Clinical characteristics and risk factors of major oral ulcers in the mandibular retromolar region in children
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ORIGINAL ARTICLE
Clinical characteristics and risk factors of major oral ulcers in the mandibular retromolar region in children Yuhong Wang 1,2 & Zeming Hui 3 & Zhaohua Ji 4 & Minghui Wei 1,2 & Haolin Zhang 2,5 & Yuanyuan Wang 1,2 & Jie Chen 6 & Xinwen Wang 1,2 & Yanfang Ren 7 Received: 31 August 2020 / Accepted: 29 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives To describe the characteristics of major aphthous ulcers (MjOU) in children and analyze its potential risk factors. Materials and methods Data were collected from the National Clinical Research Center for Oral Diseases of China between 2012 and 2017. Children younger than 15 years old, who had a giant mucosa ulcer (≥ 1 cm in diameter) and met the diagnostic criteria for MjOU were included in this study. Differences were compared between two subgroups of patients based on the location of the ulcerous lesions. A measurement of ratio (TBR) between the length of the mandibular second molar tooth germ and the height of the mandible was performed in children with MjOU lesions located in the mandibular retromolar pad region (MjOU-P) and their age- and sex-matched controls. Results A total of 1067 children were diagnosed with oral ulcers during the study period, of which 125 (11.7%, 95% CI: 9.8%–13.7%) met the diagnostic criteria for MjOU. More than half (n = 64, 51.2%) of the MjOU cases were MjOU-P, which had a male predilection (n = 52, 81.3%) with a significant majority at 7 to 9 years of age (n = 43, 67.2%). In comparison to the MjOU located in other regions, MjOU-P lasted longer in duration and had more comorbidities. Logistic regression analysis showed that MjOU-P was statistically significantly associated with TBR controlling age and gender. Conclusions MjOU-P is a predominant form of MjOU in children and is a distinct subgroup of major ulcers that is likely associated with the development of the mandibular second molars. Clinical relevance This study is the first to describe the demographic and clinical features of MjOU in children, which may facilitate the identification and treatment of these patients. Keywords Major oral ulcer . Aphthous oral ulcers . Recurrent aphthous ulceration . Children . Mixed dentition stage . Permanent molar eruption
Yuhong Wang, Zeming Hui, and Zhaohua Ji are co-first authors. * Xinwen Wang [email protected] * Yanfang Ren [email protected] 1
Department of Oral Medicine, School of Stomatology, The Fourth Military Medical University (FMMU), Xi’an, China
2
Shaanxi Clinical Research Center for Oral Diseases, National Clinical Research Center for Oral Diseases, State Key Laboratory of Military Stomatology, FMMU, Changle West Road 145, Xi’an 710032, Shaanxi Province, China
3
Hospital of the PLA, 94162 Lintong, China
4
School of Public Health, The FMMU, Xi’an, China
5
Department of Orthodontics, School of Stomatology, The FMMU, Xi’an, China
6
Department of Stomatology, The First People Hospital of Qinghai Province, Xi’an, China
7
Eastman Institute for Oral
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