Minor Recurrent Aphthous Stomatitis Research Articles

Evaluation of cytokine expressions in patients with recurrent aphthous stomatitis: A systematic review and meta-analysis.

This systematic review and meta-analysis aimed to evaluate the expression levels of various T helper (Th) cell-secreted cytokines in recurrent aphthous stomatitis (RAS). Case-control studies comparing the serum or salivary levels of cytokines between RAS patients and healthy controls were searched in PubMed, EMBASE, Web of Science, and Google Scholar prior to September 30, 2023. Cytokines produced by Th1 (interleukin [IL]-1, IL-2, IL-8, IL-12, tumor necrosis factor alpha [TNF-α], interferon gamma [IFN-γ]), Th2 (IL-4, IL-5, IL-6, IL-10, IL-13), and Th17 (IL-17A) cells were investigated. The standard mean difference (SMD) with 95% confidence interval (CI) was calculated to detect the difference. A total of 20 studies comprising 1070 RAS patients and 536 healthy controls were included. RAS patients had significantly higher salivary levels of IL-2 (SMD = 4.15, 95%CI 0.83-7.48), IL-5 (SMD = 0.53, 95%CI 0.05-1.00), IL-6 (SMD = 0.48, 95%CI 0.12-0.84), IL-12 (SMD = 0.94, 95%CI 0.18-1.71), and TNF-α (SMD = 1.31, 95%CI 0.44-2.18) compared to healthy controls. Serum levels of IL-6 (SMD = 0.48, 95%CI 0.30-0.66), TNF-α (SMD = 0.70, 95%CI 0.22-1.17), and IFN-γ (SMD = 0.72, 95%CI 0.17-1.28) were significantly increased, while serum IL-10 levels (SMD = -2.25, 95%CI -3.99 to -0.52) were reduced in RAS patients. Patients diagnosed with major RAS had markedly elevated serum IL-8 levels (SMD = 0.39, 95%CI 0.07-0.71) and a trend toward higher serum IL-6 levels (SMD = 0.51, 95%CI -0.02 to 1.04) than those with minor RAS. In conclusion, Th1/Th2-related cytokines, especially IL-2, IL-6, and TNF-α, are involved in the pathogenesis of RAS development and progression and are potential therapeutic targets for RAS.

Evaluation of caffeic acid mucoadhesive tablets on minor recurrent aphthous stomatitis: a randomized, double-blind, placebo-controlled clinical trial

BackgroundOral aphthous stomatitis is a chronic inflammatory condition. Numerous medications have been investigated to treat the symptoms of the disease. However, these days patients prefer herbal medicines due to lower side effects. Considering the anti-inflammatory, analgesic, and anti-oxidant properties of Caffeic acid and its few side effects, the aim of this study was to assess the impact of Caffeic acid on recurrent aphthous stomatitis (RAS). investigating the effect of caffeic acid mucoadhesive tablets on the size and pain intensity of the aphthous lesions.Methodsin this double-blinded clinical trial study, 47 patients who met the inclusion criteria were selected by convenient sampling method. The patients were assigned to two groups randomly; the control group (placebo recipients) and the intervention group (Caffeic acid recipients). Patients were followed up for 7 days following the intervention. The diameter of the inflammatory lesion was measured in millimeters, and the pain intensity was recorded based on the VAS scale (Visual Analogue Scale). This trial was approved by the medical ethics committee of Mazandaran University of Medical Sciences (Ethical code: IR.MAZUMS.REC.1401.261) and received IRCT code of IRCT20220815055700N1on 03/09/2022.Resultsthe diameter of the lesion in both groups decreased over time, and there was no significant difference between the intervention and control groups, except on the fifth day when the diameter of the lesion was significantly greater in the control group (P = 0.012). From the second day, the control group’s average pain intensity was significantly higher than the intervention group’s pain intensity (P < 0.05).Conclusionswhen comparing mucoadhesive tablets containing Caffeic acid and placebo, the findings demonstrated that Caffeic acid has a significant efficacy in reducing aphthous lesions’ diameter and pain intensity of the patients and are suggested for palliative oral aphthous lesions treatment since they showed significant anti-inflammatory and analgesic effects on recurrent aphthous stomatitis.

Management of major recurrent aphthous ulcers with 5% amlexanox oral paste and rebamipide tablets- A case report with a brief literature review

Recurrent aphthous stomatitis (RAS) is a common chronic inflammatory oral mucosal disorder marked by the presence of painful, recurring ulcers, occurring either as solitary lesions or in multiple clusters. While the clinical features of this condition are easily recognizable, the precise etiology remains obscure. The disorder manifests in three forms, of which minor RAS are the commonest and heal within 10-14 days. Major RAS presents as larger, painful chronic ulcerations and heals with scarring in 6-8 weeks. A comprehensive medical history and a thorough systemic examination can aid the physician in determining whether the condition is idiopathic or linked to a underlying systemic disorder. The management of oral aphthous ulcers poses a significant challenge and there is no established and defined therapeutic regimen available for RAS. We present a case of major RAS in a 37-year-old patient who was unresponsive to topical and systemic steroid therapy. 5% Amlexenox paste and rebamipide tablets were used in the present case. The patient showed favourable healing within a week therapy with no recurrences during the 6-month follow up.

Cardiovascular diseases, risk factors, and ulcer relapse in older adults with aphthous stomatitis.

To test the hypothesis that cardiovascular diseases and risk factors are associated with ulcer relapse in after-retirement patients with recurrent aphthous stomatitis. This retrospective cohort study analyzed the data of 40 minor recurrent aphthous stomatitis patients aged 55-75 years, admitted to Oral Medicine Clinic at one university hospital in China between 2016 and 2018. The diagnosis of minor recurrent aphthous stomatitis was made based on the history and manifestation of oral ulcers. The ulcer relapse was evaluated after a 5-week anti-inflammatory treatment, and the history of systemic diseases was collected. cardiovascular disease/metabolic risk referred to the presence of any cardiovascular diseases and metabolic cardiovascular disease risks. Associations among cardiovascular diseases, risk factors, and ulcer relapse were evaluated. The mean age of 40 patients with minor recurrent aphthous stomatitis was 62.4 years (SD 5.1), and 60% were women. The ulcer relapse rate was 37.5% (95% CI, 0.242-0.530). The proportion of cardiovascular disease/metabolic risk was higher in the relapse group than in the no-relapse group after 5-week anti-inflammatory treatment (Fisher's exact test, p = 0.041). According to this single-center experience, older patients with cardiovascular disease/metabolic risk may be more prone to oral ulcer recurrence. Nevertheless, larger prospective studies are needed to confirm our findings.

Atorvastatin mucoadhesive tablets in the management of recurrent aphthous stomatitis: a randomized clinical study

BackgroundAphthous stomatitis is one of the most common oral mucosal diseases. Due to the commonness of recurrent aphthous stomatitis and considering the anti-inflammatory, analgesic, and tissue regenerative properties of atorvastatin and the lack of a study on the effect of statins on minor recurrent aphthous stomatitis, this study investigates the effect of atorvastatin mucoadhesive tablets as a topical treatment on reduction of symptoms and duration of this disease.MethodsThis study is a randomized, double-blinded clinical trial. Patients were divided into two groups, atorvastatin and, placebo; each of the patients received three mucoadhesive tablets daily in the morning, noon, and night. Finally, the patients were examined on days 0 (baseline), 3, 5, and 7 to determine the diameter of the inflammatory halo. The VAS scale was used to evaluate pain intensity for up to 7 days after each meal. The data was entered into SPSS 24 software and analyzed.ResultsThe halo diameter did not significantly differ between the two groups on baseline (P > 0.05). However, on the study’s third, fifth, and seventh days, the difference between the two groups was remarkable, so in the atorvastatin group, the size of the lesions decreased in shorter healing time (P < 0.05). In addition, the patient’s pain intensity (VAS) also showed a significant decrease in the atorvastatin group except on the first, second, and seventh days of the study (P < 0.05).ConclusionAtorvastatin mucoadhesive tablets effectively reduce the pain of patients with minor recurrent aphthous stomatitis and reduce the size and healing time of the lesions, so their application should be considered in treating minor recurrent aphthous stomatitis. The present study was approved by the Medical Ethics Committee of Mazandaran University of Medical Sciences with the ethics code IR.MAZUMS.REC.1400.8346. Also, this study received code IRCT20170430033722N4.

A Comparative Study of Dexamethasone Ointment along with Triamcinolone Acetonide in Treatment of Recurrent Aphthous Stomatitis.

To assess and compare the efficacy of dexamethasone ointment with triamcinolone acetonide, the gel form, in the treatment of minor recurrent aphthous stomatitis (RAS). This was a randomized clinical trial of 60 patients of either sex with clinically diagnosed RAS who were randomly divided into two groups-the dexamethasone ointment group (Group I) and the triamcinolone acetonide gel group (Group II). Patients were asked to apply the gel three times a day on each ulcer. Estimation of the efficacy of gel was done based on the time required for regression in pain, size, and number of ulcers. The results showed there was a significant difference in size, pain, number, and duration of ulcers in Group I and Group II within 7 days. However, in both groups, no significant difference was noted in the treatment of RAS. Dexamethasone ointment was found to be efficient in this treatment and was safe as evaluated using clinical assessments.

The Role of Stress in Recurrent Aphthous Stomatitis

Abstract Objectives This study aimed to determine the role of stress in recurrent aphthous stomatitis. Stress was examined with the Perceived Stress Scale and cortisol levels; meanwhile, recurrent aphthous stomatitis was assessed with the duration of the lesion. Materials and Methods This was a cross-sectional analytical study conducted at Oral Medicine Installation, Universitas Sumatera Utara Dental Hospital, and Prodia Laboratory, Medan. The subjects were 50 patients with minor recurrent aphthous stomatitis, without systemic disease, who did not take systemic drugs or use orthodontic appliances. The diagnosis of recurrent aphthous stomatitis was established with anamnesis and clinical examination. Stress was examined by filling out the Perceived Stress Scale questionnaire and blood tests for serum cortisol levels. Statistical analysis The data were analyzed using the Fisher test and Mann–Whitney U test. Results This study showed no significant relationship between the Perceived Stress Scale category and recurrent aphthous stomatitis, with a p-value of 0.392. This study also showed no significant relationship between blood cortisol level and recurrent aphthous stomatitis with a p-value of 1.000. Conclusion Stress may play an important role in recurrent aphthous stomatitis. However, this study did not show any difference in stress examined through the Perceived Stress Scale and cortisol levels based on the duration of recurrent aphthous stomatitis.

Salivary cortisol and alpha amylase enzyme levels in different phases of minor recurrent aphthous stomatitis

Objectives: Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal lesions and stress is one of the major factors implicated in its causation. The aim of the present work is to measure the stress biomarkers, salivary cortisol (SC) and salivary alpha amylase (SAA), in the different phases of RAS. Patients and Methods: The study included 69 subjects of whom 38 patients served as the study group who suffered from minor RAS and one to three active minor oral ulcers of &lt;48 h duration. The remaining 31 healthy subjects served as controls. Unstimulated salivary samples were collected twice from the study group; during the ulcerative phase of RAS and after complete healing has occurred, and only once from the controls. Concentrations of SC, and SAA enzyme were assessed by Enzyme-linked Immunosorbent Assay (ELISA). Results: There was a significant increase of SC and SAA in both the ulcerative and the post-healing phases in comparison to the control group. The ulcerative phase had higher but insignificant levels of both biomarkers when compared to the post-healing phase. There was a significant correlation between both biomarkers in the post-healing but not in the ulcerative phase. Conclusion: RAS patients have significantly higher levels of both stress biomarkers (SC and SAA) in the ulcerative and in the post-healing phases when compared to controls.

Serum levels of reduced glutathione, oxidized glutathione, and glutathione reductase activity in minor recurrent aphthous stomatitis patients

Background/purposeRecurrent aphthous stomatitis (RAS) is one of the most prevalent oral mucosa diseases with unknown etiology. Reduced glutathione (GSH) is a major intracellular non-protein physiological antioxidant, and it has been demonstrated that GSH deficiency may be related to cardiovascular, immune, and diabetes. The purpose of this investigation was to evaluate the potential roles of GSH, oxidized glutathione (GSSG), and glutathione reductase (GR) in the etiopathogenesis of minor recurrent aphthous stomatitis (MiRAS). Materials and methodsThe study comprised 87 patients with idiopathic MiRAS and 90 race-, age-, and gender-matched healthy individuals. The spectrophotometric method was used to determine serum GSH and GSSG concentrations as well as GR activity. The GSSG/GSH ratios were subsequently computed. For statistical evaluation, the independent sample t test, Pearson's chi-square test, Mann–Whitney U test, Kruskal–Wallis H test, and Binary logistic regression analysis were used. ResultsThe serum GSSG level, GR activity and GSSG/GSH ratio were statistically higher in MiRAS patients, whereas the concentration of serum GSH was significantly decreased. With the exception of GR, serum GSSG, GSH, and GSSG/GSH were all significantly associated with MiRAS. Serum GSSG can be regarded as a risk factor, whereas serum GSH and GSSG/GSH maybe considered as protective factors against the occurrence of MiRAS. ConclusionGSSG may be a potential danger factor to MiRAS and GSH may be a protective factor, while GR may not play an important role in the aetiopathogenesis of MiRAS.

LOW-LEVEL POTENCY LASER AS TREATMENT AT RECURRENT APHTHOUS STOMATITIS ON HIV PATIENTS

Recurrent aphthous stomatitis (RAS) is a usual pathologic alteration found in the oral mucosa, defined by unique or multiple painful ulcers. Its etiopathology is not very well known. However, it is known that the low count of CD4 T lymphocytes increases the prevalence of oral lesions. In other words, immunosuppressed patients with human immunodeficiency virus (HIV) are predisposed. A 26-year-old dark-skinned male patient, HIV-positive, CD4 T cell 67, showed minor RAS in the upper lip area and lower lip on the right side, measuring approximately 5 mm, and larger RAS on the tongue and tonsillar pillar measuring 2.5 cm. The chosen treatment was dexamethasone elixir mouthwash and, as supporting therapy, the application of a low potency laser at 790 nm, punctually, for 2 minutes. Remission of injuries was noted. A GaAIAs laser is an important therapeutic approach for ulcer treatment.

"Comparison of Effectiveness of Curcumin and Triamcinolone Acetonide in Treatment of Minor Recurrent Aphthous Stomatitis” - A Randomized Controlled Trial

"Comparison of Effectiveness of Curcumin and Triamcinolone Acetonide in Treatment of Minor Recurrent Aphthous Stomatitis” - A Randomized Controlled Trial

Evaluation of cinnamaldehyde mucoadhesive patches on minor recurrent aphthous stomatitis: a randomized, double-blind, placebo-controlled clinical trial

Background & objectiveThe use of herbal medicines to treat common oral diseases increases rapidly. Recurrent aphthous stomatitis is one of the most common oral mucosal diseases, which has an unclear etiology and could lead to severe pain and dysfunction. Cinnamaldehyde is a major component of cinnamon bark oil. Biological properties of cinnamaldehyde, such as antioxidant, antitumor, antifungal, cytotoxic, and anti-mutational characteristics, have been identified. Considering the prevalence of recurrent aphthous stomatitis and the importance of using herbal resources for treatment, the present study aimed to evaluate the effect of mucosal adhesive patches containing Cinnamaldehyde on minor recurrent aphthous stomatitis lesions.Material & methodsIn this randomized, double-blind clinical trial, patients were divided into two groups. The intervention group received three daily mucosal adhesive patches to be used in the morning, afternoon, and night. The control group also did the same with a placebo. To evaluate the healing and determine the diameter of the lesions, patients were clinically examined on days zero, 3, 5, and 7. The VAS scale evaluated pain at baseline and after each meal for seven days. The Fisher's exact test, t-test, Shapiro Wilk test, Friedman test, and the Mann–Whitney test were used to analyze the data using the SPSS 20 software.ResultsThere was no statistically significant difference in the mean diameter of the inflammatory lesion and pain intensity in the two groups in the baseline (p > 0.05). However, the ulcer size was significantly reduced in the cinnamaldehyde group on the third, fifth, and seventh days of the study. Except for baseline, the mean pain intensity significantly decreased in the cinnamaldehyde group compared to the placebo group (p < 0.05).ConclusionCinnamaldehyde mucoadhesive patches effectively reduced and improved aphthous lesions and pain intensity in patients and can be considered a treatment for RAS. Registration number: IRCT20180312039060N2—First registration date: 20/07/2018. The present study was registered as a retrospective study.

Recurrent Aphthous Stomatitis: An Enigmatic Entity and Sign of Systemic Disease.

Recurrent aphthous stomatitis (RAS) is a common oral disease characterized by intermittent eruptions of painful oral ulcerations. Hippocrates first described aphthous stomatitis with the Greek word aphthi meaning "to inflame." RAS affects 10-20% of the population with the incidence being the highest among young adults. The peak age of onset is between 10 and 19 years of age. It has three main forms of presentation. The most common being minor RAS, along with the major and herpetiform types. Many local and systemic factors are associated with RAS pathogenesis. The main concern with oral aphthae in many cases is local pain, which can be severe enough to interfere with eating, speaking, and swallowing. It is important to differentiate RAS from systemic diseases with aphthae-such as Behçet's syndrome and the newly-delineated, autoinflammatory PFAPA (periodic fever with aphthous stomatitis, pharyngitis, and adenitis) syndrome-as well as from other aphthous-like ulcerations like herpes simplex virus (HSV) or Coxsackie oral lesions. The management depends upon the clinical presentation and symptomatology-focusing on analgesic, antimicrobial, and immunomodulatory drugs.

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.

Changes in Th1/Th2-related cytokine expression in the saliva of patients with recurrent aphthous stomatitis before and after prednisone treatment.

To investigate the changes of T helper cell (Th)1/Th2-related cytokine expression in the saliva of minor recurrent aphthous stomatitis (RAS) patients before and after treatment with systemic prednisone. A total of 101 patients with RAS and 15 participants with normal oral mucosa as controls were enrolled in this study. The levels of cytokine expression in the whole unstimulated saliva were examined using a multiplex bead-based cytometric bead array before and after prednisone treatment at a starting dose of 15mg/day. The levels of salivary interleukin (IL)-4, IL-5, IL-6, IL-10, interferon (IFN)-γ, and tumor necrosis factor-α (TNF-α) in RAS patients were significantly higher than those of the normal controls (all P < 0.001). Importantly, the levels of salivary IL-6, IL-10, IFN-γ, and TNF-α in RAS patients were significantly decreased following prednisone treatment (all P < 0.001). Moreover, the IFN-γ to IL-4 ratio (mean: 26.9) was significantly (P < 0.001) decreased after treatment, which almost returned to normal (mean: 24.4; P > 0.05). This preliminary study demonstrates for the first time that prednisone exerts a significant therapeutic role against RAS through decreasing salivary cytokine levels and promoting a Th1/Th2 balance. Salivary cytokine profiles may provide a noninvasive, convenient, and effective approach to monitoring the course of RAS and may even be helpful to identify key pathogenic factors and potential mechanisms.

Serum levels of vitamin D in patients with recurrent aphthous stomatitis.

Recurrent aphthous stomatitis (RAS) is one of the most common recurrent ulcerations in the oral mucosa, the etiology of which has not been elucidated; the immune system dysfunction may play an important role in the pathogenesis of RAS. The anti-inflammatory and regulatory role of vitamin D in the functioning of the immune system is well-documented. This study aimed to evaluate and compare the serum levels of vitamin D between patients with RAS and healthy controls. In this case-control study, 43 patients with minor RAS and 43 healthy controls were included. Two groups were matched in terms of age and sex. Blood samples were obtained from all participants. The serum levels of vitamin D were measured with the use of the enzyme-linked immunosorbent assay (ELISA) in patient and control groups. The data was analyzed using the SPSS for Windows software, v. 17.0, with the independent samples t test and the Mann-Whitney test. A p-value of <0.05 was considered statistically significant. The mean serum level of vitamin D in the control group was significantly higher than that in the case group (22.59 ±16.06 ng/mL vs 13.19 ±8.19 ng/mL, respectively; p = 0.002). The serum levels of vitamin D are lower in patients with RAS in comparison with healthy controls.

Effect of Omega-3 on Recurrent Aphthous Stomatitis and Improvement Quality of Life.

Objective Recurrent aphthous stomatitis is one of the most common chronic inflammatory diseases in oral mucosa. Beneficial effects of omega-3 supplements on some inflammatory diseases have been proved. The aim of present study was to evaluate the effect of omega-3 supplements in recurrent aphthous stomatitis management and improve oral health-related quality of life. Methods In this double-blind clinical trial, 40 patients with minor recurrent aphthous stomatitis were randomly divided into case and control groups. The case group received 1000 mg capsules of omega-3, while the control group received placebo capsules for 6 months. The questionnaires of the ulcer severity score and the chronic oral mucosal disease questionnaire were filled by the patients in three steps, at the baseline session, after 3 months, and after 6 months. The data were analyzed by SPSS 22 software through ANOVA, Mann–Whitney, and chi-square tests. P < 0.05 was considered as significant. Results In the omega-3 group, the ulcer severity score showed significant reduction by three-month and six-month follow-ups (P < 0.0001, P < 0.0001, respectively). The mean score of the chronic oral mucosal disease questionnaire significantly improved by three-month and six-month follow-ups in the omega-3-receiving group. Conclusion Use of omega-3 oral supplements decreased the severity of aphthous ulcer and improved oral health-related quality of life.

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

Evaluation of Novel Topical Camel Whey Protein Gel for the Treatment of Recurrent Aphthous Stomatitis: Randomized Clinical Study.

ABSTRACTAim:The aim of this article is to evaluate the topical effect of camel whey protein (CWP) on the healing of recurrent aphthous stomatitis (RAS) and the serum levels of interleukin (IL)-1, IL-6, and tumor necrosis factor (TNF)-α.Materials and Methods:Forty patients with minor RAS were randomly assigned into control and study groups. The control group applied placebo methylcellulose gel topically over the aphthous ulcer, whereas the study group used CWP dissolved in methylcellulose gel topically over the aphthous ulcer. Healing period, pain scale, and serum inflammatory biomarkers were evaluated before and after gel application. Collected data were analyzed statistically using the paired t-test or independent sample t-test.Results:Ulcer healing period, pain scale, and immunological biomarkers were statistically improved in both groups with significant shortening of the ulcer duration and significant regulation of immunological values related to the study group.Conclusion:Topical CWP gel is potentially effective in the treatment of RAS.

The Effect of Carbon Dioxide Laser on Aphthous stomatitis Treatment: A Double-Blind Randomized Clinical Trial

Introduction: This randomized clinical trial was designed to investigate the effect of carbon dioxide laser on the treatment of minor recurrent aphthous stomatitis (miRAS) as a painful and common oral ulcer. Methods: Fifteen patients with miRAS entered into this study after compliance with the inclusion and exclusion criteria. The patients were assigned to three groups of pulsed CO2 laser, continuous CO2 laser, and control. A pulsed CO2 laser with power of 261 W and pulse duration of 180 microseconds and continuous CO2 lasers with the power of 1 W and radiation duration of 5-10 seconds were used. In the control group, topical triamcinolone ointment of 0.1% was used. The degree of pain was measured using the visual analogue scale (VAS). The patients were evaluated in terms of pain intensity before and immediately after the treatment and at follow-up hours, 12, 24, 48, and 72 hours after the intervention, and changes in the size of the ulcers were measured before the treatment and on third, fifth, and seventh days. Results: The effect of CO2 laser with pulsed and continuous radiation on the pain intensity of aphthous lesions, immediately after the treatment and at subsequent follow-up hours were similar and even better than the control group (P<0.05). All three treatments had a similar effect on the size of the ulcer, which was not statistically significant (P>0.05). Conclusion: The results of this randomized controlled trial (RCT) showed that the carbon dioxide laser, whether with pulsed radiation or continuous radiation compared to the control group, had a better impact on the pain relief of aphthous lesions.