Topical medications for the treatment of recurrent aphthous stomatitis: A network meta-analysis

IF 2.7 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral Pathology & Medicine Pub Date : 2023-09-27 DOI:10.1111/jop.13480

Mubarak Ahmed Mashrah, Ying Fang, Wanxing Song, Sadeq Ali Al-Maweri, Yang Lan, Ge Linhu, Liping Wang

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引用次数: 0

Abstract

Background

The present network meta-analysis aims to answer the question “what is the best topical intervention for the treatment of recurrent aphthous stomatitis that can provide an acceptable pain relief and promote wound healing?”

Methods

From inception to October 2022, PubMed, Embase, Scopus, Cochrane Library, and China National Knowledge Infrastructure were searched to identify all potentially eligible randomized controlled trials. The primary outcomes were pain scores and/or healing time, while the secondary outcomes were the associated side effects. The Bayesian network meta-analysis accompanied by a random effect model and 95% credible intervals were calculated.

Results

Forty-three randomized controlled trials with a total of 3067 participants, comparing 20 different topical medications, were included. Concerning pain reduction, the network meta-analysis failed to show any statistically significant differences when different topical treatments were compared together or even with a placebo at different time intervals. Except for doxycycline, which showed a statistically significant difference in terms of accelerating healing time, other topical interventions showed no statistically significant differences when compared with placebo or with each other.

Conclusion

Within the limitations of the current network meta-analysis, it seems that:

A low to moderate quality of evidence showed no superiority of any topical treatment over others concerning pain reduction, although rank probability tests revealed sucralfate, doxycycline, hyaluronic acid, and chamomile as the most efficacious treatment options at different evaluation times. Hence, further well-designed clinical trials with larger sample sizes are warranted.
Topical doxycycline was shown to be the most efficacious intervention in promoting healing of recurrent aphthous stomatitis.

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局部药物治疗复发性口口炎：一项网络荟萃分析。

背景：目前的网络荟萃分析旨在回答“治疗复发性口口炎的最佳局部干预措施是什么，可以提供可接受的疼痛缓解和促进伤口愈合？”方法：从开始到2022年10月，PubMed，Embase，Scopus，Cochrane Library，和中国国家知识基础设施检索，以确定所有可能符合条件的随机对照试验。主要结果是疼痛评分和/或愈合时间，而次要结果是相关的副作用。贝叶斯网络荟萃分析结合随机效应模型和95%可信区间进行计算。结果：纳入了43项随机对照试验，共有3067名参与者，比较了20种不同的外用药物。关于疼痛减轻，当不同的局部治疗在不同的时间间隔进行比较，甚至与安慰剂进行比较时，网络荟萃分析未能显示出任何统计学上的显著差异。除了多西环素在加速愈合时间方面显示出统计学上的显著差异外，其他局部干预措施与安慰剂或彼此相比没有显示出统计学显著差异。结论：在当前网络荟萃分析的局限性范围内，似乎：低至中等质量的证据表明，在减轻疼痛方面，任何局部治疗都没有优于其他治疗，尽管秩概率测试显示，在不同的评估时间，硫糖铝、多西环素、透明质酸和洋甘菊是最有效的治疗选择。因此，需要进一步设计良好、样本量更大的临床试验。局部多西环素被证明是促进复发性口腔炎愈合的最有效干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Oral Pathology & Medicine 医学-病理学

CiteScore

5.90

自引率

6.10%

发文量

121

审稿时长

4-8 weeks

期刊介绍： The aim of the Journal of Oral Pathology & Medicine is to publish manuscripts of high scientific quality representing original clinical, diagnostic or experimental work in oral pathology and oral medicine. Papers advancing the science or practice of these disciplines will be welcomed, especially those which bring new knowledge and observations from the application of techniques within the spheres of light and electron microscopy, tissue and organ culture, immunology, histochemistry and immunocytochemistry, microbiology, genetics and biochemistry.