oral ulceration of RAS patients. Methods: This was an analytical cross-sectional study conducted among Oral Medicine Department outpatients at Gusti Hasan Aman Dental Hospital, Banjarmasin, Indonesia. A total of 38 subjects were examined to assess Oral Hygiene Index Simplified and obtained bacteria samples using the swabs technique. Bacteria were then inoculated in blood agar base media and concurrently presented with gram staining. Bacteria were then identified using the catalase test, urease test, and oxidase test. Results: Bacillus species were predominantly identified in oral ulceration of RAS patients at Gusti Hasan Aman Dental Hospital Banjarmasin. Bacillus sp. (60,5%), Streptococcus sp. (34,2%), Neisseria sp. (2,6%), and Lactobacillus sp. (2,6%) were found in ulcerated RAS lesions. Spearman test resulted in p = 0.862 (p &gt; 0.05), where no significant difference was obtained between presence of bacillus species and OHI-s in recurrent aphthous stomatitis patients. Conclusion: Bacillus species were predominantly identified in oral ulceration of RAS patients a. However, the presence of Bacillus sp. was not associated with OHI-S in RAS patients.Keywords: bacillus sp.; oral hygiene index simplified; recurrent aphthous stomatitis

Serum levels of reduced glutathione, oxidized glutathione, and glutathione reductase activity in minor recurrent aphthous stomatitis patients

Background/purposeRecurrent aphthous stomatitis (RAS) is one of the most prevalent oral mucosa diseases with unknown etiology. Reduced glutathione (GSH) is a major intracellular non-protein physiological antioxidant, and it has been demonstrated that GSH deficiency may be related to cardiovascular, immune, and diabetes. The purpose of this investigation was to evaluate the potential roles of GSH, oxidized glutathione (GSSG), and glutathione reductase (GR) in the etiopathogenesis of minor recurrent aphthous stomatitis (MiRAS). Materials and methodsThe study comprised 87 patients with idiopathic MiRAS and 90 race-, age-, and gender-matched healthy individuals. The spectrophotometric method was used to determine serum GSH and GSSG concentrations as well as GR activity. The GSSG/GSH ratios were subsequently computed. For statistical evaluation, the independent sample t test, Pearson's chi-square test, Mann–Whitney U test, Kruskal–Wallis H test, and Binary logistic regression analysis were used. ResultsThe serum GSSG level, GR activity and GSSG/GSH ratio were statistically higher in MiRAS patients, whereas the concentration of serum GSH was significantly decreased. With the exception of GR, serum GSSG, GSH, and GSSG/GSH were all significantly associated with MiRAS. Serum GSSG can be regarded as a risk factor, whereas serum GSH and GSSG/GSH maybe considered as protective factors against the occurrence of MiRAS. ConclusionGSSG may be a potential danger factor to MiRAS and GSH may be a protective factor, while GR may not play an important role in the aetiopathogenesis of MiRAS.

Evaluation of cytokines as diagnostic and therapeutic indicators for recurrent aphthous stomatitis: A statistical study

Increasing evidence indicates that inflammatory cytokines are involved in the pathogenesis of recurrent aphthous stomatitis (RAS). A wide range of over ten cytokines in peripheral blood of RAS patients have been investigated in different studies. Yet, which of the ones are the most prominent indicators contributed for the process of RAS are uncertain. Herein, a total of 16 eligible case–control studies including 1051 cases of RAS and 616 health controls were summarized. The bubble chart analysis showed that the most prominent cytokines for RAS were interleukin (IL)-6 (646 cases, 308 controls), TNF-α (498 cases, 298 controls), and IL-2 (371 cases, 264 controls). On the other hand, 9 studies on cytokines as therapeutic indicators of RAS were identified. The effect of levamisole and thalidomide on cytokines mainly were IL-6, TNF-α, and IL-8. Collectively, an optimum panel of IL-6, TNF-α, and IL-2 maybe serve as the potential significant indicators for RAS investigations.

Detection and Analysis of the Oral Flora in Patients with Recurrent Aphthous Stomatitis.

The present study detected differences in the oral mucosal flora in healthy people and patients diagnosed with recurrent aphthous stomatitis (RAS) using the 16S ribosomal RNA high-throughput sequencing (rRNA-seq). All samples were collected from the lower lip mucosa of 100 healthy individuals and 100 patients with RAS. After the extraction, DNA was subjected to PCR amplification for the bacterial 16S rRNA gene, before subjecting to high-throughput sequencing, and matched to a database. Most bacterial species and most unique bacteria were from the healthy control group, and the amount of operational taxonomic units (OTUs) calculated was similar in the ulcer and nonulcer sites. Firmicutes, Proteobacteria, and Bacteroidetes were most abundant in the healthy group and in ulcer, nonulcer, and healed ulcer sites at the phylum level. Meanwhile, the number of Prevotella was significantly elevated in ulcer sites (P < 0.05). Healthy people had more species of bacteria inhabiting their oral mucosa than did RAS patients, and patients with ulcers had the lowest abundance of bacterial species. We suggest that the number of Prevotella is associated with RAS.

Evaluation of biochemical variables in patients with recurrent aphthous stomatitis

PurposeWe investigated the effects of various biochemical agents on the etiopathogenesis of recurrent aphthous stomatitis (RAS). MethodsWe enrolled 70 RAS patients and 70 healthy volunteers. Peripheral venous blood samples were collected. We performed complete blood counts, then measured the levels of ferritin, vitamin B12, iron, magnesium, phosphorus, calcium, thyroid-stimulating hormone, T3, T4, and 25-hydroxy D3. ResultsThe groups did not differ in terms of age (p = 0.912) or sex (p = 0.612). The levels of ferritin and 25-hydroxy vitamin D were significantly lower in RAS patients (both p ˂ 0.05). ConclusionVitamin D and/or ferritin deficiency may induce RAS. Measurements of vitamin D and ferritin may assist diagnosis and follow-up.

Serum ferritin level and B12 in a sample of Iraqi re-current aphthous stomatitis patients

Background: Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal disorders with a prevalence of 50-66%. The prevalence of hematinic deficiencies including ferritin and vitamin B12 deficiencies and their role in the prophylaxis and development of RAS is not well known. Many studies have demonstrated a high prevalence of hematinic deficiencies in patients with RAS. This study aimed to compare the serum level of ferritin and vitamin B12 in patients with recurrent aphthous ulcers and healthy controls. Subjects, Materials and Methods: The data were collected from patients who needed blood analysis to exclude anemia from November 2020 to May 2021. The study was approved by the institutional ethics committee. After recording patients' demographics ( age, gender, occupation, address) 5ml of blood was drawn from patients and controls in educational laboratories centrifuged at 3000 rpm for 10 minutes, then serum was stored at -20°C till the time of assessment of both serum ferritin and vitamin B12. The data were expressed as Mean ± SD. Students Unpaired t-test was used for comparing biochemical parameters between patients and controls and a p-value of &lt;0.05 was considered as a statistically significant while a p-value of&lt;0.001 was considered highly statistically significant. Results: A total of 30 RAS patients and 30 healthy control with age and gender matches were included. In the present study statistically, significant differences were observed in the serum level of ferritin and vitamin B12 between the two groups, 40% of the patients had low serum ferritin levels and 56.6 % of the patients had low serum vitamin B12 levels. Conclusion: Measuring serum ferritin and vitamin B12 levels are necessary for patients with recurrent aphthous stomatitis. It is also important for recurrent aphthous ulcer patients to have a nutritional diet containing iron and vitamin B12 to prevent the recurrence of aphthous ulceration

COMPARATIVE EFFICACY OF 1% CURCUMIN NANOMICELLE GEL AND 2% CURCUMIN GEL FOR TREATMENT OF RECURRENT APHTHOUS STOMATITIS: A DOUBLE-BLIND RANDOMIZED CLINICAL TRIAL.

Recurrent aphthous stomatitis (RAS) is a highly prevalent painful inflammatory condition. Curcumin is currently used as a medicinal herb with optimal anti-inflammatory properties for many inflammatory conditions. However, due to its low water solubility and consequently low bioavailability, its nanoparticulate formulation has been considered for use. This study aimed to compare the efficacy of topical application of 1% curcumin nanomicelle gel and 2% curcumin gel for treatment of RAS. This double-blind randomized clinical trial evaluated 48 RAS patients. The patients randomly received 1% curcumin nanomicelle gel or 2% curcumin gel, and were asked to apply it 3 times/day for 1 week. The severity of pain was measured using a visual analog scale (VAS), and the size of lesions (in millimeters) was measured by a periodontal probe before (baseline), and at 4, and 7 days after treatment. Data were analyzed by repeated measures ANOVA. No significant difference was noted in the pain score (P = .160) or size of lesions (P = .432) between the 2 groups at baseline. At 7 days, the pain score and size of lesions significantly decreased in both groups (P < .05). The reduction in pain score and lesion size was significantly greater in the curcumin nanomicelle gel group at both 4 and 7 days (P < .05). Also, the efficacy index (EI) was higher in curcumin nanomicelle gel group. The 1% curcumin nanomicelle gel can be effectively used to enhance the healing of RAS.