Ulceração aftosa recorrente: revisão dos conceitos atuais
Recurrent aphthous ulceration: a review of the present aspects
Pereira, K.M.A.; Rocha, D.A.P.; Galvão, H.C.; Freitas, R.A.
Resumo
A ulceração aftosa recorrente (UAR) oral é uma condição caracterizada pelo desenvolvimento periódico de úlceras solitárias ou múltiplas e dolorosas na mucosa oral, de etiologia ainda não muito bem esclarecida e bastante incômoda para o paciente. Entre os fatores predisponentes propostos estão estresse, história familiar, trauma, hipersensibilidade alimentar, deficiências nutricionais, alterações hematológicas e, ainda, um possível envolvimento bacteriano. Porém, a etiologia é ainda controversa, sendo mais aceito o mecanismo imunológico, especialmente a citotoxicidade mediada por células. Como numerosos fatores têm sido propostos, torna-se difícil estabelecer um protocolo terapêutico eficaz para todos os casos. Tanto a etiologia quanto o tratamento parecem ser particulares para determinados pacientes. O entendimento dessa condição é importante para o cirurgião-dentista, pois ela dificulta a alimentação em muitos casos, interferindo na qualidade de vida dos pacientes por ela acometidos.
Palavras-chave
Abstract
Keywords
Referências
1. Birek C, Grandhi R, Mcneill K, Singer D, Ficarra G, Bowden G: Detection of Helicobacter pylori in oral aphthous ulcers. J Oral Pathol Med. 1999; 28: 197-203.
2. Natah SS, Konttinen YT, Enattah NS, Ashammakhi N, Sharkey KA, Häyrinen-Immonen R. Recurrent aphthous ulcers today: a review of the growing knowledge. Int J Oral Maxillofac Surg. 2004; 33: 221-34.
3. Fritscher AMG, Cherubini K, Chies J, Dias ACO. Association between Helicobacter pylori and recurrent aphthous stomatitis in children and adolescents. J Oral Pathol Med. 2004; 33: 129-32.
4. Sharon-Buller A, Sela M. CO2-laser treatment of ulcerative lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 97: 332-4.
5. Garnick Jj, Singh B, Winkley G. Effectiveness of a medicament containing silicon dioxide, aloe and allantoin on aphtous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 86: 550-6.
6. Ogura M, Yamamoto T, Morita M, Watanabe T. A case-control study on food intake of patients with recurrent aphthous stomatitis. � � �� � Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 91: 45-9.
7. Neville BW, Damm DD, Allen CM, Bouquot JE. �Doenças imunológicas e alérgicas. In: Neville BW, Damm DD, Allen CM, Bouquot JE. Patologia oral & maxilofacial. 2ª ed. Rio de Janeiro: Guanabara Koogan; 2004. p. 275-302.
8. � � � � � � � � � � � Victória JMN, Kalapothakis E, Silva JFC, GOMEZ RS. Helicobacter pylori DNA in recurrent aphthous stomatitis. J Oral Pathol Med. 2003; 32:219-23.
9. Scully C, Porter SR. Recurrent aphthous stomatitis: current concepts of etiology, pathogenesis and management. J Oral Pathol Med. 1989;18:21-7.
10. � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �Regezi JA, Sciubba JJ. Condições ulcerativas. In: Regezi JA, Sciubba JJ. ���������������Patologia bucal: correlações clinicopatológicas. 3ª ed. Rio de Janeiro: Guanabara Koogan; 2000. p.27-75.
11. Vicent SD, Lilly GE. Clinical, historic, and therapeutic features of aphthous stomatits. Oral Surg Oral Med Oral Pathol. 1992; 74: 70-86.
12. � � � � � � � � � � � � � � Ship JA, Chavez EM, Coerr PA, Henson BS, Sarmadi M. Recurrent aphthous stomatitis. ����������������Quintessence Int. 2000;31:95-112.
13. Kvan E, Gjerdet NR, Bondevik O. Traumatic ulcers and pain during orthodontic treatment. Community Dent Oral Epidemiol. 1987; 15: 104-7.
14. Wray D, Graykowski EA, Notkins AL. Role of mucosal injury in initiating recurrent aphthous ulcerations. Br Med J. 1981; 283 (6306): 1569-70.
15. Heft M, Wray D. Anxiety levels in recurrent aphthous stomatitis (RAS) patients. J Dent Res. 1982; 61:264.
16. Field AE, Rotter E, Speechley JA, Tyldesley WR. Clinical and haematological assessment of children with recurrent aphthous ulceration. Br Dent J. 1987; 163 (1): 19-22.
17. Atkin PA, Xu X, Thornhill MH. Minor recurrent aphthous stomatitis and smoking: an epidemiological study measuring plasma cotinine. Oral Dis. 2002; 8:173-6.
18. 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: 64-8.
19. Studd M, Maccance DJ, Lehner T. Detection of HSV-1 DNA in patients with Behçet´s syndrome and in patients with recurrent oral ulcers by polymerase chain reaction. J Med Microbiol. 1991; 34: 39-43.
20. Wormser GP, Mack L, Lennox T. Lack of effect of oral aciclovir on prevention of aphthous stomatitis. Otolaryngol Head Neck Surg. 1988; 98: 14-7.
21. Porter SR, Barker GR, Scully C, Macfarlane G, Bain L. Serum IgG antibodies to Helicobacter pylori in patients with recurrent aphthous stomatitis and other oral disorders. Oral Surg Oral Med Oral Pathol. 1997; 83 (suppl 3):325-8.
22. Natah SS, Häyrinen-Immonen R, Hietanen J, Malmströn M, Konttinen YT. � ��� � � � Quantitative assessment of mast cells in recurrent aphthous ulcers (RAU). J Oral Pathol Med. 1998;27:124-9.
23. Wray D, Charon J. Polymorphonuclear neutrophil function in recurrent aphthous stomatitis. J Oral Pathol Med. 1991; 20: 392-4.
24. Häyrinen-Immonen R, Sorsa T, Nordström M, Malmströn M, Konttinen YT. � � � � Collagenase and stromelysin in recurrent aphthous ulcers (RAU). Int J Oral Maxillofac Surg. 1993; 22: 46-9.
25. Sistig S, Cekic-Arambasin A, Rabatic S, Vucicevic-Boras V, Kleinheinz J, Piffko J. Natural immunitty in recurrent aphthous ulceration. J Oral Med Pathol. 2001; 30: 275-80.
26. Sun A., Chang JG, Chu CT, Liu BY, Wang JT, Leu JS, et al. Expression of interleukin-2 by activated peripheral blood lymphocytes upregulated by the plasma level of interleukin-2 in patients with recurrent aphthous ulcers. Proc Natl Sci Counc Repub China. B 2000; 24: 116-22.
27. Revuz J, Guillaume JC, Janier M, Hans P, Marchand C, Souteryrand P, et al. Crossover study of thalidomide vs placebo in severe recurrent aphthous stomatitis. Arch Dermatol. 1990; 126: 923-7.
28. Thompson C. Thalidomide effective for AIDS-related oral ulcers. Lancet. 1995; 346(8985): 1289.
29. Kerr AR, Drexel CA, Spielman AI. �������������The efficacy and safety of 50 mg penicillin G troches for recurrent aphthous ulcers. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 96: 685-94
30. Madhi AB, Coulter WA, Woolfson AD, Lamey PJ. Efficacy of bioadhesive patches in the treatment of recurrent aphthous stomatitis. J Oral Pathol Med. 1996; 25:416-9.
31. Lo Muzio L, Valle AD, Mignogna MD, Pannone G, Bucci P, Bucci E, et al. The treatment of oral aphthous ulceration or erosive lichen planus with topical clobetasol propionate in three preparation: a clinical and pilot study on 54 patients. J Oral Pathol Med. 2001; 30: 611-7.
32. Miles DA, Bricker SL, Razmus TF Potter RH. Triamcinolone acetonide versus chlorhexidine for treatment of recurrent stomatitis. Oral Surg Oral Med Oral Pathol. 1993; 75: 397-402.
33. Khandwala A, Van Inwegen RG, Alfano MC. 5% Amlexanox oral paste, a new treatment for recurrent minor aphthous ulcers. I. Clinical demonstration of acceleration of healing and resolution of pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997; 83: 222-30.
34. Khandwala A, Van Inwegen RG, Charney MR, Alfano MC. 5% Amlexanox oral paste, a new treatment for recurrent minor aphthous ulcers. II. Pharmacokinetics and demonstration of clinical safety. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997; 83: 231-8.
35. Herlofson BB, Barkvoll P. The effect of two toothpaste detergents on the frequency of recurrent aphthous ulcers. Acta Odontol Scand. 1996; 54: 150-3.
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email