{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:24:32Z","timestamp":1789593872539,"version":"build-2803163510"},"reference-count":14,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2025\/22650\u20104"],"award-info":[{"award-number":["2025\/22650\u20104"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Special Care in Dentistry"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To describe a probable oral mucosal injury associated with the off\u2010label sublingual administration of captopril in a medically complex patient, and to illustrate the role of structured clinical reasoning in identifying route\u2010related adverse drug reactions, with exploratory insights into AI\u2010assisted reasoning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>A 77\u2010year\u2010old patient presented with persistent burning pain and a progressive oral mucosal lesion on the floor of the mouth. Despite appropriate management of local infectious and mechanical factors, symptoms worsened over time. A consistent temporal relationship was observed between lesion exacerbation and repeated sublingual captopril use during hypertensive episodes. Structured clinical reasoning, including iterative causal analysis, supported identification of a probable route\u2010related adverse drug reaction. Discontinuation of sublingual captopril, combined with topical corticosteroid therapy, resulted in complete resolution of the lesion. An exploratory interaction with a large language model was conducted to examine how structured clinical input may influence the coherence and clinical relevance of AI\u2010assisted reasoning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sublingual administration of captopril may cause localized chemical injury to the oral mucosa, particularly in vulnerable patients with complex medical conditions. Recognition of route\u2010specific adverse effects is essential to avoid unnecessary interventions and improve patient outcomes. This case also illustrates that AI\u2010assisted reasoning is highly dependent on the structure and quality of clinical input, supporting its role as a complementary cognitive tool rather than an autonomous diagnostic system.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/scd.70228","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T07:32:52Z","timestamp":1784964772000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Adverse Oral Mucosal Reaction to Sublingual Captopril: A Case Report With Exploratory Insights Into AI\u2010Assisted Clinical Reasoning"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2400-8982","authenticated-orcid":false,"given":"Ant\u00f4nio Roberto Garcia","family":"J\u00fanior","sequence":"first","affiliation":[{"name":"Department of Stomatology, School of Dentistry University of S\u00e3o Paulo  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8276-1790","authenticated-orcid":false,"given":"Catarina Melquiades","family":"Velane","sequence":"additional","affiliation":[{"name":"Department of Stomatology, School of Dentistry University of S\u00e3o Paulo  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline Akemi Mendes","family":"Magario","sequence":"additional","affiliation":[{"name":"Department of Stomatology, School of Dentistry University of S\u00e3o Paulo  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8205-9935","authenticated-orcid":false,"given":"Paulo Sergio","family":"Pina","sequence":"additional","affiliation":[{"name":"Department of Oral Pathology, School of Dentistry University of S\u00e3o Paulo  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8615-3283","authenticated-orcid":false,"given":"Carina","family":"Domaneschi","sequence":"additional","affiliation":[{"name":"Department of Stomatology, School of Dentistry University of S\u00e3o Paulo  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9673-2756","authenticated-orcid":false,"given":"Camilla Vieira","family":"Esteves","sequence":"additional","affiliation":[{"name":"Department of Stomatology, School of Dentistry University of S\u00e3o Paulo  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,25]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102021\u2010055551"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1457187"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.5812\/ircmj.61606"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19148373"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.afjem.2020.10.003"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000002372"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.15313"},{"issue":"1","key":"e_1_2_14_9_1","first-page":"15","article-title":"Buccal Mucosa as a Route for Systemic Drug Delivery: A Review","volume":"1","author":"Shojaei A. 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