Therapeutic Efficacy of Herbal formulations for Recurrent Aphthous Ulcer . Correlation with Salivary Epidermal Growth Factor (original) (raw)
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National Journal of Maxillofacial Surgery, 2021
Recurrent Apthous Ulcers (RAU) has affected mankind through time immemorial. It is the most commonly prevalent oral mucosal lesion manifesting as painful ulcers involving non – keratinised oral mucosa. This review was done to assess herbal intervention in RAU patients for outcomes of ulcer size and pain intensity. Literature search of published articles in Medline, Scopus, Ovid and Journal of Web upto August 2020 were reviewed for the pre-described outcomes. Revman 5.4 software was used for study analysis. Total 9 articles were finally chosen for qualitative analysis. Meta analytic comparison demonstrated the ulcer reduction (CI = -2.22 to – 0.09; p <0.001) and pain intensity (CI = -4.60 to – 0.08; p <0.001) was reduced in the herbal group as compared to the controls. A definite evidence of herbal intervention was noted in alleviating RAU signs and symptoms.
Effect of Herbal Echinacea on Recurrent Minor Oral Aphthous Ulcer
The Open Dentistry Journal, 2018
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 af...
Natural Treatment of Oral Aphthous Ulcers: A Systematic Review
Translational Biomedicine, 2017
Background and purpose: Due to the large number of studies on traditional and herbal treatments for oral aphthous and lack of comprehensive studies on these cases, the purpose of this research was to study and careful analysis of the effectiveness of herbal medicines used in the treatment of these lesions and reported the final outcome that one of the best study methods in these cases is a systematic review. Methods: Five electronic databases (PubMed, ISI web of science, Scopus, Cochrane and OVID) by keywords based on the PICO were searched to identify all the clinical trials with topical and systemic therapeutic interventions aimed at treating or preventing recurrence published in Persian or English that related to the effects of drugs of natural herbal origin for the treatment of recurrent aphthous stomatitis from 2010 to 2015. A structured and standardized form has been used to extract data. Title, journal, year of publication and the field of the first author and corresponding author were recorded. Standard tools of risk of bias used in the systematic review studies that has been developed by the Cochrane (Last update 2011) was applied to investigate bias in the studies. Results: In the current study a total of 33 trials were analyzed. These studies were assessed the effectiveness of 29 different herbal drugs for RAS treatment. Only five studies were assessed as being at medium risk of bias. No study had a low risk of bias. There were insufficient evidences to support or refute the use of these interventions. Conclusion: In summary, current data suggested that there was a beneficial effect in using topical treatments with plant origin for RAS and no study did not report any side effects. Though due to very weak report and disparate studies, acknowledging the fact that which herbal treatment was the best and most effective treatment was not possible.
The Journal of Contemporary Dental Practice, 2008
Aim The aim of this article is to present a review of over-the-counter (OTC) treatment strategies used for aphthous ulcerations and to provide results from the use of an herbal extract containing glycyrrhiza. Background Aphthous ulceration, a disease of the intra-oral mucosa, is a common condition of unknown etiology that is often self-managed by OTC (no prescription required) medication. Review Preparations currently on the market can be divided into several categories: local anesthetic agents, oxygenating agents, mouth rinses, and barriers - further subdivided into paste coverings such as gels or dissolvable or non-dissolvable adhesive patches containing plant extract or synthetic drugs. Other strategies include herbs, hematinic replacement, or off-label OTC drug applications. While many OTC treatments are available and accepted for use with aphthous ulceration, a review of the literature via a number of published research search engines suggests that to date there are no randomiz...
Cureus
Background Recurrent aphthous ulcers are one of the most common lesions of the oral mucosa. Most currently available treatment methods aim to relieve symptoms, speed up healing and prevent ulcer recurrence. The current study aimed to compare the effectiveness of Aloe vera gel with that of amlexanox 5% oral paste in the treatment of recurrent small-type aphthous ulcers. Materials and Methods The study was conducted on 60 patients (27 males and 33 females) attending the Department of Oral Medicine at the Faculty of Dentistry at Damascus University. The sample age ranged between 15 to 25 years, with an average age of 20.3 ± 2.4 years. Patients were diagnosed with recurrent aphthous ulcers of the small type. The sample was divided into three groups with equal numbers of patients (n=20 for each group) according to the provided drug: Aloe vera, amlexanox, and the placebo groups. Patients' ulcer size was measured on day 0 of treatment, and the ulcer size reduction was assessed on day 3 and day 5. The pain was also recorded at the first visit, and then pain reduction was assessed during follow-up visits. Results The mean ulcer size on the fifth day of treatment was 1.85 mm 2 , 4.05 mm 2 , and 6.20 mm 2 in the Aloe vera, the amlexanox, and the placebo groups, respectively. The differences between groups were significant (p=0.003). The mean pain on the fifth day was 0.80 cm, 1.60 cm, and 3.20 cm in the Aloe vera, the amlexanox, and the placebo groups, respectively. The differences between groups were significant (p=0.026). Conclusions Within the limits of the current trial, both treatment groups proved effective in accelerating ulcer healing with the superiority of Aloe vera compared to amlexanox, as it achieved a greater reduction in ulcer size and pain when assessed on the fifth day of treatment.
Oral Ulceration and Indian Herbs: A Scoping Review
2020
Oral ulcers are one of the most prevalent oral mucosal diseases. The etiology of oral mucosal ulcers still has to be discerned as a variety of precipitating factors and causes have been implicated. Unless associated with some underlying systemic component, the condition generally takes 10 to 14 days to resolve, sometimes to recur soon. During the active disease phase, it affects eating, drinking and swallowing, thus affecting the quality of life. The treatment is generally symptomatic and is limited to the use of analgesics, antibiotics and topical application of steroids. The use of these over-the-counter drugs can sometimes lead to severe adverse effects. Herbal medicaments provide a safer and efficacious alternative to synthetic drugs. This article aims to review the most commonly used herbal medicines and investigate their efficacy in treating oral ulcers.
International Journal of Pharmaceutical Investigation, 2021
Background: Aphthous stomatitis is a painful and often inflammatory condition. Objective of the study is to evaluate safety and efficacy of Arimu mouth ulcer gel (AHPL/ AYTOP/2014A) in subjects suffering from aphthous ulcers. Methods: This study compared effect of Arimu mouth ulcer gel (Group I), with sponsors other mouth ulcer gels (Group II, Group III), marketed Ayurvedic formulation (Group IV), and conventional preparation (Group V). Subjects were advised to apply given formulations twice daily for 14 days or till complete healing of ulcer whichever was earlier. Results: A total of 276 subjects completed the study. Statistically significant reduction in the mean pain score (VAS) was observed from first follow up visit and continued till the end of the study in all the groups. If compared, the reduction in the mean pain score was significantly more in Group I than Group II, Group III and Group IV and comparable to that of Group V on Day 3. On other follow up visits, change was comparable between the groups and the difference was not significant. The same trend had been observed for burning sensation. Onset of action was less and duration of action was longer in group I compared to other groups. The number of days required to heal ulcer was less in group I than other groups. Adverse events such as vomiting and fever occurred which were not related to study drugs and did not require discontinuation of the study treatment. Conclusion: Arimu mouth ulcer gel is safe and effective in treating aphthous ulcer.
Journal of Indian Academy of Oral Medicine and Radiology, 2021
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 randomized 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 < 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.
Epidermal growth factor (EGF) is used widely in management of diabetic foot wounds to augment wound healing and to promote epithelialization. There are reports of its use in management of oral mucositis in patients receiving head and neck radio therapy. However reports of its use in management of diabetic oral ulcers are rare. we present here a case of non healing diabetic oral ulcer which we managed using tropical EGF. A 45 year old patient who is suffering from diabetes presented with non healing ulcer of oral cavity. Based on reports of investigations the ulcer was diagnosed as non healing major aphthous ulcer. oral hypoglycemic and insulin therapy was started to manage hyperglycemia. Normal glycemic control was achieved in 5 days and tropical EGF and antiseptics were given to augment ulcer healing. Healing started on 8th day and progressed to complete healing by 21st day. Tropical epidermal growth factor can be used effectively in management of non healing diabetic ulcers of oral cavity. Keywords: Epidermal growth factor (EGF), diabetic foot, radio therapy
Management of 'Mukhapaka' by 'Haridradi Tail' w.s.r. to Recurrent Aphthous Ulcer
2013
Mukhpak' or 'Sarvasar Rog' is nothing but a recurrent mouth ulcer or Stomatitis and is also termed as Aphthous ulcer. Over consumption of extremely pungent and spicy food, consuming and chewing of chemical agents like Tobacco-Gutakha, Insomnia, Vitamin deficiency, many life threatening disease like Malignancy, Submucosal fibrosis, Skin disease and disturbances in G.I. tract like Constipation, Dysentery are the main causative factors responsible for this most common ENT ailment. In modern medicine, several mouth paints and mouth gargles are used for the treatment for Aphthous ulcer adjuvant to steroids, B'Complex group of drugs, injection placentrex (sub mucosal) which have their own limitations and there is no successful, satisfactory and cost effective treatment available. The trial preparation 'Haridradi Tail' i.e. medicated oil consisted of Haridra (Curcuma longa), Nimba patra (Azadirachta indica), Yastimadhu (Glycyrrhiza glabra), Neelkamal (Nelumbo nucifera) & Sesame oil (Sesamum indicum). This was clinically tried on 30 cases of mild to severe types of 'Mukhapaka' in the form of 'Gandoosh', after every 4 hourly and also for oral administration, 10ml twice a day, for 10 days. It was observed that the trial preparation produces highly significant (p<0.05) symptomatic relief and causes marked improvement ulceration, present in buccal mucosal layer, burning sensation of palate, redness and erosion of oral cavity, difficulty in swallowing & chewing pungent things, enlargement of lymph nodes etc.