Treatment Of Recurrent Aphthous Stomatitis Research Articles

Treatment of recurrent aphthous stomatitis with clofazimine

The aim was to investigate the safety and efficacy of clofazimine for the treatment of recurrent aphthous stomatitis. In this randomized controlled partially blind study, 23 patients received clofazimine 100 mg daily for 30 days and then 100 mg every other day. Twenty-three patients received colchicine 0.5 mg 3 times daily. Twenty patients received 1 placebo pill 2 times daily. All subjects received medications for 6 months. The chi-squared or Fisher exact tests were used to assess drug efficacy with respect to objective findings and symptoms. A greater percentage of individuals in the clofazimine group had no further aphthous episodes (17%-44% compared with <or=6% in the other groups). A significantly greater percentage of treatment interruption occurred in the colchicine group because of gastrointestinal effects (23%-45%). Individuals in the clofazimine group who continued to suffer from aphthous stomatitis presented with better results for the evaluated variables. Clofazimine should be considered for the treatment of recurrent aphthous stomatitis.

A clinical evaluation of amlexanox oral adhesive pellicles in the treatment of recurrent aphthous stomatitis and comparison with amlexanox oral tablets: a randomized, placebo controlled, blinded, multicenter clinical trial

BackgroundAmlexanox has been developed as a 5 percent topical oral paste for the treatment of patients with recurrent aphthous stomatitis (RAS) in most European countries. However, it is not yet available in China and has not been generally accepted in clinical treatment. The aim of this study was to explore the effectiveness of amlexanox oral adhesive pellicles in the treatment of minor recurrent aphthous ulcers, and compare the results with those of amlexanox oral adhesive tablets in order to analyse the difference between the two dosage forms of amlexanox.MethodsWe performed a randomized, blinded, placebo-controlled, parallel, multicenter clinical study. A total of 216 patients with minor recurrent aphthous ulcers (MiRAU) were recruited and randomized to amlexanox pellicles or placebo pellicles. Pellicles were consecutively applied four times per day, for five days. The size and pain level of ulcers were measured and recorded on treatment days 0, 4 and 6. Finally, the results were compared with those of our previous 104 cases treated with amlexanox tablets.ResultsAmlexanox oral adhesive pellicles significantly reduced ulcer size (P= 0.017 for day 4, P=0.038 for day 6) and alleviated ulcer pain (P=0.021 for day 4, P=0.036 for day 6). No significant difference was observed in the treatment effectiveness between the pellicle and tablet form of amlexanox.ConclusionsAmlexanox oral adhesive pellicles are as effective and safe as amlexanox oral adhesive tablets in the treatment of MiRAU for this Chinese cohort. However, pellicles seem to be more comfortable to use when compared with the dosage form of tablets. Therefore, in clinical practice, amlexanox oral adhesive pellicles may be a better choice for RAS patients.Trials registrationNederlands Trial Register NTR1727.

The efficacy of a paste containing Myrtus communis (Myrtle) in the management of recurrent aphthous stomatitis: a randomized controlled trial

Recurrent aphthous stomatitis (RAS) is a common, painful, and ulcerative disorder of the oral cavity with unknown etiology. Treatment is a highly controversial topic. The aim of this study was to evaluate the clinical efficacy of a novel paste containing Myrtus communis (Myrtle) in the treatment of recurrent aphthous stomatitis. Myrtle is a particular herb used in some cultures as treatment for mouth ulcers. The study was a randomized, double-blind, controlled before-after clinical trial. Forty-five patients with RAS randomly participated in this study. The subjects were treated with placebo paste and myrtle oral paste in two consecutive episodes. The paste was applied by subjects themselves four times a day for 6 days. Five parameters (size change, pain scale, erythema and exudation level, oral health impact profile, and patient overall assessment of their treatment) were recorded both before (baseline) and during each episodes of treatment (on the morning of days 2, 4, and 6). There were no statistically significant differences between baseline parameters (p > 0.05). The data indicated a statistically significant reduction of ulcer size (p < 0.001), pain severity (p < 0.05), and erythema and exudation level (p < 0.001). Oral Health Impact Profile improved significantly in the treatment group (p < 0.001). Patient overall assessment of their treatment improved after applying paste containing myrtle (p < 0.05). No side effects were reported. This study has shown myrtle to be effective in decreasing the size of ulcers, pain severity and the level of erythema and exudation, and improving the quality of life in patients who suffer from RAS.

Randomised controlled trial of the efficacy of HybenX in the symptomatic treatment of recurrent aphthous stomatitis

The treatment of recurrent aphthous stomatitis (RAS) is principally directed towards reducing the pain and duration of each episode of ulceration; however, there remain few agents for which there is definitive evidence of benefit. The aims of the present study were to determine the efficacy of HybenX (Epien Medical Inc., Minneapolis, MN, USA), vs another device used for the treatment of RAS (Salicept; Carrington Laboratories Inc., lrving, TX, USA) to reduce the symptoms and duration of RAS and determine the safety of HybenX for this clinical application. Sixty-three individuals (36 male, 27 female, group median age 25 years, range 17.8-57.9 years) were entered into a prospective randomised controlled trial of HybenX vs an occlusive covering device (Salicept oral patches; Carrington Laboratories). Painful symptoms over a 5-day posttreatment period were reduced by both agents although HybenX was statistically more effective at day 2 than Salicept, and there was a trend for HybenX to cause greater pain reduction than Salicept over this 5-day period. Both agents gave rise to few adverse side effects--a total of nine adverse events in eight patients were recorded. All were unlikely to be related to the treatment devices. HybenX was only applied on one occasion to the HybenX group, while individuals in the Salicept group were able to self medicate as required. The mean number of Salicept patches used per day per subject was three (s.d. 3.3) on day 1 posttreatment, 3.4 (s.d. 3.1) on day 2 and 2.7 (s.d. 1.9) on day 3. Thereafter, the number of applications fell to a mean of 0.8 on day 7. It is concluded that HybenX safely and effectively reduces the painful symptoms of RAS.

An Evaluation of Different Treatments for Recurrent Aphthous Stomatitis and Patient Perceptions: Nd:YAG Laser versus Medication

The aim of this randomized controlled clinical trial was to determine the anxiety levels of patients with recurrent aphthous stomatitis (RAS) prior to therapy with the Nd:YAG laser or medication, and to compare the effects of these different treatment methods on the degree of post-treatment pain, discomfort, and functional complications (eating and speech) experienced. Twenty patients with RAS-related oral problems were included in the study. Levels of pre- and post-treatment pain and functional complications were assessed at patient visits on days 1, 4, and 7. The results indicated that patients treated with the Nd:YAG laser had less post-treatment pain and fewer functional complications, and reported immediate relief of pain and faster healing (p +/- 0.05). However, only after 5 d was there a significant reduction in the pain levels of the patients treated with medication. Our results suggest that the Nd:YAG laser has better patient acceptance, shorter treatment time, and lower rates of pain and post-treatment adverse events among patients with RAS.

Levamisol não previne lesões de estomatite aftosa recorrente: um ensaio clínico randomizado, duplo-cego e controlado por placebo

to utilize a double-blind protocol to provide clarification about the safety and effectiveness of levamisole in the treatment of recurrent aphthous stomatitis. Fourteen patients took a decreasing dose of oral levamisole for six months (initial dose 150mg three times a week) and ten others were placebo control patients. All were evaluated monthly. The number of crises had a tendency to decrease in both groups, but without a difference between groups. The number of lesions diminished significantly in the two groups, but upon comparison the difference was not significant. Duration of the lesions diminished significantly in the placebo, however when compared to the levamisole group, difference was not significant during treatment. The intensity of pain was significantly lower in the two groups, but upon comparison, pain was significantly lower in the placebo group. The final global evaluation showed improvement in 50% of patients of the levamisole group and in 70% of the placebo, without a significant difference between treatments. No difference in the frequency of collateral effects was observed between groups. Levamisole, as used in this protocol, is a safe drug. When compared with the placebo, levamisole is not effective in the prophylactic treatment of recurrent aphthous stomatitis. The placebo effect is important in diseases where emotional factors affect recurrence or expression of symptoms.

A Randomized, Double-blind, Placebo-Controlled Trial of Pentoxifylline for the Treatment of Recurrent Aphthous Stomatitis

A Randomized, Double-blind, Placebo-Controlled Trial of Pentoxifylline for the Treatment of Recurrent Aphthous Stomatitis

Plasma rich in growth factors as a potential therapeutic candidate for treatment of recurrent aphthous stomatitis

Despite high prevalence of recurrent aphthous stomatitis (RAS), the treatment is mainly symptomatic. Considering epithelial implantation etiology of RAS, a novel therapeutic approach was presented. Plasma rich in growth factors (PRGF) contains various active ingredients including but not limited to transforming growth factor-beta (TGF-beta), platelet-derived growth factor (PDGF), and fibrin products. PDGF accelerated the healing of ulcers. Moreover, it enhances epithelial-mesenchymal transition and hence aids in elimination of epithelial nests within underlying connective tissue. In addition, it modulated extracellular matrix and contributes to restoration of original tissue structure and function. Anti-inflammatory properties of PRGF in combination with the aforementioned scenario may prove useful both for resolution of acute periods of RAS as well as prevention of recurrent periods of the disease.

Practical aspects of management of recurrent aphthous stomatitis

Treatment of recurrent aphthous stomatitis (RAS) remains, to date, empirical and non-specific. The main goals of therapy are to minimize pain and functional disabilities as well as decrease inflammatory reactions and frequency of recurrences. Locally, symptomatically acting modalities are the standard treatment in simple cases of RAS. Examples include topical anaesthetics and analgesics, antiseptic and anti-phlogistic preparations, topical steroids as cream, paste or lotions, antacids like sucralfate, chemically stable tetracycline suspension, medicated toothpaste containing the enzymes amyloglucosidase and glucoseoxidase in addition to the well-known silver nitrate application. Dietary management supports the treatment. In more severe cases, topical therapies are again very useful in decreasing the healing time but fail to decrease the interval between attacks. Systemic immunomodulatory agents, like colchicine, pentoxifylline, prednisolone, dapsone, levamisol, thalidomide, azathioprine, methotrexate, cyclosporin A, interferon alpha and tumour necrosis factor (TNF) antagonists, are helpful in resistant cases of major RAS or aphthosis with systemic involvement.

Effectiveness of two oral pastes for the treatment of recurrent aphthous stomatitis

To compare the effectiveness of two topical medications to reduce the pain and size of recurrent minor aphthous ulcers. Ten Colombian Dental Faculties' clinics. A double-blind randomized multi-centre clinical study. Ninety-six patients complaining of at least five acute aphthous ulcers were randomized to two intervention groups. Sample size was calculated using an alpha error of 0.05 and beta of 0.20. Participants were randomly assigned to receive 5% amlexanox or a 0.05% clobetasol propionate magistral preparation. Observers at the participating institutions were previously trained to standardize clinical diagnosis and data recollection. Ulcer size and pain were measured on treatment days 0, 2 and 5. No significant differences were found between the two groups studied in any of the studied variables at baseline. Both treatment medications significantly reduced pain magnitude and the index ulcer's size on days 2 and 5 compared with day 0 without adverse reactions (within groups differences). No statistical differences between groups of the study medications were found. The two treatments applied had similar effectiveness as they both relieved pain and reduced the size of recurrent aphthous ulcers.

A Randomized, Double-blind, Placebo-Controlled Trial of Pentoxifylline for the Treatment of Recurrent Aphthous Stomatitis

To evaluate pentoxifylline for the treatment of recurrent aphthous stomatitis. A 60-day, randomized, double-blind, placebo-controlled trial with a 60-day no treatment follow-up. An oral medicine specialist referral center in Manchester. Forty-nine volunteers who passed the initial assessment for recurrent aphthous stomatitis entered a pretrial phase in which their eligibility for the trial phase of the study was assessed. Sixteen subjects were deemed ineligible, and 7 failed to attend or withdrew. The remaining 26 subjects were randomized to placebo or treatment. Six subjects withdrew because of adverse effects, and 1 was unavailable for follow-up. Pentoxifylline (also called oxpentifylline), 400 mg 3 times daily, or matching placebo. A reduction in the median pain score, ulcer size, number of ulcers, or total number of ulcer episodes. Patients taking pentoxifylline had less pain and reported smaller and fewer ulcers compared with baseline. Patients taking placebo reported no improvement in these variables. Patients taking pentoxifylline also reported more ulcer-free days than those taking placebo. However, the differences were small and, with the exception of median ulcer size (P = .05), did not reach statistical significance. Adverse effects were common with pentoxifylline, but not significantly different from those experienced by patients taking placebo. Although pentoxifylline may have some benefit in the treatment of recurrent aphthous stomatitis, the benefit is limited. It may have a role in the treatment of patients unresponsive to other treatments, but cannot yet be recommended as a first-line treatment.

Topical minocycline and tetracycline rinses in treatment of recurrent aphthous stomatitis: a randomized cross-over study

Recurrent aphthous stomatitis (RAS) is a common ulcerative condition of the oral mucosa. We assessed minocycline and tetracycline oral rinses in patients with frequent episodes of RAS in a clinical randomized crossover trial. Seventeen patients with high frequency recurrent minor RAS were randomly allocated to a cross-over topical therapy with 0.2 percent minocycline or 0.25 percent tetracycline aqueous solution mouthwash. The minimum interval between the cross-over was 30 days. The intensity of pain was recorded daily using a visual analogue scale. Minocycline mouthwashes as compared to topical tetracycline rinses resulted in significantly improved pain control, by reducing the severity and duration of pain. Topical minocycline rinse may be a potential treatment for other mucosal diseases that result in mucosal ulceration and pain.

Successful treatment of recurrent aphthous stomatitis of any origin with vitamin B12 (irrespective of its blood level)

Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal lesions seen in primary care. Over the past four years we have treated 15 RAS patients with vitamin B12. Of these, 11 patients reported a rapid and complete recovery from RAS during treatment and the other four reported pronounced reduction in the frequency and severity of RAS episodes. We suppose that a treatment with vitamin B12 can be effective for patients suffering from RAS any origin, regardless of their serum vitamin B12 level. Now we are doing double-blind, placebo-controlled, randomized clinical trial addressing the issue. It's supposed to confirm the safety and effectiveness of vitamin B12 therapy for RAS.

Triester glycerol oxide in the treatment of recurrent aphthous stomatitis: A cytological investigation

Abstract Aim: The objective of the present study was to evaluate the clinical and cytological effects of a new topical gel, (Protefix) with triester glycerol oxide (TGO) on recurrent aphthous stomatitis (RAS). Method: In this study, 50 patients referred to the Department of Oral Diagnosis and Radiology, Marmara University, Faculty of Dentistry, were studied. A clinical examination, a complete review of past medical history, and a detailed history of RAS was performed in each patient. Clinical features of apthous ulcers and visual analogue scale values scraped (VAS) were recorded. Cytological examination was performed by collecting smear material scraped off the lesion surface. Triester glycerol oxide (TGO) gel (Protefix®, Queisser Pharma) was applied to lesions three times a day. Results: A significant reduction of the number of erythrocytes and inflammatory cells, and a significant increase of mature epithelial cells were observed. Conclusions: This treatment may be used as an initial strategy for reduct...

The therapeutic effect of viscous solution of curcumine in the treatment of recurrent aphthous stomatitis (RAS)

The therapeutic effect of viscous solution of curcumine in the treatment of recurrent aphthous stomatitis (RAS)

Uji Klinik Efektifitas Pasta Gigi Antiplaque™ terhadap Kesembuhan Lesi dan Rekurensi Sariawan (Stomatitis Aftosa Minor)

Treatment of Recurrent Aphthous Stomatitis (RAS) often becomes a problem until now. It is because of the RAS characteristic that has a high recurrence, unclear etiology and has a lot of predisposing factors. Antiplaque™ tooth paste with active ingredients of Sodium monophosphate, Arnica tincture, Cloxiphenol and Oleum cariofill, has been used in this study to accelerate healing and to reduce the recurrence of RAS. Ninety one students and employees of Faculty of Dentistry, University of Indonesia who have minor RAS as subjects were divided into study group and control group. Regarding of healing the results of 58.7% from study group compared to 35.9% from control group, implies that the lesions healed faster. RAS recurrence of 83.3% from study group compared to 42.9% from control group states that recurrence had decreased.

Clinical evaluation of the use of low-intensity ultrasound in the treatment of recurrent aphthous stomatitis

Objective. The purpose of this study was to assess the efficacy of low-intensity ultrasound in the treatment of recurrent aphthous stomatitis. Study design. Fifty patients with recurrent aphthous stomatitis were enrolled, and 35 patients completed this randomized crossover trial. The ultrasound was self-administered by twice daily use of an ultrasonic toothbrush. The level of aphthous ulcer activity was first observed for each patient with the use of either an ultrasonic or placebo toothbrush over a 6 month period. Patients were then observed for a 2 to 4 month period while using the alternate toothbrush. The level of ulcer activity was calculated as a numeric index: the total duration of sores divided by the period of observation. Statistical analysis was performed with the Student's t test. Results. During the initial study period, the level of aphthous ulcer activity was lower for patients in the ultrasonic toothbrush group than for those in the placebo group (0.58 versus 0.78). This difference was not statistically significant. However, when the patients who used the placebo switched to the ultrasonic toothbrush, the level of aphthous ulcer activity dropped by 46% (0.81 to 0.44; p < 0.05). Those patients who started with the ultrasonic toothbrush worsened slightly after switching to the placebo. Conclusion. Routine use of low intensity ultrasound appears to have a modest beneficial effect on recurrent aphthous stomatitis.

Efficacy of bioadhesive patches in the treatment of recurrent aphthous stomatitis.

This study evaluated the efficacy of bioadhesive hydrogel patches, made of a pharmaceutical grade cellulose derivative, in the control of pain and as an aid to healing of aphthous ulceration. Patients kept a twice daily ulcer diary to record their pain level on a visual analogue scale. The sensitivity of the test ulcer was assessed by a challenge with pure orange juice as a stimulant before and after application of the patch by the patient. A significant reduction in stimulated pain was recorded following application of the patches to the ulcers (P < 0.01). The patches were found to adhere longer to large ulcers in the early stages of ulceration, when they achieved their maximum protective and pain-attenuating effects. The ulcer size was recorded daily by the patient and patients claimed a reduction in healing time following patch therapy.

Thalidomide and recurrent aphthous stomatitis: a follow-up study.

Thalidomide is used for the symptomatic treatment of recurrent aphthous stomatitis (RAS). Some authors reported remissions, but this was not evaluated. To evaluate the number of patients who could stop or reduce thalidomide treatment. Twenty-five patients with RAS treated with thalidomide and followed during at least 1 year were retrospectively studied. Six patients could stop the treatment and further presented minor aphthae, 10 needed minimal daily doses of thalidomide and 7 did not respond to 100 mg daily. One patient was not evaluated because of an early side effect and one was lost to follow-up. This study showed that a minority of patients responded and could stop thalidomide therapy whereas another group of patients could be maintained in remission with low doses of thalidomide which may represent a means to reduce the potentially severe side effects.

Colchicine for Recurrent Aphthous Stomatitis

Treatment of recurrent aphthous stomatitis (RAS) can be extremely frustrating. On the basis of reports of several patients with RAS and at least some