Non-Cochrane · intervention · PM41273742
Efficacy of topical application of zinc compounds for oral mucosal diseases: A systematic review and meta-analysis.
Kim M, Kho H · Medicina oral, patologia oral y cirugia bucal · 2026 · PubMed · doi:10.4317/medoral.27549
Findings
Population Patients with cancer therapy-induced (chemotherapy or radiotherapy) oral mucositis
3 findings
| Topical zinc therapy (zinc sulfate, zinc oxide or zinc chloride mouthwash, paste, spray or gel) | Control treatments (placebo, chlorhexidine, sodium bicarbonate, polyherbal, standard care) | Oral mucositis severity 2 weeks after treatment initiation | MD -0.46 [-0.63, -0.28] GRADE not reported 4 studies · 271 participants |
| Topical zinc therapy (zinc sulfate, zinc oxide or zinc chloride mouthwash, paste, spray or gel) | Control treatments (placebo, chlorhexidine, sodium bicarbonate, polyherbal, standard care) | Oral mucositis severity 3 weeks after treatment initiation | MD -0.41 [-0.79, -0.03] GRADE not reported 4 studies · 271 participants |
| Topical zinc therapy (zinc sulfate, zinc oxide or zinc chloride mouthwash, paste, spray or gel) | Control treatments (placebo, chlorhexidine, sodium bicarbonate, polyherbal, standard care) | Oral mucositis severity 4 weeks after treatment initiation | SMD -1.24 [-2.53, 0.04] GRADE not reported 3 studies · 111 participants |
Included primary studies 23
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Patil 2024 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Sahebnasagh 2023 Prevention of radiotherapy-related oral mucositis with zinc and polyherbal mouthwash: a double-blind, randomized clinical trial. PMID:36864527 | 2023 | 1 other review | not stated | not extracted yet |
| Alipour 2023 Evaluation of therapeutic effects of nanofibrous mat containing mycophenolate mofetil on oral lichen planus: In vitro and clinical trial… DOI:10.1080/26415275.2023.2283177 | 2023 | this review only | not stated | not extracted yet |
| Alipour 2023 Evaluation of therapeutic effects of nanofibrous mat containing mycophenolate mofetil on oral lichen planus: In vitro and clinical trial… PMID:38204471 | 2023 | this review only | not stated | not extracted yet |
| Brody 1981 Topical treatment of recurrent herpes simplex and post-herpetic erythema multiforme with low concentrations of zinc sulphate solution DOI:10.1111/j.1365-2133.1981.tb00044.x | 1981 | this review only | not stated | not extracted yet |
| Brody 1981 Topical treatment of recurrent herpes simplex and post-herpetic erythema multiforme with low concentrations of zinc sulphate solution. PMID:7213551 | 1981 | this review only | not stated | not extracted yet |
| Chaitanya 2020 Efficacy of Improvised Topical Zinc (1%) Ora-Base on Oral Mucositis during Cancer Chemo-Radiation—A Randomized Study DOI:10.3177/jnsv.66.93 | 2020 | this review only | Oral mucositis severity | not extracted yet |
| Chaitanya 2020 Efficacy of Improvised Topical Zinc (1%) Ora-Base on Oral Mucositis during Cancer Chemo-Radiation-A Randomized Study. PMID:32350185 | 2020 | this review only | not stated | not extracted yet |
| Ghorbani 2020 Evaluation of zinc sulfate mucoadhesive formulation on recurrent aphthous stomatitis: a randomized double-blind, placebo-controlled… DOI:10.1186/s12903-020-01194-4 | 2020 | this review only | not stated | not extracted yet |
| Ghorbani 2020 Evaluation of zinc sulfate mucoadhesive formulation on recurrent aphthous stomatitis: a randomized double-blind, placebo-controlled… PMID:32723352 | 2020 | this review only | not stated | not extracted yet |
| Hoogendoorn 1987 <b>Treatment of aphthous patients by enhancement of the salivary peroxidase system</b> DOI:10.1111/j.1600-0714.1987.tb02080.x | 1987 | this review only | not stated | not extracted yet |
| Hoogendoorn 1987 Treatment of aphthous patients by enhancement of the salivary peroxidase system. PMID:2826739 | 1987 | this review only | not stated | not extracted yet |
| Mehdipour 2010 Comparison of the Effect of Mouthwashes with and without Zinc and Fluocinolone on the Healing Process of Erosive Oral Lichen Planus. PMID:22991591 | 2010 | this review only | not stated | not extracted yet |
| Mehdipour 2011 A comparison between zinc sulfate and chlorhexidine gluconate mouthwashes in the prevention of chemotherapy-induced oral mucositis. PMID:22615642 | 2011 | this review only | Oral mucositis severity | not extracted yet |
| Mehdipour 2016 A comparison of the effect of triamcinolone ointment and mouthwash with or without zinc on the healing process of aphthous stomatitis… DOI:10.15171/joddd.2016.014 | 2016 | this review only | not stated | not extracted yet |
| Mehdipour 2016 A comparison of the effect of triamcinolone ointment and mouthwash with or without zinc on the healing process of aphthous stomatitis… PMID:27429724 | 2016 | this review only | not stated | not extracted yet |
| Mohammadi 2022 Effectiveness of sodium bicarbonate and zinc chloride mouthwashes in the treatment of oral mucositis and quality of life in patients with… DOI:10.1002/nop2.1168 | 2022 | this review only | Oral mucositis severity | not extracted yet |
| Mohammadi 2022 Effectiveness of sodium bicarbonate and zinc chloride mouthwashes in the treatment of oral mucositis and quality of life in patients with… PMID:35170247 | 2022 | this review only | not stated | not extracted yet |
| Niculita 2021 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Oshavandi 2021 Effectiveness of zinc chloride mouthwashes on oral mucositis and weight of patients with cancer undergoing chemotherapy DOI:10.1186/s12903-021-01706-w | 2021 | this review only | Oral mucositis severity | not extracted yet |
| Oshavandi 2021 Effectiveness of zinc chloride mouthwashes on oral mucositis and weight of patients with cancer undergoing chemotherapy. PMID:34294072 | 2021 | this review only | not stated | not extracted yet |
| Patil 2024 The relation between the thresholds of form, motion, and displacement in parafoveal and peripheral vision at a scotopic level of… PMID:20243616 | 1947 | this review only | not stated | not extracted yet |
| Sahebnasagh 2023 Prevention of radiotherapy-related oral mucositis with zinc and polyherbal mouthwash: a double-blind, randomized clinical trial DOI:10.1186/s40001-023-01015-8 | 2023 | this review only | Oral mucositis severity | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with oral mucosal diseases | Patients with cancer therapy-induced oral mucositis (n=8 studies), recurrent aphthous stomatitis (n=3), oral lichen planus (n=2), HSV infection (n=1) |
| Intervention | Zinc used as a topical agent | Topical zinc sulfate, zinc oxide, zinc chloride, zinc gluconate, zinc carnosine as mouthwash, paste, spray, gel, mucoadhesive tablet or nanofibrous mat (0.0002%-5%) |
| Comparison | No treatment or other treatments (or no control group) | Placebo, chlorhexidine, sodium bicarbonate, polyherbal, benzydamine, triamcinolone, standard treatment, or no control |
| Outcomes | Treatment effects such as lesion size reduction, pain reduction and other relevant clinical outcomes | Oral mucositis severity (WHO, Spijkervet, OMAS), pain (VAS), lesion/ulcer size, quality of life, weight, healing duration, relapse |
| Study designs | All study designs (case reports, RCTs, etc.); only RCTs pooled | 11 RCTs, 1 observational study, 1 pilot clinical study, 1 case series (n=14) |
| Timing | Not specified | 2, 3 and 4 weeks pooled for oral mucositis; follow-up up to 23 months across studies |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | No | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | NRSI: No · RCT: Yes | RCT: Yes · NRSI: No | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: N/A · RCT: Yes | NRSI: N/A · RCT: Yes | yes |
| 12Impact of risk of bias on the pooled results | Yes | Yes | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | No | Yes | no |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |