Treatment of recurrent aphtous stomatitis: A systematic review

Abstract

Background: Recurrent Aphtous Stomatitis (RAS) is the most common process affecting the oral mucosa. It is painful, multifactorial and generally recurrent. The aim of this systematic review is to know the last treatment approaches and their effectivity. Material and Methods: we compared the outcome of different kind of treatments in terms of the improvement of the lesions, reduction of the size of those lesions and the time needed for their healing. Inclusion criteria were: clinical trials, articles written in English or Spanish and published less than 5 years ago. Results: we used the following keywords: "treatment", "aphtous stomatitis", "canker sores"; combined with Boolean operators AND y OR. We selected 28 articles for reading the whole text, and after applying the eligibility criteria, we selected 17 articles for our revision. Among all the treatments, we emphasize the barrier method based in compound of cellulose rubber and a calcium/sodium copolymer PVM/MA, with which the difference in the 3rd and 7 th day was of -6,29 ± 0,14 points in the pain score. The treatment with insulin and chitosan gel, brought a pain suppression on the third day, with no reactivation of the pain during the whole study. The application of a film composed of polyurethane and sesame oil with chitosan, brought a reduction in the size of the lesions of 4,54 ± 2,84mm on the 6th day compared with the situation before the beginning of the treatment. The different kinds of laser, which produced a reduction in the pain score just at the beginning of the treatment up to 8,1 ± 1,6 points, and a reduction of the size of the lesions of 4,42 ± 1,02mm on the 7 th day.

Common Oral Conditions

“…Recurrent aphthous stomatitis, also known as aphthous ulcers or canker sores, is characterized by recurring episodes of 1 or more round, shallow, and painful oral ulcers. [50][51][52] It is the most prevalent acute oral mucosal condition across all geographic areas, with an estimated lifetime prevalence of 39% to 50%. 50,53 Recurrent aphthous stomatitis affects females slightly more commonly than males and usually has its onset between the ages of 10 and 19 years, with the frequency decreasing with age.…”

“…[50][51][52] It is the most prevalent acute oral mucosal condition across all geographic areas, with an estimated lifetime prevalence of 39% to 50%. 50,53 Recurrent aphthous stomatitis affects females slightly more commonly than males and usually has its onset between the ages of 10 and 19 years, with the frequency decreasing with age. 54 The frequency of recurrent aphthous stomatitis episodes varies significantly between individuals, ranging from 1 to 2 episodes per year to more than 1 episode per month.…”

“…54 The frequency of recurrent aphthous stomatitis episodes varies significantly between individuals, ranging from 1 to 2 episodes per year to more than 1 episode per month. [50][51][52] Aphthous stomatitis can be categorized into 3 distinct forms based on the size and number of ulcers: minor, major, and herpetiform aphthous stomatitis. 55 Minor aphthous stomatitis, which constitutes approximately 80% of all recurrent aphthous stomatitis ulcers, is typically found on the nonkeratinized oral mucosa, such as the labial mucosa, buccal mucosa, ventral surface of the tongue, and the floor of the mouth.…”

“…54 Minor recurrent aphthous stomatitis typically heals without scarring within 7 to 10 days. 50,51 Major aphthous stomatitis represents the most severe variant, and it accounts for 10% to 15% of recurrent aphthous stomatitis cases. 56 This form is characterized by ulcers larger than 1 cm, which may persist for longer than 4 weeks and frequently result in scarring upon healing (Figure 4).…”

“…56 This form is characterized by ulcers larger than 1 cm, which may persist for longer than 4 weeks and frequently result in scarring upon healing (Figure 4). 50,51,56 Ulcers in major aphthous stomatitis typically emerge in clusters of 1 to 3 on the lips, oropharynx, and the soft palate. 56 Herpetiform aphthous stomatitis is the least-common form of recurrent aphthous stomatitis.…”