Topical corticosteroids in Recurrent Aphthous Stomatitis. Systematic review

Objective: To evaluate the effectiveness of the topical corticosteroids compared against a placebo to shorten to the clinical course and the recurrence of the recurrent aphthous stomatitis.

Materials and methods: The following criteria of inclusion were defined:

Studies: Randomized clinical experiments.

Participants: Patients of all the immune-competent ages.

Treatments: Corticosteroids topical versus placebo; topical corticosteroids versus another treatment.

Measurements:

Primary outcome: Pain: Defined as a reduction of the initial perception of pain evaluated by a visual analogue scale of pain.

Secondary outcome: Healing: Defined as the time it takes for the disappearance or the reduction in the size of the ulcer, these measured in weeks, or the area of the ulcer respectively.

Recurrence: New appearance of the ulcers subsequent to its healing measured in weeks or months.

The key words for the strategy search of Literature in the data bases were determined in Medline, lilacs, scielo and embase.

The quality of the studies was evaluated with base in the scale of Jadad.

The extraction of data was performed by two independent evaluators and later the analysis of the collected data was made.

Results: Sixty six were excluded of 77 studies, only 8 were included in revision. All the studies showed than on an average time the healing process was shorter in days while using topical corticosteroid when it was compared with the placebo.

When evaluating the pain, the results were in favor of the active treatment. Nevertheless, the measurement methods were different in the studies. With respect to the recurrences of the ulcers, the results of the studies were not conclusive.

Conclusions: More studies and of better quality are required to be able to obtain more valuable results, that allow us with sufficient reliability to make decisions based on the evidences available in the Literature, which they benefit the patients.