The Journal of Contemporary Dental Practice

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 11 , ISSUE 4 ( July, 2010 ) > List of Articles

RESEARCH ARTICLE

Management of Aphthous Ulceration with Topical Quercetin: A Randomized Clinical Trial

Ahmed Abd El-Meguid Mostafa Hamdy, Mohamed Abd El-Moneam Ibrahem

Citation Information : Hamdy AA, Ibrahem MA. Management of Aphthous Ulceration with Topical Quercetin: A Randomized Clinical Trial. J Contemp Dent Pract 2010; 11 (4):9-16.

DOI: 10.5005/jcdp-11-4-9

License: CC BY-NC 3.0

Published Online: 01-07-2010

Copyright Statement:  Copyright © 2010; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim

Recurrent aphthous ulceration is the most commonly known oral mucosal disease. Quercetin is a useful therapeutic agent for the treatment of colitis and gastric ulcer. The objective of this study was to determine the effect of topical application of quercetin in the treatment of minor aphthous ulcers.

Methods and Materials

Forty male patients with no known pathology of the oral mucosa other than minor aphthous ulcers were enrolled in this study. Patients were randomly divided into two groups, each consisting of 20 patients. Group 1 (control group) patients used a benzydamine hydrochloride mouthwash three times daily. Group 2 patients placed two to three dabs of quercetin three times daily directly on their ulcers. Clinical evaluation of patients included assessment of ulcer size, pain measure, and interviews regarding the topical application of quercetin in terms of consistency, taste, local tolerability, and ease of application.

Results

The topical application of quercetin cream to minor mouth ulcers relieved pain and produced complete healing in seven of the Group 2 patients (35 percent) in 2–4 days, 18 patients (90 percent) in 4–7 days, and 20 patients (100 percent) in 7–10 days. When comparing the mean ulcer size after 10 days, lesions in the Group 2 patients were smaller than those in Group 1, and the size difference between the two groups was significantly different (p<0.004). Also, 90 percent of patients responded that they appreciated the ease of application when using the topical quercetin, and they did not object to its consistency or taste.

Conclusion

Quercetin is a safe, well-tolerated, and highly effective promising new, adjunctive treatment for healing common aphthous ulcers.

Clinical Significance

Although aphthous ulcers typically resolve on their own in one to two weeks, the daily topical application of quercetin may be useful in accelerating the healing process of minor aphthous ulcers.

Citation

Hamdy AAEM, Ibrahem MAE. Management of Aphthous Ulceration with Topical Quercetin: A Randomized Clinical Trial. J Contemp Dent Pract [Internet]. 2010 July; 11(4):009-016. Available from: http://www.thejcdp. com/journal/view/volume11-issue4-hamdy


PDF Share
  1. 5% amlexanox oral paste, a new treatment for recurrent minor aphthous ulcers: I. Clinical demonstration of acceleration of healing and resolution of pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;83(2):222-30.
  2. Recurrent aphthous stomatitis. An update. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996; 81(2):141-7.
  3. Inheritance patterns in recurrent aphthous ulcers: twin and pedigree data. Oral Surg Oral Med Oral Pathol. 1977; 43(6):886-91.
  4. Epidemiological aspects of recurrent aphthous ulcerations. Oral Surg Oral Med Oral Pathol. 1972; 33(3):400-6.
  5. Recurrent aphthous ulceration: a possible clinical manifestation of reactivation of varicella zoster or cytomegalovirus infection. J Oral Pathol Med. 1993; 22(2):64-8.
  6. Recurrent aphthous ulcers: a review of diagnosis and treatment. J Am Dent Assoc. 1996; 127(8):1202-13.
  7. Recurrent aphthous stomatitis. A study of the clinical characteristics of lesions in 93 cases. J Oral Pathol Med. 1991; 20(8):395-7.
  8. A clinical trial of Azelastine in recurrent aphthous ulceration, with an analysis of its actions on leukocytes. J Oral Pathol Med. 1994; 23(3):123-9.
  9. Aphthous lesions. Oral Surg Oral Med Oral Pathol. 1972; 33(3):407-16.
  10. The proportion of suppressor-inducer T-lymphocytes is reduced in recurrent aphthous stomatitis. J Oral Pathol. 1988; 17(6):293-7.
  11. Peripheral lymphocyte subpopulations in recurrent aphthous ulceration. Acta Odontol Scand. 1991; 49(4):203-6.
  12. Immunomodulation by levamisole in patients with recurrent aphthous ulcers or oral lichen planus. J Oral Pathol Med. 1994; 23(4):172-7.
  13. [Effect of quercetin on sodium diclofenac-induced ulceration]. Lik Sprava. 2003; (1):96-9.
  14. Constituents and antiulcer effect of Alchornea glandulosa: activation of cell proliferation in gastric mucosa during the healing process. Biol Pharm Bull. 2007; 30(3):451-9.
  15. The plant kingdom as a source of anti-ulcer remedies. Phytother Res. 2000; 14(8):581-91.
  16. Properties of quercetin conjugates: modulation of LDL oxidation and binding to human serum albumin. Free Radic Res. 2004; 38(8):877-84.
  17. Absorption, excretion and metabolite profiling of methyl-, glucuronyl-, glucosyl- and sulpho-conjugates of quercetin in human plasma and urine after ingestion of onions. Br J Nutr. 2006;96(1):107-16.
  18. Uptake of quercetin and quercetin 3-glucoside from whole onion and apple peel extracts by Caco-2 cell monolayers. J Agric Food Chem. 2004; 52(23):7172-9.
  19. Effect of rebamipide on cell death induced by combined treatment of mild heat shock and quercetin in RGM-1 cells: a role for HSP70 induction. Pharmacology. 2002; 64(1):28-35.
  20. Antiulcer effects of antioxidants, quercetin, alphatocopherol, nifedipine and tetracycline in rats. Jpn J Pharmacol. 1998; 78(4):435-41.
  21. [Determination of rutin and quercetin in mulberry leaves by high performance capillary electrophoresis]. Se Pu. 2001; 19(5):395-7.
  22. Anti-inflammatory effects of flavonoids: genistein, kaempferol, quercetin, and daidzein inhibit STAT-1 and NF-kappaB activations, whereas flavone, isorhamnetin, naringenin, and pelargonidin inhibit only NF-kappaB activation along with their inhibitory effect on iNOS expression and NO production in activated macrophages. Mediators Inflamm. 2007; 2007:45673.
  23. , New York, NY10021, Cited in: Lynch MA, Brightman VJ, Greenberg MS, editors. Burket's oral medicine: diagnosis and treatment. 8th ed. Philadelphia: J.B. Lippincott Co.; 1984.
  24. Gastroprotective effect of red pigments in black chokeberry fruit (Aronia melanocarpa Elliot) on acute gastric hemorrhagic lesions in rats. J Agric Food Chem. 2004; 52(8):2226-9.
  25. Quercetin activates an angiogenic pathway, hypoxia inducible factor (HIV)-1-vascular endothelial growth factor, by inhibiting HIF-prolyl hydroxylase: a structural analysis of quercetin for inhibiting HIF-prolyl hydroxylase. Mol Pharmacol. 2007; 71(6):1676-84.
  26. The antioxidative and antihistaminic properties of quercetin in ethanol-induced gastric lesions. Toxicology. 2003; 183(1-3):133-42.
  27. Increased nitric oxide synthesis in ulcerative colitis. Lancet. 1993; 341(8843):465-6.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.