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Investigating Potential Treatments For Minor Recurrent Apthous Ulceration ( Rau )

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Aim and Introduction Recurrent aphthous ulceration (RAU) is the most common oral mucosal disorder, affecting 20% of the general population (see figure 1)(Akintoye and Greenberg 1997). RAU is classified into 3 subtypes with minor RAU being the most prevalent form (Barrons 2001). Due to its unknown etiology, there is no effective method in terminating its outbreaks, though the symptoms can currently be relieved through topical treatments (Femiano et al 2007). RAU is an issue of concern for dentists, as it negatively impacts patients ' quality of life, by impeding eating, swallowing, and speaking (Baharvad 2014). Therefore, there is strong interest for researchers to find new agents to potentially treat RAU. This paper aims to critically …show more content…

Small sample sizes were used in all of the studies, making the results questionable, if applied to the general population. Also, there were no power calculations made, except in (Lui et al 2012). Although the selection criterion removed potential confounding factors, they narrowed down the applicability of the findings. This included exclusion of proposed etiological factors for RAU, such as Behcet’s, Chrohn’s and ulcerative colitis. All 5 studies analysed changes in ulcer size and pain between each treatment and control group. However, pain is subjective between individuals and hard to localise to one ulcer, thus making it a difficult variable to compare. Dexamethasone Dexamethasone is a topical steroid. Its anti-inflammatory and immunosuppressive qualities led to a systematic review that revealed a decrease in ulcer duration, in comparison to the placebo (Quijano and Rodriquez, 2008). (Lui et al 2012) were the first to look into systemic safety concerns in the use of topical dexamethasone treatment in MiRAU by measuring serum concentration of dexamethasone. This means that there was a lack of previous evidence to support their findings. Only 89/240 subjects from 2/5 centers were chosen for the safety analysis, along with no power calculation to determine the subsample size (Lui et al 2012). This further questions the reliability of their results. Smokers were removed from

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