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Title Topical Corticosteroids Improve Healing Time in Patients with Aphthous Ulcers
Clinical Question In patients with aphthous ulcers, does treatment with topical corticosteroids, as compared to a placebo, improve healing time of the ulcers?
Clinical Bottom Line Patients treated with topical corticosteroids show an improved ulcer healing time.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 25720501Staines/20158 studies/583 patients Systematic review of randomized trials
Key results5 of the 8 studies in which ulcer duration was evaluated found that application of topical corticosteroids decreased the time required for the ulcer to heal (P < 0.05-0.01).
Evidence Search “recurrent” AND “aphthous” AND “ulcers” AND “topical” AND “corticosteroids”
Comments on
The Evidence
The authors note that, due to the high degree of heterogeneity between the studies, that the current evidence available, while statistically significant, is still of a low quality. Further studies with more uniform designs need to be performed to acquire evidence of a higher quality. Studies would also need to be done to evaluate the various corticosteroids available to determine if there is any difference between them.
Applicability The evidence, while of low quality, still supports the application of topical corticosteroids to reduce the healing time of aphthous ulcers. The studies also report a reduction in the occurrence of new ulcers, the size of the ulcers, and the pain experienced by the patient due to the ulcers. A study evaluated in the systematic review shows that topical corticosteroids used intraorally do not cause adrenal suppression, if the patient uses them as instructed.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (General Dentistry) (Periodontics)
Keywords Aphthous ulcers, topical corticosteroids
ID# 3273
Date of submission: 10/16/2017spacer
E-mail mayberryd@livemail.uthscsa.edu
Author Derick Mayberry
Co-author(s) e-mail
Faculty mentor/Co-author
Faculty mentor/Co-author e-mail
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments and Evidence-Based Updates on the CAT
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by Jessica Koster (San Antonio, TX) on 09/30/2022
I completed a Pubmed search and found a more recent systematic review: Lau 2022, Pubmed:35395126. The review supported this CAT that topical steroids are effective in reducing pain of apthous ulcers, but with higher quality of evidence. The review included 4 RCTs regarding topical corticosteroids, with the strongest evidence supporting 0.1% triamcinolone acetonide being used to treat RAS. One of the 4 RCTs with a very strong study design supports the use of dexamethasone ointment in the treatment of RAS when applied to ulcers three times a day for 5 days.

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