Clinical Efficacy Of Policresulen On Aphthous Ulcer

Objectives Aphthous ulcer is one of the most common oral ulcers with a prevalence around 20%. It is noted predominantly in females and those with high socio-economic status. It can occur in any age and usually starts to develop in adolescents. Because of its recurrent nature, it is devastating for patients suffering it. The real cause is unknown. It is related to trauma, viral and bacterial infection inducing a delayed immune response, nutrition depletion, change of hormones, insomnia, pressure or food allergy. Current therapies include glucocorticosteroids, local cauterizing agents, immuno-modulating agents, herbal medicine and physical therapy. Satisfactory results have not been noted. The purpose of this study is to investigate the clinical efficacy of policresulen on aphthous ulcer.Methods Among the patients seeking help for oral ulcers in community clinics in Caotun in Taiwan from 2009 September to 2010 December, we selected 200 patients meeting the selection criteria and randomly assigned them to two groups: treatment and control groups. In the treatment group, we applied policresulen concentrates directly to the lesions for 5 seconds until they turned white. In the control group, distilled water was applied for the same interval. For each patient, we collected the name, age, gender, site of lesion, size of lesion and the degree of pain noted on each day (severe: pain affecting food intake, moderate: pain not affecting food intake, mild: not painful). We also recorded the time of healing of ulcers. Patients were followed-up in clinics or by phones until the ulcers healed completely. The difference in the degree of pain between the two groups was analyzed by a Mann-Whitney test and considered significant if p-value is less than 0.05. Results In the treatment group, there were 39 males and 61 females. The ages ranged from 12 to 65 years, with a mean of 27 years. In the control group, there were 32 males and 68 females. The ages ranged from 11 to 68 years, with a mean of 29 years. The lesion sites were, in descending order, on lip mucosa, buccal mucosa, tongue dorsum area, upper palate, floor of mouth and gingival. The mean diameter of the lesions was 3.2 mm (range 1-6 mm) in the treatment group and 3.5 mm (range 1-7 mm) in the control group. There was a significant difference in the degree of pain within 6 days of treatment (p<0.001). The difference was not noted in the healing rate on the 7th day of treatment: 96 patients (96%) versus 92 patients (92%).Conclusion We conclude that policresulen reduce the pain of apthous ulcers without shortening the length of healing time. It is not associated with significant side effect and is easy to apply. The cost is low and its effect is immediately seen. It is an acceptable approach for treating this disorder.