Single application of topical doxycycline in management of recurrent aphthous stomatitis: a systematic review and meta-a
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RESEARCH ARTICLE
Open Access
Single application of topical doxycycline in management of recurrent aphthous stomatitis: a systematic review and metaanalysis of the available evidence Sadeq Ali Al-Maweri1,2, Esam Halboub2,3, Sajna Ashraf1, Ahmed Y. Alqutaibi4, Nashwan Mohammed Qaid5, Kamila Yahya6 and Mohammed Nasser Alhajj7*
Abstract Background: Recurrent aphthous stomatitis (RAS) is a highly prevalent oral mucosal disease. The management of RAS is quite challenging, and as yet, there is no definitive cure. The present systematic review and meta-analysis assessed the efficacy of a single application of topical doxycycline for the management of RAS. Methods: A comprehensive online search of PubMed, Scopus, Embase, and Web of Science databases was conducted to identify all relevant studies published up to March 31, 2019. All randomized clinical trials that assessed the efficacy of a single application of topical doxycycline in the management of RAS were included. Primary outcome measures were pain scores and/or healing time, while secondary outcomes included the associated side effects. RevMan 5.3 software was used for data analysis. Results: Five clinical trials fulfilled the eligibility criteria, three of which were included in the meta-analysis. All of the included studies found doxycycline effective in alleviating signs and symptoms of RAS. The results of the pooled 3 studies revealed a statistically significant decrease in the healing time in favor of the doxycycline group as compared to the control groups (I2 = 51%; MD: -1.77, 95% CI: − 2.11, − 1.42, P 0.05).
Vijayabala et al. (2013) [4]
Topical, Doxycycline Hyclate 100 mg was crushed and mixed with denture adhesive and saline
pain Healing time
8 patients reported transient bitter taste
A single application of doxycycline hyclate was significantly more effective in alleviating pain and reducing healing time as compared to placebo group (P < 0.001)
Ylikontiola (1997) [13]
Doxycycline 150 mg was crushed and mixed with saline. One drop of isobutyl cyanoacrylate as adhesive
Pain
NA
A significant reduction in pain in doxycycline group from day 2 to day 7 as compared to control group (P < 0.05).
NA Not Available
study [4] reported that 8 patients in doxycycline group suffered a transient bitter taste, but no side effects were reported among the placebo group. One study did not provide any information about the side effects [13]. With regards to the mean adhesive retention time, only two studies reported on this outcome, and ranged from 2.1 to 3.5 h [4, 13].
Quality of the included studies
Meta-analysis results
Discussion A number of clinical trials have investigated the efficacy of a single application of topical doxycycline in comparison to other treatment modalities in reducing signs and symptoms of RAS [4, 17, 19]. Therefore, the present systematic review was conducted to summarize the available evidence regarding the clinical efficacy of a single application of topical doxycycline for the management of RAS. Overall, the qualitative analysis of al
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