This retrospective study aimed to investigate whether superb microvascular imaging (SMI) can predict endoscopic findings in the terminal ileum of patients with Crohn's disease (CD). Patients with CD who underwent intestinal ultrasonography (IUS) between September 2020 and April 2024 and ileocolonoscopy for terminal ileum evaluation within 3 months before or after IUS were included. Those who previously underwent small bowel resection were excluded. Aplio a550 was used for IUS. SMI signals were evaluated using simplified SMI grades (0-3) and a modified Limberg score based on SMI (mLS-SMI, 0-4). Endoscopic findings were categorized as no, aphthous, small, or large ulcer. The proportion of patients with each endoscopic finding was determined according to mLS-SMI and SMI grades. Furthermore, the sensitivity and specificity of each grade for predicting corresponding endoscopic findings were compared. In total, 204 patients were included, with 96, 68, 25, and 15 having no, aphthous, small, and large ulcers, respectively. Additionally, 161, 14, 13, 11, and 5 patients had mLS-SMI grades 0, 1, 2, 3, and 4, while 157, 27, 12, and 8 patients had SMI grades 0, 1, 2, and 3, respectively. As the mLS-SMI and SMI grades increased, the proportion of patients with aphthous, small, or large ulcers also increased. Likewise, the proportion of patients with small or large ulcers increased. The sensitivity and specificity for predicting aphthous, small, or large ulcers were 24% and 97% for mLS-SMI grade ≥2, and 37% and 93% for SMI grade ≥1, respectively. For predicting small or large ulcers, they were 50% and 95% for mLS-SMI grade ≥2, and 70% and 88% for SMI grade ≥1, respectively. SMI grade ≥ 1 offered a significantly higher sensitivity for predicting small or large ulcers than mLS-SMI grade ≥ 2 (P = .008). Higher mLS-SMI and SMI grades corresponded to an increased prevalence of endoscopic ulcers. Therefore, SMI grading may provide additional information for evaluating ulcerative lesions in patients with CD.

[This corrects the article DOI: 10.1021/acsomega.6c03295.].

The article describes a clinical case of Behcet's disease, manifested by recurrent aphthae in the oral cavity and genital ulcers. The disease occurred in childhood in the form of chronic recurrent aphthous stomatitis.

Recurrent aphthous stomatitis (RAS) is the most common cause of painful ulcers of the oral mucosa, affecting approximately 10 to 20% of the population. It is characterized by recurrent, well-demarcated superficial ulcers located on non-keratinized mucosa, which heal spontaneously within one to two weeks. Three clinical subtypes are classically described: minor aphthae (the most common form), major aphthae, and herpetiform aphthae. Diagnosis is primarily clinical, but it is essential to rule out other causes of oral ulcers (traumatic, infectious, autoimmune, neoplastic) and to identify secondary causes of RAS (e.g., Behçet's disease, inflammatory bowel disease) to avoid diagnostic delay, detect specific complications, and tailor management appropriately. The pathophysiology of RAS involves an inappropriate cell-mediated immune response in genetically predisposed individuals. Reported abnormalities affect both innate immunity (notably neutrophils) and adaptive immunity (CD8[+] T lymphocytes, Th1/Th17 profile). Precipitating factors such as nutritional deficiencies, psychological stress, microtrauma, or food intolerances may trigger flare-ups. Management is based primarily on general measures and local treatments. Severe or refractory cases may require a short course of systemic corticosteroids or maintenance therapy (e.g., colchicine, apremilast). This narrative review provides an update on recurrent oral aphthosis.

Advanced polymeric drug delivery systems, particularly electrospun nanofibers and mucoadhesive patches, are promising platforms for the local treatment of periodontal and oral mucosal diseases. However, evidence regarding fabrication reproducibility, mucosal interactions, therapeutic efficacy, and stability has not been systematically synthesized. This systematic review evaluated novel polymeric carriers for dental and oral applications, with emphasis on fabrication parameters, drug loading, mucoadhesion, release behavior, immunomodulatory effects, clinical outcomes, and safety. Following PRISMA guidelines and the PICO framework, two independent reviewers searched PubMed, Scopus, Web of Science, the Cochrane Library, and Google Scholar for English-language studies published between 2015 and 2025. Eligible studies investigated novel polymeric carriers, primarily electrospun or composite systems, and reported fabrication parameters, including polymer type, preparation method, and drug loading, along with relevant biological or clinical outcomes. Risk of bias was assessed using SYRCLE/OHAT tools for original studies and AMSTAR-2 for review articles. Eight studies (four original research studies and four review articles) met the inclusion criteria. The included studies evaluated polymers, such as PLA/nano-HAP, chitosan/PVA/PCL, and PLLA/PEO, in combination with active agents including doxycycline, neem extract, curcumin, diclofenac sodium, and binahong extract. Electrospinning consistently generated porous, uniform carriers with fiber diameters of approximately 250-500 nm, sustained release ranging from 82% over 8 h to 60-80% over 7 days, mucoadhesive strength up to 0.34 N, immunomodulatory effects reflected by reduced IL-1, TNF-α, and MMP-8 levels, and antibacterial efficacy up to 98%. These systems also maintained mucosa-compatible pH values (6.5-7.0) and showed no evidence of irritation or toxicity. Needleless electrospinning variants further improved scalability. However, heterogeneity in fabrication parameters and moderate overall risk of bias, mainly from review-based evidence, limited direct comparisons across studies. Overall, electrospun nanofibers and mucoadhesive patches demonstrated promising potential as biocompatible platforms for targeted local drug delivery in dentistry, with the capacity to enhance immunomodulatory and antimicrobial effects in periodontitis, aphthous stomatitis, and oral ulcers. Further studies incorporating standardized fabrication validation and long-term stability testing are recommended to support clinical translation.

Oral mucosal diseases, such as burning mouth syndrome, oral lichen planus, oral mucositis, and recurrent aphthous stomatitis, frequently present with altered sensory functions, including pain, dysesthesia, and changes in thermal and mechanical sensitivity. Accurate assessment of these sensory changes is essential for understanding disease mechanisms, evaluating treatment efficacy, and improving patient outcomes. This review summarizes current evidence on sensory measurement methods used in clinical trials involving patients with oral mucosal diseases, with a particular focus on quantitative sensory testing techniques.

Lymphogranuloma venereum (LGV) caused by Chlamydia trachomatis (CT) serovars L1-L3 has re-emerged among men who have sex with men (MSM), predominantly manifesting as anorectal disease. Oropharyngeal LGV remains poorly characterized, with only sporadic case reports in Western countries. Although CT genovariant L2b has been detected in an oropharyngeal specimen through surveillance in Taiwan, the clinical features of oropharyngeal LGV have not been described in Asia. We report two MSM living with HIV in Taiwan with oropharyngeal LGV. Case 1 was a 32-year-old asymptomatic patient and CT was identified through routine multi-site screening prompted by a rising rapid plasma reagin (RPR) titer. LGV was detected only at the oropharyngeal site, with a negative rectal specimen. Case 2, a 51-year-old man, presented with small oral ulcers resembling aphthous stomatitis, along with anorectal symptoms and amoebic liver abscess. Genovariant L2b was confirmed in both oropharyngeal and rectal specimens by ompA sequencing. In both cases, Treponema pallidum PCR on oropharyngeal specimens was negative despite elevated RPR titers. Case 1 received doxycycline 100 mg twice daily for 7 days for asymptomatic LGV carriage, while Case 2 received a 21-days course for symptomatic infection. Case 1 achieved microbiological cure confirmed by follow-up PCR testing. Case 2 demonstrated resolution of oral and anorectal symptoms, with microbiological cure confirmed at follow-up. These cases illustrate that oropharyngeal LGV may be asymptomatic or mimic common oral conditions. Multi-site CT testing and ompA genotyping should be considered in MSM with suspected STI, even in the absence of typical anorectal symptoms.

Aphthous ulcers are prevalent and painful oral mucosal lesions that substantially compromise patient quality of life, requiring effective localized treatment. α-Mangostin, a bioactive compound from mangosteen pericarp, exhibits potent anti-inflammatory properties but suffers from poor aqueous solubility. This study developed a double-layer mucoadhesive film incorporating an α-mangostin-based solid dispersion (MPESD) to enhance solubility and provide dual-functionality: protection and therapy. Mangosteen peel extract was formulated into solid dispersions using PVP K30, significantly enhancing solubility from undetectable levels to 8.12 ± 0.04 mg/mL (1:4 ratio). The films, comprising an ethylcellulose backing layer and a gelatin-HPMC mucoadhesive layer, were fabricated via solvent casting. Mechanical testing confirmed suitable puncture strength (1.63 N/mm[2]) and flexibility (20% elongation) for oral application. The inclusion of HPMC improved surface wettability and prolonged in vitro residence time to >8 h, while the optimized film achieved 96% drug release within 2 h. These findings demonstrate that the MPESD-loaded double-layer film presents a promising formulation strategy with the potential for managing aphthous ulcers.

Background/Objectives: The aim of this systematic review was to analyze the impact of dietary modifications on unsaturated fatty acids (UFAs) intake on the course of three oral autoimmune conditions: oral lichen planus (OLP), recurrent aphthous stomatitis (RAS), and pemphigus. These acids serve a structural function as key components of cell membrane phospholipids, influencing their fluidity and membrane receptor activity. The proper ratio of these acids in the diet may be crucial for maintaining normal functioning of the human immune system. Methods: The following bases were searched with no time restrictions: PUMS Library, Embase/Elsevier, PubMed/MEDLINE, Scopus, and Web of Science. Of the 247 results identified in pre-screening, 6 studies that met all search criteria were included in the final systematic review. The risk of bias was assessed using the Revised Cochrane Risk of Bias Tool for randomized trials and the Newcastle-Ottawa Scale for non-randomized studies. Results: The outcome measures included: proportions of LA-derived oxylipins (9-HODE, 13-HODE), ulcer size (mm), monthly number of ulcers, average pain (VAS), duration of episodes, and quality of life (OHIP-14), healing time, and fatty acid analysis of total plasma phospholipid fraction, Pemphigus Disease Area Index (PDAI) for disease severity (mild ≤ 15, severe > 15); AHEI-2010 score (9-90 points) for diet quality. In all studies, improvements in clinical parameters and subjective complaints were observed after implementing a dietary intervention. Conclusions: Dietary modification may be a valuable component of adjunctive therapy. Nutritional optimization offers a genuine opportunity to reduce reliance on conventional pharmaceuticals, thereby limiting the risk of systemic adverse effects associated with long-term pharmacotherapy.

Recurrent aphthous ulcers (RAU) are highly prevalent oral mucosal lesions, while current therapies are limited by short residence time and poor efficacy in the dynamic oral environment. Probiotics such as Lactobacillus reuteri (L. reuteri) exhibit antimicrobial, immunomodulatory, and tissue-repair functions; however, their direct application is restricted by low stability and retention in the oral cavity. In this study, L. reuteri-loaded sodium alginate/chitosan composite hydrogels were developed via ionic crosslinking as a bioadhesive platform for local delivery. The hydrogels exhibited well-defined porous structures, favorable viscoelastic properties, and tunable swelling and degradation behaviors under simulated physiological conditions. Importantly, the system enabled sustained probiotic release and maintained high viability during 30 days of storage. In vitro antibacterial assays demonstrated that the hydrogels effectively inhibited the growth of Staphylococcus aureus and Candida albicans. Among the formulations, the hydrogel with 10 mg·mL[-1] chitosan achieved an optimal balance between structural stability and mass transfer, resulting in enhanced release performance and antibacterial efficacy. Overall, this study presents a microecology-oriented hydrogel system for efficient probiotic delivery in oral environments, offering a promising bioadhesive probiotic delivery platform with potential applications in RAU management and advancing the development of bioactive, mucosa-adaptive therapeutic platforms.

Intraoral mucosal lesions are difficult to diagnose because they vary widely in appearance and cause. Deep-learning models perform well for oral lesion classification, but limited interpretability restricts clinical use. Counterfactual explanations, which modify image features to test model sensitivity, offer a practical way to improve transparency, yet no counterfactual dataset exists for intraoral images. This study presents COLLECT, the Counterfactual Oral Lesion Library for Explainable Concept Testing, a curated counterfactual reference dataset and evaluation framework for intraoral lesion images, along with a workflow for assessing model interpretability. COLLECT includes 600 manually edited counterfactual images across 4 lesion types: aphthous ulcer, geographic tongue, hairy tongue, and oral squamous cell carcinoma. Images were modified along clinically important concepts such as size, color, and opacity. We assessed the interpretability of common convolutional neural networks using true class probability, predictive entropy, testing with concept activation vectors (TCAV), and attribution scores. Counterfactual edits reduced true class probability and increased entropy, with the strongest effects observed for opacity and color changes. TCAV results showed that early network layers were less responsive to concept changes, while later layers depended more on baseline features. Attribution scores confirmed that opacity changes lowered model confidence most, followed by color and size. Some models showed limited response to lesion removal, indicating reliance on background anatomy rather than lesion-specific cues. COLLECT supports the systematic evaluation of computer vision models under clinically grounded counterfactual conditions and provides a resource for improving transparency in the automated diagnosis of oral lesions.