Skip to main content
Top
Published in: BMC Oral Health 1/2017

Open Access 01-12-2017 | Research article

Evaluation of serum zinc levels in patients with recurrent aphthous stomatitis (RAS)

Authors: Zuzanna Ślebioda, Ewa Krawiecka, Elżbieta Szponar, Barbara Dorocka-Bobkowska

Published in: BMC Oral Health | Issue 1/2017

Login to get access

Abstract

Background

Recurrent aphthous stomatitis (RAS) is an ulcerative disease of the oral mucosa without a clearly defined etiology. The aim of the study was to evaluate the serum zinc levels in patients with RAS in comparison to healthy controls and to validate the association between zinc levels and the course of RAS.

Methods

Seventy-five patients with RAS and 72 controls underwent full dental examination. Serum zinc levels were determined by flame atomic absorption spectroscopy (F AAS). The results were statistically analyzed with Kruskal-Wallis, Mann-Whitney, chi-square tests and the test of difference between the two rates of structure with p < 0.05 as a significance level (Statistica 10, StatSoft®).

Results

No statistically significant differences were detected in serum zinc levels between RAS patients and healthy controls. The mean serum zinc concentration was found to be 84.2 μg/dL in RAS group and 83.9 μd/dL in controls, within the accepted norms. Zinc deficiency was observed in 10.7% patients from the RAS group and in 6.9% controls. No significant differences in serum zinc levels were found between patients when the course of the disease was considered.

Conclusions

Serum zinc concentrations did not differ significantly in RAS patients and in healthy controls and it did not influence the course of the disease. Therefore, zinc does not appear to be an important modifying factor in the development of RAS.
Literature
1.
go back to reference Natah SS, Konttinen YT, Enattah NS, Ashammakhi N, Sharkey KA, Häyrinen-Immonen R. Recurrent aphthous ulcers today: a review of the growing knowledge. Int J Oral Maxillofac Surg. 2004;33:221–34.CrossRefPubMed Natah SS, Konttinen YT, Enattah NS, Ashammakhi N, Sharkey KA, Häyrinen-Immonen R. Recurrent aphthous ulcers today: a review of the growing knowledge. Int J Oral Maxillofac Surg. 2004;33:221–34.CrossRefPubMed
2.
go back to reference Shashy RG, Ridley MB. Aphthous ulcers: a difficult clinical entity. Am J Otolaryngol. 2000;21:389–93.CrossRefPubMed Shashy RG, Ridley MB. Aphthous ulcers: a difficult clinical entity. Am J Otolaryngol. 2000;21:389–93.CrossRefPubMed
3.
go back to reference Lewkowicz N, Lewkowicz P, Kurnatowska A, Banasik M, Glowacka E, Cedzyński M, et al. Innate immune system is implicated in recurrent aphthous ulcer pathogenesis. J Oral Pathol Med. 2003;32:475–81.CrossRefPubMed Lewkowicz N, Lewkowicz P, Kurnatowska A, Banasik M, Glowacka E, Cedzyński M, et al. Innate immune system is implicated in recurrent aphthous ulcer pathogenesis. J Oral Pathol Med. 2003;32:475–81.CrossRefPubMed
4.
go back to reference Borra RC, Andrade PM, Silva ID, Morgun A, Weckx LL, Smirnova AS, Franco M. The Th1/Th2 immune type response of the recurrent aphthous ulceration analyzed by cDNA microarray. J Oral Pathol Med. 2004;33:140–6.CrossRefPubMed Borra RC, Andrade PM, Silva ID, Morgun A, Weckx LL, Smirnova AS, Franco M. The Th1/Th2 immune type response of the recurrent aphthous ulceration analyzed by cDNA microarray. J Oral Pathol Med. 2004;33:140–6.CrossRefPubMed
5.
go back to reference Eversole LR. Immunopathogenesis of oral lichen planus and recurrent aphthous stomatitis. Semin Cutan Med Surg. 1997;16:284–94.CrossRefPubMed Eversole LR. Immunopathogenesis of oral lichen planus and recurrent aphthous stomatitis. Semin Cutan Med Surg. 1997;16:284–94.CrossRefPubMed
6.
go back to reference Eversole LR. Immunopathology of oral mucosal ulcerative, desquamative, and bullous diseases: selective review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1994;77:555–71.CrossRef Eversole LR. Immunopathology of oral mucosal ulcerative, desquamative, and bullous diseases: selective review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1994;77:555–71.CrossRef
7.
go back to reference Erel A, Özsoy E, Biberoğlu G, Bilgihan A, Hasanoğlu A, Yis MO, et al. Serum levels of vitamins a, C and E, β-carotene, selenium and zinc in patients with Behcet’s disease. Biol Trace Elem Res. 2003;95:97–105.CrossRefPubMed Erel A, Özsoy E, Biberoğlu G, Bilgihan A, Hasanoğlu A, Yis MO, et al. Serum levels of vitamins a, C and E, β-carotene, selenium and zinc in patients with Behcet’s disease. Biol Trace Elem Res. 2003;95:97–105.CrossRefPubMed
8.
go back to reference Najim RA, Sharquie KE, Abu-Raghif AR. Oxidative stress in patients with Behcet’s disease: I correlation with severity and clinical parameters. J Dermatol. 2007;34:308–14.CrossRefPubMed Najim RA, Sharquie KE, Abu-Raghif AR. Oxidative stress in patients with Behcet’s disease: I correlation with severity and clinical parameters. J Dermatol. 2007;34:308–14.CrossRefPubMed
9.
go back to reference Puzanowska-Tarasiewicz H, Kuźmicka L, Tarasiewicz M. Biological function of some elements and their compounds. III. Zinc- component and activator of enzymes. Pol Merkuriusz Lek. 2009;161:419–22. Puzanowska-Tarasiewicz H, Kuźmicka L, Tarasiewicz M. Biological function of some elements and their compounds. III. Zinc- component and activator of enzymes. Pol Merkuriusz Lek. 2009;161:419–22.
10.
go back to reference Ozturk P, Belge Kurutas E, Ataseven A. Copper/zinc and copper/selenium ratios, and oxidative stress as biochemical markers in recurrent aphthous stomatitis. J Trace Elem Med Biol. 2013;27(4):312–6.CrossRefPubMed Ozturk P, Belge Kurutas E, Ataseven A. Copper/zinc and copper/selenium ratios, and oxidative stress as biochemical markers in recurrent aphthous stomatitis. J Trace Elem Med Biol. 2013;27(4):312–6.CrossRefPubMed
11.
12.
go back to reference Arora PN, Dhillon KS, Rajan SR, Sayal SK, Das AL. Serum zinc level in cutaneous disorders. Armed Forces Med J India. 2002;58:304–6.CrossRef Arora PN, Dhillon KS, Rajan SR, Sayal SK, Das AL. Serum zinc level in cutaneous disorders. Armed Forces Med J India. 2002;58:304–6.CrossRef
13.
go back to reference Al-Jebory AAOH. Serum zinc in psoriatic patients. Mustansiriya Med J. 2012;11(2):20–3. Al-Jebory AAOH. Serum zinc in psoriatic patients. Mustansiriya Med J. 2012;11(2):20–3.
14.
go back to reference Alobaidi AH, Mothana Z, Najem WS, Alsamarai AM. Adiponectin, IL-10, IL-23 and trace elements serum levels in patients with psoriasis. American Journal of Dermatology and Venereology. 2012;1(2):6–23. Alobaidi AH, Mothana Z, Najem WS, Alsamarai AM. Adiponectin, IL-10, IL-23 and trace elements serum levels in patients with psoriasis. American Journal of Dermatology and Venereology. 2012;1(2):6–23.
15.
go back to reference Butool F, Rekha C, Gnaneswar RA. Clinical study on serum zinc levels in patients with acne vulgaris. Asian J Res Chem. 2013;S.l:464–6. Butool F, Rekha C, Gnaneswar RA. Clinical study on serum zinc levels in patients with acne vulgaris. Asian J Res Chem. 2013;S.l:464–6.
16.
go back to reference Ingen-Housz-Oro S, Blanchet-Bardon C, Vrillat M, Dubertret L. Vitamin and trace metal levels in dystrophic epidermolysis bullosa. J Eur Acad Dermatol Venereol. 2004;18:649–53.CrossRefPubMed Ingen-Housz-Oro S, Blanchet-Bardon C, Vrillat M, Dubertret L. Vitamin and trace metal levels in dystrophic epidermolysis bullosa. J Eur Acad Dermatol Venereol. 2004;18:649–53.CrossRefPubMed
17.
go back to reference Gholizadeh N, Mehdipour M, Najafi S, Bahramiyan A, Garjani S, Khoeini PH. Evaluation of the serum zinc level in erosive and non-erosive oral lichen planus. J Dent (Shiraz). 2014;15(2):52–6. Gholizadeh N, Mehdipour M, Najafi S, Bahramiyan A, Garjani S, Khoeini PH. Evaluation of the serum zinc level in erosive and non-erosive oral lichen planus. J Dent (Shiraz). 2014;15(2):52–6.
18.
go back to reference Khozeimeh F, Jafari N, Attar AM, Jafari S, Ataie M. Comparative analysis of salivary zinc level in recurrent herpes labialis. Dent Res J (Isfahan). 2012;9(1):19–23.CrossRef Khozeimeh F, Jafari N, Attar AM, Jafari S, Ataie M. Comparative analysis of salivary zinc level in recurrent herpes labialis. Dent Res J (Isfahan). 2012;9(1):19–23.CrossRef
19.
go back to reference Khademi H, Shaikhiany J. Comparison of serum zing level in recurrent patients and normal individuals. Dent Res J (Isfahan). 2006;2(2):1–5. Khademi H, Shaikhiany J. Comparison of serum zing level in recurrent patients and normal individuals. Dent Res J (Isfahan). 2006;2(2):1–5.
20.
go back to reference Kleier C, Werkmeister R, Joos U. Zinc and vitamin a deficiency in diseases of the mouth mucosa. Mund Kiefer Gesichtschir. 1998;2(6):320–5.CrossRefPubMed Kleier C, Werkmeister R, Joos U. Zinc and vitamin a deficiency in diseases of the mouth mucosa. Mund Kiefer Gesichtschir. 1998;2(6):320–5.CrossRefPubMed
21.
go back to reference Maragou P, Ivanyi L. Serum zinc levels in patients with burning mouth syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1991;71(4):447–50.CrossRef Maragou P, Ivanyi L. Serum zinc levels in patients with burning mouth syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1991;71(4):447–50.CrossRef
22.
go back to reference Bagan JV, Sanchis JM, Milian MA, Penarrocha M, Silvestre FJ. Recurrent aphthous stomatitis. A study of the clinical characteristics of lesions in 93 cases. Oral Pathol Med. 1991;20:395–7.CrossRef Bagan JV, Sanchis JM, Milian MA, Penarrocha M, Silvestre FJ. Recurrent aphthous stomatitis. A study of the clinical characteristics of lesions in 93 cases. Oral Pathol Med. 1991;20:395–7.CrossRef
23.
go back to reference Orbak R, Cicek Y, Tezel A, Dogru Y. Effects of zinc treatment in patients with recurrent aphthous stomatitis. Dent Mater. 2003;22(1):21–9.CrossRef Orbak R, Cicek Y, Tezel A, Dogru Y. Effects of zinc treatment in patients with recurrent aphthous stomatitis. Dent Mater. 2003;22(1):21–9.CrossRef
24.
go back to reference Özler GS. Zinc deficiency in patients with recurrent aphthous stomatitis: a pilot study. J Laryngol Otol. 2014;128:531–3.CrossRefPubMed Özler GS. Zinc deficiency in patients with recurrent aphthous stomatitis: a pilot study. J Laryngol Otol. 2014;128:531–3.CrossRefPubMed
25.
go back to reference Scully C, Porter S. Oral mucosal disease: recurrent aphthous stomatitis. Br J Oral Maxillofac Surg. 2008;46:198–206.CrossRefPubMed Scully C, Porter S. Oral mucosal disease: recurrent aphthous stomatitis. Br J Oral Maxillofac Surg. 2008;46:198–206.CrossRefPubMed
26.
go back to reference Khan NF, Saeed M, Chaudhary S, Khan NF. Haematological parameters and recurrent aphthous stomatitis. J Coll Physici. 2013;23:124–7. Khan NF, Saeed M, Chaudhary S, Khan NF. Haematological parameters and recurrent aphthous stomatitis. J Coll Physici. 2013;23:124–7.
27.
go back to reference Lopez-Jornet P, Camacho-Alonso F, Martos N. Hematological study of patients with aphthous stomatitis. Int J Dermatol. 2014;53(2):159–63.CrossRefPubMed Lopez-Jornet P, Camacho-Alonso F, Martos N. Hematological study of patients with aphthous stomatitis. Int J Dermatol. 2014;53(2):159–63.CrossRefPubMed
28.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
29.
go back to reference Porter S, Flint S, Scully C, Keith C. Recurrent aphthous stomatitis: the efficacy of replacement therapy in patients with underlying hematinic deficiencies. Ann Dent. 1992;51:14–6.PubMed Porter S, Flint S, Scully C, Keith C. Recurrent aphthous stomatitis: the efficacy of replacement therapy in patients with underlying hematinic deficiencies. Ann Dent. 1992;51:14–6.PubMed
30.
go back to reference 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;20:389–39.CrossRefPubMed 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;20:389–39.CrossRefPubMed
31.
go back to reference Lalla RV, Choquette LE, Feinn RS, Zawistowski H, Latortue MC, Kelly ET, et al. Multivitamin therapy for recurrent aphthous stomatitis: a randomized, double-masked, placebo-controlled trial. J Am Dent Assoc. 2012;143:370–6.CrossRefPubMedPubMedCentral Lalla RV, Choquette LE, Feinn RS, Zawistowski H, Latortue MC, Kelly ET, et al. Multivitamin therapy for recurrent aphthous stomatitis: a randomized, double-masked, placebo-controlled trial. J Am Dent Assoc. 2012;143:370–6.CrossRefPubMedPubMedCentral
32.
go back to reference Haisraeli-Shalish M, Livneh A, Katz J, Doolman R, Sela BA. Recurrent aphthous stomatitis and thiamine deficiency. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;82:634–6.CrossRefPubMed Haisraeli-Shalish M, Livneh A, Katz J, Doolman R, Sela BA. Recurrent aphthous stomatitis and thiamine deficiency. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;82:634–6.CrossRefPubMed
33.
go back to reference Endre L. Recurrent aphthous ulceration with zinc deficiency and cellular immune deficiency. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1991;72(5):559–61.CrossRef Endre L. Recurrent aphthous ulceration with zinc deficiency and cellular immune deficiency. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1991;72(5):559–61.CrossRef
34.
go back to reference Merchant HW, Gangarosa LP, Glassman AB, Sobel RE. Zinc sulfate supplementation for treatment of recurring oral ulcers. South Med J. 1977;70(5):559–61.CrossRefPubMed Merchant HW, Gangarosa LP, Glassman AB, Sobel RE. Zinc sulfate supplementation for treatment of recurring oral ulcers. South Med J. 1977;70(5):559–61.CrossRefPubMed
35.
go back to reference Sharquie KE, Najim RA, Al-Hayani RK, Al-Nuaimy AA, Maroof DM. The therapeutic and prophylactic role of oral zinc sulfate in management of recurrent aphthous stomatitis (RAS) in comparison with dapsone. Saudi Med J. 2008;29(5):734–8.PubMed Sharquie KE, Najim RA, Al-Hayani RK, Al-Nuaimy AA, Maroof DM. The therapeutic and prophylactic role of oral zinc sulfate in management of recurrent aphthous stomatitis (RAS) in comparison with dapsone. Saudi Med J. 2008;29(5):734–8.PubMed
36.
go back to reference Wray D. A double-blind trial of systemic zinc sulfate in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1982;53(5):469–72.CrossRef Wray D. A double-blind trial of systemic zinc sulfate in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1982;53(5):469–72.CrossRef
37.
go back to reference Seyedmajidi SA, Seyedmajidi M, Moghadamnia A, Khani Z, Zahedpasha S, Jenabian N, et al. Effect of zinc-deficient diet on oral tissues and periodontal indices in rats. Int J Mol Cell Med. 2014;3(2):82–7. Seyedmajidi SA, Seyedmajidi M, Moghadamnia A, Khani Z, Zahedpasha S, Jenabian N, et al. Effect of zinc-deficient diet on oral tissues and periodontal indices in rats. Int J Mol Cell Med. 2014;3(2):82–7.
38.
go back to reference Kim J, Kim S, Jeon S, Hui Z, Kim Y, Im Y, Lim W, Kim C, Choi H, Kim O. Anti-inflammatory effects of zinc in PMA-treated human gingival fibroblast cells. Med Oral Patol Oral Cir Bucal. 2015;20(2):e180–7.CrossRefPubMedPubMedCentral Kim J, Kim S, Jeon S, Hui Z, Kim Y, Im Y, Lim W, Kim C, Choi H, Kim O. Anti-inflammatory effects of zinc in PMA-treated human gingival fibroblast cells. Med Oral Patol Oral Cir Bucal. 2015;20(2):e180–7.CrossRefPubMedPubMedCentral
Metadata
Title
Evaluation of serum zinc levels in patients with recurrent aphthous stomatitis (RAS)
Authors
Zuzanna Ślebioda
Ewa Krawiecka
Elżbieta Szponar
Barbara Dorocka-Bobkowska
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2017
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-017-0450-x

Other articles of this Issue 1/2017

BMC Oral Health 1/2017 Go to the issue