Recurrent aphthous ulcers today: A review of the growing knowledge

International Journal of Oral and Maxillofacial Surgery

Volumn 33, Issue 3, 2004, Pages 221-234

  Natah, Sirajedin S ^a,b   Konttinen, Y T ^b   Enattah, N S ^c   Ashammakhi, N ^d,e   Sharkey, K A ^a   Hayrinen Immonen R ^b  

^a UNIVERSITY OF CALGARY   (Canada)

^b UNIVERSITY OF HELSINKI   (Finland)

^c BIOMEDICUM HELSINKI   (Finland)

^d TAMPERE UNIVERSITY OF TECHNOLOGY   (Finland)

^e OULU UNIVERSITY HOSPITAL   (Finland)

Author keywords

Beh et's disease; Coeliac disease; HIV; Mucosal inflammation; Recurrent aphthous ulcers

Indexed keywords

ANESTHETIC AGENT; ANTIINFECTIVE AGENT; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CAPTOPRIL; CHLORHEXIDINE GLUCONATE; CORTICOSTEROID; DEXAMETHASONE; DICLOFENAC; DODECYL SULFATE SODIUM; DRUG; DRUG VEHICLE; GLUCOCORTICOID; GOLD SALT; HYDROCORTISONE; LIDOCAINE; NICORANDIL; NIFLUMIC ACID; NONSTEROID ANTIINFLAMMATORY AGENT; PHENINDIONE; PHENOBARBITAL; PHENYLACETIC ACID; PIROXICAM; PROPIONIC ACID; SODIUM DERIVATIVE; STEROID; TETRACYCLINE; TOOTHPASTE; TRACE ELEMENT; TRIAMCINOLONE; UNINDEXED DRUG; VITAMIN;

APHTHOUS ULCER; BEHCET DISEASE; BURNING SENSATION; CELIAC DISEASE; CLINICAL FEATURE; CLINICAL TRIAL; DISEASE ACTIVITY; DISEASE MARKER; DISEASE SEVERITY; DRUG FORMULATION; DYSGEUSIA; ENDOCRINE DISEASE; EPITHELIUM; FOOD INTAKE; HEALTH STATUS; HEREDITY; HUMAN; IMMUNOLOGICAL PARAMETERS; IMMUNOPATHOLOGY; INCIDENCE; INJURY; LABORATORY DIAGNOSIS; MEDICAL RECORD; MICROBIOLOGICAL PARAMETERS; MOUTH ULCER; NUTRITIONAL DEFICIENCY; OUTCOMES RESEARCH; PAIN; PATHOGENESIS; PREVALENCE; RECURRENT DISEASE; REVIEW; RISK FACTOR; SIDE EFFECT; SKIN MANIFESTATION; SORE THROAT; STRESS; THRUSH; TISSUE INJURY; TOOTH COLOR; VITAMIN DEFICIENCY;

EID: 2342562395     PISSN: 09015027     EISSN: None     Source Type: Journal    
DOI: 10.1006/ijom.2002.0446     Document Type: Review

References (229)

1. Abdulla YH, Lehner T. The effect of immune complexes on chemotaxis in Behcet's syndrome and recurrent oral ulcers. In: Lehner T, Barnes CG, eds: Behçet's Syndrome: Clinical and Immunological Features. London: Academic Press 1979: 55-59.
2. Albanidou-farmaki E, Kayavis IG, Polymenidis Z, Papanayotou P. HLA-A, B, C and DR antigens in recurrent oral ulcers. Ann Dent 1988: 47: 5-8.
3. Andrews VH, Hall HR. The effect of relaxation/imagery training on recurrent aphthous stomatitis: a preliminary study. Psychosom Med 1990: 52: 526-535.
4. Arber N, Klein T, Meiner Z, Pras E, Weinberger A. Close association of HLA-B51 and B52 in Israeli patients with Behçet's syndrome. Ann Rheum Dis 1991: 6: 351-353.
5. Axéll T. A prevalence study of oral mucosal lesions in an adult Swedish population. Odont Rev 1976: 27: 1S-103S.
6. Axéll T, Henricsson V. The occurrence of recurrent aphthous ulcers in an adult Swedish population. Acta Odontol Scand 1985: 43: 121-125.
7. Axéll T, Henricsson V. Association between recurrent aphthous ulcers and tobacco habits. J Dent Res 1985: 93: 239-242.
8. Bach MC, Howell DA, Valenti AJ, Smith TJ, Winslow DL. Aphthous ulceration of the gastrointestinal tract in patients with the acquired immunodeficiency syndrome (AIDS). Ann Intern Med 1990: 112: 465-467.
9. Bachtiar EW, Cornain S, Siregar B, Raharjo TW. Decreased CD4+/CD8+ ratio in major type of recurrent aphthous ulcers: comparing major to minor types of ulcers. Asian Pac J Allergy Immunol 1998: 16: 75-79.
10. Bagg J, Williams BD, Amos N, Dagalis P, Walker DM. Absence of circulating IgG immune complexes in minor recurrent aphthous ulceration. J Oral Pathol Med 1987: 16: 53-56.
11. Barile MF, Graykowski EA, Driscoll EJ, Riggs DB. L form of bacteria isolated from recurrent aphthous stomatitis lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1963: 16: 1395-1402.
12. Barrons RW. Treatment strategies for recurrent oral aphthous ulcers. AJHP 2001: 58: 41-53.
13. Beckman JS, Beckman TW, Chen J, Marshall PA, Freeman BA. Apparent hydroxyl radical production by peroxynitrite: implications for endothelial injury from nitric oxide and superoxide. Proc Natl Acad Sci U S A 1990: 87: 1620-1624.
14. Ben-Aryeh H, Malberger E, Gutman D, Anavi Y. Salivary IgA and serum IgG and IgA in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1976: 42: 746-752.
15. 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.
16. Bittoun R. Recurrent aphthous ulcers and nicotine. Med J Aust 1991: 154: 471-472.
17. Boggess KA, Williamson HO, Homm RJ. Influence of the menstrual cycle on systemic diseases. Obstet Gynecol Clin North Am 1990: 17: 321-342.
18. Boismenu R, Havran WL. Modulation of epithelial cell growth by intraepithelial γδ T cells. Science 1994: 266: 1253-1255.
19. Boismenu R, Havran W. An innate view of γδ T cells. Curr Opin Immunol 1997: 9: 57-63.
20. Boismenu R. Function of intestinal γδ T cells. Immunol Res 2000: 2-3: 123-127.
21. Boulinguez S, Reix S, Bedane C, Debrock C, Bouyssou-Gauthier ML, Sparsa A, et al. Role of drug exposure in aphthous ulcers: a case-control study. Br J Dermatol 2000: 143: 1261-1265.
22. Boulinguez S, Cornée-Leplat I, Bouyssou-Gauthier M-L, Bedane C, Bonnetblanc J-M. Aphtes induits par les médicaments: analyse de la littérature. Ann Dermatol Venereol 2000: 127: 155-158.
23. Brice SL, Cook D, Leahy M, Huff JC, Weston WL. Examination of the oral mucosa and peripheral blood cells of patients with recurrent aphthous ulceration for human herpesvirus DNA. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000: 89: 193-198.
24. Brady H, Silverman S. Studies on recurrent oral aphthae. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1969: 27: 27-34.
25. Brody D, Metcalfe DD. Mast cells: A unique and functional diversity. Clin Exp Allergy 1998: 28: 1167-1170.
26. Buno IJ, Huff JC, Weston WL, Cook DT, Brice SL. Elevated levels of interferon gamma, tumor necrosis factor α, interleukins 2, 4, and 5, but not interleukin 10, are present in recurrent aphthous stomatitis. Arch Dermatol 1998: 134: 827-831.
27. Burnett PR, Wray D. Lytic effects of serum and mononuclear leukocytes on oral epithelial cells in recurrent aphthous stomatitis. Clin Immunol 1985: 34: 197-204.
28. Burton-Kee JE, Mowbray JF, Lehner T. Different cross-reacting circulating immune complexes in Behçets syndrome and recurrent oral ulcers. J Lab Clin Med 1981: 97: 559-567.
29. Casiglia JM. Recurrent aphthous stomatitis: Etiology, diagnosis and treatment. Gen Dent 2002: 50: 157-166.
30. Challacombe JJ, Batchelor JR, Kennedy LA, Lehner T. HLA antigens in recurrent oral ulcerations. Arch Dermatol 1977: 113: 1717-1719.
31. Challacombe SJ, Scully C, Keevil B, Lehner T. Serum ferritin in recurrent oral ulceration. J Pathol 1983: 12: 290-299.
32. Corone S, Davido A, Corone P. A rare complication of captopril: ulceration of the lingual and jugal mucosa. Rev Med Interne 1987: 8: 73-74.
33. Crivelli MR, Aguas S, Adler I, Quarracino C, Bazerque P. Influence of socioeconomic status on oral mucosa lesion prevalence in schoolchildren. Community Dent Oral Epidemiol 1988: 16: 58-60.
34. Dagalis P, Bagg J, Walker DM. Spontaneous migration and chemotactic activity of neutrophil polymorphonuclear leukocytes in recurrent aphthous ulceration. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1987: 64: 298-301.
35. De Libero G. Sentinel function of broadly reactive human γδ T cells. Immunol 1997: 18: 22-26.
36. Dolby AE. Recurrent Mikulicz's oral aphthae - their relationship to the menstrual cycle. Br Dent J 1968: 124: 359-360.
37. Dolby AE. Recurrent aphthous ulceration. Effects of sera and peripheral blood lymphocytes upon oral epithelial tissue culture cells. Immunology 1969: 17: 709-714.
38. Dolby AE, Allison RT. Quantitative changes in the mast cell population in Mikulicz's recurrent oral aphthae. J Dent Res 1969: 48: 901-903.
39. Dolby AE, Walker DM, Slade M, Allan C. HLA histocompatibility antigens in recurrent aphthous ulceration. J Dent Res 1977: 56: 105-107.
40. Donatsky O. An immunofluorescence study on the cross-reaction between Strep. 2A and human oral mucosa. Scand J Dent Res 1975: 83: 111-119.
41. Donatsky O. A leukocyte migration study on the cell-mediated immunity against adult human oral mucosa and streptococcal antigens in patients with recurrent aphthous stomatitis. Acta Pathol Microbiol Scand (C) 1976: 84: 227-234.
42. Donatsky O. Comparison of cellular and humoral immunity against streptococcal and adult oral mucosa antigens in relation to exacerbation of recurrent aphthous stomatitis. Acta Pathol Microbiol Scand 1976: 84: 270-282.
43. Donatsky O, Justesen T, Lind K, Fabber Vestergaard B. Microorganisms in recurrent aphthous ulceration. Scand J Dent Res 1977: 85: 426-433.
44. Embil JA, Stephens RE, Mauriel R. Prevalence of recurrent herpes labialis and aphthous ulcers among young adults on six continents. CMAJ 1975: 113: 630-637.
45. Endre L. Recurrent aphthous ulceration with zinc deficiency and cellular immune deficiency. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1991: 72: 559-561.
46. Eversole LR, Shopper TP, Chambers DW. Effects of suspected foodstuff challenging agents in the etiology of recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1982: 54: 33-38.
47. Eversole LR. Immunopathology of oral mucosal ulcerative, desquamative, and bullous diseases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1994: 77: 555-571.
48. Fahmy MS. Recurrent aphthous ulcers in a mixed Arab community. Community Dent Oral Epidemiol 1976: 4: 160-164.
49. Ferguson R, Basu MK, Asquith P, Cooke WT. Jejunal mucosal abnormalities in patients with recurrent aphthous ulceration. Br Med J 1976: 1: 11-13.
50. Ferguson MM, Wray D, Carmichael HA, Russell RI, Lee FD. Coeliac disease associated with recurrent aphthae. Gut 1980: 21: 223-226.
51. Ferguson MM, Carter J, Boyle P. An epidemiological study of factors associated with recurrent aphthae in women. J Oral Pathol Med 1984: 39: 212-217.
52. Field AE, Rotter E, Speechley JA, Tyldesley WR. Clinical and haematological assessment of children with recurrent aphthous ulceration. Br Dent J 1987: 163: 19-22.
53. Field EA, Brookes V, Tyldesley WR. Recurrent aphthous ulceration in children: a review. Int J Pediatric Dent 1992: 2: 1-10.
54. Fink-Puches R, Kainz JT, Kahr A, Urban C, Smolle J, Kerl H. Granulocyte colony-stimulating factor treatment of cyclic neutropenia with recurrent oral aphthae. Arch Dermatol 1996: 132: 1399-1400.
55. Flak TA, Goldman WE. Autotoxicity of nitric oxide in airways disease. Am J Respir Crit Care Med 1996: 154: S202-206.
56. Fletcher AE, Hunt BM, Bulpitt CJ. Evaluation of quality of life in clinical trials of cardiovascular disease. J Chron Dis 1987: 40: 557-566.
57. Freysdottir J, Lau SH, Fortune F. γ/δ T cells in Behçet's disease (BD) and recurrent aphthous stomatitis (RAS). Clin Exp Immunol 1999: 118: 451-457.
58. Gadol N, Greenspan JS, Hoover CI, Olson J. Leukocyte migration inhibition in recurrent aphthous ulceration. J Oral Pathol Med 1985: 14: 121-132.
59. Gallina G, Cumbo V, Messina P, Caruso C. HLA-A, B, C, DR, MT, MB antigens in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1985: 59: 364-370.
60. Ghodratnama F, Riggio MP, Wray D. Search for human herpesvirus 6, human cytomegalovirus and varicella zoster virus DNA in recurrent aphthous stomatitis tissue. J Oral Pathol Med 1997: 26: 192-197.
61. Glick M, Muzyka BC. Alternative therapies for major aphthous ulcers in aids patients. Jada 1992: 123: 61-65.
62. Grady D, Ernster VL, Stillman L, Greenspan J. Smokeless tobacco use prevents aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1992: 74: 463-465.
63. Graykowski EA, Barile MF, Lee WB, Stanley HR. Recurrent aphthous stomatitis. Clinical, therapeutic, histopathologic, and hypersensitivity aspects. JAMA 1966: 196: 129-136.
64. Greenspan JS, Gadol N, Olson JA, Talal N. Antibody-dependent cellular cytotoxicity in recurrent aphthous ulceration. Clin Exp Immunol 1981: 44: 603-610.
65. Greenspan JS, Daniels TE, Shillitoe FJ, Olson JA. Mononuclear cell sub-populations in recurrent aphthous ulceration enumerated using monoclonal antibodies, flow cytometry and the ABC technique [Abstract 1507]. J Dent Res 1982: 61: 346.
66. Greenspan JS, Gadol N, Olson JA, Hoover CI, Jacobsen PL, Shillitoe EJ, Armitage GC. Lymphocyte function in recurrent aphthous ulceration. J Oral Pathol Med 1985: 14: 592-602.
67. Greenspan D, Hilton JF, Westenhouse JL. Association between oral lesions and smoking in a clinic population (Abstract no. PoB 3362). Amsterdam, Netherland, Int Conference AIDS VIII: 1992: B147.
68. Hasan A, Childerstone A, Pervin K, Shinnick T, Mizushima Y, Van Der Zee R, Vaughen R, Lehner T. Recognition of a unique peptide epitope of the mycobacterial and human heat shock protein 65-60 antigen by T cells of patients with recurrent oral ulcers. Clin Exp Immunol 1995: 99: 392-397.
69. Hasan A, Fortune F, Wilson A, Warr K, Shinnick T, Mizushima Y, Van Der Zee R, Stanford MR, Sanderson J, Lehner T. Role of γ /δ T cells in pathogenesis and diagnosis of Behçet's disease. Lancet 1996: 347: 789-794.
70. Havran WL. A role for epithelial γδ T cells in tissue repair. Immunol Research 2000: 2-3: 63-69.
71. Hay KD, Reade PC. The use of elimination diet in the treatment of recurrent aphthous ulceration of the oral cavity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1984: 57: 504-507.
72. Häyrinen-Immonen R, Nordström D, Malmström M, Hietanen J, Konttinen YT. Immune-inflammatory cells in recurrent oral ulcers (ROU). Scand J Dent Res 1991: 99: 510-518.
73. Häyrinen-Immonen R. Immune-activation in recurrent oral ulcers (ROU). J Dent Res 1992: 100: 222-227.
74. Häyrinen-Immonen R, Malmström M, Nordström D, Sorsa T, Konttinen YT. Distribution of adhesion receptors in recurrent oral ulcers. J Oral Pathol Med 1992: 21: 199-202.
75. Häyrinen-Immonen R, Sorsa T, Nordström D, Malmström M, Konttinen YT. Collagenase and stromelysin in recurrent aphthous ulcers (RAU). Int J Oral Maxillofac Surg 1993: 22: 46-49.
76. Häyrinen-Immonen R, Sorsa T, Pettilä J, Konttinen YT, Teronen O, Malmström M. Effect of tetracyclines on collagenase activity in patients with recurrent aphthous ulcers. J Oral Pathol Med 1994: 23: 269-272.
77. Healy CM, Thornhill MH. An association between recurrent oro-genital ulceration and non-steroidal anti-inflammatory drugs. J Oral Pathol Med 1995: 24: 46-48.
78. Healy CM, Carvalho D, Pearson JD, Thornhill MH. Raised anti-endothelial cell autoantibodies (AECA), but not anti-neutrophil cytoplasmic autoantibodies (ANCA), in recurrent oral ulceration: modulation of AECA binding by tumor necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ). Clin Exp Immunol 1996: 106: 523-528.
79. Healy CM, Thornhill MH. Induction of adhesion molecule expression on blood vessels and keratinocytes in recurrent oral ulceration. J Oral Pathol Med 1999: 28: 5-11.
80. Heft M, Wray D. Anxiety levels in recurrent aphthous stomatitis (RAS) patients. J Dent Res 1982: 61: 264.
81. Herlofson BB, Barkvoll P. The effect of two toothpaste detergents on the frequency of recurrent aphthous ulcers. Acta Odontol Scand 1996: 54: 150-153.
82. Hermanns-Le T, Paquet P, Pierard-Franchimont C, Arrese JE, Pierard GE. Regulatory function of factor-XIIIa-positive dendrocytes in incipient toxic epidermal necrolysis and graft-versus-host reaction, a hypothesis. Dermatology 1999: 198: 184 -186.
83. Hoover CI, Olson JA, Greenspan JS. Humoral responses and cross-reactivity to oral streptococci in recurrent aphthous ulceration. J Dent Res 63 (special issue) 1984: 279: 972.
84. Hunter L, Addy M. Chlorhexidine gluconate mouthwash in the management of minor aphthous ulceration. Br Dent J 1987: 162: 106-109.
85. Hunter IP, Ferguson MM, Scully C, Galloway AR, Main ANH, Russell RI. Effects of dietary gluten elimination in patients with recurrent minor aphthous stomatitis and no detectable gluten enteropathy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1993: 75: 595-598.
86. International Study Group for Behcet's Disease. Criteria for diagnosis of Behçet's disease. Lancet 1990: 335: 1078-1080.
87. Jones-Carson J, Torres-Vazquez A, Van Der Heyde HC, Warner T, Wagner RD, Balish E. γδ T cell-induced nitric oxide production enhances resistance to mucosal candidiasis. Nat Med 1995: 1: 552-557.
88. Jorizzo JL, Taylor RS, Schmalstieg FC. Complex aphthosis: a form fruste of Behçet's syndrome? J Am Acad Dermatol 1985: 13: 80-84.
89. Kennet S. Stomatitis medicamentosa due to barbiturates. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1968: 25: 351-356.
90. Kimura H, Hokari R, Miura S, Shigematsu T, Hirokawa M, Akiba Y, Kurose I, Higuchi H, Fujimori H, Tsuzuki Y, Serizawa H, Ishii H. Increased expression of an inducible isoform of nitric oxide synthase and the formation of peroxynitrite in colonic mucosa of patients with active ulcerative colitis. Gut 1998: 42: 180-187.
91. Kleinman DV, Swango PA, Pindborg JJ. Epidemiology of oral mucosal lesions in United States school children. Community Dent Oral Epidemiol 1994: 22: 243-253.
92. Kuffer R, Baumont M, Brocheriou C. Oral aphthoid toxic dermatoses. Rev Stomatol Chir Maxillofac 1976: 77: 747-755.
93. Kvam E, Gjerdet NR, Bondevik O. Traumatic ulcers and pain during orthodontic treatment. Community Dent Oral Epidemiol 1987: 15: 104-107.
94. Lähteenoja H, Maki M, Viander M, Toivanen A, Syrjanen S. Local Challenge of oral mucosa with gliadin in patients with coeliac disease. Clin Exp Immunol 2000: 120: 38-45.
95. Lähteenoja H, Maki M, Viander M, Raiha I, Vilja P, Rantala I, Toivanen A, Syrjanen S. Local challenge on oral mucosa with an alpha-gliadin related synthetic peptide in patients with celiac disease. Am J Gastroenterol 2000: 95: 2880-2887.
96. 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 Oral Radiol Endod 1990: 69: 205-208.
97. Lashner BA, Hanauer SB, Siverstein MD. Testing nicotine gum for ulcerative colitis patients: experience with single patient trials. Dig Dis Sci 1990: 35: 827-832.
98. Lehner T. Autoimmunity in oral diseases with special reference to recurrent oral ulceration. Proc Roy Soc Med 1968: 61: 515-524.
99. Lehner T. Pathology of recurrent oral ulceration and oral ulceration in Behçet's syndrome: light, electron and fluorescence microscopy. J Pathol 1969: 97: 481-493.
100. Lehner T. Immunological estimation of blood and saliva in human recurrent oral ulceration. Arch Oral Biol 1969: 14: 351-364.
101. Lehner T. Progress report. Oral ulceration and Behçet's syndrome. Gut 1977: 18: 491-511.
102. Lehner T. Immunological aspects of recurrent oral ulceration and Behçet's syndrome. J Oral Pathol Med 1978: 7: 424-430.
103. Lehner T, Batchelor JR. In: Lehner T, ed.: Behçet Syndrome. New York: Academic press Inc 1979: 13.
104. Lehner T, Adinolfi M. Acute phase proteins, C9, factor B, and lysozyme in recurrent oral ulceration and Behçet's syndrome. J Clin Pathol 1980: 33: 269-275.
105. Lehner T, Welsh KI, Batchelor JR. The relationship of HLA-B and DR phenotypes to Behçet's syndrome, recurrent oral ulceration and the class of immune complexes. Immunology 1982: 47: 581-587.
106. Lehner T, Lavery E, Smith R, Van Der Zee R, Mizushima Y, Shinnick T. Association between the 65-kilodalton heat shock protein, Streptococcus sanguis, and the corresponding antibodies in Behç et's syndrome. Infect Immun 1991: 59: 1434-1441.
107. Lichtig C, Haim S, Hammel I, Friedman-Birnbaum R. The quantification and significance of mast cells in lesions of Behcet's disease. Br J Dermatol 1980: 102: 255-259.
108. MacPhail LA, Greenspan D, Feigal DW, Lennette ET, Greenspan JS. Recurrent aphthous ulcers in association with HIV infection: description of ulcer types and analysis of T-lymphocyte subsets. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1991: 71: 678-683.
109. MacPhail LA, Greenspan D, Greenspan JS. Recurrent aphthous ulcers in association with HIV infection. Diagnosis and treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1992: 73: 283-288.
110. MacPhail LA, Greenspan JS. Oral ulceration in HIV infection: investigation and pathogenesis. Oral Dis 1997: 3: 190S-193S.
111. Majorana A, Sapelli PL, Malagoli A, Meini A, Pillan MN, Duse M, Ugazio AG. Celiac disease and recurrent aphthous stomatitis: the clinical and immunogenetic aspects. Minerva Stomatol 1992: 41: 33-40.
112. Malmström M, Salo OP, Fyhrquist F. Immunogenetic markers and immune response in patients with recurrent oral ulceration. Int J Oral Maxillofac Surg 1983: 12: 23-30.
113. Manders SM, Kostman JR, Mendez L, Russin VL. Thalidomide-resistent HIV-associated aphthae successfully treated with granulocyte colony-stimulating factor. J Am Acad Dermatol 1995: 33: 380-382.
114. McCartan BE, Sullivan A. The association of menstrual cycle, pregnancy, and menopause with recurrent oral aphthous stomatitis: A review and critique. Obstet Gynecol 1992: 80: 455-458.
115. Meiller TF, Kutcher MJ, Overholser DC, Niehaus C, Depaola LG, Siegel MA. Effect of an anti-microbial mouthrinse on recurrent aphthous ulcerations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1991: 72: 425-429.
116. Meini A, Pillan MN, Plebani A, Ugazio AG, Majorana A, Sapelli PL. High prevalence of DRw10 and DQw1 antigens in celiac disease associated with recurrent aphthous stomatitis. Am J Gastroenterol 1993: 88: 972.
117. Menni S, Piccinno R, Pistritto MG. Ulcerative stomatitis in a neonate due to a chlorine antiseptic. Contact Dermatitis 1988: 18: 320-321.
118. Merchant HW, Gangarosa LP, Glassman AB, Sobel RE. Zinc sulphate supplementation for the treatment of recurring oral ulcers. South Med J 1977: 70: 559-561.
119. Merchant HW, Gangarosa LP, Morse PK, Strain WH, Baisden CR. Zinc sulphate as a preventive of recurrent aphthous ulcers. J Dent Res 1981: 60A: 609.
120. Merchant NE, Ferguson MM, Ali A, Hole DJ, Gillis CR. The detection of IgA-reticulin antibodies and their incidence in patients with recurrent aphthae. J Oral Pathol Med 1986: 41: 31-34.
121. Miller MF, Ship II. A retrospective study of the prevalence and incidence of recurrent aphthous ulcers in a professional population, 1958-1971. Oral Surg Oral Med Oral Pathol Oral Radio Endod 1977: 43: 532-537.
122. Miller MF, Garfunkel AA, Ram C, Ship II. Inheritance patterns in recurrent aphthous ulcers: twin and pedigree data. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1977: 43: 886-891.
123. Miller MF, Garfunkel AA, Ram CA, Ship II. The inheritance of recurrent aphthous stomatitis. Observations on susceptibility. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1980: 49: 409-412.
124. Mills MP, Mackler BF, Nelms DC, Peavy DL. Quantitative distribution of inflammatory cells in recurrent aphthous stomatitis. J Dent Res 1980: 59: 562-566.
125. Moreira AL, Sampaio EP, Zmuidzinas A, Frindt P, Smith KA, Kaplan G. Thalidomide exerts its inhibitory action on tumor necrosis factor alpha by enhancing mRNA degradation. J Exp Med 1993: 177: 1675-1680.
126. Muzyca BC, Glick M. Major aphthous ulcers in patients with HIV disease. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1994: 77: 116-120.
127. Natah SS, Häyrinen-Immonen R, Hietanen J, Malmström M, Konttinen YT. Factor XIIIa-positive dendrocytes are increased in number and size in recurrent aphthous ulcers (RAU). J Oral Pathol Med 1997: 26: 408-413.
128. Natah SS, Häyrinen-Immonen R, Hietanen J, Malmström M, Konttinen YT. Quantitative assessment of mast cells in recurrent aphthous ulcers (RAU). J Oral Pathol Med 1998: 27: 124-129.
129. Natah SS, Häyrinen-Immonen R, Hietanen J, Malmström M, Konttinen YT. Immunolocalization of tumor necrosis factor-α expressing cells in recurrent aphthous ulcer lesions (RAU). J Oral Pathol Med 2000: 29: 19-25.
130. Natah SS, Häyrinen-Immonen R, Patinen P, Hietanen J, Malmström M, Savilahti E, Konttinen YT. Increased density of lymphocytes bearing γ/δ T-cell receptors in recurrent aphthous ulceration (RAU). Int J Oral Maxillofac Surg 2000: 29: 375-380.
131. Nestle FO, Nickoloff BJ. A fresh morphological and functional look at dermal dendritic cells. J Cutan Pathol 1995: 22: 385-393.
132. Nolan A, McIntosh WB, Allam BF, Lamey P-J. Recurrent aphthous ulceration: Vitamin B1, B2 and B6 status and response to replacement therapy. J Oral Pathol Med 1991: 20: 389-391.
133. Nolan A, Lamey P-J, Milligan KA, Forsyth A. Recurrent aphthous ulceration and food sensitivity. J Oral Pathol Med 1991: 20: 473-475.
134. 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 1991: 20: 476-478.
135. Olson JA, Feinberg I, Silverman S, Abrams D, Greenspan JS. Serum vitamin B12, folate, and iron levels in recurrent aphthous ulceration. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1982: 54: 517-520.
136. Ozbakir F, Yazici H, Mat C, Tüzün Y, Yurdakul S, Yilmazer S. HLA antigens in recurrent oral ulcerations: evidence against a common disease spectrum with Behçet's syndrome. Clin Exp Rheumatol 1987: 5: 263-265.
137. PANG JF. Relation between treatment with traditional Chinese medicine for recurrent aphthous ulcer and human zinc and copper. Zhongguo Zhong Xi Yi Jie He Za Zhi 1992: 12: 280-282.
138. Patinen P, Savilahti E, Hietanen J, Malmström M, Maki M, Reunala T. Intraepithelial lymphocytes bearing the gamma/delta receptor in the oral and jejunal mucosa in patients with dermatitis herpetiformis. Eur J Oral Sci 1997: 105: 130-135.
139. Peavy DL, Nelms DC, Mackler BF. Failure of autologous oral epithelia to activate RAU lymphocytes. Clin Immunol 1982: 22: 291-295.
140. Pedersen A. Psychologic stress and recurrent aphthous ulceration. J Oral Pathol Med 1989: 18: 119-122.
141. Pedersen A. Acyclovir in the prevention of severe aphthous ulcers. Arch Dermatol 1992: 128: 119.
142. 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: 64-68.
143. Pedersen A, Madsen HO, Vestergaard BF, Ryder LP. Varicella zoster virus DNA in recurrent aphthous ulcers. Scand J Dent Res 1993: 101: 311-313.
144. Pedersen A, Pedersen BK. Natural killer cell function and number of peripheral blood are not altered in recurrent aphthous ulceration. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1993: 76: 616-619.
145. Pedersen A, Ryder LP. γδ T-cell fraction of peripheral blood is increased in recurrent aphthous ulceration. Clin Immunol 1994: 72: 98-104.
146. Pepin LF, Roger T, Morisset J, Seman M. Preferential Vδ1 expression among TcR γ/δ-bearing T cells in human oral epithelium. Scand J Immunol 1993: 37: 289-294.
147. Peretz B. Major recurrent aphthous stomatitis in an 11 year old girl: case report. J Clin Pediatr Dent 1994: 18: 309-311.
148. Phelan JA, Eisig S, Freedman PD, Newsome N, Klein RS. Major aphthous-like ulcers in patients with AIDS. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1991: 71: 68-72.
149. Pizarro A, Navarro A, Fonseca E, Vidaurrazaga C, Herranze P. Treatment of recurrent aphthous stomatitis with pentoxifylline. Br J Dermatol 1995: 133: 659-660.
150. Platz P, Ryder LP, Donatsky O. No evidence of HLA-A and B antigens in patients with recurrent aphthous stomatitis. Tissue Antigens 1976: 8: 279-280.
151. Porter SR, Cassar A, Flint G, Scully C. Haematological assessment of patients with recurrent aphthous stomatitis. Br Society Dent Res 1986: 344.
152. Porter SR, Scully C, Flint S. Hematologic status in recurrent aphthous stomatitis compared with other oral disease. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1988: 66: 41-44.
153. Porter SR, Scully C. Aphthous stomatitis - an overview of aetiopathogenesis and management. Clin Exp Dermatol 1991: 16: 235-243.
154. Porter SR, Scully C, Bowden J. Immunoglobulin G subclasses in recurrent aphthous stomatitis. J Oral Pathol Med 1992: 21: 26-27.
155. 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 Oral Radiol Endod 1997: 83: 325-328.
156. Porter SR, Scully C, Pedersen A. Recurrent aphthous stomatitis. Crit Rev Oral Biol Med 1998: 9: 306-321.
157. Poulter LW, Lehner T. Immunohistology of oral lesions from patients with recurrent oral ulcers and Behçet's syndrome. Clin Exp Immunol 1989: 78: 189-195.
158. Qureshi MN, Barr CE, Hewlitt I, Boorstein R, Kong F, Bagasra O, Bobroski LE, Joshi B. Detection of HIV in oral mucosal cells. Oral Dis 1997: 1: S73-78.
159. Regezi JA, MacPhail LA, Richards DW, Greenspan JS. A study of macrophages, macrophage-related cells, and endothelial adhesion molecules in recurrent aphthous ulcers in HIV-positive patients. J Dent Res 1993: 72: 1549-1553.
160. Rennie JS, Reade PC, Hay D, Scully C. Recurrent aphthous stomatitis-review. Br Dent J 1985: 159: 361-367.
161. Revuz J, Guillaume JC, Janier M, Hans P, Marchand C, Souteyrand P, Bonnetblanc JM, Claudy A, Dallac S, Klene C. Crossover study of thalidomide vs placebo in severe recurrent aphthous stomatitis. Arch Dermatol 1990: 126: 923-927.
162. Riggio MP, Lennon A, Ghodratnama F, Wray D. Lack of association between Streptococcus oralis and recurrent aphthous stomatitis. J Oral Pathol Med 2000: 29: 26-32.
163. Rodu B, Mattingly G. Oral mucosal ulcers: diagnosis and management. J Am Dent Assoc 1992: 123: 83-86.
164. Rogers RS 3rd, Movius DL, Pierre RV. Lymphocyte-epithelial cell interactions in oral mucosal inflammatory diseases. J Invest Dermatol 1976: 67: 599-602.
165. Ross R, Kutscher AH, Zegarelli EV, Silvers H, Piro JD. Relationship of mechanical trauma to recurrent ulcerative (aphthae) stomatitis. NY State Dent J 1958: 24: 101-102.
166. Sallay K, Kulesár G, Nász I, Dán P, Geck P. Adenovirus isolation from recurrent oral ulcers. J Peridontal 1973: 44: 712-717.
167. Santis HR. Aphthous stomatitis and its management. Curr Opin Dent 1991: 1: 763-768.
168. Savage NW, Seymour GJ, Kruger BJ. T-lymphocyte subset changes in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1985: 60: 175-181.
169. Savage NW, Seymour GJ, Kruger BJ. Expression of Class I and Class II major histocompatibility complex antigens on epithelial cells in recurrent aphthous stomatitis. J Oral Pathol Med 1986: 15: 191-195.
170. 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 Med 1988: 17: 293-297.
171. Schroeder HE, Müller-Glauser W, Sallay K. Stereologic analysis of leukocyte infiltration in oral ulcers of developing Mikulicz aphthae. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1983: 56: 629-639.
172. Schroeder HE, Müller-Glauser W, Sallay K. Pathomorphologic features of the ulcerative stage of oral aphthous ulceration. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1984: 58: 293-305.
173. Scully C, MacFadyen EE, Campbell A. Orofacial manifestations in cyclic neutropenia. Oral Surg Oral Med Oral Pathol Oral Radiol Ended 1982: 20: 96-101.
174. Scully C. Serum β2 microglobulin in recurrent aphthous stomatitis and Behçet's syndrome. Clin Exp Dermatol 1982: 7: 61-64.
175. Scully C, Yap L, Boyle P. IgE and IgD concentrations in patients with recurrent aphthous stomatitis. Arch Dermatol 1983: 119: 31-34.
176. Scully C, Porter S. Recurrent aphthous stomatitis: current concepts of etiology, pathogenesis and management. J Oral Pathol Med 1989: 18: 21-27.
177. Segal AL, Katcher AH, Brightman KJ, Miller MF. Recurrent herpes labialis, recurrent aphthous ulcers, and the menstrual cycle. J Dent Res 1974: 53: 797-803.
178. Shapiro S, Olsson DL, Chellemi SJ. The association between smoking and aphthous ulcers. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1970: 30: 624-630.
179. Shimizu T, Ehrlich GE, Inaba G, Hayashi K. Behçet's disease (Behçet's syndrome). Semin Arthritis Rheum 1979: 8: 223-260.
180. Shimoyama T, Horie N, Kato T, Kaneko T, Komiyama K. Helicobacter pylori in oral ulcerations. J Oral Sci 2000: 42: 225-229.
181. Ship II, Morris AW, Durocher RT, Burket LW. Recurrent aphthous ulceration and recurrent herpes labialis in a professional school student population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1960: 13: 17-29.
182. Ship II, Moris AL, Durocher RT, Burket LW. Recurrent aphthous ulceration in a professional school student population. IV - Twelve months study of natural disease patterns. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1961: 14: 30-39.
183. Ship II. Inheritance of aphthous ulcers of the mouth. J Dent Res 1965: 44: 837-844.
184. Ship II. Socio-economic status and recurrent aphthous ulcers. J Am Dent Assoc 1966: 73: 120-123.
185. Ship II, Brightman VJ, Laster LL. The patient with recurrent aphthous ulcers and the patient with herpes labialis: a study of two population samples. J Am Dent Assoc 1967: 74: 645-654.
186. Ship II. Epidemiologic aspects of recurrent aphthous ulcerations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1972: 33: 400-406.
187. Ship JA. Recurrent aphthous stomatitis. An update. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996: 81: 141-147.
188. Ship JA, Ahvez EM, Doerr PA, Henson BS, Sarmadi M. Recurrent aphthous stomatitis. Quintessence Int 2002: 31: 95-112.
189. Shohat-Zabarski R, Kalderon S, Klein T, Weinberger A. Close association of HLA-B51 in persons with recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1992: 74: 455-458.
190. Shotts RH, Scully C, Avery CM, Porter SR. Nicorandil-induced severe oral ulceration: a newly recognized drug reaction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999: 87: 706-707.
191. Siegel MA, Balciunas BA. Medication can induce severe ulceration. J Am Dent Assoc 1991: 122: 75-77.
192. Sircus W, Church R, Kelleher J. Recurrent aphthous ulceration of the mouth: a study of the natural history, aetiology, and treatment. Quart J Med 1957: 26: 235-249.
193. Sistig S, Cekic-Arambasin A, Rabatic S, Vucicevic-Boras V, Kleinheinz J, Piffko J. Natural immunity in recurrent aphthous ulceration. J Oral Pathol Med 2001: 30: 275-280.
194. Stanley HR. Aphthous lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1972: 33: 407-416.
195. Studd M, McCance DJ, Lehner T. Detection of HSV-1 DNA in patients with Behçet's syndrome and in patients with recurrent oral ulcers by the polymerase chain reaction. J Med Microbiol 1991: 34: 39-43.
196. Sun A, Hsieh RP, Chu CT, Wu YC. Strong association of HLA DRw9 in Chinese patients with recurrent oral ulcers. J Am Acad Dermatol 1991: 24: 195-198.
197. Sun A, Chu C-T, Wu Y-C, Yuan JH. Mechanisms of depressed natural killer cell activity in recurrent aphthous ulcers. Clin Immunol 1991: 60: 83-92.
198. Sun A, Chang JG, Kao CL, Liu BY, Wang JT, Chu CT, Yuan JH, Chiang CP. Human cytomegalovirus as a potential etiologic agent in recurrent aphthous ulcers and Behçet's disease. J Oral Pathol Med 1996: 25: 212-218.
199. Sun A, Chang JG, Chu CT, Liu BY, Yuan JH, Chiang CP. Preliminary evidence for an association of Epstein-Barr virus with pre-ulcerative oral lesions in patients with recurrent aphthous ulcers or Behçet's disease. J Oral Pathol Med 1998: 27: 168-175.
200. Sun A, Chu CT, Liu BY, Wang JT, Leu JS, Chiang CP. 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: 116-122.
201. Suzuki Y, Hoshi K, Matsuda T, Mizushima Y. Increased peripheral blood γδ+ T cells and natural killer cells in Behçet's disease. J Rheumatol 1992: 19: 588-592.
202. Taylor LF, Bagg J, Warker DM. Increased production of tumor necrosis factor by peripheral blood leukocytes in patients with recurrent oral aphthous ulceration. J Oral Pathol Med 1992: 21: 21-25.
203. 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 disease. J Clin Pathol 1973: 26: 371-374.
204. Thomas DW, Bagg J, Walker DM. Characterisation of the effector cells responsible for the in vitro cytotoxicity of blood leucocytes from aphthous ulcer patients for oral epithelial cells. Gut 1990: 31: 294-299.
205. Thompson C. Thalidomide effective for AIDS-related oral ulcers. Lancet 1995: 346: 1289.
206. Tuft L, Ettleson LN. Canker sores from allergy to weak organic acids (citric and acetic). J Allergy Clin Immunol 1956: 27: 536-543.
207. Tuzun B, Wolf R, Tuzun Y, Serdaroglu S. Recurrent aphthous stomatitis and smoking. Int J Dermatol 2000: 39: 358-360.
208. Tyldesley WR. Recurrent oral ulceration and coeliac disease. Br Dent J 1981: 151: 81-83.
209. Ueta E, Umazume M, Yamamoto T, Osaki T. Leukocyte dysfunction in oral mucous membrane diseases. J Oral Pathol Med 1993: 22: 120-125.
210. Van Eden W, Van Der Zee R, Paul AGA, Prakken BJ, Wendling U, Anderton SM, Wauben MHM. Do heat shock proteins control the balance of T-cell regulation in inflammatory diseases? Trends Immunol 1998: 19: 303-307.
211. Vanhale HM, Rogers RS, Doyle JA, Schroeter AL. Immunofluorescence microscopic studies of recurrent aphthous stomatitis. Arch Dermatol 1981: 117: 779-781.
212. Veloso FT, Saleiro JV. Small-bowel changes in recurrent ulceration of the mouth. Hepatogastroenterology 1987: 34: 36-37.
213. Verdickt GM, Savage NW, Dodd NM, Walsh LJ. Expression of the CD54 (ICAM-1) and CD11a (LFA-1) adhesion molecules in oral mucosal inflammation. J Oral Pathol Med 1992: 21: 65-69.
214. Vicente M, Soria A, Mosquera A, Pérez J, Lamas A, Castellano T, Ramos A. Immunoglobulin G subclass measurements in recurrent aphthous stomatitis. J Oral Pathol Med 1996: 25: 538-540.
215. Vincent SD, Lilly GE. Clinical, historic, and therapeutic features of aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1992: 74: 79-86.
216. Viguier M, Fouere S, Pascal F, Morel P. Herpetiform ulceration: 5 cases. Ann Dermatol Venereol 2000: 127: 707-710.
217. Wall P. Pain: the Science of Suffering, 2nd edn. London: Phoenix Ltd 2000: 35.
218. Wilson CWM. Food sensitivities, tast changes, aphthous ulcers and atopic symptoms in allergic disease. Ann Allergy Asthma Immunol 1980: 44: 302-307.
219. Wormser GP, Mack L, Lennox T. Lack of effect of oral acyclovir on prevention of aphthous stomatitis. Otolaryngol Head Neck Surg 1988: 98: 14-17.
220. Wray D, Ferguson MM, Mason DK, Hutcheon AW, Dagg JH. Recurrent aphthae: treatment with vitamin B12, folic acid, and iron. Br Med J 1975: 2: 490-493.
221. Wray D. Gluten-sensitive recurrent aphthous stomatitis. Dig Dis Sci 1981: 26: 737-740.
222. Wray D, Graykowski EA, Notkins AL. Role of mucosal injury in initiating recurrent aphthous ulceration. Br Med J 1981: 283: 1569-1570.
223. Wray D. A double-blind trial of systemic zinc sulfate in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1982: 53: 469-472.
224. Wray D, Vlagopoulus TP, Siraganian RP. Food allergens and basophil histamine release in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1982: 54: 388-395.
225. Wray D, Charon J. Polymorphonuclear neutrophil function in recurrent aphthous stomatitis. J Oral Pathol Med 1991: 20: 392-394.
226. Wright A, Ryan FP, Willingham SE, Holt S, Page AC, Hindle MO, Franklin CD. Food allergy or intolerance in sever recurrent aphthous ulceration of the mouth. Br Med J 1986: 292: 1237-1238.
227. Ylikontiola L, Sorsa T, Häyrinen-Immonen R, Sato, T. Doxymycine-cyanoacrylate treatment of recurrent aphthous ulcers. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997: 83: 329-333.
228. Yoo YH, Park BS, Whitaker-Menezes D, Korngold R, Murphy GF. Dermal dendrocytes participate in the cellular pathology of experimental acute graft-versus-host disease. J Cutan Pathol 1998: 25: 426-434.
229. Zabel P, Ulrich-Shade F, Schlaak M. Inhibition of endogenous TNF-α formation by pentoxifylline. Immunobiol 1993: 187: 447-463.