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APTHOUS ULCER

APTHOUS ULCER. BY DR. MANISHA MISHRA. Apthous ulcer is characterised by development of painful recurring solitary or multiple ulcerations of the oral mucosa. Etiology: Bacterial infections : Streptococcus sanguis Immunological abnormalities Iron,VitaminB12 or folic acid deficiency.

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APTHOUS ULCER

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  1. APTHOUS ULCER BY DR. MANISHA MISHRA

  2. Apthous ulcer is characterised by development of painful recurring solitary or multiple ulcerations of the oral mucosa. • Etiology: • Bacterial infections : Streptococcus sanguis • Immunological abnormalities • Iron,VitaminB12 or folic acid deficiency

  3. Precipitating factors: • Trauma : Due to self inflicted bites,Oral surgical procedures like extractions and tooth brushing • Endocrine conditions : Pregnancy and premenstrual period • Psychic factors • Food and drug Allergies

  4. Types of Apthous ulcer 1.Recurrent Apthous minor : • It is frequent in women than men • Onset : 10-30 years • Frequency of outbreaks : 1 or more attacks in a year and in some 1 in a month also and every attack may be of prolong periods • Some patients may never be free of this lesions • There may be generalisedoedema of the oral cavity , low grade fever , localisedlymphadenopathy • No. of lesions: Exceeds 100 but usually more than 6

  5. Size:2-3mm to more than 10mm • Sites : Buccal and labial mucosa , Buccal and lingual sulci , Soft palate and tongue , Pharynx and gingiva • Ulcers persists for 7-14 days and then heal gradually with little or no evidence of scarring • It begins as a single or multiple erosions,superficial erosions covered by a gray membrane and has a well circumscribed margin.

  6. 2.Recurrent abscess major • Females are more commonly affected • Occur at any age group • These are large painful ulcers • No. 1-20 • Size:>10mm • Sites:Lips,cheeks,tongue,soft palate • This lesions persists upto 6 weeks and leave a scars upon healing

  7. 3.Recurrent herptiform ulcers • It is similar to herpes simplex infection but virus is not found • These are characterised by crops of multiple small shallow ulcers, often upto 100 in number • Can occur at any site of oral cavity • Numerous small lesions may be found on any intraoral mucosal surface • Lesions begins as small pin-head size erosions that gradually enlarge and collaese • Lesions are more painful • This lesions could be present almost continuously for upto 1-2 years with relatively short remissions • 2% tetracycline mouthwash may relief pain

  8. 4.Behcet’s Syndrome • Etiology : Unknown • Age : 10-45 years • It is 5-10 times more common in males • Lesions is very painful • Size : Several mm to cm or even more in diameters

  9. Treatment of Apthous ulcres: • Vitamin supplements : VitB12,Iron and Folic acid • Metronidazole 400mg PO TDS for 5 days • Removal of the decayed tooth • Mouthwash: 2%tetracycline or 0.2% Chlorhexidine 3-4 times for 7 days.

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