Study of the epithelial state of the oral mucosa in patients with recurrent aphthous stomatitis

Abstract

Relevance. Recurrent aphthous stomatitis (RAS) is one of the most common diseases affecting the oral mucosa. It is characterized by the recurrent appearance of ulcers (aphthae) and a prolonged course with periodic exacerbations.Purpose. To study the condition of the oral mucosa epithelium in patients with recurrent aphthous stomatitis undergoing treatment with antiseptics and reparative agents.This study examined samples of buccal epithelium from 64 patients, who were randomly divided into two equal groups: the first group used chlorhexidine as a mouthwash (control group); the second group used octenidine + phenoxyethanol for 7 days. For pain relief, patients in both groups applied a gel containing lidocaine + chamomile extract. After 7 days, the therapy continued with reparative agents (a hydrogel-based material with sodium alginate, Derinat, and lidocaine, deproteinized calf blood extract, and sea buckthorn oil). Each group was further divided into three subgroups for this part of the therapy. The condition of the buccal epithelium was assessed three times: before treatment, on the 7th day, and on the 21st day of therapy. Buccal epithelium preparations were prepared and analyzed using standard methods.Results. The analysis of cytogenetic and karyological indicators of buccal epithelial cells in patients with CRAS revealed that, at the peak of the inflammatory process, cells with micronuclei and various forms of nuclear protrusions were more frequently observed. During therapy, there was a notable reduction in buccal epithelial cells exhibiting these pathological features.Conclusion. Before therapy, patients with RAS exhibited cytogenetic instability and various karyological anomalies in the buccal epithelial cells of the oral mucosa. These anomalies included significantly higher occurrences of micronuclei, karyopyknosis, karyolysis, nuclear vacuolization, intercellular bridges, and chromatin condensation. During the different therapy regimens for RAS, normalization of the epithelial state of the oral mucosa was observed, with the most pronounced improvements seen with the use of octenidine + phenoxyethanol in combination with a hydrogel-based material containing sodium alginate, Derinat, and lidocaine.