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Expert Opin Emerg Drugs. 2011 Mar;16(1):183-202. doi: 10.1517/14728214.2011.528390. Epub 2011 Jan 19.

Topical immunomodulators for management of oral mucosal conditions, a systematic review; Part II: miscellaneous agents.

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  • 1Hebrew University - Hadassah School of Dental Medicine, Department of Oral Medicine, POB 12272, Jerusalem 91120, Israel.



Topical immunomodulating preparations have utility in inflammatory/immune-mediated oral mucosal disease resistant to topical steroids, in immunologically mediated systemic disease with primary oral involvement or more severe lesions primarily involving the oral mucosa.


This paper is the second part of a systematic review of a variety of topical immunomodulators for management of immune/inflammatory oral mucosal conditions. The literature search revealed studies of azathioprine, benzydamine, GM-CSF and G-CSF, tetracyclines, retinoids, imiquimod, amlexanox, sirolimus and bacillus Calmette-Guerin polysaccharide nucleic acid. Weighted conclusions are provided for the topical use of each of the immunomodulators reviewed in the management of these oral diseases.


Topical immunomodulators may be useful as second line treatment in several oral diseases, particularly oral lichen planus and recurrent aphthous stomatitis. Benzydamine was found to be preventive in radiotherapy-induced mucositis; however, it is unclear if this outcome is related to its immunomodulating effects or other mechanisms of action. Topical application of tetracyclines and retinoic acid also shows potential anti-inflammatory actions.

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