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Review
. 2022 Jun 7;58(6):771.
doi: 10.3390/medicina58060771.

Efficacy of Topical Intervention for Recurrent Aphthous Stomatitis: A Network Meta-Analysis

Hao Liu  1 , Lei Tan  2 , Gege Fu  3 , Ling Chen  4 , Hua Tan  4
Affiliations
Review

Efficacy of Topical Intervention for Recurrent Aphthous Stomatitis: A Network Meta-Analysis

Hao Liu et al. Medicina (Kaunas). .

Abstract

Background and objectives: To compare the efficacy and safety of topical interventions used for recurrent aphthous stomatitis. Materials and Methods: This network meta-analysis was conducted in accordance with the PRISMA statement. We searched four electronic databases, PubMed, Web of Science (WOS), Cochrane Central Register of Controlled Trials and Embase, for randomized controlled trials reporting efficacy and safety data on topical interventions for recurrent aphthous stomatitis. We performed a quality evaluation using a methodology based on the Cochrane Handbook. Two authors independently extracted data on healing effect, size reduction effect, symptom reduction effect, recurrence and safety assessment. Network meta-analysis was then performed using ADDIS and RevMan. Results: A total of 72 trials (5272 subjects) involving 29 topical interventions were included. Honey, lnsulin liposome gel, laser, amlexanox, glycyrrhiza and triamcinolone had better efficacy performance. Probiotics and chlorhexidine helped to prolong ulcer intervals and reduce recurrence. Doxycycline and penicillin had a high risk of adverse events. Hematologic evaluation showed no preference. The rank possibility of size-reducing effect and symptom-reducing effect supported the short-term effect of laser and the long-term effect of probiotics. Conclusions: We recommend the use of laser as a short-term intervention during the exacerbation phase of RAS and probiotics as a long-term intervention during the exacerbation and remission phases of RAS.

Keywords: network meta-analysis; recurrent aphthous stomatitis; topical intervention.

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Conflict of interest statement

The authors state they have no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the study selection process.
Figure 2
Figure 2
Network plots for the main outcomes considered in the review. (a) Healing effect; (b) size-reducing effect; (c) symptom-reducing effect; (d) adverse effect. Nodes and edges are weighted according to volume of studies, including that treatment or comparison.
Chart 1
Chart 1
“Time-Rank 1 probability” folding line chart of side-reducing effect.
Chart 2
Chart 2
“Time-Rank 1 probability” folding line chart of symptom-reducing effect.
See this image and copyright information in PMC

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