Effectiveness of combination the photobiomodulation therapy and triamcinolone acetonide on managing oral major aphthous ulcer in Crohn's disease: A case report.

RATIONALE: Inflammatory bowel diseases like Crohn's disease can manifest with oral ulcers that negatively impact quality of life. Managing these stubborn symptomatic lesions requires an integrated medical and dental approach.

PATIENT CONCERNS: A 23-year-old male was diagnosed with Crohn's disease 3 years ago. He was referred to the oral medicine department due to a painful 3 cm ulcer on the dorsum of the tip of his tongue, which was interfering with his ability to eat and drink.

DIAGNOSES: A gastrointestinal endoscopy revealed a rectal ulcer, a cecal ulcer, superficial erosion, and scattered millimetric warts in the rectal area.

INTERVENTIONS: The patient was treated with a daily dose of azathioprine (50 mg) for 2 years. Once the clinical symptoms improved, the medication was discontinued. The major aphthous ulcer was managed with a combined treatment of 0.1% triamcinolone acetonide oral base and photobiomodulation laser therapy.

OUTCOMES: This dual therapy approach aimed to reduce pain, accelerate healing, and prevent scarring.

LESSONS: Collaborative care between gastroenterology and dentistry led to better symptom control and clinical outcomes for this patient with miserable mouth ulcers from Crohn's disease. The case highlights the benefits of a transdisciplinary treatment strategy targeting both oral and intestinal manifestations of inflammatory bowel disorders.