Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,106 questions · 1,202 findings · 24 reviews · Oral medicine and oral cancer

No studies found 145 · 12.1%GRADE not reported 760 · 63.2%Very low 201 · 16.7%Low 66 · 5.5%Moderate 29 · 2.4%High 1 · 0.1%

Subantimicrobial dose doxycycline (20 mg twice daily for 90 days) vs placebo

Total number of new ulcers over 90 days · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…

Subantimicrobial dose doxycycline (20 mg twice daily for 90 days) led to lower total number of new ulcers over 90 days compared with placebo; GRADE not reported.

1 finding from 1 review

Vitamin B12 (sublingual, 1000 mcg daily for 6 months) vs placebo

Pain score · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…

Vitamin B12 (sublingual, 1000 mcg daily for 6 months) led to lower pain score compared with placebo; GRADE not reported.

1 finding from 1 review

Levamisole (150 mg per day) vs placebo

Decrease in duration of attacks · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…

Levamisole (150 mg per day) showed no clear difference in decrease in duration of attacks compared with placebo; GRADE not reported.

1 finding from 1 review

1% pimecrolimus cream vs Placebo (vehicle cream)

Participant global self-assessment · People with erosive oral lichen planus
1 finding from 1 review
  • One study (Passeron 2007) assessed participant global self-assessment on a 5-point scale: 5/6 participants in the 1% pimecrolimus group rated their improvement as moderate or important versus 1/6 in the placebo group…
    1 study · 12 participants
    GRADE not reported

Sulodexide (heparin plus dermatan sulphate chains) vs prednisone

Overall effectiveness (days to resolution; number of aphthae per month) · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…
1 finding from 1 review
  • A comparison between sulodexide (n=10) and prednisone (n=10) was made in a trial at high risk of bias (Femiano 2003). Data presented as ranges/totals only with no estimate of variability, precluding further analysis.…
    1 study · 20 participants
    GRADE not reported

Colchicine (0.5 mg three times per day) vs Clofazimine (100 mg daily for 30 days, then 100 mg every other day)

Complete remission, pain intensity, patient and physician evaluation · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…
1 finding from 1 review
  • One trial at high risk of bias (de Abreu 2009) compared clofazimine (n=23) with colchicine (n=23). The number with no further aphthous episodes at 6 months was significantly greater in the clofazimine group than the…
    1 study · 46 participants
    GRADE not reported

Bee propolis (one 500 mg capsule per day) vs placebo

Mean number of lesions over treatment period · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…

Bee propolis (one 500 mg capsule per day) showed no clear difference in mean number of lesions over treatment period compared with placebo; GRADE not reported.

1 finding from 1 review

Levamisole 50 mg three times per day for days 1 and 2 vs Levamisole 50 mg three times per day for day 1 and placebo for day 2 (lower dose)

Adverse effects · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…
1 finding from 1 review

LongoVital (herbal plus vitamin component) vs placebo

Number of ulcer-free days and number of new ulcers · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…
1 finding from 1 review
  • Forty patients were randomised to receive LongoVital (herbal plus vitamin) or placebo (Kolseth 2005). Data presented as medians with 95% confidence intervals, unsuitable for further analysis. The authors report no…
    1 study · 40 participants
    GRADE not reported

Bee propolis (one 500 mg capsule per day) vs placebo

Reduction of outbreaks (expected vs observed ulcers) · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…
1 finding from 1 review
  • Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes
    6 months (minimum)
    The authors report a statistically significant difference in the reduction of outbreaks based on the difference between expected and observed number of ulcers (Fisher's exact test, one sided, P=0.04).
    1 study · 19 participants
    GRADE not reported

Betamethasone (systemic corticosteroid) vs Placebo or no treatment

Outcome not reported · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…

The review found no eligible studies for this question.

1 finding from 1 review

Fluticasone propionate spray vs Betamethasone sodium phosphate mouthwash

Pain reduction (VAS 0-100) · People with erosive oral lichen planus
1 finding from 1 review
  • In the Hegarty 2002 cross-over trial (n=22), no statistical testing of the pain score (VAS 0 to 100) was reported; it is not clear whether the difference is statistically significant (fluticasone mean score 19.8 versus…
    1 study · 22 participants
    GRADE not reported

Individualised homeopathic medicine (two doses over 24 hours) vs placebo

Ulcer healing · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…

Individualised homeopathic medicine (two doses over 24 hours) led to higher complete ulcer healing by end of study (day 6) compared with placebo; GRADE not reported.

1 finding from 1 review

LongoVital (herbal plus vitamin component) vs LongoVital (herbal component alone)

Number of ulcer-free days and number of new ulcers · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…
1 finding from 1 review
  • A single trial at high risk of bias (Kolseth 2005) randomised participants to the herbal component of LongoVital alone or LongoVital with herbal plus vitamin component. Data presented as medians with 95% CIs,…
    1 study · 40 participants
    GRADE not reported

Multivitamin vs placebo

Average number of new lesions per week · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…

Daily multivitamin showed no clear difference in mean number of new lesions compared with placebo; GRADE not reported.

1 finding from 1 review

Colchicine (0.5 mg per day for 3 months) vs prednisolone

Pain at completion of treatment · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…

Colchicine (0.5 mg per day for 3 months) showed no clear difference in pain at completion of treatment compared with prednisolone (5 mg per day for 3 months); GRADE not reported.

1 finding from 1 review

Prednisone (oral, commencing 25 mg with phased dose reduction over 2 months) vs placebo

Total number of new lesions over 2-month treatment period · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…

Prednisone (oral, commencing 25 mg with phased dose reduction over 2… led to lower total number of new lesions over 2-month treatment period compared with placebo; GRADE not reported.

1 finding from 1 review