Salvizan Gel (Sage) Effectively Improves Pain Recovery and Wound Healing in Subjects with Recurrent Aphthous Stomatitis 

by | May 9, 2023 | 2023, Botanicals, Oral Health

Written by Taylor Woosley, Staff Writer. Results of this double-blinded randomized clinical trial shows that the duration of wound healing was 3.3 days for the Salvizan group and 6 days for the triamcinolone group (p < 0.001), with the mean duration of pain recovery being 1.5 days for the Salvizan group and 2.5 days for the triamcinolone group (p < 0.001). 

Recurrent aphthous stomatitis (RAS) is a common oral disease characterized by multiple, small, round, or oval mucosal ulcers1. Symptoms normally start with a burning sensation, followed by the pre-ulcerative stage, in which the epithelium is infiltrated by lymphocytes2. Factors that modify the immunologic responses in RAS include genetic predisposition, viral and bacterial infections, hormonal imbalance, systemic diseases, food allergies, and stress3.

Sage (Salvia officinalis L.) has a long history in alternative medicine and has been used to treat pharyngitis, stomatitis, and inflammation in the mouth and throat4. Sage can protect the body against oxidative stress, free radical damage, and bacterial and viral infections5. It’s anti-inflammatory and antibacterial properties aid in healing mouth sores and pharyngeal disorders6.

Abbasi et al. conducted a double-blinded randomized study to evaluate the effect of Salvizan gel on minor oral aphthous ulcers in comparison to triamcinolone acetonide, a steroidal drug commonly used to treat inflammatory disorders. Study inclusion consisted of subjects with confirmed RAS that were aged 18-50. Participants were assigned to either the Salvizan gel group or the triamcinolone acetonide group and were instructed to topically apply to aphthous ulcers three times a day using a swab. Subjects were also given a card to record the pain score of the lesion three times a day for a week. Visual Analogue Scale (VAS) was used to determine pain severity.

Participants were recalled for sessions on days 2, 4, 6, and 8 after receiving the treatment to reexamine the lesion and observe the healing process. Subjects were further informed to record the day when the lesion pain was completely relieved. All data was analyzed using independent t-test, paired t-test, ANOVA for repeated measures, and survival analysis, including Kaplan-Meier and Cox regression. 60 subjects partook in the study, with 36 women (60%) and 24 men (40%), with an age range of 18-56 years. Significant findings of the study are as follows:

  • The results showed a significant difference between the two groups in pain and complete recovery (p < 0.001). For a more detailed analysis, survival analysis (Kaplan-Meier) was performed and showed a significant difference between the two groups in terms of the duration of pain recovery and complete recovery (p < 0.001).
  • The mean duration of pain recovery was 1.5 days for the Salvizan and 2.5 days for triamcinolone acetonide (p < 0.001).
  • The duration of wound healing was 3.3 days for Salvizan and 6 days for triamcinolone acetonide (p < 0.001).

Results of the study show that Salvizan gel performed more efficiently than triamcinolone acetonide in terms of reducing the pain recovery and wound healing times. Findings suggest that Salvizan may be considered a potential drug for treating RAS. Study limitations include the potential treatment differences among populations of different regions and the lack of control over drug usage.

Source: Abbasi, Fatemeh, Zeinab Rasoulzadeh, and Amirmohammad Yavari. “The effect of sage (Salvizan gel) compared to triamcinolone acetonide on the treatment of recurrent aphthous stomatitis: a double-blinded randomized clinical trial.” BMC Oral Health 23, no. 1 (2023): 1-5.

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Posted May 9, 2023.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

References:

  1. Manfredini M, Guida S, Giovani M, et al. Recurrent Aphthous Stomatitis: Treatment and Management. Dermatol Pract Concept. Sep 2021;11(4):e2021099. doi:10.5826/dpc.1104a99
  2. Suharyani I, Fouad Abdelwahab Mohammed A, Muchtaridi M, Wathoni N, Abdassah M. Evolution of Drug Delivery Systems for Recurrent Aphthous Stomatitis. Drug Des Devel Ther. 2021;15:4071-4089. doi:10.2147/dddt.S328371
  3. Chiang CP, Yu-Fong Chang J, Wang YP, Wu YH, Wu YC, Sun A. Recurrent aphthous stomatitis – Etiology, serum autoantibodies, anemia, hematinic deficiencies, and management. J Formos Med Assoc. Sep 2019;118(9):1279-1289. doi:10.1016/j.jfma.2018.10.023
  4. Monsen RE, Herlofson BB, Gay C, et al. A mouth rinse based on a tea solution of Salvia officinalis for oral discomfort in palliative cancer care: a randomized controlled trial. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. Sep 2021;29(9):4997-5007. doi:10.1007/s00520-021-06021-2
  5. Kerkoub N, Panda SK, Yang MR, et al. Bioassay-Guided Isolation of Anti-Candida Biofilm Compounds From Methanol Extracts of the Aerial Parts of Salvia officinalis (Annaba, Algeria). Front Pharmacol. 2018;9:1418. doi:10.3389/fphar.2018.01418
  6. Fathi F, Sadrnia M, Arjomandzadegan M, Mohajerani HR. In vitro and in vivo evaluation of antibacterial and anti-biofilm properties of five ethnomedicinal plants against oral bacteria by TEM. Avicenna J Phytomed. Mar-Apr 2021;11(2):180-189.