CHRONIC NON-SPECIFIC ULCERS IN THE ORAL CAVITY CAN RESEMBLE DIABETIC FOOT ULCERS
Keywords:
Oral ulcers, Root canal treatment, Oral Pathology, Oral medicine, Diabetic foot
Abstract
Oral ulcers are one of the most common mucosal lesions seen in different locations in the oral cavity. Most of these ulcers will resolve within two weeks. However, chronic ulcers remain problematic in the way they are managed and investigated for possible etiological factors. Viral infections, gastrointestinal disorders, blood diseases, cancer treatment, local trauma, medications or a combination of more than one factor contribute to oral ulcerations. The terms idiopathic or non-specific oral ulcers are still used when no possible explanation could be found regards the causative factors of the ulcerations. We present a unique case of a completely healthy 45 year old female, where a chronic fistula related to a failed root canal treatment developed into a chronic non-specific ulcer over the period of thirty years. The chronic ulcer resembled a diabetic foot ulcer in both clinical and histopathological pictures. Associated teeth with poor prognosis were extracted. Muco-gingival corrective surgery to close the associated gingival defect as well as a ridge preservation surgery to compensate for the associated bone loss produced excellent healing of both soft and hard tissues.
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References
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29-Schroeter T, Kiefer P, Sauer M, Mohr FW. Fistula Formation 6 Years after Removal of Infected Pacemaker Leads. Thorac Cardiovasc Surg 2015; 4: 49–51.
30- Ferguson MW, Herrick SE, Spencer MJ, Shaw JE, Boulton A J, Sloan P. The histology of diabetic foot ulcers. Diabet Med 1996; 13(1Suppl): s30-s33.
2-S´lebioda Z, Szponar E, Kowalska A. Etiopathogenesis of Recurrent Aphthous Stomatitis and the Role of Immunologic Aspects: Literature Review. Arch.
Immunol. Ther. Exp 2014; 62: 205–215.
3-Mostafa MB, Porter SR, Smoller BR, Sitaru C. Oral mucosal manifestations of autoimmune skin diseases. Autoimmunity reviews 2015; 14(10):930-951.
4- Yuan A, Woo S. Adverse drug events in the oral cavity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2015; 119(1): 35-47.
5-Talacko AA, Gordon AK, Aldred MJ. The patient with recurrent oral ulceration. Australian Dental Journal 2010; 55(1Suppl): 14-22.
6- Sato C, Matsumura Y, Sbimizu K. A case of gingival ulcer thought to be caused by Allopurinol. J Oral Maxillfac Surg 2009;67: 2510-2513.
7-Kharazmi M, SjÖvist K, RizkM, Warfvinge G. Oral ulcer associated with Alendronate: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110(6):e11-e13.
8- Kharazmi M, SjÖvist K, Warfvinge G. Oral ulcers, a little known adverse effect of Alendronate: Review of literature. J Oral Maxillofac Surg 2012; 70(4): 830-836.
9-Badawi M, Almazrooa S, Azher F, Alsayes F. Hydroxyurea induced oral ulceration. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120(6): 232-e234.
10-Baccaglini L, Lalla RV, Bruce AJ, Sartori-Valinotti JC, Latortue MC, Carrozzo M, Rogers RS. Urban legends: recurrent aphthous stomatitis. Oral Dis 2011; 17(8): 755-70.
11- Munoz-Corcuera M, Esparza-Gomez G, Gonzalez-Moles MA, BasconesMartınez A. Oral ulcers: clinical aspects. A tool for dermatologists. Part I. Acute ulcers. Clinical and Experimental Dermatology 2009; 34(3): 289–294.
12- Munoz-Corcuera M, Esparza-Gomez G, Gonzalez-Moles MA, BasconesMartınez A. Oral ulcers: clinical aspects. A tool for dermatologists. Part II. Chronic ulcers. Clinical and Experimental Dermatology 2009; 34(4): 456–461.
13-Danesh M, Murase JE. Use of nonnarcotic antitussive for severe, treatment resistant oral ulcers.J Am Acad Dermatol 2015; 72(6): e159.
14- Piluso S, Ficarra G, Lucatorto FM, Orsi A, Dionisio D, StendardiL, Eversole LR. Cause of oral ulcers in HIV-infected patients: a study of 19 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996; 82(2):166–172.
15- Reichart PA. Oral ulcerations in HIV infection. Oral Dis 1997; 3(1): 180–182.
16- Delgado WA, Almeida OP, Vargas PA, Leo JE. Oral ulcers in HIV-positive Peruvian patients: an immunohistochemical and in situ hybridization study. J Oral athol Med 2009; 38: 120–125.
17-Sekhar MS, Unnikrishnan MK, Vijayanarayana K, Rodrigues GS, Mukhopadhyay C. Topical application/formulation of probiotics: Will it be a novel treatment approach for diabetic foot ulcers? Medical Hypotheses 2014; 82: 86-89.
18-Aljbab AA, Almuhaiza M, Patil SR, Alanezi K. Management of Recurrent Aphthous Ulcers: An Update. Int J Dent Oral Health 2016; 2(2): 1-4. Doi http://dx.doi.org/10.16966/2378-7090.164
19- Boulton AJ. The diabetic foot: from art to science. The 18th Camillo Golgi lecture.Diabetologia 2004; 47: 1347- 1353.
20-Aoun N,El-Hajj G, El-Toum S. Oral ulcers: An uncommon site in primary turberclosis. Australian Dental Journal 2015; 60(1): 119-122.
21- Nagaraj V, Sashykumar S, Viswanathan S, Kumar S. Multiple oral ulcers leading to diagnosis of pulmonary tuberculosis. European Journal of Dentistry 2013;
7(2): 243-245.
22- Chen Y, Ma W, Chen J, Cai J. Multiple chronic non-specific ulcer of small intestine characterized by anaemia and hypoalbuminemia. World J Gastroenterol 2010; 16(6): 782-784.
23-Naidu A, Kessler HP, Pavelka MA. Epstein-Barr Virus – positive oral ulceration simulating Hodgkin Lymphoma in a patient treated with Methotrexate: Case report and review of literature.J Oral Maxillfac Surg 2014; 72: 724-729.
24-Martinez-Sandoval B, CeballosHernández H, Téllez-Rodríguez J, Xochihua-Díaz L, Durán-Ibarra G, Pozos-Guillen AJ. Idiopathic Ulcers as an Oral Manifestation in Pediatric Patients with AIDS: Multidisciplinary Management. Journal of Clinical Pediatric Dentistry 2012; 37(1): 65-69.
25-Balfield PM, Dwyer AA. Oral complications of childhood cancer and its treatment: current best practice. Eur J Cancer 2004; 40: 1035-1041.
26-Lula ECO, Lula CEO, Alves CMC, Lopes FF, Pereira ALA. Chemotherapy induced oral complications in leukemic patients. Int J Paed Otorhinolaryngology 2007; 71: 1681-1685.
27- Feller L, Khammissa RAG, Wood NH, Meyerov R, Pantanowitz L, Lemmer J. Oral Ulcers and Necrotizing Gingivitis in Relation to HIV-Associated Neutropenia: A Review and an llustrative Case. AIDS Research and Human Retroviruses 2012; 28(4): 346- 351.
28-Beck-Broichsitter BE, Klapper W, Günther A, WiltfangJ, Becker ST. Gingival ulceration and exposed bone. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2013; 115(3): 288-292.
29-Schroeter T, Kiefer P, Sauer M, Mohr FW. Fistula Formation 6 Years after Removal of Infected Pacemaker Leads. Thorac Cardiovasc Surg 2015; 4: 49–51.
30- Ferguson MW, Herrick SE, Spencer MJ, Shaw JE, Boulton A J, Sloan P. The histology of diabetic foot ulcers. Diabet Med 1996; 13(1Suppl): s30-s33.
How to Cite
1.
Mahmoud M Bakr, Usman A Khan, Paul Kim, Ryan Butler, Nabil Khzam. CHRONIC NON-SPECIFIC ULCERS IN THE ORAL CAVITY CAN RESEMBLE DIABETIC FOOT ULCERS. Med. res. chronicles [Internet]. 1 [cited 2024Nov.6];3(1):183-90. Available from: https://medrech.com/index.php/medrech/article/view/158
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Case Report
