Background: Recurrent APHTHOUS Stomatitis (RAS) is a common oral inflammatory disease with unknown pathogenesis. Although the immune system alterations could be involved in predisposition of individuals to oral candidiasis, precise ethiologies of RAS have not been understood yet. Considering the inflammatory nature of interleukin (IL) -17F and RAS, we aimed to sequence the gene in a number of patients with RAS to identify any disease-associated mutation.Methods: Sixty-two Iranian patients with RAS and fifty healthy subjects enrolled in this study. After DNA extraction from the whole blood, amplification was accomplished by polymerase chain reaction for IL-17F.Finding: The results of sequencing revealed a missense, heterozygous mutation, converting a threonine to proline in a patient with RAS. The Polyphen software suggested a damaging probability predicting this substitution to have a harmful effect on IL-17F protein function. Nevertheless, this substitution was predicted to change the β-aggregation propensity using TANGO software. Such mutation was not detected in any control subject. In addition, one of the IL-17F SNPs is associated with the RAS.Conclusion: This is a first study showing a mutation that seems to be associated with susceptibility to RAS. Further studies on more patients with RAS are required to confirm this finding.

Introduction: Recurrent APHTHOUS stomatitis (RAS) is a disorder, which is characterized by ulcers restricted to oral mucousa. Regarding the inspection of histological similarities between peptic ulcers and recurrent oral APHTHOUS and the response of RAS to the broad-spectrum antibiotic treatment such as tetracycline and the identified role of H.pylori in peptic ulcers, the possibility of bacterial involvement in the progression of oral aphtous ulcers has been suggested. Hence, there are limited evidence available for colonization of H. pylori and its probable role in induction of oral APHTHOUSe ulcers.Objective: We aimed to distinguish the probable presence of H.pylori in brushed sample of oral APHTHOUS ulcers by PCR method. Materials and Methods: In this study, we sampled the oral aphtous ulcers with the toothbrush in patients with RAS. PCR which is a very precise and sensitive technique for isolation of H. pylori in ulcer samples of recurrent APHTHOUS stomatitis and in samples from other parts of the oral cavity. Serologic tests such as ELISA were also done in all patients for determination of IgG antibody. Both PCR and ELISA were done in all patients. Evaluated patients were people presenting to the laboratory with the diagnosis of RAS, from the beginning of 2001 till the end of 2002.Results: Study patients were between 18 to 60 years old and the average age among them was 32/38 ± 11/30. 26 patients (52%) had positive ELISA test and we obtained H.pylori DNA in one patient (2%) in a total of 50 evaluated patients.Conclusion: According to the results of this study, H. Pylori DNA cant be found in APHTHOUS ulcers of these patients, even in those with positive anti H. Pylori, anti body (IgG) results. And it is probable that these bacteria aren't involved in oral recurrent APHTHOUS ulcers.

Recurrent APHTHOUS stomititis (RAS) which appeare as painful recurrent ulcers in oral mucosa, usually considered as an idopathic lesion. But there are some studies suggesting a probable malabsorption background, secondary to Giardiasis. This disease may manifest as an asymptomatic infection of small bowel with voiding of parasites in cystic form. Since both RAS and Giardiasis are common in Isfahan, so we decided to design a case-control study for evaluating probable relationship. Stool analysis were taken three times for each person in two group (80 case & 80 control). Unfortunately insufficent number of sample size and low sensivity of stool analysis couldn't revaled any statistical relationship. Nevertheless we suggest continuing of such studies with Greater number of cases and supplementory laboratory procedures.

Introduction: Recurrent APHTHOUS Stomatitis (RAS) is one of the most common oral ulcerative diseases. This lesion affects 20%of general population. Clinical features of these lesions are as minor, major and herpetiform ulcers. Etiology is unknown. It seems that RAS to be multifactorial.Objective:  Evaluarte the associated factors with recurrent APHTHOUS stomatitis. Materials and Methods: In this descriptive –analytical and cross sectional study, 1105 persons attending to health-therapeutic centers in Zahedan were selected in a multi-stage random manner; they were assessed for associated factors to development of RAS. Data gathered as single stage and by interview, filling questionnaire and clinical exam. Diagnosis was performed at base of clinical feature, in this type, in minor aphthea, the ulcers are less than 1cm in diameter, round, clearly defined and erythematic ulcers. In major RAS, painful lesions are more than 1cm in diameter which may last for several weeks, and usually heal with scar formation. The herpetiform APHTHOUS stomatitis, the least common type, presents itself as multiple clusters of pinpoint lesions that may give rise to large irregular ulcers lasting 7 to 10 days.Finally all of data were extracted from the questionnaire and statistically analyzed by SPSS and chi-square manner.Results: Among 1105 examined person (476 males and 629 females), 199 persons(18%) were affected to aphthea that among them, 168 cases (84.4%) minor aphthea,26 cases (13.1%) major and 5 cases (2.5%) had herpetiform. There were significant statistically correlation between the abundance of RAS and age (P<0.001), education (P<0.001), job (P=0.002), history of aphtea (P<0.001), family history (P<0.001) and brushing (P<0.001). There were significant statiscally correlation between the abundance of RAS and sex, using snuff, using tobacco and using mouthwash. Conclusion: RAS is multifactorial lesion and factors such as age, high stress job groups, high education were associated with occurrence of the aphthea in this study. Tobacco had no correlation with occurrence of RAS.

Recurrent APHTHOUS stomatitis (RAS) is a common oral disorder that despite extensive researches, the etiology of this phenomenon is still unknown. Because this phenomenon has been observed more often in families than in individual cases, genetic influence has been investigated in most researches.Purpose: The aim of the present study was to evaluate the association between Human Leukocyte Antigen (HLA) and APHTHOUS stomatitis more precisely.Materials and Methods: In this study, 60 patients with RAS were examined for HLA-A and HLA- B types and 37 of them were examined for HLA- DR and HLA-DQ types. The results were compared through Fisher test with those of 25 healthy control subjects, aged more than 30 years.Results: A significant decrease in the frequency of some antigens such as HLA-DQW 3 and HLA-A 26 in subjects with RAS was observed. Therefore, according to the results of this study, these antigens were considered as resistant antigens to recurrent APHTHOUS stomatitis. In contrast, there was no significant increase in the frequency of any HLA antigens in the test group, compared to the control group. This finding is in contrast with the multiple reports about Behest's disease. (Because a high frequency of HLA-B 51 has been found in Behcet"s syndrome.)Conclusion: According to the findings of this study, it is suggested that the pathogenicity of APHTHOUS ulcerations in Behest's disease and recurrent APHTHOUS stomatitis is not the same. However, further studies are necessary to prove this theory.

BACKGROUND AND OBJECTIVE: Recurrent APHTHOUS Stomatitis (RAS) is one of the most common oral mucosal diseases. Nowadays, the majority of published systematic reviews is increasing, hence healthcare decision makers are meeting much evidence in order to solving their clinical problems. The aim of the present umbrella review was to report current knowledge on etiology, diagnosis and treatment of RAS. METHODS: In the present umbrella review, we searched for systematic reviews using PubMed, ISI web of science, Scopus and the Cochrane Library from the beginning of 2000 up to end of 2018 using the following key words: “ systematic review” “ Meta-analysis” and “ APHTHOUS” . Two investigators independently screened, extracted the data, and quality appraised the papers using Joanna Bridges Institute (JBI) protocol. FINDINGS: Finally, 18 systematic reviews were included (8 on etiology and 10 on treatment). Out of these papers, findings of 6 meta-analysis suggested that hematologic deficiencies, interleukin polymorphism and helicobacter pylori seem to have association with RAS, however for treatment of RAS (including: topical, systemic and laser therapy) there were not conclusive findings. CONCLUSION: According to results of this study, hematologic deficiencies, interleukin polymorphism and helicobacter pylori are among the novel etiologies of recurrent APHTHOUS stomatitis, although there is no presented unique and conclusive treatment option for this common lesion yet.

Background: Recurrent APHTHOUS stomatitis (RAS) is one of the most common painful diseases affecting the oral mucosa. The role of psychosocial factors especially depression and anxiety in RAS is controversial. Objective: This study was performed to determine the association between anxiety, depression and RAS.Methods: This descriptive-analytic study was carried out at Department of Oral Medicine of Zahedan Dental School from May 2007 to May 2008. Ninety patients were evaluated in three groups marked as RAS, negative control and positive control groups using Beck Anxiety (BAI) and Beck Depression (BDI) Questionnaires. Data were analyzed using ANOVA and Tukey tests. Findings: RAS patients and positive controls had significantly higher anxiety and depression levels compared to the negative controls (P< 0.05). However, no statistically significant difference was found in anxiety level between the RAS and positive control groups. In contrast, there was a significant difference in depression levels between the RAS and positive control groups (P<0.05).Conclusion: Regarding the data found in study, It seems that the psychosocial factors may play an important role in causation of RAS. These factors may form a starting point for initiation of various immune reactions, shown to be contributory to the pathogenesis of RAS.

Introduction: Recurrent APHTHOUS stomatitis (RAS) is a multifactorial recurrent oral lesion; which is an autoimmune disease. TH1 cytokines are the most important etiological factors. Autoimmune thyroid disease (ATD) is one of the most common autoimmune diseases and generally coexists with other autoimmune diseases. This study assessed the prevalence of thyroid disease in patients with recurrent APHTHOUS stomatitis. Materials and Methods: This case control study assessed 100 patients with RAS. Oral medicine specialists diagnosed RAS clinically; venous blood samples were analyzed for thyroid stimulating hormone (TSH), free triiodothyronine (fT3), total thyroxine (fT4), thyroglobulin, anti-thyroid peroxidase antibody (anti-TPO) and anti-thyroglobulin antibody (anti-TG) levels. Results: Fifty patients with RAS aged between 18-42 years (28. 5± 5. 8) and 50 healthy volunteers aged 19-45 years (27. 3± 5. 4) participated. In RAS patients, fT3 and TSH levels were significantly higher (P=0. 031, P=0. 706); however, fT4 level was lower in the RAS group (P=0. 447). Anti TG and anti-TPO levels were significantly higher in the RAS group (P=0. 008, P=0. 067). Conclusion: Our study showed that ATD prevalence was significantly higher in RAS patients. Based on this study, we recommend assessment of thyroid hormones and antibodies in RAS patients.