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The Cochrane Database of Systematic... Sep 2014Behçet's disease is a chronic inflammatory vasculitis that can affect multiple systems. Mucocutaneous involvement is common, as is the involvement of many other systems... (Review)
Review
BACKGROUND
Behçet's disease is a chronic inflammatory vasculitis that can affect multiple systems. Mucocutaneous involvement is common, as is the involvement of many other systems such as the central nervous system and skin. Behç̧et's disease can cause significant morbidity, such as loss of sight, and can be life threatening. The frequency of oral ulceration in Behçet's disease is thought to be 97% to 100%. The presence of mouth ulcers can cause difficulties in eating, drinking, and speaking leading to a reduction in quality of life. There is no cure for Behçet's disease and therefore treatment of the oral ulcers that are associated with Behçet's disease is palliative.
OBJECTIVES
To determine the clinical effectiveness and safety of interventions on the pain, episode duration, and episode frequency of oral ulcers and on quality of life for patients with recurrent aphthous stomatitis (RAS)-type ulceration associated with Behçet's disease.
SEARCH METHODS
We undertook electronic searches of the Cochrane Oral Health Group Trials Register (to 4 October 2013); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 9); MEDLINE via Ovid (1946 to 4 October 2013); EMBASE via Ovid (1980 to 4 October 2013); CINAHL via EBSCO (1980 to 4 October 2013); and AMED via Ovid (1985 to 4 October 2013). We searched the US National Institutes of Health trials register (http://clinicaltrials.gov) and the World Health Organization (WHO) Clinical Trials Registry Platform for ongoing trials. There were no restrictions on language or date of publication in the searches of the electronic databases. We contacted authors when necessary to obtain additional information.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) that looked at pre-specified oral outcome measures to assess the efficacy of interventions for mouth ulcers in Behçet's disease. The oral outcome measures included pain, episode duration, episode frequency, safety, and quality of life. Trials were not restricted by outcomes alone.
DATA COLLECTION AND ANALYSIS
All studies meeting the inclusion criteria underwent data extraction and an assessment of risk of bias, independently by two review authors and using a pre-standardised data extraction form. We used standard methodological procedures expected by The Cochrane Collaboration.
MAIN RESULTS
A total of 15 trials (n = 888 randomised participants) were included, 13 were placebo controlled and three were head to head (two trials had more than two treatment arms). Eleven of the trials were conducted in Turkey, two in Japan, one in Iran and one in the UK. Most trials used the International Study Group criteria for Behçet's disease. Eleven different interventions were assessed. The interventions were grouped into two categories, topical and systemic. Only one study was assessed as being at low risk of bias. It was not possible to carry out a meta-analysis. The quality of the evidence ranged from moderate to very low and there was insufficient evidence to support or refute the use of any included intervention with regard to pain, episode duration, or episode frequency associated with oral ulcers, or safety of the interventions.
AUTHORS' CONCLUSIONS
Due to the heterogeneity of trials including trial design, choice of intervention, choice and timing of outcome measures, it was not possible to carry out a meta-analysis. Several interventions show promise and future trials should be planned and reported according to the CONSORT guidelines. Whilst the primary aim of many trials for Behç̧et's disease is not necessarily reduction of oral ulceration, reporting of oral ulcers in these studies should be standardised and pre-specified in the methodology. The use of a core outcome set for oral ulcer trials would be beneficial.
Topics: Acyclovir; Adrenal Cortex Hormones; Alanine; Behcet Syndrome; Colchicine; Cyclosporine; Etanercept; Humans; Immunoglobulin G; Interferon-alpha; Oral Ulcer; Quinolones; Randomized Controlled Trials as Topic; Receptors, Tumor Necrosis Factor; Stomatitis, Aphthous; Sucralfate; Thalidomide
PubMed: 25254615
DOI: 10.1002/14651858.CD011018.pub2 -
American Journal of Dentistry Apr 2022To perform a scoping review on the available literature regarding the side effects of sodium lauryl sulfate (SLS) used in toothpastes. (Review)
Review
PURPOSE
To perform a scoping review on the available literature regarding the side effects of sodium lauryl sulfate (SLS) used in toothpastes.
METHODS
A scoping review was performed according to the PRISMA extension using PubMed. The electronic search was supplemented with a manual search for a complete overview. A customized data collection form was used to map data which was developed to register the extracted relevant data. The results of the selected articles were classified according to effects in the mouth, on the mucous membrane or elsewhere in the body and the healing effects of SLS-free toothpaste on aphthous ulcers. The outcomes from each category were reported in separate data forms and the studies with incomplete information were excluded from the assessment.
RESULTS
Possible harmful effects of SLS were reported as mucosal desquamation, irritation or inflammation of oral mucosa or the dorsal part of the tongue, ulcerations, and toxic reactions in the oral cavity.
CLINICAL SIGNIFICANCE
There is limited evidence that patients with recurrent aphthous ulcers can benefit from the use of SLS-free toothpastes in terms of decrease in the number of ulcerations, duration of the ulcerations and the intensity of the pain caused by the ulcerations. It is essential to create awareness for the side effects of SLS in toothpastes but further research is needed on its effect on oral and gastrointestinal systems when used in toothpastes.
Topics: Humans; Inflammation; Mouth Mucosa; Sodium Dodecyl Sulfate; Stomatitis, Aphthous; Toothpastes
PubMed: 35506963
DOI: No ID Found -
TheScientificWorldJournal 2015Recurrent aphthous ulcers (RAUs) are the most common lesion found in the oral cavity. There is no definitive cure for RAUs and current treatments are aimed at minimizing... (Review)
Review
Recurrent aphthous ulcers (RAUs) are the most common lesion found in the oral cavity. There is no definitive cure for RAUs and current treatments are aimed at minimizing symptoms. Since low-level laser therapy (LLLT) modulates inflammatory responses, and promotes pain reduction and cellular biostimulation, LLLT can be suggested as an alternative treatment for RAUs. The literature concerning the potential of LLLT in the treatment of RAUs was evaluated. A systematic literature review identified 22 publications, of which only 2 studies were adopted. The eligibility criteria consisted of randomized controlled trials (RCTs). Both RCTs achieved significant results concerning LLLT and pain-level reductions and reduced healing times. Despite the variance in irradiation conditions applied in both studies, very similar wavelengths were adopted. There is accordingly strong evidence that wavelength plays an important role in RAU treatment. Taking into account the different parameters applied by selected RCTs, it is not possible to suggest that a specific protocol should be used. However, in light of the significant results found in both studies, LLLT can be suggested as an alternative for RAU treatment. Additional RCTs should be performed in order to reach a clinical protocol and better understand the application of LLLT in RAU treatment.
Topics: Animals; Humans; Laser Therapy; Low-Level Light Therapy; Mouth; Randomized Controlled Trials as Topic; Recurrence; Stomatitis, Aphthous
PubMed: 25879049
DOI: 10.1155/2015/150412 -
Journal of Clinical and Experimental... Oct 2021To evaluate the clinical and histopathological effects of natural extracts in the treatment of oral ulcers induced in animal experimental models. (Review)
Review
BACKGROUND
To evaluate the clinical and histopathological effects of natural extracts in the treatment of oral ulcers induced in animal experimental models.
MATERIAL AND METHODS
We carried out a search in the Medline, Scopus, WoS and Embase databases from the start of the databases to December 2020, and also made a manual search of the references. The search and selection were carried out by two researchers independently. The inclusion criteria were: experimental studies in animal models, in english, which complied with the study object.
RESULTS
A total of 705 articles were identified. After selection by title, abstract and full text, 19 articles were finally included. Natural extracts of , , curcumin and provoked a significantly greater reduction in the size of the ulcer. Extracts of , , mycelia and , as well as preparations of Kouyanqing Granule and curcumin, were able to reduce levels of pro-inflammatory cytokines and increase the expression and serum levels of growth factors and anti-inflammatory cytokines. Extracts of , and provoked a reduction in the severity of the histological inflammation. No significant differences were observed compared to controls in the treatments with extracts of , Miller and in reducing the area of the oral ulcers.
CONCLUSIONS
Most of the natural extracts described in this review presented a positive clinical and histological effect on the cicatrisation of oral ulcers induced in animal models. Recurrent aphthous stomatitis, oral ulcer, plants, herbs, extracts, medicine, treatment.
PubMed: 34667500
DOI: 10.4317/jced.58567 -
JBI Library of Systematic Reviews 2010
PubMed: 27820363
DOI: 10.11124/01938924-201008341-00015 -
Oral Surgery, Oral Medicine, Oral... Aug 2015This systematic review aimed to (1) explore the patient-reported outcome measures (PROMs) currently used in the oral mucosal disease literature and report on the type... (Review)
Review
OBJECTIVE
This systematic review aimed to (1) explore the patient-reported outcome measures (PROMs) currently used in the oral mucosal disease literature and report on the type and context of the use of these instruments and (2) provide a future direction for PROMs in Oral Medicine practice and research.
STUDY DESIGN
A systematic review of published English-language articles relating to the use of PROMs in the oral mucosal diseases literature was performed in November 2013.
RESULTS
In total, 131 articles met the inclusion criteria; these articles addressed the following oral mucosal conditions: lichen planus (75); recurrent aphthous stomatitis (30); mucous membrane pemphigoid/pemphigus vulgaris (14); orofacial granulomatosis (1); and multiple oral mucosal diseases (11). The most commonly used instruments were visual analog scales (VAS) and the oral health impact profile (OHIP).
CONCLUSIONS
Limited progress has been achieved with use of PROMs in Oral Medicine in the last few decades in both clinical practice and a research setting. With the engagement of allied medical disciplines in PROM usage and the promotion of PROMs by national health care bodies globally, advancement of PROMs is imperative for Oral Medicine. Exposure through the World Workshop on Oral Medicine (WWOM), along with potential involvement in the Core Outcome Measures in Effectiveness Trials (COMET) or other such initiatives, will enable worldwide collaboration to promote the development and utilization of valid and reliable PROMs in oral medicine, and improve patient care.
Topics: Humans; Mouth Diseases; Outcome Assessment, Health Care; Self Report
PubMed: 25934415
DOI: 10.1016/j.oooo.2015.01.023 -
Expert Opinion on Emerging Drugs Mar 2011Topical immunomodulating preparations have utility in inflammatory/immune-mediated oral mucosal disease resistant to topical steroids, in immunologically mediated... (Review)
Review
INTRODUCTION
Topical immunomodulating preparations have utility in inflammatory/immune-mediated oral mucosal disease resistant to topical steroids, in immunologically mediated systemic disease with primary oral involvement or more severe lesions primarily involving the oral mucosa.
AREAS COVERED
This paper is the second part of a systematic review of a variety of topical immunomodulators for management of immune/inflammatory oral mucosal conditions. The literature search revealed studies of azathioprine, benzydamine, GM-CSF and G-CSF, tetracyclines, retinoids, imiquimod, amlexanox, sirolimus and bacillus Calmette-Guerin polysaccharide nucleic acid. Weighted conclusions are provided for the topical use of each of the immunomodulators reviewed in the management of these oral diseases.
EXPERT OPINION
Topical immunomodulators may be useful as second line treatment in several oral diseases, particularly oral lichen planus and recurrent aphthous stomatitis. Benzydamine was found to be preventive in radiotherapy-induced mucositis; however, it is unclear if this outcome is related to its immunomodulating effects or other mechanisms of action. Topical application of tetracyclines and retinoic acid also shows potential anti-inflammatory actions.
Topics: Administration, Topical; Clinical Trials as Topic; Drug Discovery; Humans; Immunologic Factors; Lichen Planus, Oral; Mouth Diseases; Mouth Mucosa; Retinoids; Stomatitis, Aphthous; Tetracyclines; Treatment Outcome
PubMed: 21244328
DOI: 10.1517/14728214.2011.528390 -
Journal of Oral Pathology & Medicine :... Sep 2020In oral medicine, colchicine is a therapeutic alternative for idiopathic recurrent aphthous stomatitis (RAS), Behçet disease (BD), periodic fever, aphthous stomatitis,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
In oral medicine, colchicine is a therapeutic alternative for idiopathic recurrent aphthous stomatitis (RAS), Behçet disease (BD), periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome, and mouth and genitals ulcers with inflamed cartilage (MAGIC) syndrome. The present review aims to evaluate reliability of colchicine against recurrent oral ulcers.
METHODS
A systematic review was conducted, with the following PICO (Patient, Intervention, Control, Outcome) question: "In populations with idiopathic or secondary recurrent oral ulcers, is colchicine more effective in improving pain and accelerating healing, compared to other intervention or placebo?"
RESULTS
Seven RCTs and 3 OCTs were considered eligible. Four RCTs focused on BD, two RCTs and three OCTs on RAS, and one RCT on PFAPA syndrome. Heterogeneity between RCTs prevented from meta-analysis. Regarding BD, no significant difference between colchicine and placebo was found in two of three placebo-controlled RCTs, whereas the third RCT showed benefit. A comparative RCT found ciclosporin more effective than colchicine for oral lesions of BD. One open-label RCT showed promising but partial results on colchicine in reducing PFAPA attacks, when compared to corticosteroids. Concerning RAS, colchicine appeared less effective than clofazimine, thalidomide and dapsone, and with outcomes similar to low-dosage corticosteroids but higher gastric discomfort than prednisolone. One OCT reported positive results compared with no treatment but a RCT found no difference with placebo.
CONCLUSION
Role of colchicine as treatment for idiopathic or secondary recurrent oral ulcers is still controversial. Further standardized RCTs and crossover trials are needed.
Topics: Colchicine; Humans; Lymphadenitis; Oral Ulcer; Reproducibility of Results; Stomatitis, Aphthous
PubMed: 32281694
DOI: 10.1111/jop.13020 -
Minerva Stomatologica 2010This study explores the possibility that the celiac disease (CD) may be correlated with the insurgence of some oral signs, as based on a systematic review of the... (Review)
Review
This study explores the possibility that the celiac disease (CD) may be correlated with the insurgence of some oral signs, as based on a systematic review of the literature. Should this correlation be proven, any dentistry's screening would then be important to diagnose early celiac sprue pathogenesis. A literature survey was accomplished by using the Medline database (Entrez PubMed). The survey, which covered the period from the year 1972 to 2009, provided 382 published articles. Of these, 29 articles were selected according to inclusionary/exclusionary criteria, and consequently qualified for the final review analysis. Manual searching through the reference lists of the selected articles allowed the obtainment of others 17 articles. Findings gathered through this literature's review corroborate the significance of a causal relationship between some oral signs and CD. There are enough evidence making the correlation between CD and oral defects scientifically sustainable. This recognition should lead dentists to play more significant roles in screening for CD, as otherwise, if not properly diagnosed and not treated with a gluten-free diet, may eventually cause some malignancies.
Topics: Adult; Atrophy; Avitaminosis; Bibliometrics; Celiac Disease; Child; Clinical Trials as Topic; Dental Enamel Hypoplasia; Glossitis; Humans; Malabsorption Syndromes; Recurrence; Stomatitis, Aphthous; Tongue; Tooth Eruption
PubMed: 20212408
DOI: No ID Found -
The British Journal of Dermatology Oct 2011Homoeopathic therapies are routinely used for the management of skin diseases. However, there is a lack of evidence-based data on their effectiveness. (Review)
Review
BACKGROUND
Homoeopathic therapies are routinely used for the management of skin diseases. However, there is a lack of evidence-based data on their effectiveness.
OBJECTIVES
To assess the evidence for the efficacy of homoeopathic treatments in dermatology.
METHODS
We designed a systematic review of the controlled clinical trials (January 1962-April 2011) investigating homoeopathic therapies for the treatment of cutaneous diseases. We collected data from MEDLINE, PubMed, Current Contents, HomInform (Glasgow), reference lists, specialist textbooks and contacts with homoeopathic manufacturers. There was no restriction on language. Subsets were defined according to treated skin disease/condition. For each subset, two reviewers extracted data for information on study quality, type of remedy, population and outcomes.
RESULTS
After an extensive search, we isolated a very limited number of trials investigating homoeopathic treatments for cutaneous diseases. Overall, of the 12 trials with interpretable results, nine trials indicated no positive effects of homoeopathy. The three trials showing a positive effect were of low methodological quality.
CONCLUSIONS
Reviewed trials of homoeopathic treatments for cutaneous diseases were highly variable in methods and quality. We did not find sufficient evidence from these studies that homoeopathy is clearly efficacious for any single dermatological condition.
Topics: Candidiasis, Vulvovaginal; Controlled Clinical Trials as Topic; Female; Humans; Materia Medica; Recurrence; Skin Diseases; Stomatitis, Aphthous
PubMed: 21668433
DOI: 10.1111/j.1365-2133.2011.10457.x