Minor Recurrent Aphthous Ulceration Research Articles

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 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.

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.

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.

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.

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.

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.

Expression of endocan and vascular endothelial growth factor in recurrent minor aphthous ulcers.

BackgroundRecurrent aphthous ulcers (RAU) are common painful inflammatory lesions of the mucous lining of the mouth. Endocan, previously identified as endothelial cell specific molecule-1, is implicated as a vital player in the regulation of several inflammatory processes. A number of inflammatory cytokines and pro-angiogenic growth factors including VEGF upregulate endothelial cells synthesis and expression of endocan.Material and MethodsClinical scores of pain and ulcer size as well as level of endocan and VEGF were determined in swaps from aphthous ulcer and contra lateral normal mucosa in 30 patients (nine males and twenty one females) with age ranging from 18 to 45 years and mean age is 31.5 years.ResultsIn the early days of ulcer development, ulcer showed statistically significantly higher mean endocan (8.2 ±5.3) and VEGF levels (1220.7 ±294.6) than control healthy mucosal site (1.1 ±0.5) and (518.6 ± 61.7) respectively. An increase in endocan is associated with an increase in pain score and vice versa. A statistically significant positive correlation were also found between endocan and VEGF levels.ConclusionsEndocan and VEGF are strongly associated with the destructive phase of minor aphthous ulcers especially Endocan which was positively correlated with pain severity. Key words:Endocan, ESM-1, VEGF, Recurrent Apthous Ulcer.

A Randomized, Double-Blind, Placebo-Controlled Trial on Clinical Efficacy of Topical Agents in Reducing Pain and Frequency of Recurrent Aphthous Ulcers.

Introduction:Recurrent Aphthous Ulcers (RAU) is one of the most common oral ulcerative Disease of the oral mucosa with high recurrence rate. Standard topical treatment options provide symptomatic relief with few have been found to be effective in treating or relieving the symptoms.Aim:The study aimed to evaluate the clinical efficacy of various topical agents in order to find the better treatment modality so as to decrease the number, size, exudate level and discomfort associated with pain with RAU.Materials and methods:The patients diagnosed with minor recurrent aphthous ulcers fulfilling the inclusion and exclusion criteria were enrolled. All the baseline parameters were measured by the principal investigator. The treatment modality was assigned by generating a randomization list by computer software, double-blinded in consecutively numbered sealed envelopes. The topical treatment modalities that were included: 5% Amlexanox, 0.1% Triamcinolone Acetonide, 20% Benzocaine gel, 100 mg Doxycycline hyclatemixed with denture adhesive and normal saline (20:2:1); The study was placebo controlled in which placebo gel 10 gm was used. The size, no of ulcers, pain, erythema and exudate level were measured by the principal investigator at days 1, 4, 8 and 10. All quantitative variables were estimated using measures of central tendency (mean, median) and measures of dispersion (standard deviation). Qualitative or categorical variables were described as frequencies or proportions. Proportions were compared using Post Hoc Test and N Par Tests. Effectiveness was checked using p-value (< 0.005).Results:It was observed that 0.1% Triamcinolone Acetonide and 5% Amlexanox proven to be more efficacious in the reduction of size, Number, Pain, Erythema and Exudate Levels at day 8, (p = .000*) and at day 10 (p =. 000*) as compared to single application of 100 mg Doxycycline Hyclate, 20% Benzocaine gel and the placebo, which was statistically significant. VAS scale was significant for 100 mg Doxycycline Hyclate and 20% Benzocaine gel.Conclusion:The selected topical treatment modality can deliver cheap, effective and safe drug therapy which benefits the patient in refining their regular activities and everyday events of life.

Effect of Herbal Echinacea on Recurrent Minor Oral Aphthous Ulcer.

Background:The oral aphthous is a common oral ulcer with intense pain and there is no treatment for it, yet. Echinacea is an herbal medicine that moderated the immune system.Objective:The aim of this study was to investigate the effects of Echinacea on the treatment of aphthous ulcer.Methods:50 patients with minor aphthous participated in our study. 25 patients take 3 tablets in a day for five weeks (case group) and 25 patients didn’t take any tablets (control group). The patients were monitored for one month before taking the tablets for six months. During this period, the number of lesions, complete improvement of ulcers, recurrence rate and intensity of pain were considered in each month. Finally, the Friedman and ANOVA tests used to analyze the obtained data.Result:Our study showed a significant difference between a number of lesions during six-month in case and control groups (p>0.001). In this way, we observed that the number of lesions was decreased significantly after six months in the case group. Hence, ANOVA analysis showed a significant decrease between each month for the intensity of pain (p=0.025), complete improvement (p<0.001) and recurrence rate (p=0.026).Conclusion:In conclusion, we showed that Echinacea tablets as an herbal medicine have positive effects on a number of lesions, intensity of pain, complete improvement and recurrence rate in patients with recurrent minor aphthous ulcers.

Short-Term Efficacy of Pudilan Keyanning Toothpaste in Treatment of Minor Recurrent Aphthous Ulcers.

Aim. To examine the potential of Pudilan Keyanning toothpaste (PKT) to treat minor aphthous ulcers (MiAU). Method. A double-blind clinical trial was conducted in which 80 volunteers were randomly assigned to the PKT group (N = 40) or the control group (N = 40). The control group used a placebo toothpaste containing no Pudilan extract. At baseline, after 3 days, and after 6 days the following parameters were recorded for the target ulcers: healing rate, healing period, pain (visual analogue scale, VAS), areas of the target ulcerated lesions, degree of exudation, and hyperemia. Results. At the end of the study, the healing rate in the PKT group was 80%, compared to 50% in the control group (p < 0.05). At day 6, the VAS scores, ulcer area, degree of exudation, and hyperemia were significantly different between the two groups, with better performance observed in the PKT group (p < 0.05). Conclusion. PKT toothpaste appears to promote effective healing of MiAU.

Efficacy of honey in comparison to topical corticosteroid for treatment of recurrent minor aphthous ulceration: a randomized, blind, controlled, parallel, double-center clinical trial.

Recurrent aphthous ulceration represents a very common mucosal disorder that general dentists may encounter on a daily basis, and for which there is no curative treatment. The best treatment that can be achieved is to avoid local traumatic precipitants, lessen the pain and duration of ulceration by suppressing the local immune response, and prevent secondary infection. The objective of this study was to clinically determine the efficacy of honey as a topical treatment of recurrent minor aphthous ulceration in a Saudi cohort. A randomized, blind, controlled, parallel, double-center clinical trial was carried out. Honey was applied by patients four times a day for 5 days. Clinical parameters (ulcer size, pain scale, and degree of erythema and healing) were recorded both at baseline and during the follow-up period. There were 94 subjects, with 180 minor recurrent aphthous ulcerations. The ulcers were distributed as 67, 57, and 56 ulcers for honey, topical corticosteroid, and Orabase treatment, respectively. There was a statistically significant difference between the honey group and the other two groups in terms of reduction of ulcer size, days of pain, and degree of erythema. No side effects were reported in any group. Honey was found to be effective and safe in reducing minor aphthous ulcer pain, size, and erythema in a Saudi cohort.

Assessment of immediate pain relief with laser treatment in recurrent aphthous stomatitis

To compare immediate pain relief, healing time between minor recurrent aphthous ulcers treated with a single session of carbon dioxide (CO2) laser and a placebo. A prospective clinical study was performed on 25 patients with minor recurrent aphthous stomatitis. Pretreatment pain levels were recorded using a numerical rating scale. Ulcers were randomized to either receive treatment or placebo. Pain levels were assessed immediately after treatment and after 24 h. Healing was assessed on days 3 and 4, and once every 2 days thereafter for 2 weeks. Mean pain scores in the laser group were significantly reduced immediately after treatment (0.68 ± 0.6) compared with pretreatment (8.48 ± 0.71; P < .001). In contrast, the placebo group showed little difference in pain scores between pretreatment (8.08 ± 0.70) and immediately after treatment (7.96 ± 0.84). In the laser group, significant improvements in healing times were observed (4.08 ± 0.81 vs. 7.84 ± 0.90 days; P < .001). CO2 laser therapy in recurrent aphthous stomatitis (RAS) provides immediate pain relief sustained over 24 h, along with accelerated healing time.

A clinical evaluation of 5% amlexanox oral paste in the treatment of minor recurrent aphthous ulcers and comparison with the placebo paste: A randomized, vehicle controlled, parallel, single center clinical trial

The primary objective of the following study is to determine and secondary objective is to compare the efficacy and safety of 5% amlexanox oral paste in the treatment of recurrent minor aphthous ulcers and also to evaluate the recurrence rate of aphthous ulcers over a period of 1 year. The present study was conducted on 100 patients diagnosed to have recurrent minor aphthous ulcers of which, 50 patients were advised to apply 5% amlexanox oral paste directly on the ulcer 4 times a day for 6 days and the other 50 patients were given placebo paste for the same duration. The baseline parameters were recorded on the first visit which includes ulcer size, pain, erythema and exudation. Efficacy and safety evaluations were made on the 4 th day and 6 th day. In total 30 patients with increased frequency of ulcers were advised to use 5% amlexanox paste for one whole year and the number of ulcers per month was recorded to evaluate any decrease in the recurrence rate. Male patients dominated the study with 73 males and 27 females. The mean age of the total sample was 26.6 years. The amlexanox group showed marked reduction in ulcer size (P < 0.001), significant reduction in the visual analog scale scores of pain (P < 0.001), significant lower scores of erythema and exudation (P < 0.001) when compared to the placebo group on the 6 th day of follow-up. The incidence of recurrence of ulcers was significantly reduced up to the 6 th month, but thereafter recurrence rate slowly increased. Almost 5% of Amlexanox oral paste is clinically beneficial in reducing the pain, erythema, exudation and size of the ulcer over a period of 6 days. There was no definite conclusion drawn with respect to its effect on the recurrence rate of aphthous ulcers over a period of 1 year.

Clinical evaluation of allicin oral adhesive tablets in the treatment of recurrent aphthous ulceration

We investigated the effectiveness and safety of topical application of 5 mg allicin adhesive tablets in the treatment of minor recurrent aphthous ulcerations (MiRAU). A randomized, double-blinded, placebo-controlled, clinical trial was performed. Tablets containing 5 mg allicin or vehicle only were consecutively applied 4 times per day for 5 days. The size and pain level of ulcers were measured and recorded on days 1, 2, 4, and 6. A total of 96 subjects with MiRAU fulfilled the study. Allicin adhesive tablets significantly reduced ulcer size (P < .005, P < .003, P < .001 for days 2, 4, and 6, respectively) and alleviated ulcer pain score (P < .03, P < .001, P < .05 for days 2, 4, and 6, respectively) compared with vehicle tablets. Minor and major adverse reactions were not observed. Allicin adhesive tablets were effective in reducing ulcer size and alleviating ulcer pain of the patients in the treatment of MiRAU without significant side effects.

Efficacy and Safety of Dexamethasone Ointment on Recurrent Aphthous Ulceration

ObjectiveRecurrent aphthous ulceration is the most common oral mucosal lesion and may be associated with many systemic diseases. Topical corticosteroids are used frequently for recurrent aphthous ulceration; however, the number of high-quality clinical experiments available is insufficient, and no reports exist on the blood level of corticosteroids after topical usage in the oral mucosa. The objective was to determine the efficacy and safety of dexamethasone ointment in the treatment of recurrent aphthous ulceration and detect serum dexamethasone concentrations in the patients. MethodsA randomized, double-blinded, placebo-controlled, parallel, multicenter clinical trial was conducted in 5 centers to compare the efficacy and safety of dexamethasone ointment with placebo. There were 810 patients with minor recurrent aphthous ulcerations screened for study eligibility, and 240 patients were enrolled at 5 centers from March 1, 2009 to April 30, 2010; 120 were assigned randomly to the treatment group and 120 to a control group. Patients were instructed to apply the given agent to the identified ulcer 3 times a day (after meals) for 5 days. The size, pain level, healing ratio, and average duration of ulcers and the safety of the agents were evaluated. The serum concentration of dexamethasone was detected using a high-performance liquid chromatography/mass spectrometry assay. ResultsThe results showed that baseline characteristics were similar (P>.5). At day 6±2 after treatment, there was significant difference in the variation of ulcer size between the treatment group (7.167±6.3415 mm2) and the control group (4.346±7.0666 mm2; P=.000); and in the variation of pain level between the treatment group (5.623±1.9570) and the control group (4.940±2.2449; P=.001). The healing ratio was 83.33% in the treatment group and 54.70% in the control group (P=.000). No severe adverse reactions were observed. No serum dexamethasone was detected before or after the use of the agents (<0.502 ng/mL). ConclusionDexamethasone ointment was efficient in the treatment of recurrent aphthous ulceration and was safe as evaluated using clinical assessment and serum level detection.

Estimation of Salivary Nitric Oxide in Recurrent Aphthous Ulcer and Oral Lichen Planus Patients with Its Clinical Significance

The present study was undertaken to study the role of nitric oxide in human saliva and its diagnostic/prognostic role in recurrent aphthous ulcers (RAU) and oral lichen planus (OLP). The study was carried out at outpatient department of Govt Dental College and Hospital, Aurangabad. Twenty cases with RAU, 15 with OLP and 30 healthy individuals were included in the study. The clinically diagnosed known cases of RAU and OLP were included after taking the detail case history and subjected to blood analysis for hemogram and biochemically salivary nitric oxide was estimated. The salivary nitric oxide levels were found to be increased significantly in RAU and OLP group, when compared with controls. Further, significantly increased levels have been observed in OLP group, when compared with RAU group (p < 0.001). The salivary nitric oxide levels were found to be increased significantly in minor RAU than major RAU and increased in erosive type of OLP than nonerosive type of OLP. Thus, salivary nitric oxide can be treated as a diagnostic tool for the differential diagnosis of RAU and OLP. Nitric oxide plays an important role in modifying physiopathological processes of oral mucosal membrane so has diagnostic as well as prognostic value.

Clinical evaluation of the topical use of propolis in recurrent minor aphthous ulceration

Our purpose was to evaluate the therapeutic effects of a natural product (propolis) on recurrent aphthous ulceration (RAU) of the minor type regarding the number of lesions, their duration and frequency of recurrence. Seventy patients with RAU composed the study group who were examined according to pre-established criteria. Forty patients presenting with RAU (mean age 38.5 years; 25 women and 15 men) were selected and medicated during the recurrence of their lesions using a purified propolis solution in a 5%propyleneglycol vehicle. Patients applied the topical solution three times a day from the first premonitory sign of RAU appearance and also during episodes of recurrence for a period of one year. A statistically significant reduction was observed in the number, frequency and duration of the lesions (p≤ 0.01). The natural propolis product utilized in this study for RAU therapy was without any adverse effects and proved beneficial.

Evaluation of penicillin G potassium troches in the treatment of minor recurrent aphthous ulceration in a Chinese cohort: a randomized, double-blinded, placebo and no-treatment–controlled, multicenter clinical trial

The aim of this study was to explore the effectiveness and safety of topical application of 50 mg penicillin G potassium troches in the treatment of minor recurrent aphthous ulcerations (MiRAU) in a Chinese cohort. A randomized, double-blinded, placebo and no-treatment-controlled, multicenter clinical trial was performed. Troches were consecutively applied 4 times per day for 4 days. The size and pain level of ulcers were measured and recorded on days 0, 3, 4, 5, and 6. A total of 258 subjects with minor recurrent aphthous ulcerations (86 subjects in penicillin G potassium group, 88 subjects in placebo control group, and 84 subjects in no-treatment control group) fulfilled the study. Penicillin G potassium significantly reduced ulcer size (P < .00001 for days 3, 4, 5, and 6) and alleviated ulcer pain (P < .00001 for days 3, 4, 5, and 6). No severe adverse reactions were observed. Only 4 subjects experienced mild adverse reaction. Penicillin G potassium troches are effective in reducing ulcer size and alleviating ulcer pain of the patients in the treatment of a single episode of MiRAU in this Chinese cohort. Few adverse effects were observed with this therapeutic approach.