Oral Manifestations of Crohn’s Disease: A Systematic Review

Abstract

Crohn’s disease (CD) is a chronic inflammatory intestinal condition that can affect the entire gastrointestinal tract. It is characterized by its clinical heterogeneity and irregularities in its course. The etiology and pathogenesis are not well established, so it is difficult to establish an early diagnosis and an effective treatment plan. The objective of this systematic review was to present a qualitative synthesis of the studies referring to the oral manifestations of CD. This systematic review was carried out following the PRISMA guide. Research was conducted in the Pubmed, Web of Science, Scopus, Scielo, and Cocrahne Library databases on 23 February 2023, and updated on 1 September 2023. Articles published between 2012 and 2023 were selected. Articles that analyzed the oral manifestation of CD patients and met the established search terms. In addition, the quality of all the selected studies was analyzed following the CARE guidelines for case reports and the STROBE scale for observational studies. A total of 19 articles were included in this review that met the inclusion criteria. Regarding the oral manifestation of CD, oral ulcers, angular cheilitis, and gingivitis stand out. Periodontitis and vegetative pyostomatitis were the least representative manifestations. The most prevalent locations were lips, mucosa, and gingivae. Ulcers, gingivitis, and angular cheilitis are the most frequent oral manifestations in patients with CD. Their early identification and possible relationship with the disease are important for an early diagnosis and an adequate treatment plan.

HIV-Related Oral Mucosa Lesions: A Cross-Sectional Study on a Cohort of Italian Patients

“…The specimen was dipped in the Preserve-Cyt ® (Marlborough, USA) fixative liquid and sent to the pathology unit for the detection of HPV in the oral cavity. In case of HPV detection, HPV genotyping was also performed to assess the presence of high-risk HPV types (18,31,33,35,52,53,56,58,66,67,68,73,83) versus low-risk HPV types (6,11,54,56, 61, 62, 71, 72, 74, 80, 81, 82, 84, 85, 86, 89, 107, SIBX1, SIBX3). In presence of oral mucosal lesions, a diagnostic biopsy was performed, when required, and sent to the histopathology unit in order to confirm the clinical hypothesis.…”

“…The oral mucosal manifestations of HIV in particular can be, for the patient, the first sign of the disease, although they are associated with AIDS. Therefore, the importance of recognizing HIV-related oral lesions is pivotal for the diagnosis of the underlying disease, as it also occurs in other infections or chronic disorders for which oral lesions may represent an important clinical manifestation: COVID-19, monkeypox, scarlet fever, syphilis, and inflammatory bowel diseases including Crohn's disease and ulcerative colitis [7][8][9][10][11][12]. Nonetheless, the detection of HIV-related oral lesions can also be useful in evaluating disease progression and, representing the effects of a reduced immune competence, could play an important role as indicators of the effectiveness of antiretroviral therapy [13][14][15].…”

A potential brain functional biomarker distinguishing patients with Crohn’s disease with different disease stages: a resting-state fMRI study

“…The main symptoms of CD may include fatigue, abdominal pain, diarrhea, weight loss and fever and may range from mild to severe. In addition to gastrointestinal manifestations, patients with CD experience other systemic manifestations and complications, such as arthritis ( Roda et al, 2020 ; Pecci-Lloret et al, 2023 ).…”

Celiac Disease-Related Enamel Defects: A Systematic Review

“…A holistic approach to patient care involves considering oral health as a reflection of systemic well-being [66]. In light of the complexity surrounding CD, its oral manifestations, and the diagnostic challenges in DEDs, there arises a compelling need for a systematic review [67]. Such a review aims to synthesize existing evidence, elucidate patterns in celiac-related enamel defects, and establish guidelines for differential diagnosis [68].…”