Evaluation of the effect of probiotic lozenges in the treatment of recurrent aphthous stomatitis: a randomized, controll
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ORIGINAL ARTICLE
Evaluation of the effect of probiotic lozenges in the treatment of recurrent aphthous stomatitis: a randomized, controlled clinical trial Reham Lotfy Aggour 1
&
Sawsan Hafez Mahmoud 2 & Amira Abdelwhab 1
Received: 22 May 2020 / Accepted: 12 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives The study aimed to explore the effectiveness of probiotics in the treatment of minor recurrent aphthous stomatitis (RAS). Materials and methods We performed a randomized, controlled clinical study. Sixty adult (group A) and 60 children patients (group B) with diagnosis of minor RAS were included. Both groups were divided into two subgroups; AI and BI (test subgroups) and AII and BII (control subgroups). For test subgroups, probiotic lozenges were consecutively administered twice daily, for 5 days. The size and pain level of ulcers were recorded on treatment days 0, 3, and 5. The outbreak frequency of RAS within 6 months was investigated for all subgroups. Results Compared with baseline, an improvement was evident for all subgroups. However, for effectiveness in pain reduction, a statistically significant difference in favor of AI was observed for all evaluation periods when compared with control subgroup. Regarding effectiveness in ulcer size reduction, a statistically significant difference in favor of BI was observed at day 5 when compared with control subgroup. No significant difference was observed in the effectiveness index between subgroups AI and BI (test subgroups) except in effectiveness in pain reduction at day 3. The outbreak frequency decreased significantly in subgroup BI. Conclusions Topical application of probiotics decreased pain intensity and accelerates RAS healing. The effectiveness in pain reduction is more evident in adult patients while acceleration of healing is more evident in children. Clinical relevance Probiotics could be a well-tolerated, topical therapeutic agent in the treatment of minor RAS. Trial registration ClinicalTrials.gov ID: NCT04383236 Keywords Aphthous . Randomized controlled trial . Lactobacillus . Probiotics
Introduction
* Reham Lotfy Aggour [email protected] Sawsan Hafez Mahmoud [email protected] Amira Abdelwhab [email protected] 1
Department of Oral Medicine &Periodontology, Faculty of Dentistry, October 6 University, Cairo, Egypt
2
Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
Recurrent aphthous stomatitis (RAS) is the most common painful oral mucosal disease. It affects nonkeratinized mucosa in men and women of all ages, races, and geographic regions. The prevalence ranges from 0.7–20% in the general population [1]. In children, the prevalence differs according to age, ranging from 1.2–36.2% [2]. Minor RAS is the most common form, which accounts for approximately 70 to 87% of the population with RAS [3, 4] and usually has 1 to 5 ulcers at one episode, with a size of less than 1 cm in diameter [5]. For RAS patients, t
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