Abstract

AimTo evaluate the effectiveness of non-aromatic very rich in steranes (NAVS) naphthalan in the treatment of oral lichen planus (OLP) and recurrent aphthous stomatitis (RAS). Null hypothesis was that there would be no difference between NAVS and topical steroids in the treatment of OLP and RAS.MethodsThe study consisted of two sub-trials conducted as randomized, double-blind controlled studies: first included OLP patients and second patients with RAS. Patients received either NAVS or 0.05% betamethasone dipropionate. Primary outcomes were activity score (OLP patients), No of lesions and lesion diameter (RAS patients) and pain intensity (VAS) while secondary outcome included the impact of the disease on quality of life assessed by Oral health impact profile (OHIP 14).ResultsNo significant differences in terms of OLP clinical signs (p = 0.84, η2 = 0.001) and responses on the OHIP-14 (p = 0.81, η2 = 0.002) or on VAS (p = 0.14, η2 = 0.079) between NAVS and betamethasone groups were observed. In RAS patients, no significant differences between the groups in terms of lesion number (at days 3 and 5, p = 0.33 and p = 0.98, respectively), lesion diameter (days 3 and 5, p = 0.24 and p = 0.84, respectively) were observed. However, in NAVS group a significant reduction of lesions diameter was observed on the 3rd day, while in betamethasone group a significant reduction in lesions diameter was evident only after the 5th day. No significant differences in VAS (p > 0.05) and the OHIP-14 (p > 0.05) between groups were found.ConclusionNo evidence of differences between the two compared interventions was found.RegistrationRetrospective registration of this trial was conducted in ClinicalTrials.gov on September 30, 2016; trial registration number: NCT02920658.https://clinicaltrials.gov/ct2/show/NCT02920658?term=NAVS&draw=2&rank=4.

Highlights

  • Non-aromatic-very rich in steranes (NAVS) naphthalan is a transparent, earth mineral oil prepared by a complex set of separations and refining steps

  • Since steranes contain similar chemical structures as well-known bioactive substances, such as vitamin D3 and steroid hormones, we proposed that NAVS is effective in the treatment of immune-mediated oral diseases, such as oral lichen planus (OLP) and recurrent aphthous stomatitis (RAS)

  • Results of this study showed the efficacy of topical NAVS and betamethasone in the treatment of OLP and RAS lesions, as well as subjective symptoms reduction, but with no statistically significant differences

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Summary

Introduction

Non-aromatic-very rich in steranes (NAVS) naphthalan is a transparent, earth mineral oil prepared by a complex set of separations and refining steps. Since steranes contain similar chemical structures as well-known bioactive substances, such as vitamin D3 and steroid hormones, we proposed that NAVS is effective in the treatment of immune-mediated oral diseases, such as OLP and RAS. Naphthalan has antiproliferative effects and reduces the number of immunocompetent cells in psoriatic skin [5]. Naphthalan in vitro appears to inhibit proliferation of keratinocytes, with a tendency towards normalization in psoriatic skin [6]. Another study showed pronounced dose-dependent inhibition of proliferation in a squamous cell carcinoma cell line. Topical steroids are considered first-line therapy for many chronic immune-mediated oral diseases. We published a pilot study using topical NAVS naphthalan and the results were favorable [9].

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