The efficacy of Punica granatum extract in the management of recurrent aphthous stomatitis

Abstract

Objective:Recurrent aphthous stomatitis (RAS) is a common, painful ulcerative disorder of the oral cavity with unknown etiology. No documented cure exists and topical application of medications aims to reduce pain associated with this condition. The aim of this study was to evaluate the efficacy of Punica granatum (PG) extract on the clinical management of RAS.Methods:A total of 40 patients with RAS participated in this randomized, double-blind, and placebo-controlled study. During three episodes of RAS, the efficacy of topical PG gel (10%) was evaluated. Patients were randomly assigned to use placebo gel or PG gel daily. The time of pain elimination and the time of complete healing were recorded and the pain degree was assessed and recorded by each patients in different time intervals including: Before using the oral gel (day 0), and on days 1, 3, 5, 7 after using the product. Data were analyzed using the repeated measures ANOVA, paired and independent t-test.Findings:Mean time of pain elimination showed a significant difference (P < 0.001) between PG group (3.4 ± 1.09) and placebo group (5.9 ± 0.6). The mean duration of complete healing also showed a significant difference (P < 0.001) between PG group (5.3 ± 0.81) and placebo group (8.6 ± 0.99). The visual analog scale score in PG group was significantly less than the placebo group in all time intervals (day 1 to day 7) (P < 0.001).Conclusion:The findings of this study revealed that PG extract in the form of oral gel (10%) may be beneficial in reducing RAS pain and has a positive effect in reducing the overall time period of complete healing. It was concluded that PG is an effective herbal medicine for the management of RAS.

The effect of extract of Punica granatum var. pleniflora for treatment of minor recurrent aphthous stomatitis

“…The results of the study suggest that PG with a mean healing time of 5.3 days can be a proper alternative for the clinical management of RAS. The results also showed that the mean time for pain elimination after therapy with Z. multiflora extract, A. nobelis extract, mixture of these two, and M. communis mouth rinse was 3 days, 5 days, 3.1 days, and 4 days, respectively 21 . PG with a mean pain elimination time of 3.4 days was shown to have a comparable effect with other herbal agents in the management of RAS symptoms.…”

Design, Formulation and Evaluation of an Oral Gel from Punica Granatum Flower Extract for the Treatment of Recurrent Aphthous Stomatitis

“…Considering these pharmacological effects of pomegranate flower extract and the preliminary studies indicating effectiveness of pomegranate flower extract on aphthous ulcers. 16 We decided to utilize these effects and design a suitable, stable and easily accessible formulation of this herb. The folin-ciocalteu , s method was used to indicate the amount of poly-phenols in dried extract.…”

“…15 Considering these side effects and based on preliminary studies on pomegranate flower effectiveness on aphthous ulcers. 16 We prepare a stable mucoadhesive formulation of pomegranate flower that can be used as an alternative treatment for aphthous stomatitis. ethanol, gallic acid, sodium carbonate were prepared from Merck Company (Germany) and Folin-ciocalteu's indicator was purchased from Sigma Aldrich Company (Germany).…”

Different modalities for treatment of recurrent aphthous stomatitis. A Randomized clinical trial

“…It is a multifactorial disease and several predisposing and risk factors have been implicated in its pathogenesis. Due to uncertain etiology and unpredictable course of the disease, there is no definitive treatment for RAS (2). Treatment strategies therefore aim at relieving pain, promoting healing and preventing secondary infection (3).…”

“…The use of natural products, including medicinal plant preparations for pain reduction and shortening of healing time of oral aphthous ulcers are gaining more attention due to their decreased side effects and drug resistance (2). …”