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Word of the Day

Topical steroid effective for aphthous ulcer healing

Clinical Question:
Is topical dexamethasone ointment effective in hastening the resolution of recurrent aphthous ulcers?

Bottom Line:
Topically applied dexamethasone (a more potent corticosteroid than the triamcinolone found in dental paste in many countries) improves healing rates in patients with recurrent aphthous ulcers. (LOE = 1b-)

Reference:
Liu C, Zhou Z, Liu G, et al. Efficacy and safety of dexamathesone ointment on recurrent aphthous ulceration. Am J Med 2012;125(3):292-301.  [PMID:22340928]

Study Design:
Randomized controlled trial (double-blinded)

Funding:
Industry

Allocation:
Uncertain

Setting:
Outpatient (specialty)

Synopsis:
The Chinese dentists conducting this study enrolled 240 patients with minor recurrent aphthous ulcers at 5 clinical centers. The patients were adults with up to 3 ulcers less than 10 mm in diameter with a duration of less than 48 hours. All patients were nonsmokers (smoking seems to prevent aphthous ulcers). The patients were randomly assigned, allocation concealment unknown, to use dexamethasone ointment 0.1% or matching placebo 3 times a day for 5 days. At day 6, 83.33% of ulcers were healed in the treatment group as compared with 54.70% in the control group (P < .001). The average size of the ulcers was significantly smaller in the treated patients: 7.2 mm^2 vs 5.6 mm^2 (P <. 01). The authors do not report whether blinding was affected by possible differences in taste between the active product and the control product.

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