Recurrent Aphthous Stomatitis: Treatment and Management

Manfredini, Marco; Guida, Stefania; Giovani, Matteo; Lippolis, Nicola; Spinas, Enrico; Farnetani, Francesca; Dattola, Annunziata; Matteo, Eleonora Di; Pellacani, Giovanni; Giannetti, Luca

doi:10.5826/dpc.1104a99

Cited by 27 publications

(22 citation statements)

References 47 publications

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“…Promoting healing, relieving pain and reducing recurrence are the goals of treatment [13]. In patients with minor RAS and major RAS not accompanied by systemic symptoms, local interventions are frequently used [100]. A wide variety of local interventions are available, many of which have demonstrated promising results in clinical trials relative to placebo.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Topical Intervention for Recurrent Aphthous Stomatitis: A Network Meta-Analysis

Líu

Tan

et al. 2022

Medicina

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Background and objectives: To compare the efficacy and safety of topical interventions used for recurrent aphthous stomatitis. Materials and Methods: This network meta-analysis was conducted in accordance with the PRISMA statement. We searched four electronic databases, PubMed, Web of Science (WOS), Cochrane Central Register of Controlled Trials and Embase, for randomized controlled trials reporting efficacy and safety data on topical interventions for recurrent aphthous stomatitis. We performed a quality evaluation using a methodology based on the Cochrane Handbook. Two authors independently extracted data on healing effect, size reduction effect, symptom reduction effect, recurrence and safety assessment. Network meta-analysis was then performed using ADDIS and RevMan. Results: A total of 72 trials (5272 subjects) involving 29 topical interventions were included. Honey, lnsulin liposome gel, laser, amlexanox, glycyrrhiza and triamcinolone had better efficacy performance. Probiotics and chlorhexidine helped to prolong ulcer intervals and reduce recurrence. Doxycycline and penicillin had a high risk of adverse events. Hematologic evaluation showed no preference. The rank possibility of size-reducing effect and symptom-reducing effect supported the short-term effect of laser and the long-term effect of probiotics. Conclusions: We recommend the use of laser as a short-term intervention during the exacerbation phase of RAS and probiotics as a long-term intervention during the exacerbation and remission phases of RAS.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Topical Intervention for Recurrent Aphthous Stomatitis: A Network Meta-Analysis

Líu

Tan

et al. 2022

Medicina

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“…However, RAS may be persistent and it may significantly reduce quality of life in some individuals 3,4 . Management protocols include maintaining oral hygiene, avoiding exacerbating factors, pain control, preventing secondary infections, topical corticosteroids, dietary supplements, colchicine, dapsone, systemic corticosteroids, laser therapy, and even biologic agents in severe cases 5,6 …”

Section: Introductionmentioning

confidence: 99%

“…3,4 Management protocols include maintaining oral hygiene, avoiding exacerbating factors, pain control, preventing secondary infections, topical corticosteroids, dietary supplements, colchicine, dapsone, systemic corticosteroids, laser therapy, and even biologic agents in severe cases. 5,6 In recent years, complete blood cell parameters have been used as practical, cost-effective, and easily accessible indicators of disease prognosis in various fields of the medicine. [7][8][9][10][11] Clinical importance of some complete blood cell parameters was also investigated for RAS.…”

Section: Introductionmentioning

confidence: 99%

The correlation of systemic immune‐inflammation index, neutrophil‐to‐lymphocyte ratio, derived neutrophil‐to‐lymphocyte ratio, and platelet‐to‐lymphocyte ratio with disease severity in recurrent aphthous stomatitis

Tanacan

Rota

Oktem

2022

J of Cosmetic Dermatology

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Background/Aim To evaluate the correlation of systemic immune inflammation index (SII), neutrophil‐to‐lymphocyte ratio (NLR), derived neutrophil‐to‐lymphocyte ratio (NLR), and platelet‐to‐lymphocyte ratio (PLR) with disease severity in recurrent aphthous stomatitis (RAS). Methods The present retrospective cohort study was performed on patients with RAS. Patients were divided into three groups: 1) Major (n = 75), 2) Minor (n = 123), and 3) Herpetiform aphthae (n = 17). The study groups were compared in terms of demographic features, acute phase proteins, and complete blood cell count parameters. Moreover, correlation analyses were performed for the correlation of ulcer severity score (USS) with C‐reactive protein (CRP), SII, erythrocyte sedimentation rate (ESR), ferritin, dNLR, NLR, and PLR. Results Significantly higher values were observed for USS, neutrophil count, ferritin, SII, NLR, and dNLR (p < 0.05 for all) in the major and herpetiform aphthae groups compared to the minor aphthae group. Positive, strong, significant correlations were observed between USS, SII, and NLR (r = 0.80 for SII, r = 0.74 for NLR and p < 0.001 for both). Positive, moderate, significant correlations were observed between USS, PLR, ESR, and CRP (r = 0.54 for PLR, r = 0.39 for ESR, r = 0.36 for CRP, and p < 0.001 for all). Positive, weak, significant correlations were observed between USS, dNLR, and ferritin (r = 0.13 and p = 0.05 for ferritin, r = 0.27 and p < 0.001 for dNLR). Conclusion Higher values of SII, NLR, dNLR, and PLR were associated with disease severity in patients with RAS.

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“…Local therapy is usually sufficient; nevertheless, sometimes patients with major RAS or with many minor ulcers require systemic therapy. Currently available therapeutic strategies include antiseptics (e.g., chlorhexidine gluconate), antibiotics, local anesthetic gels, corticosteroids (e.g., prednisone), laser therapy, nonsteroidal anti-inflammatory drugs (e.g., pentoxifylline-PTX), and/or systemic immunomodulators (e.g., thalidomide) [ 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

The Evaluation of Healing Properties of Galium verum-Based Oral Gel in Aphthous Stomatitis in Rats

et al. 2022

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Although oral ulcers represent one of the most frequent oral mucosal diseases, the available treatment is not sufficient to provide complete ulcer recovery without side-effects. Therefore, the aim of our study was to prepare a mucoadhesive oral gel based on Galium verum ethanol extract (GVL gel) and reveal its healing effects in the model of aphthous stomatitis in rats. Rats with oral ulcers were divided into the following groups: control (untreated), gel base (ulcer was treated with the gel base, three times per day for 10 days), and GVL gel group (the ulcer was treated with GVL gel in the same way as the gel base). Animals from each group were sacrificed on days 0, 3, 6, and 10 for collecting blood and ulcer tissue samples. Healing properties of oral gel were determined by clinical evaluation, as well as biochemical and histopathological examinations. Our findings suggest a significant decrease in the ulcer size in GVL gel group, with healing effects achieved through the alleviation of oxidative stress, reduction in COX-2 immunopositivity, and increase in collagen content in buccal tissue. Significant ulcer repairing potential of GVL gel highlights this oral mucoadhesive gel as a promising tool for prevention and treatment of RAS.

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Recurrent Aphthous Stomatitis: Treatment and Management

Cited by 27 publications

References 47 publications

Efficacy of Topical Intervention for Recurrent Aphthous Stomatitis: A Network Meta-Analysis

Efficacy of Topical Intervention for Recurrent Aphthous Stomatitis: A Network Meta-Analysis

The correlation of systemic immune‐inflammation index, neutrophil‐to‐lymphocyte ratio, derived neutrophil‐to‐lymphocyte ratio, and platelet‐to‐lymphocyte ratio with disease severity in recurrent aphthous stomatitis

The Evaluation of Healing Properties of Galium verum-Based Oral Gel in Aphthous Stomatitis in Rats

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