The Frequency and Etiology of Recurrent Apthous Stomatitis in Helicobacter Pylori Positive Patients
American Journal of Internal Medicine
Volume 2, Issue 4, July 2014, Pages: 72-78
Received: Jun. 25, 2014; Accepted: Jul. 25, 2014; Published: Jul. 30, 2014
Views 3518      Downloads 221
Ayşe Neslin Akkoca, Mustafa Kemal University, Faculty of Medicine, Department of Family Medicine, Hatay, Turkey
Zeynep Tuba Özdemir, Bozok University, Faculty of Medicine, Department of İnternal Medicine, Yozgat, Turkey
Serdar Yanık, İskenderun State Hospital, Department of Pathology, Hatay, Turkey
Seçil Günher Arıca, Istanbul Okmeydanı Research Hospital,Department of Famıly Medicine,Istanbul,Turkey
Hülya Yalçin, Mustafa Kemal University, Faculty of Medicine, Department of Nuclear Medicine,Hatay ,Turkey
Gül Soylu Özler, Mustafa Kemal University, Faculty of Medicine, Department of Otorhinolarıngology, Hatay ,Turkey
Article Tools
Follow on us
Objective: Recurrent aphthous ulcerations (RAU) is a disease characterized by recurrent painful ulcerations of the oral mucosa. The etiopathogenesis of the disease still unknown, and recently the role of Helicobacter pylori (HP) is overlooked. RAU frequency and etiologic factors of HP positive patients have been investigated in this study. Materials and Methods: 64 patients who attended to Mustafa Kemal University Department of Nuclear Medicine and presented with positive HP were included in the study. A questionnaire about sociodemographic characteristics and etiologies for RAU was administered to the patients. Results: The mean age of 64 patients determined a HP infection with C- 14 urea breath test was 54.1 ± 19.3. 35(54.7% ) of 64 patients were females , 29( 45.3 % ) of 64 patients were males . Smoking prevalence rate were 65.6%. 43.8 % of patients had RAU 1-3 times per year , 35.9 % more than 3 times. 35.9 % of the patients had RAU in tongue, 28.1% of the patients had RAU on lips, tongue and cheek. 42% of the patients had minor, 51.6 % of patients had major, 6.4% of patients had herpetiform ulcers. The average degree of pain ( score out of ten ) were found 7.39 ± 1.54 . There was correlation between the number of aphthae in the past year and the degree of pain. The degree of pain in herpetiform ulcers were higher. Familial history was found to be 32.8%. 68.7 % of the patients had reflux. 51.6 % of the patients declared hoarseness. Conclusion: High incidence of RAU in HP positive patients and patients with reflux may cause the idea that HP may be suspected to be an etiologic factor of RAU.
Helicobacter Pylori, Recurrent Aphthous Ulcers, Aphthae
To cite this article
Ayşe Neslin Akkoca, Zeynep Tuba Özdemir, Serdar Yanık, Seçil Günher Arıca, Hülya Yalçin, Gül Soylu Özler, The Frequency and Etiology of Recurrent Apthous Stomatitis in Helicobacter Pylori Positive Patients, American Journal of Internal Medicine. Vol. 2, No. 4, 2014, pp. 72-78. doi: 10.11648/j.ajim.20140204.14
Rogers RS, Mehregan DA. Disorders of the oral cavity.In: Moschella SL,Hurley HJ, eds. Dermatology, 3th ed. Philadelphia :W.B. Saunders Company,1992:2087-121.
Scully C, Porter S. Oral mucosal disease: recurrent aphthous stomatitis. Br J Oral Maxillofac Surg.2008;46:198–206.
Chavan M, Jain H, Diwan N, Khedkar S, Shete A, Durkar S. Recurrent aphthous stomatitis:a review. J Oral Pathol Med. 2012;41:577–83.
Zhou Y, Chen Q, Meng W, Jiang L, Wang Z, Liu J. Evaluation of penicillin G potassium troches in the treatment of minor recurrent aphthous ulceration in a Chinese cohortOral Surg Oral Med Oral Pathol Oral Radiol Endod.2010;109:561–6.
Meng W, Dong Y, Liu J, Wang Z, Zhong X, Chen R. A clinical evaluation of amlexanox oral adhesive pellicles in the treatment of recurrent aphthous stomatitis and comparison with amlexanox oral tabletsTrials. 2009;10:30.
Liang MW, Neoh CY. Oral aphthosis: management gaps and recent advances. Ann Acad Med Singapore.2012;41:463–70.
Preeti L, Magesh KT, Rajkumar K, Karthik R. Recurrent aphthous stomatitis. J Oral Maxillofac Pathol.2011;15:252–6.
Jurge S, Kuffer R, Scully C, Porter SR. Recurrent aphthous stomatitis. Oral Dis 2006; 12: 1-21.
Shashy RG, Ridley MB. Aphthous ulcers: A difficult clinical entity. Am. J. Otolaryngol 2000; 21: 389-393.
Bilgili SG, Ozkol H, Takci Z, et al. Assessment of the serum paraoxonase activity and oxidant /antioxidant status in patients with recurrent aphthous stomatitis. Int J Dermatol. 2013
Koybasi S, Parlak AH, Serin E, et al. Recurrent aphthous stomatitis: investigation of possible etiologic factors. Am J Otolaryngol. 2006;27:229–232.
McCullough MJ, Abdel-Hafeth S, Scully C. Recurrent aphthous stomatitis revisited; clinical features, associations, and new association with infant feeding practices? J Oral Pathol Med. 2007;36:615–620.
Veller-Fomasa C, Gallina P. Recurrent aphthous stomatitis as an expression of pathergy in atopics. Acta Dermatovenerol Alp Panonica Adriat. 2006;15:144–147.
Poulter LW, Lehner T. Immunohistology of oral lesions from patients with recurrent oral ulcers and Behçet’s syndrome. Clin Exp Immunol. 1989;78:189–195.
Natah SS, Konttinen YT, Enattah NS, et al. Recurrent aphthous ulcers today: a review of growing knowledge. Int J Oral Maxillofac Surg. 2004;33:221–234.
Shimoyama T, Horie N, Kato T, et al. Helicobacter pylori in oral ulcerations. J Oral Sci. 2000;42:225–229.
Barile MF, Graykowski EA, Driscoll EJ, et al. L form of bacteria isolated from recurrent aphthous stomatitis lesions. Oral Surg Oral Med Oral Pathol. 1963;16:1395–1402.
Fritscher AM, Cherubini K, Chies J, et al. Association between Helicobacter pylori and recurrent aphthous stomatitis in children and adolescents. J Oral Pathol Med. 2004;33:129–132.
Mansour-Ghanaei F, Asmar M, Bagherzadeh AH, et al. Helicobacter pylori infection in oral lesions of patients with recurrent aphthous stomatitis. Med Sci Monit. 2005;11:CR576–CR579.
Taş DA, Yakar T, Sakalli H, et al. Impact of Helicobacter pylori on the clinical course of recurrent aphthous stomatitis. J Oral Pathol Med. 2013;42:89–94.
RoduB, MattinglyG. Oral mucosal ulcers :diagnosis and managament . J Am Dent Assoc 1992 :123 : 83-6.
Rogers RS.Recurrent aphtous stomatitis: clinical characteristics and associated systemic disorders. Semin Cutan Med Surg 1997,16(4):278-83.
Navabi N, Aramon M, Mirzazadeh A. Does the presence of the Helicobacter pylori in the dental plaque associate with its gastric infection? Dent Res J (Isfahan) 2011;8:178–82.
Albanidou-Farmaki E, Giannoulis L, Markopoulos A, Fotiades S, Aggouridaki X, Farmakis K, et al. Outcome following treatment for Helicobacter pylori in patients with recurrent aphthous stomatitis. Oral Dis. 2005;11:22–6.
Dowsett SA, Kowolik MJ. Oral Helicobacter pylori: Can we stomach it? Crit Rev Oral Biol Med. 2003;14:226–33.
Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M, et al.Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001;345:784-9
Solnick JV, Vandamme P. Taxonomy of the Helicobacter Genus. In: Mobley HL, Mendz GL, Hazell SL, editors. Helicobacter pylori: Physiology and Genetics. Washington (DC): ASM Press; 2001. Chapter 5.
Kilmartin CM. Dental implications of Helicobacter pylori. J Can Dent Assoc. 2002;68:489–93
Czesnikiewicz-Guzik M, Bielanski W, Guzik TJ, Loster B, Konturek SJ. Helicobacter pylori in the oral cavity and its implications for gastric infection, periodontal health, immunology and dyspepsia.J Physiol Pharmacol. 2005;56(Suppl 6):77–89
De Giacomo C, Fiocca R, Villani L, Lisato L, Licardi G, Diegoli N, et al. Helicobacter pyloriinfection and chronic gastritis: Clinical, serological, and histologic correlations in children treated with amoxicillin and colloidal bismuth subcitrate. J Pediatr Gastroenterol Nutr. 1990;11:310–6
Dye BA, Kruszon-Moran D, McQuillan G. The relationship between periodontal disease attributes and Helicobacter pylori infection among adults in the United States. Am J Public Health. 2002; 92: 1809–15.
Riggio MP, Lennon A, Wray D. Detection of Helicobacter pylori DNA in recurrent aphthous stomatitis tissue by PCR. J Oral Pathol Med. 2000;29:507–13.
Silva Rossi-Aguiar VP, Navarro-Rodriguez T, Mattar R, de Melo Peres MP Siqueira, Correa Barbuti R, Silva FM, et al. Oral cavity is not a reservoir for Helicobacter pylori in infected patients with functional dyspepsia. Oral Microbiol Immunol. 2009;24:255–9.
Brown LM. Helicobacter pylori: Epidemiology and routes of transmission. Epidemiol Rev. 2000; 22:283–97.
Pedersen A. Are recurrent oral aphthous ulcers of viral etiology? Med Hypotheses.1991;36:206–10.
ilva DG, Tinoco EM, Rocha GA, Rocha AM, Guerra JB, Saraiva IE, et al. Helicobacter pylori transiently in the mouth may participate in the transmission of infection. Mem Inst Oswaldo Cruz. 2010; 105:657–60.
Thomas E, Jiang C, Chi DS, Li C, Ferguson DA., Jr The role of the oral cavity in Helicobacter pylori infection. Am J Gastroenterol. 1997;92:2148–54.
Nguyen AM, el-Zaatari FA, Graham DY. Helicobacter pylori in the oral cavity. A critical review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79:705–9.
Gebara EC, Pannuti C, Faria CM, Chehter L, Mayer MP, Lima LA. Prevalence of Helicobacter pylori detected by polymerase chain reaction in the oral cavity of periodontitis patients. Oral Microbiol Immunol .2004;19:277–80.
Song Q, Haller B, Schmid RM, Adler G, Bode G. Helicobacter pylori in dental plaque: A comparison of different PCR primer sets. Dig Dis Sci . 1999;44:479–84.
Pytko-Polonczyk J, Konturek SJ, Karczewska E, Bielański W, Kaczmarczyk-Stachowska A. Oral cavity as permanent reservoir of Helicobacter pylori and potential source of reinfection. J Physiol Pharmacol . 1996;47:121–9.
Butt AK, Khan AA, Khan AA, Izhar M, Alam A, Shah SW, Shafqat F. Correlation of Helicobacter pylori in dental plaque and gastric mucosa of dyspeptic patients. J Pak Med Assoc. 2002;52:196–200.
ChitsaziMT ChitsaziMT, Fattahi E, Farahani RM, FattahiS FattahiS. Helicobacter pylori in the dental plaque: Is it of diagnostic value for gastric infection? Med Oral Patol Oral Cir Bucal 2006;11:E325-8.
Braun –Falco O,PlewigG,Wolff HH,Burgdorf WHC. Disease of the Lips and Oral Mucosa .In: Dermatology. 4th ed. Berlin : Springer-Verlag. 1996:1163-94.
PorterSR , ScullyC. Aphthous stomatitis an overview of actiopathogenesis and management. Clin Exp Dermatol 1991:16(4):235-43.
Rennie JS, Reade PC, Hay KD, Scully C. Recurrent aphthous stomatitis. Br Dent J 1985;159(11): 361-367.
Shashy RG, Ridley MB. Aphthous ulcers: a difficult clinical entity. Am J Otolaryngol 2000; 21: 389-393.
Birek C,Grandhi R,Mcneil K,Singer D,Ficarra G,Bowden G.Detection of Helicobacter pylori in oral aphtous ulcers .J Oral Pathol M ED 1999;28(5):197-203
Greenspan JS, Gadol N, Olson JA, Hoover CI, Jacobsen PL, Shillitoe EJ,et al. Lymphocyte function in recurrent aphthous ulceration. J Oral Pathol 1985; 14(8): 592-602
Leimola-Virtanen R, Happonen RP, Syrjänen S. Cytomegalovirus (CMV) and Helicobacter pylori (HP) found in oral mucosal ulcers. J Oral Pathol Med . 1995;24:14–7.
Rubin JS, Benjamin E, Prior A, Lavy J. The prevalence of Helicobacter pylori infection in malignant and premalignant conditions of the head and neck. J LaryngolOtol . 2003;117:118–21.
Marshall B. Helicobacter pylori: 20 years on. Clin Med. 2002;2:147–152.
Piqueres P, Moreno Y, Alonso JL, Ferrús MA. A combination of direct viable count and fluorescent in situ hybridization for estimating Helicobacter pylori cell viability. Res Microbiol. 2006;157:345–349.
Silva DG, Tinoco EM, Rocha GA, Rocha AM, Guerra JB, Saraiva IE, Queiroz DM. Helicobacter pylori transiently in the mouth may participate in the transmission of infection. Mem Inst Oswaldo Cruz. 2010;105:657–660.
Dowsett SA, Archila L, Segreto VA, Gonzalez CR, Silva A, Vastola KA, Bartizek RD, Kowolik MJ. Helicobacter pylori infection in indigenous families of Central America: serostatus and oral and fingernail carriage. J Clin Microbiol. 1999;37:2456–2460.
Allaker RP, Young KA, Hardie JM, Domizio P, Meadows NJ. Prevalence of helicobacter pylori at oral and gastrointestinal sites in children: evidence for possible oral-to-oral transmission. J Med Microbiol. 2002;51:312–317.
Assumpção MB, Martins LC, Melo Barbosa HP, Barile KA, de Almeida SS, Assumpção PP, Corvelo TC. Helicobacter pylori in dental plaque and stomach of patients from Northern Brazil. World J Gastroenterol.2010;16:3033–3039.
Gao J, Li Y, Wang Q, Qi C, Zhu S. Correlation between distribution of Helicobacter pylori in oral cavity and chronic stomach conditions. J Huazhong Univ Sci Technolog Med Sci. 2011;31:409–412.
Namavar F, Roosendaal R, Kuipers EJ, de Groot P, van der Bijl MW, Peña AS, de Graaff J. Presence of Helicobacter pylori in the oral cavity, oesophagus, stomach and faeces of patients with gastritis. Eur J Clin Microbiol Infect Dis. 1995;14:234–237.
Momtaz H, Souod N, Dabiri H, Sarshar M. Study of Helicobacter pylori genotype status in saliva, dental plaques, stool and gastric biopsy samples. World J Gastroenterol. 2012;18:2105–2111
Sahin FI, Tinaz AC, Simşek IS, Menevşe S, Görgül A. Detection of Helicobacter pylori in dental plaque and gastric biopsy samples of Turkish patients by PCR-RFLP. Acta Gastroenterol Belg. 2001;64:150–152.
Doré-Davin C, Heitz M, Yang H, Herranz M, Blum AL, Corthésy-Theulaz I. Helicobacter pylori in the oral cavity reflects handling of contaminants but not gastric infection. Digestion. 1999;60:196–202.
Cheng LH, Webberley M, Evans M, Hanson N, Brown R. Helicobacter pylori in dental plaque and gastric mucosa. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81:421–423.
Bürgers R, Schneider-Brachert W, Reischl U, Behr A, Hiller KA, Lehn N, Schmalz G, Ruhl S. Helicobacter pylori in human oral cavity and stomach. Eur J Oral Sci. 2008;116:297–304.
Cześnikiewicz-Guzik M, Karczewska E, Bielański W, Guzik TJ, Kapera P, Targosz A, Konturek SJ, Loster B. Association of the presence of Helicobacter pylori in the oral cavity and in the stomach. J Physiol Pharmacol.2004;55 Suppl 2:105–115.
Cammarota G, Tursi A, Montalto M, Papa A, Veneto G, Bernardi S, Boari A, Colizzi V, Fedeli G, Gasbarrini G. Role of dental plaque in the transmission of Helicobacter pylori infection. J Clin Gastroenterol.1996;22:174–177.
Loster BW, Majewski SW, Cześnikiewicz-Guzik M, Bielanski W, Pierzchalski P, Konturek SJ. The relationship between the presence of Helicobacter pylori in the oral cavity and gastric in the stomach. J Physiol Pharmacol. 2006;57 Suppl 3:91–100.
Oshowo A, Tunio M, Gillam D, Botha AJ, Holton J, Boulos P, Hobsley M. Oral colonization is unlikely to play an important role in Helicobacter pylori infection. Br J Surg. 1998;85:850–852.
Chaudhry S, Iqbal HA, Khan AA, Izhar M, Butt AK, Akhter MW, Izhar F, Mirza KM. Helicobacter pylori in dental plaque and gastric mucosa: correlation revisited. J Pak Med Assoc. 2008;58:331–334.
Berroteran A, Perrone M, Correnti M, Cavazza ME, Tombazzi C, Goncalvez R, Lecuna V. Detection of Helicobacter pylori DNA in the oral cavity and gastroduodenal system of a Venezuelan population. J Med Microbiol. 2002;51:764–770.
Zou QH, Li RQ. Helicobacter pylori in the oral cavity and gastric mucosa: a meta-analysis. J Oral Pathol Med. 2011;40:317–324.
Cellini L, Grande R, Artese L, Marzio L. Detection of Helicobacter pylori in saliva and esophagus. New Microbiol. 2010;33:351–357.
Fernández-Tilapa G, Axinecuilteco-Hilera J, Giono-Cerezo S, Martínez-Carrillo DN, Illades-Aguiar B, Román-Román A. vacA genotypes in oral cavity and Helicobacter pylori seropositivity among adults without dyspepsia. Med Oral Patol Oral Cir Bucal. 2011;16:e175–e180.
Eskandari A, Mahmoudpour A, Abolfazli N, Lafzi A. Detection of Helicobacter pylori using PCR in dental plaque of patients with and without gastritis. Med Oral Patol Oral Cir Bucal. 2010;15:e28–e31.
Karczewska E, Konturek JE, Konturek PC, Cześnikiewicz M, Sito E, Bielański W, Kwiecień N, Obtułowicz W, Ziemniak W, Majka J, et al. Oral cavity as a potential source of gastric reinfection by Helicobacter pylori. Dig Dis Sci. 2002;47:978–986.
Madinier IM, Fosse TM, Monteil RA. Oral carriage of Helicobacter pylori: a review. J Periodontol.1997;68:2–6.
Nguyen AM, Engstrand L, Genta RM, Graham DY, el-Zaatari FA. Detection of Helicobacter pylori in dental plaque by reverse transcription-polymerase chain reaction. J Clin Microbiol. 1993;31:783–787
Silva DG, Stevens RH, Macedo JM, Albano RM, Falabella ME, Veerman EC, Tinoco EM. Detection of cytotoxin genotypes of Helicobacter pylori in stomach, saliva and dental plaque. Arch Oral Biol. 2009;54:684–688.
Rasmussen LT, Labio RW, Gatti LL, Silva LC, Queiroz VF, Smith Mde A, Payão SL. Helicobacter pylori detection in gastric biopsies, saliva and dental plaque of Brazilian dyspeptic patients. Mem Inst Oswaldo Cruz.2010;105:326–330.
Oshowo A, Gillam D, Botha A, Tunio M, Holton J, Boulos P, Hobsley M. Helicobacter pylori: the mouth, stomach, and gut axis. Ann Periodontol. 1998;3:276–280.
Al Asqah M, Al Hamoudi N, Anil S, Al Jebreen A, Al-Hamoudi WK. Is the presence of Helicobacter pylori in dental plaque of patients with chronic periodontitis a risk factor for gastric infection? Can J Gastroenterol.2009;23:177–179.
Silva DG, Stevens RH, Macedo JM, Albano RM, Falabella ME, Fischer RG, Veerman EC, Tinoco EM. Presence of Helicobacter pylori in supragingival dental plaque of individuals with periodontal disease and upper gastric diseases. Arch Oral Biol. 2010;55:896–901.
Hardo PG, Tugnait A, Hassan F, Lynch DA, West AP, Mapstone NP, Quirke P, Chalmers DM, Kowolik MJ, Axon AT. Helicobacter pylori infection and dental care. Gut. 1995;37:44–46
Rajendran R, Rajeev R, Anil S, Alasqah M, Rabi AG. Helicobacter pylori coinfection is a confounder, modulating mucosal inflammation in oral submucous fibrosis. Indian J Dent Res. 2009;20:206–211.
Bago I, Bago J, Plečko V, Aurer A, Majstorović K, Budimir A. The effectiveness of systemic eradication therapy against oral Helicobacter pylori. J Oral Pathol Med. 2011;40:428–432.
Gall-Troselj K, Mravak-Stipetić M, Jurak I, Ragland WL, Pavelić J. Helicobacter pylori colonization of tongue mucosa--increased incidence in atrophic glossitis and burning mouth syndrome (BMS) J Oral Pathol Med.2001;30:560–563.
Adler I, Denninghoff VC, Alvarez MI, Avagnina A, Yoshida R, Elsner B. Helicobacter pylori associated with glossitis and halitosis. Helicobacter. 2005;10:312–317
Tangerman A, Winkel EG, de Laat L, van Oijen AH, de Boer WA. Halitosis and Helicobacter pylori infection. J Breath Res. 2012;6:017102.
Suzuki N, Yoneda M, Naito T, Iwamoto T, Masuo Y, Yamada K, Hisama K, Okada I, Hirofuji T. Detection of Helicobacter pylori DNA in the saliva of patients complaining of halitosis. J Med Microbiol.2008;57:1553–1559.
Yildirim B, Oztürk MA, Unal S. The anti-Helicobacter pylori antibiotherapy for the treatment of recurrent oral aphthous ulcers in a patient with Behcet’s syndrome. Rheumatol Int. 2009;29:477–478
Attia EA, Abdel Fattah NS, Abdella HM. Upper gastrointestinal findings and detection of Helicobacter pylori in patients with oral lichen planus. Clin Exp Dermatol. 2010;35:355–360
Pourshahidi S, Fakhri F, Ebrahimi H, Fakhraei B, Alipour A, Ghapanchi J, Farjadian S. Lack of association between Helicobacter pylori infection and oral lichen planus. Asian Pac J Cancer Prev. 2012;13:1745–1747
Cecchini MP, Pellegrini C, Bassetto MA, Osculati F, Sbarbati A, Marcolini L, Pegoraro M, Fontana R, De Franceschi L. Might Helicobacter pylori infection be associated with distortion on taste perception? Med Hypotheses. 2013;81:496–499.
Zaric S, Bojic B, Jankovic Lj, Dapcevic B, Popovic B, Cakic S, Milasin J. Periodontal therapy improves gastric Helicobacter pylori eradication. J Dent Res. 2009;88:946–950.
Song Q, Lange T, Spahr A, Adler G, Bode G. Characteristic distribution pattern of Helicobacter pylori in dental plaque and saliva detected with nested PCR. J Med Microbiol. 2000;49:349–353.
Namiot DB, Leszczyńska K, Namiot Z, Chilewicz M, Bucki R, Kemona A. The occurrence of Helicobacter pylori antigens in dental plaque; an association with oral health status and oral hygiene practices. Adv Med Sci.2010;55:167–171.
Chaudhry S, Khan AA, Butt AK, Idrees M, Izhar M, Iqbal HA. Helicobacter pylori in dental plaque; is it related to brushing frequency, plaque load and oral health status? J Coll Physicians Surg Pak. 2011;21:589–592
Mravak-Stipetić M, Gall-Troselj K, Lukac J, Kusić Z, Pavelić K, Pavelić J. Detection of Helicobacter pylori in various oral lesions by nested polymerase chain reaction (PCR) J Oral Pathol Med. 1998;27:1–3.
Loster BW, Czesnikiewicz-Guzik M, Bielanski W, Karczewska E, Loster JE, Kalukin J, Guzik TJ, Majewski S, Konturek SJ. Prevalence and characterization of Helicobacter pylori (H. pylori) infection and colonization in dentists. J Physiol Pharmacol. 2009;60 Suppl 8:13–18.
Nguyen AM, el-Zaatari FA, Graham DY. Helicobacter pylori in the oral cavity. A critical review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79:705–709.
Karaca S, Seyhan M, Senol M, Harputluoglu MM, Ozcan A. The effect of gastric Helicobacter pylorieradication on recurrent aphthous stomatitis. Int J Dermatol. 2008;47:615–7.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186