Essentials of recurrent aphthous stomatitis

Abstract

Recurrent aphthous stomatitis (RAS), also known as canker sores, is the most common disease of the oral mucosa. Unlike caries and periodontal disease, patients with RAS are unable to prevent it. The clinical picture of RAS is characterized by recurrent episodes of solitary or multiple painful ulcerations without association with systemic diseases. The objective of this review is to present the essential characteristics of RAS, including its definition, pathogenesis, clinical and microscopic characteristics, proposed experimental models and recommended pharmacological management. This understanding can serve as a theoretical framework for research proposals.

Keywords: aphthae; etiology; experimental models; pathogenesis; review; therapeutics.

Figure 1.

Cell-mediated immunity in the pathogenesis of recurrent aphthous stomatitis. Lymphocytic cells infiltrate the oral epithelium and edema develops as a result of inflammatory stimuli. Keratinocyte vacuolization and localized vasculitis cause a papular swelling. The papule ulcerates and is infiltrated by neutrophils, lymphocytes and plasma cells, followed by healing and regeneration of the epithelium. Adapted from Cui et al (24).

Figure 2.

Small ulcers of recurrent aphthous stomatitis minor-type (Mikulicz ulcer). These ulcers are painful.