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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) 25720501 | Staines/2015 | 8 studies/583 patients | Systematic review of randomized trials | | Key results | 5 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: |
10/16/2017 |
| E-mail |
mayberryd@livemail.uthscsa.edu |
| Author |
Derick Mayberry |
| Co-author(s) |
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| Co-author(s) e-mail |
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| Faculty mentor/Co-author |
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| Faculty mentor/Co-author e-mail |
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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?) |
post a rationale |
| None available | |
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
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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