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Dorsareh F, Vahid-Dastjerdi G, Bouyahya A, Zarshenas MM, Rezaie M, Yang WM, Amiri-Ardekani E. Topical Licorice for Aphthous: A Systematic Review of Clinical Trials. IRANIAN JOURNAL OF MEDICAL SCIENCES 2023; 48:437-447. [PMID: 37786470 PMCID: PMC10541548 DOI: 10.30476/ijms.2022.94467.2576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 05/06/2022] [Accepted: 06/25/2022] [Indexed: 10/04/2023]
Abstract
Background Recurrent aphthous stomatitis (RAS) is the most common ulcerative disease that affects oral mucosa. The coating agents, topical analgesics, and topical steroids are usually used as treatment methods. Glycyrrhiza glabra has been used for RAS treatment based on its anti-inflammatory, antioxidant, and immunomodulatory properties. In this study, a systemic review on the therapeutic effect of topical licorice on RAS management was performed. Methods Science Direct, Scopus, Cochrane databases, PubMed Google Scholar, and ResearchGate were searched up to September 2021 to find all English randomized clinical trials studying the effect of G. glabra, or its compositions on RAS. Meta-analysis was not conducted because of data heterogeneity. Articles were reviewed qualitatively, and only those with a Jadad score ≥3 were included. Animal studies, in vitro, review papers, non-English papers, and case reports were excluded. Results Six studies with 314 subjects were included after screening. The result showed licorice has significant effects on RAS pain reduction, ulcer size, and healing time. Its effectiveness is related to its dose-dependent anti-inflammatory and antioxidant effects through several mechanisms. It also has antibacterial effects against Streptococci mutans and Porphyromonas gingivalis as another mechanism of action in RAS treatment. In addition, licorice can elevate the epidermal growth factor (EGF) level compared to the control group, which has an essential role in oral mucosal tissue integrity. Conclusion Licorice extract has been used in different dosage forms, including paste, patch, and mouthwash with concentrations of 1% or 5%. The healing time after licorice therapy is expected to be within 4-8 days. Licorice did not show any adverse effect in the intervention groups, indicating its effectiveness and safety in RAS treatment.
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Affiliation(s)
- Fereshteh Dorsareh
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Scientific Association of Indigenous Knowledge, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gita Vahid-Dastjerdi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Scientific Association of Indigenous Knowledge, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdelhakim Bouyahya
- Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences, and Genomic Center of Human Pathologies, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Mohammad Mehdi Zarshenas
- Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mostafa Rezaie
- Department of Oral and Maxillofacial Medicine, School Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Woong Mo Yang
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Ehsan Amiri-Ardekani
- Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Widhowaty Santoso A, Sufiawati I. Effectiveness of Photobiomodulation in Reducing Pain of Oral Mucosal Diseases: A Case Series. Int Med Case Rep J 2023; 16:407-417. [PMID: 37465549 PMCID: PMC10351595 DOI: 10.2147/imcrj.s414313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/27/2023] [Indexed: 07/20/2023] Open
Abstract
Introduction Pain management becomes important in the treatment of oral mucosal diseases since it can impair the quality of life. Photobiomodulation (PBM) as an alternative therapy, has potency in reducing pain through several mechanisms targeting peripheral nerves in the target tissue. Purpose To discuss the effectiveness of PBM in the management of four cases of oral mucosal diseases. Case Four patients, two females and two males, with an age ranging from 24 to 63 years came to the Oral Medicine Department complaining of painful lesions in their oral cavity. Three cases showed ulceration of the oral mucosa and had been diagnosed with recurrent aphthous stomatitis, recalcitrant chronic ulcer, and non-specific chronic sialadenitis. One patient who complained of intense pain and swelling on the right side of the face was diagnosed with post-herpetic neuralgia (PHN). Case Management PBM was administered in all four cases (976 nm diode laser, three cases with spot size 0.01 cm2, fluency 10 J/cm2, and one case with spot size 0.5 cm2; fluency 3 J/cm2). Visual analog scale (VAS) control was performed before and after the PBM at each visit. The recorded VAS results show a reduction in pain that started at the post-laser time, with VAS before PBM ranging from 5 to 7 and after PBM ranging from 0 to 4. Three patients were given triamcinolone acetonide 0.1%, chlorhexidine gluconate 0.2% mouthwash, petroleum jelly, and multivitamins. One patient was given mefenamic acid and multivitamins. Conclusion PBM can be a useful adjunctive treatment to relieve the pain of oral mucosal diseases due to its ability to reduce pain intensity.
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Affiliation(s)
- Astrid Widhowaty Santoso
- Oral Medicine Residency Program, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Irna Sufiawati
- Oral Medicine Department, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
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Efficacy of Topical Intervention for Recurrent Aphthous Stomatitis: A Network Meta-Analysis. Medicina (B Aires) 2022; 58:medicina58060771. [PMID: 35744034 PMCID: PMC9227309 DOI: 10.3390/medicina58060771] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 12/05/2022] Open
Abstract
Background and objectives: To compare the efficacy and safety of topical interventions used for recurrent aphthous stomatitis. Materials and Methods: This network meta-analysis was conducted in accordance with the PRISMA statement. We searched four electronic databases, PubMed, Web of Science (WOS), Cochrane Central Register of Controlled Trials and Embase, for randomized controlled trials reporting efficacy and safety data on topical interventions for recurrent aphthous stomatitis. We performed a quality evaluation using a methodology based on the Cochrane Handbook. Two authors independently extracted data on healing effect, size reduction effect, symptom reduction effect, recurrence and safety assessment. Network meta-analysis was then performed using ADDIS and RevMan. Results: A total of 72 trials (5272 subjects) involving 29 topical interventions were included. Honey, lnsulin liposome gel, laser, amlexanox, glycyrrhiza and triamcinolone had better efficacy performance. Probiotics and chlorhexidine helped to prolong ulcer intervals and reduce recurrence. Doxycycline and penicillin had a high risk of adverse events. Hematologic evaluation showed no preference. The rank possibility of size-reducing effect and symptom-reducing effect supported the short-term effect of laser and the long-term effect of probiotics. Conclusions: We recommend the use of laser as a short-term intervention during the exacerbation phase of RAS and probiotics as a long-term intervention during the exacerbation and remission phases of RAS.
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Shavakhi M, Sahebkar A, Shirban F, Bagherniya M. The efficacy of herbal medicine in the treatment of recurrent aphthous stomatitis: A systematic review of randomized clinical trials. Phytother Res 2021; 36:672-685. [PMID: 34816511 DOI: 10.1002/ptr.7332] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 09/09/2021] [Accepted: 10/23/2021] [Indexed: 01/08/2023]
Abstract
This systematic review was undertaken with the main aim of assessing the therapeutic effects of herbal medicines in recurrent aphthous stomatitis (RAS). A comprehensive search was performed in PubMed, Scopus, ISI Web of Science, and Google Scholar up to July 2021 to identify randomized clinical trials investigated the effects of herbal medicines on RAS. Thirty-three papers comprising 2,113 patients met the eligibility criteria, of which 30 studies had a high quality based on the Jadad scale. Totally, 22 out of 30 studies which assessed the pain showed that herbal agents significantly decreased the pain compared with the control group or placebo. In 17 out of 25 studies that evaluated ulcer size, herbal agents significantly reduced the size of ulcers compared with the control or placebo groups. In 15 out of 18 studies that assessed the healing time, herbal agents significantly reduced healing time in the intervention groups compared with the placebo or control groups. Few adverse events were reported only in four studies. Findings of the current review indicated medicinal plants and phytochemicals as effective and safe agents that for the treatment of RAS.
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Affiliation(s)
- Mojgan Shavakhi
- Department of Orthodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,School of Medicine, The University of Western Australia, Perth, Australia.,School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farinaz Shirban
- Department of Orthodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Bagherniya
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.,Anesthesia and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Khaleel Ahmed M, Jafer M, Nayeem M, Hussain Moafa I, Quadri MFA, Gopalaiah H, Ali Quadri MF. Low-Level Laser Therapy and Topical Medications for Treating Aphthous Ulcers: A Systematic Review. J Multidiscip Healthc 2020; 13:1595-1605. [PMID: 33239881 PMCID: PMC7680689 DOI: 10.2147/jmdh.s281495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 10/06/2020] [Indexed: 12/31/2022] Open
Abstract
Objective The study compares low-level laser therapy with topical medications for treating aphthous ulcers. Methods A search of articles in this systematic review was completed in six databases. Treatment and comparative groups comprised of patients subjected to laser therapy and topical medications, respectively. Two different treatment outcomes were considered; pain and size of the lesion. Risk of bias was assessed using the Revised Cochrane risk-of-bias tool for randomized trials. Results From 109 articles, five randomized control trials fulfilled the selection criteria. The overall sample comprised of 98 males and 232 females, with a mean age of 32.4 years. The laser therapies in each included study had different active media and varying wavelengths. Topical medication used in the comparative group were triamcinolone acetonide, amlexanox, granofurin, and solcoseryl. Findings showed that patients who reported lower pain and decreased aphthous ulcer lesions were more in the laser therapy group than in the topical medication group. Conclusion Low-level laser therapy was better in treating aphthous ulcer lesions in comparison to topical medications, and all laser wavelengths in the included reports were seen to be effective. However, the results should be interpreted with caution, because no study demonstrated low-risk of bias in all the assessed domains.
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Affiliation(s)
| | - Mohammed Jafer
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia
| | - Maryam Nayeem
- Department of Pharmacology, College of Pharmacy, Jazan University, Saudi Arabia
| | - Ibtisam Hussain Moafa
- Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
| | - Mir Furruq Ali Quadri
- Department of Internal Medicine, Lister Hospital, East and North Hertfordshire, NHS Trust, Stevenage, UK
| | - Hema Gopalaiah
- Department of Oral Medicine and Radiology, M.N.R Dental College, India
| | - Mir Faeq Ali Quadri
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia
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How to transfer traditional knowledge about medicinal herbs? or TCM plants: a black box for modern oncologists. J Cancer Res Clin Oncol 2020; 147:351-359. [PMID: 33037900 DOI: 10.1007/s00432-020-03415-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 09/28/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE How could we transfer knowledge about healing plants from other cultures? We analyzed the results of literature search in two exemplary fields-oral mucositis and polyneuropathy. MATERIALS AND METHODS In both systematic searches of existing literature, we found 57 studies investigating 68 plants from different traditional cultures (16 Western Medicine, 14 Persian Medicine, 9 Japanese, 10 Chinese, and 8 other sources). We analyzed studies regarding their ingredient plants and reproducibility in relation to the system of origin. RESULTS Western and Persian Medicine trials investigate single plants, whereas Japanese and Chinese trials focus on mixtures and decoctions. European folk medicine knows of only 50% of plants used in both Asian cultures. The used ingredients and dosages were reproducible in all analyzed trials except TCM studies. CONCLUSIONS Herbal knowledge has been transferred from all folk medicines worldwide. However, Western oncologists should be aware that Traditional Chinese Medicine herbs are still a black box of knowledge for us until today.
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Buentzel J, Bauer C, Buentzel J. How to bridge the gap? European medical plants used for treating oral mucositis: on the search for evidence. J Cancer Res Clin Oncol 2020; 146:985-1001. [PMID: 31955287 PMCID: PMC7085484 DOI: 10.1007/s00432-020-03124-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/02/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Oral mucositis is a common, painful side effect of cancer treatment-be it locoregional (e.g. irradiation) or systemic (e. g. chemotherapy). Phytotherapy is often used by patients to alleviate symptoms. However, knowledge on which medical plants are recommended by literature about Traditional European Medicine (TEM), their effect(s) on symptoms and their efficacy is severely lacking. Therefore, we developed a novel approach to assess traditional knowledge of herbals used in TEM and searched the online databases for studies reporting effects of these plants. METHODS At first, online research did not yield a satisfying number of studies (MESH terms: "mucositis" OR "stomatitis" AND "herbal" OR "herbal medicine"). Trials were labelled by the country conducting the study. In parallel, we compiled a list of 78 plants recommended for treating oral mucositis by screening 14 books on TEM. Then, a "hit list" of the plants most often mentioned was composed and used further for a second online investigation using the Latin plant designations as MESH term. Studies of both online searches were pooled for analysis. RESULTS There is a gap between traditional knowledge and trials investigating medical plants used by TEM. Overall, herbal remedies alleviate oral mucositis and especially, gingivitis well. There is good evidence for using Matricaria recutita L., Salvia officinalis L., Calendula officinalis L. and Thymus spp. L. for treating oral mucositis. CONCLUSION Clinical trials investigating medical plants known in TEM are rare. However, following our research strategy, we could extrapolate four plants with good evidence for alleviating symptoms of oral mucositis and gingivitis.
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Affiliation(s)
- Judith Buentzel
- Department of Haematology and Medical Oncology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany.
| | - Christoph Bauer
- Department of Nephrology and Hypertension, Center for Internal Medicine and Medical Clinic III, Klinikum Fulda, Fulda, Germany
| | - Jens Buentzel
- Department of Otolaryngology, Head Neck Surgery, Südharz Hospital, Nordhausen, Germany
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