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Etiopatogenia e tratamento das aftas (úlceras orais)
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Abstract(s)
As Ulcerações Orais (UO), vulgarmente designadas por Aftas, são uma patologia com um elevado grau de incidência na mucosa oral.
Esta patologia pode ocorrer de forma isolada, neste caso habitualmente originada por fatores locais, ou pode apresentar-se de uma forma clínica recidivante, e aqui poderá ser desencadeada por uma grande variedade de patologias sistémicas específicas, ou finalmente poderemos estar perante um caso da chamada Estomatite Aftosa Recorrente (EAR).
As lesões ulcerativas da mucosa oral apresentam todas uma aparência similar, mas existe na sua génese uma muito variada etiopatogenia, a qual é, na maioria dos casos, multifatorial. Torna-se assim fundamental o diagnóstico diferencial entre todas as suas etiologias possíveis, pois cada uma delas terá um tratamento diferenciado e o mais apropriado a cada uma.
Esta patologia tem habitualmente um impacto importante sobre a qualidade de vida dos pacientes devido à dor que provoca, o ardor permanente e a interferência que pode ter na vida diária do paciente, nomeadamente na alimentação e na fala.
O diagnóstico de EAR não pode ser efetuado sem que primeiro se excluam outras causas específicas para a origem das ulcerações orais. A EAR é uma doença de origem multifatorial e com vários fatores predisponentes, mas que se continua a considerar de causa desconhecida. Outros diagnósticos têm primeiro que ser excluídos.
Existe uma grande variedade de tratamentos possíveis, que serão então aplicados após um diagnóstico efetuado de forma correta. Esses tratamentos poderão ser locais e/ou sistémicos, e poderão, em casos específicos de diagnóstico, levar à resolução definitiva da doença.
No que diz respeito à EAR, e dado o seu caracter idiopático e multifatorial, o tratamento será principalmente um tratamento sintomático e terá como objetivo reduzir o máximo possível a duração do episódio clínico. Além disso terá também o objetivo de aumentar o máximo possível os períodos de remissão.
Oral Ulcerations (OU), commonly known as Canker Sores, are a pathology with a high degree of incidence in the oral mucosa. This pathology can occur in isolation, in this case usually caused by local factors, or it can present itself in a recurrent clinical form, and here it may be triggered by a wide variety of specific systemic pathologies, or finally we may be facing a case of the so-called Recurrent aphthous stomatitis (RAS). Ulcerative lesions of the oral mucosa all have a similar appearance, but there is a very varied etiopathogenesis in their genesis, which is, in most cases, multifactorial. Therefore, the differential diagnosis between all its possible etiologies becomes fundamental, since each one of them will have a differentiated treatment and the most appropriate for each. This pathology usually has an important impact on the quality of life of patients due to the pain it causes, the permanent burning and the interference that it can have on the patient's quality of life, namely in eating and speaking. The diagnosis of RAS cannot be made without first excluding other specific causes for the origin of oral ulcerations. Other diagnoses must first be excluded. There is a wide variety of possible treatments, which will then be applied after a correct diagnosis has been made. These treatments may be local and/or systemic, and may, in specific cases of diagnosis, lead to the definitive resolution of the disease. With regard to RAS, and given its idiopathic and multifactorial character, the treatment will be mainly symptomatic and will aim to reduce the duration of the clinical episode as much as possible. In addition, it will also aim to increase the remission periods as much as possible.
Oral Ulcerations (OU), commonly known as Canker Sores, are a pathology with a high degree of incidence in the oral mucosa. This pathology can occur in isolation, in this case usually caused by local factors, or it can present itself in a recurrent clinical form, and here it may be triggered by a wide variety of specific systemic pathologies, or finally we may be facing a case of the so-called Recurrent aphthous stomatitis (RAS). Ulcerative lesions of the oral mucosa all have a similar appearance, but there is a very varied etiopathogenesis in their genesis, which is, in most cases, multifactorial. Therefore, the differential diagnosis between all its possible etiologies becomes fundamental, since each one of them will have a differentiated treatment and the most appropriate for each. This pathology usually has an important impact on the quality of life of patients due to the pain it causes, the permanent burning and the interference that it can have on the patient's quality of life, namely in eating and speaking. The diagnosis of RAS cannot be made without first excluding other specific causes for the origin of oral ulcerations. Other diagnoses must first be excluded. There is a wide variety of possible treatments, which will then be applied after a correct diagnosis has been made. These treatments may be local and/or systemic, and may, in specific cases of diagnosis, lead to the definitive resolution of the disease. With regard to RAS, and given its idiopathic and multifactorial character, the treatment will be mainly symptomatic and will aim to reduce the duration of the clinical episode as much as possible. In addition, it will also aim to increase the remission periods as much as possible.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Ulceração oral Estomatite aftosa recorrente Diagnóstico diferencial Tratamento local Tratamento sistémico