Elevated insulin resistance in patients with recurrent aphthous stomatitis

Topical insulin-liposomal formulation in management of recurrent aphthous ulcers: A randomized placebo-controlled trial

AIM

To evaluate the effectiveness of topical insulin-liposomal gel in aphthous ulcer treatment.

METHODS

80 participants with minor aphthous ulcers were randomly divided to receive either topical insulin-liposomal gel or placebo gel (once daily) for 6 days. Assessment of outcomes included visual analog scale (VAS) for pain (primary outcome), and secondary outcomes included ulcer duration and impact of treatment on quality of life using the Oral Health Impact Profile 14 (OHIP-14). Testing of the outcomes was carried out at 1, 2, 3, 4 and 6 days after treatment for VAS and at 6 days for OHIP-14.

RESULTS

For pain scores, the test group showed a significant decrease by time, this was evident from day 1 (P < .001); at day 3, median and interquartile range (IQR) values were 0 (0-1). For the placebo group, a non-significant change by time was reported between baseline and day 1; at day 3, the median value was 7 (IQR, 7-9). The test group showed significantly lower mean duration than the placebo group (P < .001). OHIP-14 scores after 6 days showed that the test group had a significantly lower score than placebo (P < .001).

CONCLUSIONS

Topical insulin-liposomal formulation showed marked effectiveness in management of aphthous ulcers.

Recurrent aphthous ulceration: a review of potential causes and novel treatments

Purpose of article: This review examines studies published between May 2012 and 2017 with a specific interest in potential recurrent aphthous ulceration (RAU) etiologies and treatment modalities/efficacy, including topical treatments, systemic regimens, vitamin repletion, and laser therapy, among others.

MATERIALS AND METHODS

PubMed MEDLINE and Cochrane Database of Systematic Reviews were searched using various combinations of: 'aphthous', 'ulcer', and 'treatment'. The titles and abstracts from the initial literature search were appraised to identify articles for full review and reference sections from each article were searched manually for relevant publications. Both randomized controlled trials and observational reports were included in this review, as some treatment types have not been formally examined in randomized trials. Relevant studies were reviewed, compared, and summarized.

RESULTS

RAU can result from systemic disease and trauma, but recent studies have shown a variety of potential etiologies, ranging from vitamin deficiencies, oral microbiota derangements, hematological considerations, stress, genetic polymorphisms to oxidant-antioxidant imbalances, among others. Many modalities of therapy are available and have proven efficacious.

CONCLUSIONS

As the exact etiology of RAU is still unknown, therapy is based on symptomatic relief.

Subclinical atherosclerosis in patients with recurrent aphthous stomatitis

OBJECTIVE

Recurrent aphtous stomatitis (RAS) is an inflammatory oral mucosal disease. It has been known that inflammatory cascade plays important role in the atherosclerotic process. The aim of the study was to investigate the relationship between subclinical atherosclerotic findings and a systemic inflammatory disease, RAS.

METHODS

In total, 32 patients with RAS were matched with 30 control subjects on the basis of age, sex, and major cardiovascular risk factors. Laboratory parameters including lipid profiles were determined for patients and controls. B-mode ultrasonography was used to assess carotid extra-medial thickness (cEMT) and carotid intima-media thickness (cIMT).

RESULTS

Both cEMT and cIMT in the RAS group were significantly higher than in the control group (P = 0.002 and 0.013, respectively). There was a significant positive correlation between cIMT and cEMT (r = 0.381, P = 0.034). cIMT was positively correlated with age, triglyceride levels, and systolic blood pressure, while cEMT was positively correlated with age in patients with RAS.

CONCLUSIONS

To our knowledge, this is the first reported study to evaluate cEMT and cIMT in patients with RAS. This study presents morphological evidence of subclinical atherosclerosis in patients with RAS. Further studies investigating the relationship between atherosclerosis and RAS are needed.