Recurrent apthous

stomatitis

. Done by: Marwa Anwar Abu Madegem

ID: 201811773.
. Supervisor: Dr. Mohammed Shalabi
 :Seminar outline

.Definition -1
.Etiology -2
.clinical feature -3
.presentation -4
.calcification -5
.clinical type -6
.syndrome related -7
.differential diagnosis -8
.treatment -9
 Aphthous/ canker

:The term
”Aphthous“ canker

Greek word Latin word

””Aphtha“ ””cancer“

But not a type

Ulceration
of cancer
 Definition
Canker sores, also called aphthous
.ulcers
They are small, shallow lesions that
develop on the soft tissues in your
.mouth or at the base of your gums
They can be painful, however, and
can make eating and talking
difficult
 Etiology

Bacterial Self traumatic like

infection: Stress is a "bites", oral
surgical
"streptococci, common procedures, tooth
and etiology of brushing, dental
streptococcus .mouth ulcers procedures, and
.Sanguis needle injections
 Etiology

allergy or
sensitivity such as
to sodium lauryl Iron, vitamin B12,
sulfate present in
Folic Acid
toothpaste, and
oral hygiene
.deficiency
products, foods
.such as cinnamon
 Clinical features
Small round ulcers Surrounded by
.2-3mm erythematous halo and
.some edema

Ulcer floor that is

Gray hue when the ulcer
.initially yellowish
.is healed
 Presentation
Pin point
Begins round area central area of
.of erythema white Next 3-7 days
.ulceration

As healing Becomes cupped

The ulcer
.commences .out
.enlarge laterally

The Small punctate

erythematous red areas dot
area the white ulcer
.diminishes .bed
Classification of aphthous

:Simple aphthous :Complex aphthou

is described when
:is described when Develop recurrent oral -1
Ulcer recurrences -1 .ulcers
.are few When there is a -2
Not associated -2 continuous disease
.with systemic factors .activity
Occur only 2-4 -3 When ulcers are -3
.times each year associated with systemic
.diseases
 Clinical types
Recurrent aphthous Minor 
Age: 10-30yr -1
.Gender: F more than M -2
Site: common on non-keratinized mucosa like buccal and -3
.labial mucosa, soft palate, pharynx, gingiva
Appearance: begins as a single or multiple superficial erosions -4
covered by greyish - white membrane encircled by erythematous
.halo
.Number: 1-6 -5
.Size: 2-3mm up to 10mm -6
.persist for 7-14 days, heal without scarring -7
Recurrent aphthous minor
 Recurrent aphthous Major 
.Severe expression of aphthous stomatitis
Common site: lips, cheeks, tongue, soft palate, cause severe pain &
.dysphagia
.Involve keratinized mucosa
.Incidence: common in HIV patient
.Size: Larger than the minor apthous ulcer diameter more than 10mm
.week to heal, and heal with scarring 4-6
Appearance: extend deeper with rolled margins which are indurated
.on palpation because of underlying fibrosis
Recurrent aphthous Major
 Recurrent herpetiform ulcers
.Site: any intra oral site -1
.Size: 1-3 mm in diameter -2
Appearance: characterized by crop of small, shallow -3
.ulcers that may be joined together and form large ulcer
.Number: 10 – 100 -4
.Healing occur in 1 to 2 weeks -5
.Heal with scarring -6
.Lesions persist for 1 to 3 year with short remissions -7
Recurrent herpetiform ulcers
 Syndromes associated with
apthous :ulcers
.Behcet's Syndrome -1
.Magic Syndrome -2
.Cyclic Neutropenia -3
.PFAPA Syndrome -4
 Differential diagnosis
Recurrent
herpes simplex Squamous cell
.infection .carcinoma

Cyclic
.neutropenia

Bednar's Erosive lichen

.aphthae .planus
 Treatment of aphthous stomatitis
Tetracycline mouth rinse: one capsule in 5ml water -1
.and gargled, 4 times a day, to 7 days
.5%Amlexanox is an anti- inflammatory, antiallergic -2
.It is applied on the Ulcer's directly 3-4 times a day
Triamcinolone: a corticosteroid, it is used to reduce -3
.swelling and ulcers in the mouth
.Applied 3-4 times a day on the ulcer
Analgesic's and Antiseptics: such as Deltagel which -4
contain lignocaine helps in reliving pain and help
.preventing secondary infections
 Treatment

.Vitamin B12, Folic Acid Iron -6

Surgical
.Laser surgery
If you have any questions, keep it to your self, I’m not
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