Chronic recurrent aphthous stomatitis: study of possible etiopathogenetic factors

Abstract

Actuality: The prevalence, high frequency and deterioration in quality of life caused by chronic recurrent aphthous stomatitis have led to a significant number of studies of the etiology and effective therapy of this disease. However, the etiology of chronic recurrent aphthous stomatitis is still unclear and the currently available therapies are insufficient.

Purpose: to study the clinical and pathogenetic features of chronic recurrent aphthous stomatitis.

Materials and methods: The study included 80 patients: 29 men (36.25%) and 51 women (63.75%) with CRAS who sought help at the Department of Therapeutic Dentistry of the Bogomolets National Medical University. The age of the study participants was from 19 to 55 years. Patients with CRAS were divided into two groups: the first group (n=35) without gastrointestinal diseases, the second group (n=45) with gastrointestinal pathology. The control group (n=20) consisted of patients with diseases of the oral mucosa. To study the spectrum and number of microorganisms, biological material was taken from the surface of aphthous elements and PCR testing was performed (Diagen laboratory, Kyiv). The concentration of blood haemoglobin, iron, vitamin B 12, folic acid in the blood was determined using tests performed in the Diagen laboratory, Kyiv. Statistical analysis was performed using the licensed package MedStat 12 and Microsoft Excel.

Results: In patients with gastrointestinal diseases (chronic gastritis and duodenitis, chronic pancreatitis), the most common recurrence of aphthae is 2 times per year, and in patients without gastrointestinal pathology, the most common recurrence of aphthae is 1 time per year. The results of the PCR study showed that in almost all clinical groups of patients examined, in samples taken from the surface of the aphthae, microorganisms of the genus Streptococcus and Staphylococcus were detected in 91.8% of cases, and Lactobacillus spp. were isolated in 51.4% of cases. Patients with CRAS had a significantly higher incidence of haemoglobin, iron, vitamin B12 and folic acid deficiency than patients in the control group.

Conclusion: When recurrent oral aphthae are detected, it is advisable to conduct an examination by a dentist and a gastroenterologist to identify the presence of gastrointestinal diseases in patients. There is a significant association of haemoglobin, iron, vitamin B12 and folic acid deficiency with CRAS.

Key words: chronic recurrent aphthous stomatitis, gastrointestinal pathology, microbiome, blood parameters.