Volume 31, Issue 11 (February 2021)                   Studies in Medical Sciences 2021, 31(11): 874-880 | Back to browse issues page

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Sarrafan N, Seyedi S A, Pishva S S, Taram S, Mollazadeh G. VITAMIN B12 AND FOLIC ACID DEFICIENCY IN PATIENTS WITH RECURRENT APHTHOUS STOMATITIS: A CROSS-SECTIONAL STUDY. Studies in Medical Sciences 2021; 31 (11) :874-880
URL: http://umj.umsu.ac.ir/article-1-5262-en.html
Assistant Professor of Oral and Maxillofacial Diseases, School of Dentistry, Urmia University of Medical Sciences, Urmia, Iran (Corresponding Author) , Seyedi.a@umsu.ac.ir
Abstract:   (2600 Views)
Background & Aims: Recurrent Aphthous Stomatitis (RAS) is one of the most common painful oral mucosal conditions seen among patients. This study aimed to compare the vitamin B12 and folate intake in RAS-positive patients with the control group.
Materials & Methods: In this cross-sectional study, 184 patients who were referred to Taleghani Hospital (Urmia, Iran) participated in the study. Vitamin B12 and folate serum levels were measured using Vitamin B12 Assay Kit (Siemens Healthineers Active-B12 (AB12) assay offered on the Atellica® IM Analyzer and ADVIA Centaur® CP), then oral examination of patients were taken to rule out the prevalence of RAS between participants. The serum level of vitamin B12 and folate were compared between patients with RAS and control group. The data were analyzed by IBM SPSS 20.0 (Chicago, USA).
Results: The study subjects had significantly lower daily intake of vitamin B12 (p < 0.0001) as compared to the controls. No significant differences were observed with regard to folate intake between two groups (p = 0.579).
Conclusion: Our results demonstrated that patients with RAS are more likely to have lower dietary intakes of vitamin B12 than the control group, but no difference was observed between two groups concerning the folate intake. These findings suggest that consuming sufficient amounts of Vitamin B12 may be a useful strategy to reduce the number and/or duration of RAS episodes.
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1. Greenberg MS, Glick M. Ship J. Bueket's Oral Medicine. 11th ed. London: Decker; 2015. [URL]
2. Neville BW, Damm DD, Allen CM, Chi AC. Oral And Maxillofacial Pathology.3rd ed. London: saunders; 2008. [URL]
3. Kwan DN, Rocha JTQ, Niero-Melo L, Domingues MAC, Oliveira CC. p53 and p21 expression in bone marrow clots of megaloblastic anemia patients. Int J Clin Exp Pathol 2020 ;13(7):1829-33.. [PMID] [PMCID]
4. Wakeman M, Archer DT. Metformin and Micronutrient Status in Type 2 Diabetes: Does Polypharmacy Involving Acid-Suppressing Medications Affect Vitamin B12 Levels? Diabetes Metab Syndr Obes 2020 ;13:2093-2108. [DOI:10.2147/DMSO.S237454] [PMID] [PMCID]
5. Davatchi F, Tehrani BA, Jamshidi AR, Shams DS, Gholami Z, Moradi M, et al. The Prevalence of Oral Aphthosis in a Normal Population in Iran: A WHO-ILAR COPCORD Study. Arch Iranian Med 2008:11 (2):207-9. [PMID]
6. Al-Amad SH, Hasan H. Vitamin D and hematinic deficiencies in patients with recurrent aphthous stomatitis. Clin Oral Investig 2020;24(7):2427-32. [DOI:10.1007/s00784-019-03102-9] [PMID]
7. Sonis ST, Fazio RC,Fang L. Principles and Practice of Oral Medicine.2nd ed. Philadelphia: Saunders; 1995. P.34-43.
8. Crisoian S. Aphtgous Ulceration. New Europain J Medicine 2006:35(5):165-72. [DOI:10.1056/NEJMcp054630] [PMID]
9. Regezi J, Sciubba J, Jordan R. Oral Pathology: Clinical Pathologic Correlation. London: saunders; 2012. [DOI:10.1016/B978-0-7020-4618-6.00039-7]
10. Porter SR, Hegarty A, Kaliakatsou F, Hodgson TA, Scully C. Recurrent Aphthous Stomatitis. Clinics in Dermatology 2000:18: 569-78. [DOI:10.1016/S0738-081X(00)00147-4]
11. Cynghia H. Recommendation for the Diagnosis and Management of Recurrent Aphthous Stomatitis. National Guideline Clearinghouse 2003:12(3):1-9.
12. Natah S, Kontinen Y, Enattah NS. Recurrent Aphthous Ulcers Today: A Review of Growing Knowledge. Int J Oral Maxillofacial surg 2004:33(1):221-34 . [DOI:10.1006/ijom.2002.0446] [PMID]
13. Pieter J, Antonio C. Pathology of Head and Neck. 3rd ed. Spain:Spring; 2006. P.76-78 [Google Scholar]
14. Chiang CP, Wu YH, Yu-Fong Chang J, Wang YP, Chen HM, Sun A. Serum thyroid autoantibodies are not associated with anemia, hematinic deficiencies, and hyperhomocysteinemia in patients with Behcet's disease. J Dent Sci 2018 ;13(3):256-62. [DOI:10.1016/j.jds.2018.05.001] [PMID] [PMCID]
15. Kafayi P. Oral Aphthous Lesions. Yazd Med J 2004;14(3):84-90. [URL]
16. Zand N. Afafi S. Investigation the role of Diode laser on reducing Major oral Aphthous lesions pain. Laser Med J 2009;6(4):7-12.
17. Jackson K. Is Laser Thrapy Effctive at Relieving Pain in Adult Patients with Recurrent Aphthous Stomatitis?.PCOM 2016;280:1-14. [URL]
18. Zand N, Mansouri P, Fateh M, Ataie-Fashtami L, Khiabanloo SR, Safar F, et al. Relieving Pain in Oral Lesions of Pemphigus Vulgaris Using the Non-ablative, Non-thermal, CO2 Laser Therapy (NTCLT): Preliminary Results of a Novel Approach. J Lasers Med Sci 2017;8(1):7-12. [DOI:10.15171/jlms.2017.02] [PMID] [PMCID]
19. Suppelt S. The Application of Diode Laser (970 nm) in the Treatment of Aphthous Ulcers. Laser Dentistry 2014:37-40. [URL]
20. 20 Alidaee MR, Taheri A, Mansoori P, Ghodsi SZ. Silver Nitrate Cautery in Aphthous Stomatitis: a Randomized Controlled Trial. Br J Dermatol 2005:153:521-5. [DOI:10.1111/j.1365-2133.2005.06490.x] [PMID]
21. Arikan OK, Birol A, Tuncez F, Erkek E, Koc C. A Prospective Randomized Controlled Trial to Determine if Cryotherapy Can Reduce the pain of Patients with Minor form of Recurrent Aphthous Stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006:101:E1-5 . [DOI:10.1016/j.tripleo.2005.07.035] [PMID]
22. 22 Jijin MJ, Rakaraddi M, Pai J, Jaishankar HP, Krupashankar R, Kavitha AP, et al. Low-Level Laser Therapy Versus 3% Amlexanox: A Comparison of Treatment Effects in a Cohort of Patients with Minor Aphthous Ulcers. Oral Surg Oral Med Oral Pathol Oral Radiol 2016:121:269-73. [DOI:10.1016/j.oooo.2015.11.021] [PMID]
23. Stanbury R.Graham E. Systemic Corticosteroid Therapy:Side Effects and Their Management.Br J Ophthalmol 1998:82:704-8. [DOI:10.1136/bjo.82.6.704] [PMID] [PMCID]
24. Piskin S, Sayan C, Durukan N, Senol M. Serum iron, ferritin, folic acid, and vitamin B12 levels in recurrent aphthous stomatitis. J Eur Acad Dermatol Venereol 2002; 16(1): 66-7. [DOI:10.1046/j.1468-3083.2002.00369.x] [PMID]
25. Kozlak ST, Walsh SJ, Lalla RV. Reduced dietary intake of vitamin B12 and folate in patients with recurrent aphthous stomatitis. J Oral Pathol Med 2010; 39(5): 420-3. [DOI:10.1111/j.1600-0714.2009.00867.x] [PMID] [PMCID]
26. Neville BW, Damm DD, Allen CM, Chi AC. Oral and maxillofacial pathology. 4th Ed. Elsevier Philasdelphia; 2016.P.303-10. [URL]
27. Yıldırımyan N, Özalp Ö, Şatır S, Altay MA, Sindel A. Recurrent Aphthous Stomatitis as a Result of Zinc Deficiency. Oral Health Prev Dent 2019;17(5):465-8. [PMID]
28. Volkov I, Rudoy I, Freud T, Sardal G, Naimer S, Peleg R, et al. Effectiveness of vitamin B12 in treating recurrent aphthous stomatitis: a randomized, double-blind, placebo-controlled trial. J Am Board Fam Med 2009;22:9-16. https://doi.org/10.3122/jabfm.2009.01.080113 [DOI:10.3122/jabfm.2009.05.090161] [PMID]
29. Piskin S SC, Durukan N, Senol M. Serum iron , ferritin , folic acid , and vitamin B12 levels in recurrent aphthous stomatitis. J Eur Acad Dermatology Venereol 2002;16:55-7. [DOI:10.1046/j.1468-3083.2002.00369.x] [PMID]
30. Kozlak ST, Walsh SJ, Lalla RV. Reduced dietary intake of vitamin B12 and folate in patients with recurrent aphthous stomatitis. J Oral Pathol Med 2010;39:420-3. [DOI:10.1111/j.1600-0714.2009.00867.x] [PMID] [PMCID]
31. Langan RC, Goodbred AJ. Vitamin B12 Deficiency: Recognition and Management. Am Fam Physician 2017;96:384‐9 [URL]
32. Lindenbaum J, Savage DG, Stabler SP, Allen RH. Diagnosis of cobalamin deficiency: II. Relative sensitivities of serum cobalamin, methylmalonic acid, and total homocysteine concentrations. Am J Hematol 1990;34:99-107. [DOI:10.1002/ajh.2830340205] [PMID]
33. Wray D, Ferguson MM, Mason DK, Hutcheon AW, Dagg JH. Recurrent aphthae: treatment with vitamin B12, folic acid, and iron. Br Med J 1975;2:490-3. [DOI:10.1136/bmj.2.5969.490] [PMID] [PMCID]
34. Nolan A, McIntosh WB, Allam BF, Lamey PJ. Recurrent aphthous ulceration: vitamin B1, B2 and B6 status and response to replacement therapy. J Oral Pathol Med 1991;20:389-91. [DOI:10.1111/j.1600-0714.1991.tb00950.x] [PMID]
35. Porter S, Flint S, Scully C, Keith O. Recurrent aphthous stomatitis: the efficacy of replacement therapy in patients with underlying hematinic deficiencies. Ann Dent 1992;51:14-6. [URL]
36. Khan NF, Saeed M, Chaudhary S, Khan NF. Haematological parameters and recurrent aphthous stomatitis. J Coll Physicians Surg Pak 2013;23:124-7. [PMID]
37. Scully C, Gorsky M, Lozada-Nur F. The diagnosis and management of recurrent aphthous stomatitis: a consensus approach. J Am Dent Assoc 2003;134:200-7. [DOI:10.14219/jada.archive.2003.0134] [PMID]
38. Morris MS, Jacques PF, Rosenberg IH, Selhub J. Folate and vitamin B-12 status in relation to anemia, macrocytosis, and cognitive impairment in older Americans in the age of folic acid fortification. Am J Clin Nutr 2007;85:193-200. [DOI:10.1093/ajcn/85.1.193] [PMID] [PMCID]
39. Harker LA, Harlan JM, Ross R. Effect of sulfinpyrazone on homocysteine-induced endothelial injury and arteriosclerosis in baboons. Circ Res 1983;53:731-39. [DOI:10.1161/01.RES.53.6.731] [PMID]

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