Abstract
The objective was to describe and recommend the most effective combination of Natural-Based Product (NBP) and mucoadhesive for Recurrent Aphthous Stomatitis (RAS) treatment. This systematic review writing was based on PRISMA guidelines. The articles published in the last 10 y were selected using PubMed and Google Scholar database carried out during May 2021. The keywords were: natural-based product, mucoadhesive, and Recurrent Aphthous Stomatitis. The risk of bias was assessed using the Oxford Quality Scoring System. Six articles of Randomized Controlled Trial were selected. The NBP were: Aloe vera, Myrrh, Curcuma longa, propolis, ginger, Punica granatum flower, and sesame oil. The drug’s formulation was: gel, film, and spray. The mucoadhesive polymers as vehicles were Hydroxy Propyl Ethyl Cellulose (HPEC), Hydroxy Propyl Methylcellulose (HPMC), Benzocaine, Tragacanth Gum, Carbomer 934, Sodium CMC (carboxymethyl cellulose), and chitosan. Curcuma longa 10 mg/g with HPMC was the most effective to relieve pain, while Punica granatum flower extract with Carbomer 934 and Sodium CMC was the most effective to reduce the ulcer size in RAS. Both of the formulations were in gel form.
Highlights
Recurrent Aphthous Stomatitis (RAS) is the most common oral mucosal ulceration found in society, causing pain, recurrence, and can decrease the patient's quality of life [1, 2]
Combination of Myrrh extract with Hydroxy Propyl Ethyl Cellulose (HPEC) was better in relieving pain, while the combination of Aloe Vera extract and HPEC was better in reducing the ulcer size
Combination of Curcuma longa extract 10 mg/g with Hydroxy Propyl Methylcellulose (HPMC) was as effective as Triamcinolone Acetonide 0.1% on relieving pain and reducing the ulcer size
Summary
Recurrent Aphthous Stomatitis (RAS) is the most common oral mucosal ulceration found in society, causing pain, recurrence, and can decrease the patient's quality of life [1, 2]. RAS is divided into 3 types i.e., minor RAS (>70%), major RAS (10%) and Herpetiform Stomatitis (10%) [1, 3]. Several studies concluded that the cause of RAS was multifactorial such as local trauma, hereditary, stress, nutritional deficiency, virus, bacteria, allergy, hormone disorders and the like [1, 3, 5]. Management of RAS was very specific, using steroid in topical or systemic drug form. This treatment sometimes caused side effects to the patients
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