Minor Aphthous Ulcers Research Articles

Comparison of Two Oral Pastes Containing Triamcinolone and Rhus Coriaria L. for Treating Minor Aphthous Lesions

BackgroundRecurrent aphthous stomatitis (RAS) is a common oral mucosal lesion. Herbal medicine has been explored to treat this condition. This study compared the effectiveness of two oral pastes containing Triamcinolone and Sumac, for the healing, size, and symptomatology of RAS. MethodsThis triple-blind randomized clinical trial included 60 patients with minor aphthous ulcers. Participants were informed about the study and provided consent. Exclusion criteria consisted of specific medical conditions and medication use. The patients were divided into three groups and received either Sumac adhesive gel, Triadent oral paste, or a placebo. Ulcer size was measured before and after treatment. The medication was prepared using carboxymethylcellulose-based gel and Sumac powder extract. The study was triple-blinded, and the groups were labelled as A, B, and C. Data analysis was performed using SPSS version 22, employing repeated measurement, student t test, Kolmogorov–Smirnoff, and one-way ANOVA for quantitative data. Statistical significance was set at P ≤ .05. ResultsA clinical trial involving 59 participants compared the Sumac, Triadent, and placebo groups. The Sumac group exhibited the shortest healing time, significantly reduced lesion size, and lower Visual Analog Scale scores. Triadent took the longest time to heal ulcers. ANOVA test indicated no significant difference in age and gender distribution. ConclusionThis clinical trial evaluated two oral pastes for treating aphthous ulcers and found that the Sumac group achieved faster healing and reduced lesion size compared to the Triadent and control groups. Sumac shows promise as a treatment option, but further studies are necessary to confirm its efficacy and safety. These favourable results support the use of herbal treatments and suggest their potential for broader utilization in managing diseases such as RAS.

Comparative Efficacy of Triadent and Ora-Aid Mucoadhesive Patch for Treatment of Minor Aphthous Ulcers: A Clinical Trial

Comparative Efficacy of Triadent and Ora-Aid Mucoadhesive Patch for Treatment of Minor Aphthous Ulcers: A Clinical Trial

Examining the role of salivary IL-2 and IL-22 in recurrent aphthous stomatitis: a diagnostic approach

Background: Recurrent aphthous stomatitis (RAS) is a prevalent inflammatory condition, that manifests as mouth ulcers. This study aims to evaluate IL-2 and IL-22 levels in saliva samples of individuals with recurrent aphthous stomatitis (RAS) compared to healthy volunteers. Methods: A case-control study was conducted between April 1st and September 30th, 2023, at the Dental Center of New Baquba, Diyala, Iraq. Saliva samples were collected from 40 patients diagnosed with recurrent aphthous stomatitis and 40 healthy controls. IL-2 and IL-22 levels were assessed in both groups using enzyme-linked immunosorbent assay (ELISA). Statistical analysis, employing paired sample ‘t’ test, was conducted with a significance threshold below. Results: In the case group, the mean age was 53.4 years (SD=1.58), ranging from 26 to 81 years, while in the control group, it was 47.18 years (SD=1.55), ranging from 24 to 78 years. Females predominated in both groups, comprising 62.5% in cases and 52.2% in controls. Most aphthous ulcers (77.5%) were found in the buccal mucosa, with minor aphthous ulcers being the most common (67.5%). Results from paired-samples t-tests revealed significantly higher levels of IL-2 in RAS cases (M=62.090, SD=20.242) compared to controls (M=36.366, SD=14.596), (t(39)=7.101, p < 0.001). Similarly, IL-22 levels were significantly elevated in RAS cases (M=106.537, SD=44.112) compared to controls (M=73.399, SD=32.852), (t(39)=3.553, p=0.001). These results suggest a potential association between RAS and increased IL-2 and IL-22 levels, indicating their involvement in RAS pathophysiology. Conclusion: In summary, females showed a significant predominance in RAS cases. Significant differences were observed in IL-2 and IL-22 levels between case and control groups.

Laser - Revolutionizing The Treatment Of Recurrent Aphthous Stomatitis

Introduction Apthous ulcers frequently referred as lsquocanker soresrsquo are one of the most prevalent ulcerative lesions of the oral mucosa. These are more often painful and are coupled with redness and occasional bleeding.Aims The aim of the present study was to assess and compare the clinical effects of the administration of low-level laser therapy LLLT and a topical corticosteroid in patients with recurrent aphthous stomatitis RAS.Methods A total of 28 patients who presented with aphthous ulcers were recruited for the study. Out of the 28 patients who initially began treatment only 20 were included in the study. These 20 patients were randomly divided into Group I and Group II. Patients treated with LLLT were included in Group I while those treated with topical corticosteroid were in Group II. Clinical evaluations were carried during all the sessions and pain intensity was recorded before and after the therapy. Unpaired t-test was applied to evaluate the comparison between Group I and Group II.Results Intra group comparison revealed statistically highly significant reduction in both the parameters both in Group I and Group II. On intergroup comparison the LLLT group exhibited a statistically significant reduction in pain based on VAS scores compared to the steroid group on day 1 and 2. However on 3rd day statistically non-significant difference was observed. Likewise the mean reduction in ulcer size was assessed to evaluate the effectiveness of laser therapy in improving lesion size. The LLLT group revealed a statistically significant decline in pain but a non-significant difference was noted between the efficacies of two agents in terms of reduction in the size of the lesion.Conclusion In the present study LLLT used as a mode of treatment for managing minor recurrent aphthous ulcers provided instantaneous pain relief.

The Effectiveness Of Topical Avocado In The Treatment Of Minor Recurrent Aphthous Ulceration: A Randomized Controlled Clinical Trial

The Effectiveness Of Topical Avocado In The Treatment Of Minor Recurrent Aphthous Ulceration: A Randomized Controlled Clinical Trial

The effect of sage (Salvizan gel) compared to triamcinolone acetonide on the treatment of recurrent aphthous stomatitis: a double-blinded randomized clinical trial

BackgroundRecurrent Aphthous Stomatitis (RAS) is one of the most common lesions of the oral mucosa. Herbal medicine can be used for the treatment of this disease. The present study aimed to compare the effects of topical application of Sage (Salvizan) and triamcinolone acetonide gels on RAS.MethodsThis double-blind clinical study recruited sixty patients with minor aphthous ulcers. Half of the patients were treated with Salvizan gel, and the other half were treated with oral triamcinolone acetonide gel. The effect of Salvizan topical gel was evaluated and compared with that of oral triamcinolone acetonide gel. Factors such as Pain recovery time, wound healing time, and pain level was evaluated. Data were analyzed by SPSS version 22 using independent t-test, paired t-test, repeated measures ANOVA, and survival analysis, including Kaplan-Meier and Cox regression.ResultsThe mean duration of pain recovery was 1.5 days for Salvizan and 2.5 days for triamcinolone acetonide (p < 0.001). Moreover, the duration of wound healing was 3.3 days for Salvizan and 6 days for triamcinolone acetonide (p < 0.001). Patients’ satisfaction from factors such as taste and smell had no significant difference between the two groups.ConclusionThe results of this study showed that Salvizan gel is very effective in the treatment of RAS. It was significantly better than triamcinolone acetonide in the pain recovery and wound healing. These promising results favor herbal treatments and show that they can be used more commonly for treating diseases such as RAS.Trial registrationThis study was approved by the ethics committee of Isfahan University of Medical Sciences (IR.MUI.RESEARCH.REC.1399.834) on 17/03/2021. It was also registered in the Iranian Registry of Clinical Trials (IRCT20100202003251N7).

The Potential of Corchorus olitorius Seeds Buccal Films for Treatment of Recurrent Minor Aphthous Ulcerations in Human Volunteers.

Aphthous ulcers are very common disorders among different age groups and are very noxious and painful. The incidence of aphthous ulcer recurrence is very high and it may even last for a maximum of 6 days and usually, patients cannot stand its pain. This study aims to prepare a buccoadhesive fast dissolving film containing Corchorus olitorius seed extract to treat recurrent minor aphthous ulceration (RMAU) in addition to clinical experiments on human volunteers. An excision wound model was used to assess the in vivo wound healing potential of Corchorus olitorius L. seed extract, with a focus on wound healing molecular targets such as TGF-, TNF-, and IL-1. In addition, metabolomic profiling using HR-LCMS for the crude extract of Corchorus olitorius seeds was explored. Moreover, molecular docking experiments were performed to elucidate the binding confirmation of the isolated compounds with three molecular targets (TNF-α, IL-1β, and GSK3). Additionally, the in vitro antioxidant potential of C. olitorius seed extract using both H2O2 and superoxide radical scavenging activity was examined. Clinical experiments on human volunteers revealed the efficiency of the prepared C. olitorius seeds buccal fast dissolving film (CoBFDF) in relieving pain and wound healing of RMAU. Moreover, the wound healing results revealed that C. olitorius seed extract enhanced wound closure rates (p ≤ 0.001), elevated TGF-β levels and significantly downregulated TNF-α and IL-1β in comparison to the Mebo-treated group. The phenotypical results were supported by biochemical and histopathological findings, while metabolomic profiling using HR-LCMS for the crude extract of Corchorus olitorius seeds yielded a total of 21 compounds belonging to diverse chemical classes. Finally, this study highlights the potential of C. olitorius seed extract in wound repair uncovering the most probable mechanisms of action using in silico analysis.

Minor Recurrent Aphthous Ulcer Management with Hyaluronic Acid Gel in an Italian Cohort: A Double-Blind Randomized Clinical Trial

Background. Recurrent aphthous ulcer is a common mucosal disease and encompasses diverse interventions for its management of symptoms like pain and discomfort. Since new therapies keep evolving with better outcomes as compared to traditional interventions, one such therapy using hyaluronic acid has been recently explored using clinical studies based on advances in dental therapeutics. Therefore, we designed this clinical study which is double blinded and randomized using minor recurrent aphthous cases. Objective. To evaluate the efficacy of hyaluronic acid topical oral gel in the treatment of minor RAS ulcers, with regard to pain relief and reduction in ulcer size. Design. A double-blind randomized controlled clinical trial was designed to conduct an experimental research at IRCCS Fondazione Ca’ Granda, Ospedale Maggiore Policlinico, Milan. The participants were recruited from the unit of oral maxillofacial surgery and randomly assigned to test (hyaluronic acid gel) and control groups (placebo gel). 1 : 1 computer-generated random sequence was prepared, and opaque closed envelopes were used for allocation concealment. Participants and clinical investigators were blinded. The outcome measures included ulcer size (mm) and the visual analogue scale for pain and healing as a secondary outcome measure (efficacy index). Results. The mean baseline score for ulcer size for the test group was1.85±1and the placebo group was1.85±1.2. At day 7, the test group was1±1.5and the placebo group was2±1.5(p&lt;0.001). There was significant reduction in ulcer size as compared to the placebo group. In addition, there was significant improvement in pain levels (p&lt;0.01) in the test group as compared to the control group. Conclusion. In conclusion, there was significant decrease in the size of the ulcer in the test group as compared to the placebo group. Hyaluronic acid seems to have promising effects on the ulcer size and pain relief associated with minor aphthous ulcers. Trial Registration. The protocol of this clinical trial was registered with the Clinical Trial Registry of ISRCTN with study ID ISRCTN16509838, registered 30 June 2020. It can be accessed on this URL: 10.1186/ISRCTN16509838

The Effect of Duration of Laser Radiation with the Same Dose in the Treatment of Recurrent Aphthous Stomatitis

Introduction: Recurring aphthous ulcers is a common and painful ulcer in the oral area. The aim of this study was to evaluate the impact of length of radiation in the same dose for the treatment of recurrent aphthous stomatitis. To date no similar study is available.&#x0D; Materials &amp; Methods: In this double-blinded clinical trial, 30 patients with minor aphthous ulcer that were referred to Oral medicine department of Islamic Azad university were selected according to convenience sampling and inclusion exclusion criteria and were randomly divided into two similar groups. Low level laser therapy with diode 660nm was used in group A with 200 mW and 20 seconds setting and in group B with 20 mW and 200 seconds setting in two sessions on the first and third days were used. The time of clinical healing and the pain intensity as VAS were recorded. Data were analyzed by Independent t-test and Mann-Whitney test (p value &lt; 0.05).&#x0D; Results: The pain intensity from first day after the laser until the seventh day in group B was significantly less than group A (p value &lt; 0.001). The mean size of lesion was significantly lower in the third day (p value = 0.03), fifth (p value &lt; 0.001) and seventh (p value = 0.001). The mean clinical healing time in group B was significantly lower than group A (p value &lt; 0.001).&#x0D; Conclusion: According to this study's findings, longer time of irradiation in lower output power of 660 nm diode laser was suggested for treatment of recurrent aphthous ulcer.

Effects of Propolis and Persica Mouthwashes on Minor Aphthous Ulcers: A Comparative Study

Effects of Propolis and Persica Mouthwashes on Minor Aphthous Ulcers: A Comparative Study

Impact of Vitamin D3 Supplementation on Recurrent Aphthous Ulcer

Vitamin D is a well-known secosteroid hormone, which exerts multiple essential roles in bone physiology, cell growth and differentiation, the neuromuscular system, immunomodulatory functions and autoimmune diseases. Deficiency of vitamin D has been linked to many oral disorders including tooth decay, periodontitis, oral cancer, oral candidiasis, oral lichen planus and recurrent aphthous ulcers. Many studies have revealed a significant lower serum vitamin D level in recurrent aphthous ulcer patients compared with healthy volunteers. This proposes that vitamin D supplementation may reduce the severity of the lesion. To evaluate the efficacy of vitamin D3 replacement on recurrent aphthous ulcer severity is the objective of the study. This study involved 65 patients with idiopathic minor recurrent aphthous ulcer and vitamin D deficiency/insufficiency. These patients received vitamin D3 supplement over 1 y. Severity of the disease was delineated by the duration of episodes, the number of ulcers per attack and the frequency of recurrence. Severity parameters were compared before and after vitamin D3 intake. In addition, 25-hydroxy vitamin D3 concentrations were measured before and after administration of vitamin D3 by enzyme-linked immunosorbent assay technique. We found a significant decrease in the frequency of attacks and the number of ulcers in each attack with p-value<0.05 following vitamin D replacement. Moreover, a highly significant lowering in the duration of episodes was detected with p-value<0.001. Gender specific analysis showed no statistically significance regarding severity parameters at any point of the study stages. Correlation studies revealed the only detectable correlation was between serum 25-hydroxy vitamin D3 level at baseline and the number of ulcers before and after vitamin D correction. Vitamin D3 supplementation has a safe and positive impact on improving the severity of recurrent aphthous ulcer with regards to the number of lesions, the frequency of recurrence and the duration of episodes, in patients who have vitamin D deficiency/insufficiency.

IL-10 and TGF-β1 gene polymorphisms in Greek patients with recurrent aphthous stomatitis.

Background Recurrent aphthous stomatitis (RAS) is one of the most frequent inflammatory disorders of the oral mucosa. Cytokines, which play an important role in RAS pathogenesis, participate directly or indirectly in normal, immunological and inflammatory processes and are secreted from cells belonging to innate and adaptive immunity as a consequence of microbial and antigenic stimuli. Gene polymorphisms in specific cytokines may predispose to RAS development. The aim of this study was the investigation and association of IL-10 and TGF-β1 gene polymorphisms with RAS.Material and Methods Study’s cohort consisted of 60 Greek patients diagnosed with RAS, including 40 patients with minor, 10 patients with major and 10 with herpetiform aphthous ulcers. Forty age- and sex-matched control subjects were included in this study. DNA was extracted from whole blood samples of all patients and sequence-specific primers (SSP)-based polymerase chain reaction (PCR) was used for genotyping. Gene polymorphisms for cytokines IL-10 at loci -592 and -819 and for TGF-β1 at codon 10 were detected.Results Significant differences between patients with minor RAS and healthy controls were recorded for IL-10 genotypes distribution at position -592 (p=0.042) and -819 (p=0.045) with predominance of C/A and C/T genotypes in RAS patients, respectively. Also, in patients with minor and herpetiform aphthous ulcerations, heterozygous TGF-β1 genotype C/T at codon 10 was associated with increased risk of RAS (p=0.044 and p=0.020, respectively).Conclusions These data provide evidence that genetic predisposition for RAS and possibly its specific clinical variants is related with the presence of gene polymorphisms for specific cytokines, including IL-10 and TGF-β1, which, in turn, may vary according to geographic origin and genetic background. Key words:Recurrent aphthous stomatitis, aphthae, IL-10, TGF-β, gene polymorphisms, oral mucosa.

Appraising the Clinical Efficacy of Herbal Topical Medications in the Treatment of Recurrent Aphthous Stomatitis - A Review

: Oral ulcers are common complaints to the dental clinic. Among these, Recurrent Aphthous Stomatitis/Ulcer (RAS) is frequently reported lesions of which recurrent minor aphthous ulcers are most prevalent. Though these mucosal lesions are self-limiting, painful ulcerative and inflamed mucosa could affect the patient’s daily routine such as food intake, speaking and swallowing. Since precise etiology is unknown, various treatment options are tailor made to each individual patient’s condition. Topical steroids are the widely prescribed medication as local therapy. In spite of a dearth in evidence based data on the effectiveness of plant based topical therapies for oral aphthous ulcers, these are used as primary medications which aids in natural cure of such lesions. These alternative medications are also useful to patients who refuse to take allopathic medicines, having history of drug allergies, history of multiple drug therapy, when allopathic medication is not recommended and in refractory cases. Hence the aim of this paper is to review the clinical efficacy of potential herbal medications for the topical management of recurrent aphthous ulcers. An electronic data search was performed using different search engines and the relevant articles were reviewed. All the placebo controlled studies have shown clinically significant results in the treated group in various outcome measures without noticeable side effects. Generally, topical herbal treatment were effective on RAS as palliative therapy, however more scientific evidence is needed for clinical recommendation in repeated cases.Key words: Aphthous stomatitis /ulcer, Alternative medications, Topical herbs, Topical treatment, Recurrent oral ulcer,Herbal medications.

Low-Level Diode Laser Therapy (LLLT) versus Topical Corticosteroids in the Management of Recurrent Aphthous Stomatitis Patients. A Randomized Controlled Trial

Objectives: The current study was conducted to evaluate the effect of low-level laser therapy (LLLT) on recurrent aphthous stomatitis for reduction of pain score and ulcer size. Subjects and Methods: 28 participants with symptomatic minor recurrent aphthous ulcers were randomly allocated into two groups. The treatment group received a 980 nm diode laser and the control group received topical triamcinolone acetonide 0.1%. The measured outcomes included pain score as visual analog scale (VAS) at baseline, second day, and seventh day, and the lesion size at baseline and seventh day. Results: A statistically significant difference was found between the laser and the corticosteroid groups when comparing VAS scores on day two (pain reduction was -2.2 ± 0.9 and -4.786 ± 1 for corticosteroid and laser groups respectively with a p -value of 0.001) and day seven (pain reduction was -4.643 ± 1.646 and -6.071 ± 1.439 for corticosteroid and laser groups respectively with a p -value of 0.024) in favor of the laser group. Moreover, a statistically significant difference was noticed between the laser and the corticosteroid groups regarding the decrease in lesion size (lesion diameter reduction was -3.036 ± 1.447 and -4.536 ± 1.846 for corticosteroid and laser groups respectively with a p -value of 0.024) in favor of the laser group. Two participants experienced severe mouth dryness after corticosteroid application. None of the laser patients experienced any side effects. Conclusion: LLLT can be considered a reliable alternative to topical steroids in the management of recurrent aphthous ulcers since it was more effective in reducing both pain intensity and ulcer size.

A comparative study of amlexanox and tetracyclines in the management of recurrent aphthous stomatitis

Background: Although there are many drugs which are used for topical therapy in recurrent aphthous stomatitis (RAS) patients, there are few clinical trials that have used tetracycline and amlexanox. Aim and Objectives: To evaluated the therapeutic efficacy of topical tetracycline and amlexanox. Materials and Methods: Here in this study we divided the RAS patients into two groups in each group alternative selection was done. Patients of 1st Group received topical application of tetracycline crushed tablets with denture adhesive and few drops of saline solution on each alternative day visit. Same as Group 2nd subject received amlexanox. Treatment response was assessed by measuring pain reduction, photographic record, ulcer duration, and adhesive retention time. Results: Amlexanox oral paste show more efficacy in comparision of topical tetracycline in the treatment of recurrent minor aphthous ulcers. Conculsion: Amlexanox is more effective in comparison of tetracycline.

Assessment of Clinical Efficacy of Microbiome and Topical Hyaluronic Acid Gel Combination Therapy in Minor Aphthous Ulcer Management – A comparative study

Aim: This study aimed to determine the clinical efficacy of the combination of microbiomes and 0.2% topical hyaluronic acid gel, alongside topical monotherapy with 0.2% hyaluronic acid gel and steroids, respectively, in minor aphthous ulcer management. Subjects and Methods: A total of 45 patients were divided into three groups: Group A (n = 15) –– a combination of microbiome therapy––pre- and probiotics capsules p. o. and topical 0.2% hyaluronic acid gel; Group B (n = 15)––topical 0.2% hyaluronic acid gel; and Group C (n = 15)––0.1% triamcinolone acetonide oromucosal paste. Numerical rating scale (NRS) for pain, ulcer dimensions measured by Digital Planimetry using android mobile application to determine the degree of ulcer healing (%) and occurrence of new ulcers were recorded on 0, third, and seventh days of treatment. Statistical Analysis Used: One-way ANOVA with post hoc Tukey test among the groups and independent t - test for the degree of ulcer healing between third and seventh days were applied. Results: NRS for pain at day 3 showed a statistically significant pain reduction in Group A compared with Groups B and C (P = 0.04, 0.01, respectively). Though Group A showed the highest grade of closure (93.4 ± 2.5%) and a greater decrease in mean NRS score (0.2 ± 0.42) on the seventh day when compared to Groups B and C, results were not statistically significant (P &gt; 0.05). Conclusion: Microbiome and topical hyaluronic acid gel combination therapy helps in immediate pain relief and faster healing. Hence, it could be an excellent alternative for topical steroid management.

Comparison of Virgin Coconut Oil with 5% Amlexanox in Management of Minor Recurrent Aphthous Ulcers - A Randomized Control Trial

Objective: Recurrent Aphthous Ulcer (RAU) is a common (75-80%) painful inflammatory ulcerative disorder of the non-keratinized oral mucosa. Wide range of antiseptics, anti-inflammatory, antibiotics and corticosteroids are available for treatment. Amlexanox is a topical anti-inflammatory and anti-allergic drug used to treat RAS. Recently, there has been increase in interest in use of essential oil and herbal medicine in managing RAU, one such natural product is virgin coconut oil. This study is aimed to determine the efficacy of VCO in management of signs and symptoms of minor recurrent aphthous ulcers. Methodology: 40 patients were included for the study who were randomly divided into two groups. 20 patients in Group A (VCO) and 20 patients in Group B (5%Amlexanox). Primary outcome measured were reduction in ulcer size (in mm) and pain (VAS 1-10). Results: There is high statistical significant difference within the groups in ulcer healing and pain reduction (p=0.00) on 3rd and 5th day. In group A significant reduction in pain was present on the 5th day (p=0.02) and no significant reduction in ulcer size (p=0.083). No adverse effects were reported in either group. Conclusion: VCO could be used as an effective and safe drug in managing the signs and symptoms of RAS. It is edible oil with no known adverse effects and could be a safe therapeutic alternative in children and pregnant women.

Correlation of Pain Score with Ulcer Size in Oral Aphthous Ulcers Using 2% Curcumin Gel and 0.1% Triamcinolone Oral Paste - A Parallel Comparison Study

Background: Recurrent aphthous stomatitis (RAS) is a common inflammatory condition affecting the oral mucosa causing interference with mastication and speech with significant impact on quality of life. The use of topical steroids remains the mainstay as the primary therapeutic approach and they are often considered to be the first choice of treatment. Turmeric has been used in the Indian traditional medicine for centuries. Its anti-inflammatory and wound healing activities are demonstrated by the rapid healing of the ulcers. Aim: The primary aim of this study was to assess and correlate pain score with ulcer size using topical curcumin 2% gel and triamcinolone acetonide oral paste 0.12% in recurrent minor oral aphthous ulcerations. Methodology: Following convenient sampling, 60 volunteered students with oral aphthous ulcers were included to take part in this single-blinded randomised study. Randomization was done by flip coin method. Group I received Topical Curcumin oral gel 2% and Group II received Topical Triamcinolone acetonide 0.1%. Statistical Analysis: Qualitative data was expressed in percentage and quantitative in mean (SD). Independent sample t test and correlation was done. Results: The ulcer size was smaller initially and gradually increased in the next few days and the size decreased upon ulcer healing. Initially, the pain score was higher and gradually decreased as the ulcer healed. Positive correlation of ulcer size and pain score was obtained in Group I on the 1st day, 4th day and 5th day with statistical significance of P &lt; 0.001 and negative correlation on 2nd day without statistical significance. Ulcer size and pain score in Group II was correlated negatively on Day 1, 2, 6 and 7 without statistical significance and positively correlated from Day 3-5 without statistical significance. Ulcer size and pain score was negatively correlated with statistical significance for Day 6 and 7. Conclusion: Our study showed that Curcumin performed on par with triamcinolone and there is no positive correlation between ulcer size and pain score with topical management of Curcumin and Triamcinolone in aphthous ulcers. Though both the drug was effectively able to bring down the pain and size without any side effects, with a borderline favorable result with steroid.

Topical Curcumin and Triamcinolone Acetonide in Recurrent Minor Aphthous Ulcers: A Pilot Trial

To evaluate the efficacy of topical curcumin and topical triamcinolone acetonide in a professional population with minor aphthous ulcers by assessing six clinical variables: site, size, pain, healing period, frequency of recurrence and number of ulcers. This randomized, parallel designed pilot trial was performed on 60 symptomatic individuals with minor aphthous ulcer. Willing participants were allocated randomly into group I and group II. Participants in group I were treated with topical curcumin and group II were treated with topical triamcinolone acetonide for a period of 6 months. All participants were blinded to the drug they received. Participants were assessed on day 1, day 3, day 5, day 7, and after healing for symptomatic reduction in pain, size, healing period, frequency of recurrence, and in the number of ulcers. Statistically, independent sample t test, Chi-square test, and Log rank Kaplan-Meier survival analysis were performed. Lower labial mucosa was found to be the predominant site of minor aphthous ulcer in both the groups. A gradual reduction in pain and size was noted in both the groups with statistical significance of p value <0.001. All the ulcers in both the groups healed completely without scarring within 2 weeks with statistical significance. In both the treatment groups, new ulcers occurred throughout the follow-up period of 6 months. The mean number of the ulcers are statistically not significant with p value >0.05. Our study showed clinically beneficial effects with topical curcumin with regard to ulcer size, pain, healing, and recurrence rate. Also topical curcumin gel was well tolerated and performed ot par with topical triamcinolone acetonide oral paste with a borderline favorable result with triamcinolone. Curcumin can be safely recommended on a long-term basis as a more appealing therapeutic agent and is a better alternative choice for aphthous ulcers in children, pregnant woman, lactating mother, and in immunocompromised individuals.

Topical insulin-liposomal formulation in management of recurrent aphthous ulcers: A randomized placebo-controlled trial.

To evaluate the effectiveness of topical insulin-liposomal gel in aphthous ulcer treatment. 80 participants with minor aphthous ulcers were randomly divided to receive either topical insulin-liposomal gel or placebo gel (once daily) for 6days. Assessment of outcomes included visual analog scale (VAS) for pain (primary outcome), and secondary outcomes included ulcer duration and impact of treatment on quality of life using the Oral Health Impact Profile 14 (OHIP-14). Testing of the outcomes was carried out at 1, 2, 3, 4 and 6days after treatment for VAS and at 6days for OHIP-14. For pain scores, the test group showed a significant decrease by time, this was evident from day 1 (P<.001); at day 3, median and interquartile range (IQR) values were 0 (0-1). For the placebo group, a non-significant change by time was reported between baseline and day 1; at day 3, the median value was 7 (IQR, 7-9). The test group showed significantly lower mean duration than the placebo group (P<.001). OHIP-14 scores after 6days showed that the test group had a significantly lower score than placebo (P<.001). Topical insulin-liposomal formulation showed marked effectiveness in management of aphthous ulcers.