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RECURRENT APHTHOUS ULCERATIONS AND CURRENT APPROACHES IN ITS TREATMENT

Yıl 2008, Cilt: 11 Sayı: 2, 118 - 125, 04.11.2011

Feyza Otan Ozden Bora Ozden Umut Tunga

Öz

Recurrent aphthous ulcer (RAU) is one of the most common oral mucosal diseases and it affects approximately %25 of the society. It is characterized with recurrent painful, round-shaped ulcers surrounded with erythemathosus halo. Local and systemic conditions together with genetic, immunologic and microbiological factors were shown to be possible etiological factors but there is no consensus for its etiology. Although several immunomodulators, topical and systemic steroid drugs, topical analgesics and antibiotics have shown to be effective for the treatment of RAU, it is not possible to eliminate the recurrence. In this article; etiology, clinical appearance, differential diagnosis and treatment methods are reviewed.

 

ÖZET

Tekrarlayan aftöz ülserler (TAÜ) en sık rastlanılan ağız mukozası hastalıklarından biridir ve toplumun yaklaşık %25’ini etkilemektedir. Tipik olarak tekrarlayan, sığ ve eritematöz bir hale ile çevrili, oldukça ağrılı ülserler ile karakterizedir. Lokal ve sistemik koşullar ile genetik, immünolojik ve mikrobiyal faktörler olası etiyolojik faktörler arasında gösterilmiş olmakla beraber, kesin bir etiyolojik faktörden söz edilememektedir. TAÜ tedavisi amacıyla çeşitli immün modülatörler, topikal ve sistemik steroidler, topikal analjezikler, topikal antibiyotikler ve çeşitli kaplayıcı ajanların başarılı bir şekilde uygulandığı gösterilmiş olmasına rağmen tekrarları önlemek mümkün olmamıştır. Bu makalede tekrarlayan aftöz ülserlerin etiyolojisi, klinik görünümü, ayırd edici özellikleri ve tedavi seçenekleri ele alınmıştır.

Anahtar Kelimeler: Aftöz ülserler, etiyoloji, klinik görünüm, tedavi

Anahtar Kelimeler

Aphthous ulcers etiology clinical appearance treatment

Kaynakça

  • Ship JA. Recurrent aphthous stomatitis. An update. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996; 81: 141-7.
  • Cawson RA, Odell EW. Diseases of the oral mucosa: Non- infective stomatitis. In: Cawson RA, Odell EW, 8th ed: Cawson’s Essentials of Oral Pathology and Oral Medicine. London: Churchill Livingston; 2002. p. 192-6.
  • Rodu B, Mattingly G. Oral mucosal ulcers: diagnosis and management. J Am Dent Assoc 1992; 123: 83-6.
  • Rogers RS. Recurrent aphthous stomatitis: clinical characteristics and associated systemic disorders. Semin Cutan Med Surg 1997; (4): 278-83. 5-Brody HA, Silverman S. Studies on recurrent oral aphthae. I.
  • Clinical and laboratory comparisons. Oral Surg Oral Med Oral Pathol ; 27(1): 27-34. Neville BW, Damm DD, Allen CM, Bouquot J. Allergies and Immunologic Diseases. In: Neville B, Damm D, Allen C, Bouquot J, nd ed: Oral and Maxillofacial Pathology. Philadelphia, Pennsylvania: W.B. Saunders Company; 1995.p. 236-9.
  • Woo SB, Sonis ST. Recurrent aphthous ulcers: a review of diagnosis and treatment. J Am Dent Assoc 1996; 127: 1202-13.
  • McCartan BE, Sullivan A. The association of menstrual cycle, pregnancy and menapause with recurrent oral aphthous stomatitis: a review and critique. Obstet Gynecol 1992; 80(3): 455-8.
  • Porter SR, Scully C, Flint S. Hematologic status in recurrent aphthous stomatitis compared with other oral disease. Oral Surg Oral Med Oral Pathol 1988; 66(1): 41-4.
  • Shashy RG, Ridley MB. Aphthous ulcers: a difficult clinical entity. Am J Otolaryngol 2000; 21: 389-393.
  • Pedersen A. Recurrent aphthous ulceration: virological and immunological aspects. APMİS 1993; 37 (101): 1-37.
  • Weusten BL, Van de Wiel A. Aphthous ulcers and vitamin B12 deficiency Neth J Med 1998; 53(4): 172-5.
  • Thomas HC, Ferguson A, McLennan JG, Mason DK. Food antibodies in oral disease: a study of serum antibodies to food proteins in aphthous ulceration and other oral diseases. J Clin Pathol ; 26(5): 371-4. Wray D, Graykowski EA, Notkins AL. Role of mucosal injury in initiating recurrent aphthous stomatitis. Br Med J (Clin Res Ed) ; 283(6306): 1569-70.
  • Wray D. Gluten-sensitive recurrent aphthous stomatitis. Dig Dis Sci 1981; 26(8): 737-40.
  • Hay KD, Reade PC. The use of an elimination diet in the treatment of recurrent aphthous ulceration of the oral cavity. Oral Surg Oral Med Oral Pathol 1984; 57(5): 504-507.
  • Wright A, Ryan FP, Willingham SE, Holt S, Page AC, Hindle MO, Franklin CD. Food allergy or intolerance in severe aphthous ulceration of the mouth. Br Med J(Clin Res Ed) 1986; 292(6530): 8.
  • Nolan A, Lamey PJ, Milligan KA, Forsyth A. Recurrent aphthous ulceration and food sensitivity. J Oral Pathol Med 1991; (10): 473-5.
  • O’Farrelly C, O’Mahony C, Graeme-Cook F, Feighery C, McCartan BE, Weir DG. Gliadin antibodies identify gluten-sensitive oral ulceration in the absence of villous atrophy. J Oral Pathol Med ; 20(10): 476-8. Lamey PJ, Lewis MA, Rees TD, Fowler C, Binnie WH, Forsyth A. Sensitivity reaction to the cinnamonaldehyde component of toothpaste. Br Dent J 1990; 168(3): 115-8.
  • Veloso FT, Saleiro JV. Small-bowel changes in recurrent ulceration of the mouth. Hepatogastroenterology 1987; 34(1): 36-7.
  • Porter SR, Scully C. Aphthous stomatitis-an overview of aetiopathogenesis and management. Clin Exp Dermatol 1991; 16(4): 243.
  • Rennie JS, Reade PC, Hay KD, Scully C. Recurrent aphthous stomatitis. Br Dent J 1985; 159(11): 361-367.
  • Bernstein ML, McDonald JS. Oral lesions in Crohn's disease: report of two cases and update of the literature. Oral Surg Oral Med Maeda K, Okada M, Yao T, Sakurai T, Iida M., Fuchigami T, Yoshinaga K, Imamura K, Okada Y, Sakamoto K. Intestinal and extraintestinal complications of Crohn's disease: predictors and cumulative probability of complications. J Gastroenterol, 1994; (5): 577-82.
  • Rehberger A, Puspok A, Stallmeister T, Jurecka W, Wolf K. Crohn’s disease masquerading as aphthous ulcers. Eur J Dermatol ; 8(4): 274-6. Greenspan JS, Gadol N, Olson JA, Hoover CI, Jacobsen PL, Shillitoe EJ, Armitage GC. Lymphocyte function in recurrent aphthous ulceration. J Oral Pathol 1985; 14(8): 592-602.
  • Savage NW, Seymour GJ, Kruger BJ. T-lymphocyte subset changes in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1985; 60(2): 175-81.
  • Savage NW, Mahanonda R, Seymour GJ, Bryson GJ, Collins RJ. The proportion of suppressor-inducer T-lymphocytes is reduced in recurrent aphthous stomatitis. J Oral Pathol 1988; 17(6): 293-7.
  • Pedersen A, Klausen B, Hougen HP, Stenvang JP. T-lymphpcyte subsets in recurrent aphthous ulceration. J Oral Pathol Med 1989; (1): 59-60.
  • Pedersen A, Hougen HP, Kenrad B. T-lymphocyte subsets in oral mucosa of patients with recurrent aphthous ulceration. J Oral Pathol Med 1992; 21(4): 176-8.
  • Landesberg R, Fallon M, Insel R. Alterations of T helper/inducer and T suppressor/inducer cells in patients with recurrent aphthous ulcers. Oral Surg Oral Med Oral Pathol 1990; 69(2): 205-8.
  • Hoover CI, Olson JA, Greenspan JS. Humoral responses and cross-reactivity to viridans streptococci in recurrent aphthous ulceration. J Dent Res 1986; 65(8): 1101-4.
  • Riggio MP, Lennon A, Ghodratnama F, Wray D.. Lack of association between streptococcus oralis and recurrent aphthous stomatitis. J Oral Pathol Med 2000; 29(1): 26-32.
  • Riggio MP, Lennon A, Wray D. Detection of Helicobacter pylori DNA in recurrent aphthous stomatitis tissue by PCR. J Oral Pathol Med 2000; 29(10): 507-13.
  • Domingue GJ, Woody HB. Bacterial persistence and expression of disease. Clin Microbiol Rev 1997; 10(2): 320-344.
  • Lindemann RA, Riviere GR, Sapp JP. Serum antibody responses to indigenous oral mucosal antigens and selected laboratory- maintained bacteria in recurrent aphthous ulceration. Oral Surg Oral Med Oral Pathol 1985; 59(6): 585-9.
  • Francis TC, Oppenheim JJ. Impaired lymphocyte stimulation by some streptococcal antigens in patients with recurrent aphthous stomatitis and rheumatic heart disease. Clin Exp Immunol 1970; 6(4): 86.
  • Fritscher AM, Cherubini K, Chies J, Dias AC. Association between Helicobacter pylori and recurrent aphthous stomatitis in children and adolescents. J Oral Pathol Med 2004; 33(3): 129-32.
  • Albanidou-Farmaki E, Giannoulis L, Markopoulos A, Fotiades S, Aggouridaki X, Farmakis K, Papanayotou P. Outcome following treatment for Helicobacter pylori in patients with recurrent aphthous stomatitis. Oral Dis 2005; 11(1): 22-6.
  • Pedersen A. Are recurrent oral aphthous ulcers of viral etiology? MedHypotheses 1991; 36(3): 206-210.
  • Tantivanich S, Vanadurongwan S, Tharavanij S. Herpes simplex virus in patients with aphthous ulcers in Bangkok. Southest Asian J Trop Med Public Health 1981; 12(4): 533-5.
  • Studd M, McCance DJ, Lehner T. Detection of HSV-1 DNA in patients with Behcet’s syndrome and in patients with recurrent oral ulcers by the polymerase chain reaction. J Med Microbiol 1991; (1): 39-43.
  • Pedersen A, Hornsleth A. Recurrent aphthous ulceration: a possible clinical manifestation of reactivation of varicella zoster or cytomegalovirus infection. J Oral Pathol Med 1993; 22(2): 64-8.
  • Pedersen A, Madsen HO, Vestergaard BF, Ryder LP. Varicella- zoster virus DNA in recurrent aphthous ulcers. Scand J Dent Res ; 101(5): 311-3. Lehner T. Pathology of recurrent oral ulceration and oral ulceration in Behcet’s syndrome:light, electron and fluorescence microscopy. J Pathology 1969; 97(3): 481-494.
  • Field EA, Allan RB. Review article: oral ulceration- aetiopathogenesis, clinical diagnosis and management in the gastrointestinal clinic. Review. Aliment Pharmacol Ther 2003; (10): 949-962.
  • Weathers DR, Griffin JW. Intraoral ulcerations of recurrent herpes simplex and recurrent aphthae: two distinct clinical entities. J Am Dent Assoc 1970; 81(1): 81-88.
  • Natah SS, Hayrinen-Immonen R, Hietanen J, Malmstrom M, Konttinen YT. Immunolocalisation of tumour necrosis factor-alpha expressing cells in recurrent aphthous ulcer lesions (RAU). J Oral Pathol Med 2000; 29(1): 19-25.
  • International Study Group For Behçet’s disease Criteria for diagnosis of Behçet’s disease. Lancet 1990; 335: 1078-1080.
  • Burgess JA, Johnson BD, Sommers E. Pharmacological management of recurrent oral mucosal ulceration. Drugs 1990; 39(1): 65.
  • Rodu B, Russell CM. Performance of a hydroxypropyl cellulose film former in normal and ulcerated oral mucosa. Oral Surg Oral Med Eisen D, Ellis CN. Topical cyclosporin for oral mucosal disorders. J Am Acad Dermatol 1990; 23: 1259-64.
  • Katz J, Langevitz P, Shemer J, Barak S, Livneh A. Prevention of recurrent aphthous stomatitis with colchicine: an open trial. J Am Acad Dermatol 1994; 31: 459-461.
  • Murray B, McGuinness N, Biagioni P, Hyland P, Lamey PJ. A comparative study of the efficacy of Aphtheal in the management of recurrent minor aphthous ulceration. J Oral Pathol Med 2005; 34(7): 9.
  • Handfield-Jones S, Allen BR, Littlewood SM. Dapsone use with oral-genital ulcers. Br J Dermatol 1985; 113(4): 501.
  • Pedersen A, Klausen B, Hougen HP, Ryder L, Winther K. Immunomodulation by LongoVital in patients with recurrent aphthous ulceration. J Oral Pathol Med 1990; 19(8): 376-80.
  • Pedersen A, Hougen HP, Klausen B, Winther K. LongoVital in the prevention of recurrent aphthous ulceration. J Oral Pathol Med ; 19(8): 371-5. Sun A, Chiang CP, Chiou PS, Wang JT, Liu BY, Wu YC. Immunomodulation by levamisole in patients with recurrent aphthous ulcers or oral lichen planus. J Oral Pathol Med 1994; 23(4): 172-7.
  • Colvard M, Kuo P. Managing aphthous ulcers: laser treatment applied. J Am Dent Assoc 1991; 122(6): 51-3. 61-Wormster GP, Mack L, Lenox T, Hewlett D, Goldfarb J,
  • Yarrish RL, Reitano M. Lack of effect of oral acyclovir on prevention of aphthous stomatitis. Otolaryngol Head Neck Surg ; 98(1): 14-7. 62- Wright EF.. Clinical effectiveness of lysine in treating recurrent aphthous ulcers and herpes labialis. Gen Dent 1994; 42(1): 42. 63- McBride DR. Management of Aphthous Ulcers. Am FamPhysician 2000; 62:149-154. 64- Scully C, Gorsky M, Lozada-Nur F. The, diagnosis and management of recurrent aphthous stomatitis: A consensus approach. J Am Dent Assoc 2003; 134: 200–207.

TEKRARLAYAN AFTÖZ ÜLSERASYONLAR VE TEDAVİSİNDE GÜNCEL YAKLAŞIMLAR

Yıl 2008, Cilt: 11 Sayı: 2, 118 - 125, 04.11.2011

Feyza Otan Ozden Bora Ozden Umut Tunga

Öz

Tekrarlayan aftöz ülserler (TAÜ) en sık rastlanılan ağız mukozası hastalıklarından biridir ve toplumun yaklaşık %25’ini etkilemektedir. Tipik olarak tekrarlayan, sığ ve eritematöz bir hale ile çevrili, oldukça ağrılı ülserler ile karakterizedir. Lokal ve sistemik koşullar ile genetik, immünolojik ve mikrobiyal faktörler olası etiyolojik faktörler arasında gösterilmiş olmakla beraber, kesin bir etiyolojik faktörden söz edilememektedir. TAÜ tedavisi amacıyla çeşitli immün modülatörler, topikal ve sistemik steroidler, topikal analjezikler, topikal antibiyotikler ve çeşitli kaplayıcı ajanların başarılı bir şekilde uygulandığı gösterilmiş olmasına rağmen tekrarları önlemek mümkün olmamıştır. Bu makalede tekrarlayan aftöz ülserlerin etiyolojisi, klinik görünümü, ayırd edici özellikleri ve tedavi seçenekleri ele alınmıştır

Anahtar Kelimeler

Aftöz ülserler etiyoloji klinik görünüm tedavi

Kaynakça

  • Ship JA. Recurrent aphthous stomatitis. An update. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996; 81: 141-7.
  • Cawson RA, Odell EW. Diseases of the oral mucosa: Non- infective stomatitis. In: Cawson RA, Odell EW, 8th ed: Cawson’s Essentials of Oral Pathology and Oral Medicine. London: Churchill Livingston; 2002. p. 192-6.
  • Rodu B, Mattingly G. Oral mucosal ulcers: diagnosis and management. J Am Dent Assoc 1992; 123: 83-6.
  • Rogers RS. Recurrent aphthous stomatitis: clinical characteristics and associated systemic disorders. Semin Cutan Med Surg 1997; (4): 278-83. 5-Brody HA, Silverman S. Studies on recurrent oral aphthae. I.
  • Clinical and laboratory comparisons. Oral Surg Oral Med Oral Pathol ; 27(1): 27-34. Neville BW, Damm DD, Allen CM, Bouquot J. Allergies and Immunologic Diseases. In: Neville B, Damm D, Allen C, Bouquot J, nd ed: Oral and Maxillofacial Pathology. Philadelphia, Pennsylvania: W.B. Saunders Company; 1995.p. 236-9.
  • Woo SB, Sonis ST. Recurrent aphthous ulcers: a review of diagnosis and treatment. J Am Dent Assoc 1996; 127: 1202-13.
  • McCartan BE, Sullivan A. The association of menstrual cycle, pregnancy and menapause with recurrent oral aphthous stomatitis: a review and critique. Obstet Gynecol 1992; 80(3): 455-8.
  • Porter SR, Scully C, Flint S. Hematologic status in recurrent aphthous stomatitis compared with other oral disease. Oral Surg Oral Med Oral Pathol 1988; 66(1): 41-4.
  • Shashy RG, Ridley MB. Aphthous ulcers: a difficult clinical entity. Am J Otolaryngol 2000; 21: 389-393.
  • Pedersen A. Recurrent aphthous ulceration: virological and immunological aspects. APMİS 1993; 37 (101): 1-37.
  • Weusten BL, Van de Wiel A. Aphthous ulcers and vitamin B12 deficiency Neth J Med 1998; 53(4): 172-5.
  • Thomas HC, Ferguson A, McLennan JG, Mason DK. Food antibodies in oral disease: a study of serum antibodies to food proteins in aphthous ulceration and other oral diseases. J Clin Pathol ; 26(5): 371-4. Wray D, Graykowski EA, Notkins AL. Role of mucosal injury in initiating recurrent aphthous stomatitis. Br Med J (Clin Res Ed) ; 283(6306): 1569-70.
  • Wray D. Gluten-sensitive recurrent aphthous stomatitis. Dig Dis Sci 1981; 26(8): 737-40.
  • Hay KD, Reade PC. The use of an elimination diet in the treatment of recurrent aphthous ulceration of the oral cavity. Oral Surg Oral Med Oral Pathol 1984; 57(5): 504-507.
  • Wright A, Ryan FP, Willingham SE, Holt S, Page AC, Hindle MO, Franklin CD. Food allergy or intolerance in severe aphthous ulceration of the mouth. Br Med J(Clin Res Ed) 1986; 292(6530): 8.
  • Nolan A, Lamey PJ, Milligan KA, Forsyth A. Recurrent aphthous ulceration and food sensitivity. J Oral Pathol Med 1991; (10): 473-5.
  • O’Farrelly C, O’Mahony C, Graeme-Cook F, Feighery C, McCartan BE, Weir DG. Gliadin antibodies identify gluten-sensitive oral ulceration in the absence of villous atrophy. J Oral Pathol Med ; 20(10): 476-8. Lamey PJ, Lewis MA, Rees TD, Fowler C, Binnie WH, Forsyth A. Sensitivity reaction to the cinnamonaldehyde component of toothpaste. Br Dent J 1990; 168(3): 115-8.
  • Veloso FT, Saleiro JV. Small-bowel changes in recurrent ulceration of the mouth. Hepatogastroenterology 1987; 34(1): 36-7.
  • Porter SR, Scully C. Aphthous stomatitis-an overview of aetiopathogenesis and management. Clin Exp Dermatol 1991; 16(4): 243.
  • Rennie JS, Reade PC, Hay KD, Scully C. Recurrent aphthous stomatitis. Br Dent J 1985; 159(11): 361-367.
  • Bernstein ML, McDonald JS. Oral lesions in Crohn's disease: report of two cases and update of the literature. Oral Surg Oral Med Maeda K, Okada M, Yao T, Sakurai T, Iida M., Fuchigami T, Yoshinaga K, Imamura K, Okada Y, Sakamoto K. Intestinal and extraintestinal complications of Crohn's disease: predictors and cumulative probability of complications. J Gastroenterol, 1994; (5): 577-82.
  • Rehberger A, Puspok A, Stallmeister T, Jurecka W, Wolf K. Crohn’s disease masquerading as aphthous ulcers. Eur J Dermatol ; 8(4): 274-6. Greenspan JS, Gadol N, Olson JA, Hoover CI, Jacobsen PL, Shillitoe EJ, Armitage GC. Lymphocyte function in recurrent aphthous ulceration. J Oral Pathol 1985; 14(8): 592-602.
  • Savage NW, Seymour GJ, Kruger BJ. T-lymphocyte subset changes in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1985; 60(2): 175-81.
  • Savage NW, Mahanonda R, Seymour GJ, Bryson GJ, Collins RJ. The proportion of suppressor-inducer T-lymphocytes is reduced in recurrent aphthous stomatitis. J Oral Pathol 1988; 17(6): 293-7.
  • Pedersen A, Klausen B, Hougen HP, Stenvang JP. T-lymphpcyte subsets in recurrent aphthous ulceration. J Oral Pathol Med 1989; (1): 59-60.
  • Pedersen A, Hougen HP, Kenrad B. T-lymphocyte subsets in oral mucosa of patients with recurrent aphthous ulceration. J Oral Pathol Med 1992; 21(4): 176-8.
  • Landesberg R, Fallon M, Insel R. Alterations of T helper/inducer and T suppressor/inducer cells in patients with recurrent aphthous ulcers. Oral Surg Oral Med Oral Pathol 1990; 69(2): 205-8.
  • Hoover CI, Olson JA, Greenspan JS. Humoral responses and cross-reactivity to viridans streptococci in recurrent aphthous ulceration. J Dent Res 1986; 65(8): 1101-4.
  • Riggio MP, Lennon A, Ghodratnama F, Wray D.. Lack of association between streptococcus oralis and recurrent aphthous stomatitis. J Oral Pathol Med 2000; 29(1): 26-32.
  • Riggio MP, Lennon A, Wray D. Detection of Helicobacter pylori DNA in recurrent aphthous stomatitis tissue by PCR. J Oral Pathol Med 2000; 29(10): 507-13.
  • Domingue GJ, Woody HB. Bacterial persistence and expression of disease. Clin Microbiol Rev 1997; 10(2): 320-344.
  • Lindemann RA, Riviere GR, Sapp JP. Serum antibody responses to indigenous oral mucosal antigens and selected laboratory- maintained bacteria in recurrent aphthous ulceration. Oral Surg Oral Med Oral Pathol 1985; 59(6): 585-9.
  • Francis TC, Oppenheim JJ. Impaired lymphocyte stimulation by some streptococcal antigens in patients with recurrent aphthous stomatitis and rheumatic heart disease. Clin Exp Immunol 1970; 6(4): 86.
  • Fritscher AM, Cherubini K, Chies J, Dias AC. Association between Helicobacter pylori and recurrent aphthous stomatitis in children and adolescents. J Oral Pathol Med 2004; 33(3): 129-32.
  • Albanidou-Farmaki E, Giannoulis L, Markopoulos A, Fotiades S, Aggouridaki X, Farmakis K, Papanayotou P. Outcome following treatment for Helicobacter pylori in patients with recurrent aphthous stomatitis. Oral Dis 2005; 11(1): 22-6.
  • Pedersen A. Are recurrent oral aphthous ulcers of viral etiology? MedHypotheses 1991; 36(3): 206-210.
  • Tantivanich S, Vanadurongwan S, Tharavanij S. Herpes simplex virus in patients with aphthous ulcers in Bangkok. Southest Asian J Trop Med Public Health 1981; 12(4): 533-5.
  • Studd M, McCance DJ, Lehner T. Detection of HSV-1 DNA in patients with Behcet’s syndrome and in patients with recurrent oral ulcers by the polymerase chain reaction. J Med Microbiol 1991; (1): 39-43.
  • Pedersen A, Hornsleth A. Recurrent aphthous ulceration: a possible clinical manifestation of reactivation of varicella zoster or cytomegalovirus infection. J Oral Pathol Med 1993; 22(2): 64-8.
  • Pedersen A, Madsen HO, Vestergaard BF, Ryder LP. Varicella- zoster virus DNA in recurrent aphthous ulcers. Scand J Dent Res ; 101(5): 311-3. Lehner T. Pathology of recurrent oral ulceration and oral ulceration in Behcet’s syndrome:light, electron and fluorescence microscopy. J Pathology 1969; 97(3): 481-494.
  • Field EA, Allan RB. Review article: oral ulceration- aetiopathogenesis, clinical diagnosis and management in the gastrointestinal clinic. Review. Aliment Pharmacol Ther 2003; (10): 949-962.
  • Weathers DR, Griffin JW. Intraoral ulcerations of recurrent herpes simplex and recurrent aphthae: two distinct clinical entities. J Am Dent Assoc 1970; 81(1): 81-88.
  • Natah SS, Hayrinen-Immonen R, Hietanen J, Malmstrom M, Konttinen YT. Immunolocalisation of tumour necrosis factor-alpha expressing cells in recurrent aphthous ulcer lesions (RAU). J Oral Pathol Med 2000; 29(1): 19-25.
  • International Study Group For Behçet’s disease Criteria for diagnosis of Behçet’s disease. Lancet 1990; 335: 1078-1080.
  • Burgess JA, Johnson BD, Sommers E. Pharmacological management of recurrent oral mucosal ulceration. Drugs 1990; 39(1): 65.
  • Rodu B, Russell CM. Performance of a hydroxypropyl cellulose film former in normal and ulcerated oral mucosa. Oral Surg Oral Med Eisen D, Ellis CN. Topical cyclosporin for oral mucosal disorders. J Am Acad Dermatol 1990; 23: 1259-64.
  • Katz J, Langevitz P, Shemer J, Barak S, Livneh A. Prevention of recurrent aphthous stomatitis with colchicine: an open trial. J Am Acad Dermatol 1994; 31: 459-461.
  • Murray B, McGuinness N, Biagioni P, Hyland P, Lamey PJ. A comparative study of the efficacy of Aphtheal in the management of recurrent minor aphthous ulceration. J Oral Pathol Med 2005; 34(7): 9.
  • Handfield-Jones S, Allen BR, Littlewood SM. Dapsone use with oral-genital ulcers. Br J Dermatol 1985; 113(4): 501.
  • Pedersen A, Klausen B, Hougen HP, Ryder L, Winther K. Immunomodulation by LongoVital in patients with recurrent aphthous ulceration. J Oral Pathol Med 1990; 19(8): 376-80.
  • Pedersen A, Hougen HP, Klausen B, Winther K. LongoVital in the prevention of recurrent aphthous ulceration. J Oral Pathol Med ; 19(8): 371-5. Sun A, Chiang CP, Chiou PS, Wang JT, Liu BY, Wu YC. Immunomodulation by levamisole in patients with recurrent aphthous ulcers or oral lichen planus. J Oral Pathol Med 1994; 23(4): 172-7.
  • Colvard M, Kuo P. Managing aphthous ulcers: laser treatment applied. J Am Dent Assoc 1991; 122(6): 51-3. 61-Wormster GP, Mack L, Lenox T, Hewlett D, Goldfarb J,
  • Yarrish RL, Reitano M. Lack of effect of oral acyclovir on prevention of aphthous stomatitis. Otolaryngol Head Neck Surg ; 98(1): 14-7. 62- Wright EF.. Clinical effectiveness of lysine in treating recurrent aphthous ulcers and herpes labialis. Gen Dent 1994; 42(1): 42. 63- McBride DR. Management of Aphthous Ulcers. Am FamPhysician 2000; 62:149-154. 64- Scully C, Gorsky M, Lozada-Nur F. The, diagnosis and management of recurrent aphthous stomatitis: A consensus approach. J Am Dent Assoc 2003; 134: 200–207.
Toplam 53 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Case Reports
Yazarlar

Feyza Otan Ozden

Bora Ozden

Umut Tunga

Yayımlanma Tarihi 4 Kasım 2011
Gönderilme Tarihi 4 Kasım 2011
Yayımlandığı Sayı Yıl 2008Cilt: 11 Sayı: 2

Kaynak Göster

EndNote Otan Ozden F, Ozden B, Tunga U (01 Kasım 2011) TEKRARLAYAN AFTÖZ ÜLSERASYONLAR VE TEDAVİSİNDE GÜNCEL YAKLAŞIMLAR. Cumhuriyet Dental Journal 11 2 118–125.

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