Page 19 - SPEMD_59-1

rev port estomatol med dent cir maxilofac . 2018;59(1):10-17 11

Caracterização da estomatite aftosa recorrente numa população
infantojuvenil

r e s u m o

Palavras-chave: Objetivo: Caracterizar a estomatite aftosa recorrente numa população infantojuvenil, averi-
Aftas guando a sua relação com fatores predisponentes e possíveis modificações nas rotinas diá-
Aftosa rias das crianças.
Medicina oral Métodos: Os alunos da Escola Básica de S. Miguel, Vizela, e respetivos encarregados de edu-
Recorrente cação foram submetidos a um questionário. Foi também realizada uma revisão da literatu-
Estomatite ra nas bases de dados PubMed, Cochrane e Biblioteca Virtual da Universidade do Porto.
Infantojuvenil Resultados: Foi determinada uma prevalência de aftas em 53,0% dos participantes, sendo
que a maioria referiu um número de lesões entre 1 e 5, com localização na mucosa jugal/
labial e com período de cicatrização de 4 a 7 dias. Cerca de 46,4% da amostra apresentou
história familiar, tendo sido a mãe o progenitor mais indicado. Cerca de 29,6% dos inquiridos
associaram a presença de aftas com eventos traumáticos na mucosa oral, enquanto 9,8%
associaram com o stress. Foi apenas encontrada uma associação significativa entre a fre-
quência de aftas e alterações gastrointestinais, não se verificando o mesmo com outros
fatores. Verificou-se ainda uma utilização acentuada de medicamentos tópicos, sendo o
farmacêutico o profissional de saúde mais consultado.
Conclusões: Os resultados deste estudo estão de acordo com a literatura quanto às caracte-
rísticas clínicas das aftas e quanto ao impacto negativo desta doença na qualidade de vida
das crianças, verificando-se a relação com alterações gastrointestinais. (Rev Port Estomatol
Med Dent Cir Maxilofac. 2018;59(1):10-17)
© 2018 Sociedade Portuguesa de Estomatologia e Medicina Dentária.
Publicado por SPEMD. Este é um artigo Open Access sob uma licença CC BY-NC-ND
(http://creativecommons.org/licenses/by-nc-nd/4.0/).

develop RAS at an earlier age, with more-severe symptoms and
Introduction
frequent episodes. 4-6,14,15
The recurrent aphthous stomatitis (RAS) is the most common It is thought that some allergies can cause RAS. Hypersen-
1,2
ulcerous disease of the oral mucosa. It usually onsets in sitivity to some food components and oral microbial agents
childhood and affects about 25% of the world population. 3-6 are considered potential etiological factors. 1,16,17
Its typical lesions are well-circumscribed rounded ulcers sur- The association between RAS and some nutritional and
rounded by a peripheral halo of erythema, with a white/yel- blood deficits has been studied, and patients with RAS have
lowish fibromembranous center. It has three main presenta- been proved to present iron, B12 vitamin, folic acid and hemo-
18
tions: minor, major and herpetiform, of which the minor is globin deficits more frequently. The fact that 5-10% of pa-
the most common. In the minor presentation, the aphthae tients with RAS present low blood levels of folate, zinc, iron,
generally heal in 4 to 7 days without leaving a scar, while in and B1, B2, B6 and B12 vitamins may suggest these nutrition-
the major presentation aphthae need a larger period and al deficits as potential causes. 1,19,20
might leave a scar. 3-6 Stress-causing events were also subjectively found to be
The etiopathogeny of RAS is still unknown and is often strongly associated with RAS episodes, but not with these ep-
multifactorial. Several factors have been suggested as trig- isodes’ duration. Furthermore, it was demonstrated that expe-
gering agents, including local factors, such as local trauma, riencing a stress-inducing situation raises almost three times
which is considered an etiological agent of RAS in susceptible the odds of RAS occurring. 21
patients. 1,7,8 Lastly, RAS treatment acts mainly on symptoms’ relief,
Regarding systemic factors, the infection by H. pylori has and a topical approach is effective in most patients. Never-
9
been reported as an etiological factor of RAS. The ulcerous theless, systemic treatment should be considered in patients
colitis and the Crohn’s disease have also been associated with with multiple episodes of minor RAS or patients with major
1
the appearance of oral ulcers similar to the ones of RAS. Some RAS. 1
authors state that patients with RAS have a higher prevalence The present work aims to characterize RAS in a young pop-
of celiac disease and that RAS may be their first complaint. 10-13 ulation, according to its frequency, location, painful symptom-
The role of genetic factors is also important in the etiology atology, applied therapies and time of healing. It also aims to
of RAS, as it is thought that at least 40% of patients with RAS study these lesions’ association with predisposing factors and
have a family history of that condition. These patients tend to potential changes in children’s daily routines.