Non-Cochrane · intervention · PMC13701429
Bridging Conventional and Natural Therapies for Recurrent Aphthous Stomatitis: A Systematic Review and Meta-Analysis of Triamcinolone and Non-Steroidal Alternatives
2026 · PubMed
Findings
11 findings
| Population | ||||
|---|---|---|---|---|
| Patients with recurrent aphthous stomatitis | Any non-steroidal topical or alternative therapy (natural and synthetic combined) | Topical triamcinolone | VAS pain score Post-treatment, about 5 to 10 days · Sensitivity: leave out Shrivastava 2018 | SMD 0.48 [0.22, 0.73] GRADE not reported 13 studies |
| Patients with recurrent aphthous stomatitis (RAS) | Alternative topical agents (natural and synthetic, pooled across interventions) | Topical triamcinolone | Ulcer healing time | SMD -1.28 [-2.33, -0.23] GRADE not reported 5 studies · 245 participants |
| Patients with recurrent aphthous stomatitis (RAS) | Alternative topical agents (natural and synthetic, pooled across interventions) | Topical triamcinolone | Pain (VAS) | SMD 0.37 [0.04, 0.69] GRADE not reported 14 studies · 836 participants |
| Patients with recurrent aphthous stomatitis | Any non-steroidal topical or alternative therapy (natural and synthetic combined) | Topical triamcinolone | Pain recovery time Post-treatment, about 5 to 10 days · Sensitivity: leave out Raman 2020 | SMD 2.74 [-0.20, 5.69] GRADE not reported 3 studies |
| Patients with recurrent aphthous stomatitis (RAS) | Alternative topical agents (natural and synthetic, pooled across interventions) | Topical triamcinolone | Pain recovery time | SMD 2.62 [-3.06, 8.30] GRADE not reported 4 studies · 182 participants |
| Patients with recurrent aphthous stomatitis (RAS) | Natural topical interventions (honey preparations, curcumin, Punica granatum, Rhus coriaria, HiOra SG, honey-lemon) | Topical triamcinolone | Pain (VAS reduction from baseline) Intervention category: natural | SMD 0.44 [0.03, 0.85] GRADE not reported 8 studies · 470 participants |
| Patients with recurrent aphthous stomatitis (RAS) | Synthetic topical interventions (hyaluronic acid, amlexanox, triester glycerol oxide, Ora-Aid) | Topical triamcinolone | Pain (VAS) Intervention category: synthetic | SMD 0.25 [-0.33, 0.83] GRADE not reported 6 studies · 366 participants |
| Patients with recurrent aphthous stomatitis | Synthetic topical interventions (hyaluronic acid, amlexanox, triester glycerol oxide, Ora-Aid) | Topical triamcinolone | VAS pain score Post-treatment, about 5 to 10 days · Synthetic interventions; sensitivity: leave out Shrivastava 2018 | SMD 0.58 [0.35, 0.81] GRADE not reported 5 studies |
| Patients with recurrent aphthous stomatitis (RAS) | Honey-based therapies (honey, thyme honey, honey-lemon) | Topical triamcinolone | Pain (VAS) Intervention: honey-based | SMD 0.33 [-0.28, 0.95] GRADE not reported 4 studies · 260 participants |
| Patients with recurrent aphthous stomatitis (RAS) | Amlexanox | Topical triamcinolone | Pain (VAS) Intervention: amlexanox | SMD -0.43 [-1.89, 1.03] GRADE not reported 2 studies · 80 participants |
| Patients with recurrent aphthous stomatitis (RAS) | Hyaluronic acid | Topical triamcinolone | Pain (VAS) Intervention: hyaluronic acid | SMD 0.70 [0.35, 1.04] GRADE not reported 2 studies · 137 participants |
Included primary studies 26
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Abbasi 2023 The effect of sage (Salvizan gel) compared to triamcinolone acetonide on the treatment of recurrent aphthous stomatitis: a double-blinded… DOI:10.1186/s12903-023-02861-y | 2023 | 1 other review | Pain recovery time; Ulcer healing time | not extracted yet |
| Deshmukh 2014 Comparison of effectiveness of curcumin with triamcinolone acetonide in the gel form in treatment of minor recurrent aphthous stomatitis:… DOI:10.4103/2230-973x.138346 | 2014 | 1 other review | Pain (VAS); Ulcer healing time; Pain (VAS reduction from baseline) | not extracted yet |
| El-Haddad 2014 DOI:10.3290/j.qi.a32241 | NR | 1 other review | Pain (VAS); Pain (VAS reduction from baseline) | not extracted yet |
| Ghalwash 2025 Efficacy of thyme honey in the management of oral aphthous ulcers: A randomized controlled clinical trial DOI:10.1111/eos.13032 | 2024 | 1 other review | Pain (VAS); Pain (VAS reduction from baseline) | not extracted yet |
| Giroh 2019 Efficacy of aloe vera and triamcinolone acetonide 0.1% in recurrent aphthous stomatitis: A preliminary comparative study DOI:10.4103/jiaomr.jiaomr_203_18 | 2019 | 1 other review | Ulcer healing time | not extracted yet |
| Huo 2021 Effect of different treatments on recurrent aphthous stomatitis: laser versus medication DOI:10.1007/s10103-020-03166-0 | 2020 | 1 other review | Ulcer healing time | not extracted yet |
| Kia 2020 New concentration of curcumin orabase in recurrent aphthous stomatitis: A randomized, controlled clinical trial DOI:10.1016/j.hermed.2020.100336 | 2020 | 1 other review | not stated | not extracted yet |
| Koray 2016 The Efficacy of Hyaluronic Acid Gel in Pain Control of Recurrent Aphthous Stomatitis DOI:10.19070/2377-8075-1600055 | 2016 | 1 other review | Pain (VAS); VAS pain score | not extracted yet |
| Kuduva Ramesh 2021 Assessment of Clinical Efficacy of Microbiome and Topical Hyaluronic Acid Gel Combination Therapy in Minor Aphthous Ulcer Management – A… DOI:10.4103/jiaomr.jiaomr_236_20 | 2021 | 1 other review | not stated | not extracted yet |
| Lavaee 2022 The Comparative Effects of Rhus Coriaria and Triamcinolone in Patients with Recurrent Aphthous Stomatitis: A Single‐Blinded Randomized… DOI:10.1155/2022/5855067 | 2022 | 1 other review | Pain recovery time | not extracted yet |
| Nayak 2023 Comparison of Effectiveness of Hiora SG Gel With Triamcinolone Acetonide Gel in Recurrent Aphthous Stomatitis DOI:10.7759/cureus.40403 | 2023 | 1 other review | Pain (VAS); Pain (VAS reduction from baseline) | not extracted yet |
| Ofluoglu 2017 An evaluation of the efficacy of a topical gel with Triester Glycerol Oxide (TGO) in the treatment of minor recurrent aphthous stomatitis… DOI:10.4317/medoral.21469 | 2017 | 1 other review | Pain (VAS); VAS pain score | not extracted yet |
| Raman 2020 Topical Curcumin and Triamcinolone Acetonide in Recurrent Minor Aphthous Ulcers: A Pilot Trial DOI:10.5005/jp-journals-10024-2901 | 2020 | 1 other review | Pain recovery time | not extracted yet |
| Rezvani 2025 Comparison of Two Oral Pastes Containing Triamcinolone and Rhus Coriaria L. for Treating Minor Aphthous Lesions DOI:10.1016/j.identj.2024.09.008 | 2025 | 1 other review | Pain (VAS); Pain (VAS reduction from baseline) | not extracted yet |
| Seyyedi 2020 The Effect of Carbon Dioxide Laser on Aphthous stomatitis Treatment: A Double-Blind Randomized Clinical Trial DOI:10.34172/jlms.2020.s11 | 2020 | 1 other review | not stated | not extracted yet |
| Sharma 2018 A Randomized, Double-Blind, Placebo-Controlled Trial on Clinical Efficacy of Topical Agents in Reducing Pain and Frequency of Recurrent… DOI:10.2174/1745017901814010700 | 2018 | 1 other review | Pain (VAS); VAS pain score | not extracted yet |
| Shrivastava 2018 Comparative evaluation of the efficacy of topical amlexanox 5% oral paste and triamcinolone acetonide 0.1% oral paste in the treatment of… DOI:10.4103/jiaomr.jiaomr_40_18 | 2018 | 1 other review | Pain (VAS); VAS pain score | not extracted yet |
| Tavangar 2019 DOI:10.30476/dentjods.2019.44913 | NR | 1 other review | Pain recovery time; Ulcer healing time | not extracted yet |
| Umpreecha 2023 Efficacy and safety of topical 0.1% cannabidiol for managing recurrent aphthous ulcers: a randomized controlled trial DOI:10.1186/s12906-023-03886-0 | 2023 | 1 other review | not stated | not extracted yet |
| Barzegar 2024 Comparative Efficacy of Triadent and Ora-Aid Mucoadhesive Patch for Treatment of Minor Aphthous Ulcers: A Clinical Trial DOI:10.61186/jrdms.9.3.151 | 2024 | this review only | Pain (VAS); VAS pain score | not extracted yet |
| Hussein 2021 Low-Level Diode Laser Therapy (LLLT) versus Topical Corticosteroids in the Management of Recurrent Aphthous Stomatitis Patients. A… DOI:10.21608/adjc.2021.90071.1109 | 2021 | this review only | not stated | not extracted yet |
| Kour 2020 A comparative randomized clinical trial to assess the effectiveness of the diode lasers in both contact and non-contact mode and 0.1%… DOI:10.1007/s41547-020-00086-8 | 2020 | this review only | not stated | not extracted yet |
| Lavaee 2024 Evaluation of the Effects of <i>Punica granatum</i> Flower Tablets on Pain and Healing of Minor Recurrent Aphthous Stomatitis: A… DOI:10.1002/cre2.920 | 2024 | this review only | Pain (VAS); Pain (VAS reduction from baseline) | not extracted yet |
| Mhapuskar 2022 Comparison of Effects of Honey and 0.1% Triamcinolone Acetonide in the Management of Recurrent Aphthous Stomatitis - A Randomised,… DOI:10.4103/jiaomr.jiaomr_157_22 | 2022 | this review only | Pain (VAS); Pain (VAS reduction from baseline) | not extracted yet |
| Mustafa 2020 Comparative Evaluation of The Efficacy of Topical Hyaluronic Acid ( 0.2%) and Topical Triamcinolone Acetonide( 0.1%) in The Treatment of… DOI:10.26505/djm.19025470628 | 2020 | this review only | Pain (VAS); VAS pain score | not extracted yet |
| Shirzaiy 2023 Effects of honey-lemon spray on recurrent aphthous stomatitis comparing to Triamcinolone ointment DOI:10.20396/bjos.v22i00.8667560 | 2023 | this review only | Pain (VAS); Pain (VAS reduction from baseline) | 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 | Shared studies | Jaccard |
|---|---|---|
| Effectiveness of 0.1% triamcinolone acetonide compared with those of other therapies for minor recurrent aphthous stomatitis: a systematic… (2025) | 19 | 0.38 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Individuals with recurrent aphthous stomatitis | Patients with recurrent aphthous stomatitis (VAS meta-analysis n=836) |
| Intervention | Pharmacological and nonpharmacological topical or alternative treatments | Honey, curcumin, Punica granatum, Rhus coriaria, sage, aloe vera, CBD, hyaluronic acid, amlexanox, TGO, Ora-Aid, HiOra SG, lasers, others (26 RCTs) |
| Comparison | Topical triamcinolone | Topical triamcinolone |
| Outcomes | Pain relief (VAS), pain recovery time, ulcer healing time | VAS pain (14 RCTs); pain recovery time (4 RCTs); ulcer healing time (5 RCTs) |
| Study designs | RCTs (parallel group and split-mouth), English, 2014 to 2025 | RCTs (n=26) |
| Timing | Follow-up one day to one year | Mostly 5 to 10 days; one study up to 6 months |
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 | Partial Yes | No | no |
| 5Study selection in duplicate | No | No | 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: N/A · RCT: Yes | RCT: Yes · NRSI: N/A | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: N/A · RCT: No | RCT: No · NRSI: N/A | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |