Oral pathology in inflammatory bowel disease

Table 1 Oral manifestations and complications in inflammatory bowel disease

Oral tissue	Manifestations	Etiology
Lips	Lips swelling with or without fissures[12,15,16,21,22,34,36,156]	Crohn's disease
	Angular cheilitis[15,22,31]	Fungal and bacterial infections, nutritional deficiency
	Erythema multiforme, Stevens-Johnson syndrome[143,144]	Infliximab; adalimumab
Tongue	Fissuring[23]	Crohn's disease
	Cobblestone plaques[17]	Crohn's disease
	Pyostomatitis vegetans[17,37,38,45]	Ulcerative colitis (more common) and Crohn's disease
	Aphthous stomatitis[11,31]	Nutritional deficiency; decreased heat shock protein 27 expression
	Taste disturbance[17,23,147,155]	Related to disease activity and nutritional habits; sulfasalazine; metronidazole
	Candida infections[78,131,132,141]	Corticosteroids; thiopurines; cyclosporin A; infliximab
	Erythema multiforme, Stevens-Johnson syndrome[143,144]	Infliximab; adalimumab
Oral mucosa	Buccal edema[15,34,48]	Crohn's disease
(labial/buccal/	Cobblestoning[12,14,15,21,24,34]	Crohn's disease
palatal/vestibular)	Deep linear ulceration[15,16,21-24,34,38]	Crohn's disease
	Mucosal tags[12,16,21,29,34]	Crohn's disease
	Buccal sulcus ulcerations[20,34]	Crohn's disease
	Palatal ulcerations[20,44]	Crohn's disease
	Pyostomatitis vegetans[33,37,45-47,49,50]	Ulcerative colitis (more common) and Crohn's disease
	Aphthous stomatitis[11,22,29,31,45]	Nutritional deficiency; decreased heat shock protein 27 expression
	Lichen planus/lichenoid reaction[29,85,140,142]	Sulfasalazine; mesalazine; infliximab;
		certolizumab pegol
	Erythema multiforme, Stevens-Johnson syndrome[143,144]	Infliximab; adalimumab
Periodontal tissue	Mucogingivitis[12,21,22,32,34]	Crohn's disease
	Cobblestoning[29,32]	Crohn's disease
	Pyostomatitis vegetans/pustular ulcerations[17,32,33,37,44,46,50]	Ulcerative colitis (more common) and Crohn's disease
	Nonspecific gingivitis[13,19,147]	Cause not clearly specified
	Periodontal diseases/periodontitis[20,156]	Cause not clearly specified
Alveolar bone	Periapical lesions[30]	Related to disease activity
	Alveolar bone loss[156]	Cause not clearly specified
Teeth	Caries[20,30,39,40]	Related to disease activity and malabsorption
	Hypoplasia of enamel[40]	Related to disease activity and malabsorption
Salivary glands	Hyposalivation/dry mouth[23,36]	Granulomatous inflammation
		Autoimmune changes in minor salivary glands
	Salivary duct fistula[36]	Crohn's disease