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J Dermatolog Treat. 2019 Nov 21:1-5. doi: 10.1080/09546634.2019.1688231. [Epub ahead of print]

N-acetylcysteine versus chlorhexidine in treatment of aphthous ulcers: a preliminary clinical trial.

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Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.
Department of Periodontology and Oral Medicine, Faculty of Dentistry, Ibb University, Ibb, Yemen.
Department of Preventive Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia.
College of Dentistry, Jazan University, Jazan, Saudi Arabia.
Teaching Assistant, Faculty of Dentistry, Ibb University, Ibb, Yemen.
Madinat Khalifa Health Center, Primary Health Care Corporation, Doha, Qatar.
Department of Restorative Dentistry, Faculty of Dentistry, University of Western Cape, Cape Town, South Africa.


Introduction: This study sought to assess the efficacy of N-acetyl cysteine (NAC) in the treatment of recurrent aphthous stomatitis (RAS).Methods: Fifty-eight patients, aged 28 ± 9.7 years, presented with clinically diagnosed RAS to two oral medicine centers. They were assigned randomly to a single application of either NAC (200 mg dissolved in water, n = 38) or 0.12% chlorhexidine digluconate (CHX, n = 20) mouthwashes for 30 seconds. Pain was measured using a Visual Analog Scale (VAS). The size of the ulcer was measured through its greatest dimension using a periodontal probe. These two measurements were taken pre-application (day 1) and 2nd, 4th, and 6th day post-application. Average time (in days) until complete healing was assessed.Results: Of all participants, 33 (57%) were females; 34 (59%) married; 29 (50%) reported a family history of aphthae; and 51 (88%) were affected with minor RAS. There were greater improvement in pain from day 1 with NAC on the second day (-3.0 ± 2.0 versus -1.8 ± 1.9; p = .028) and on the fourth day (-5.0 ± 2.6 versus -3.4 ± 2.7; p = .041). The differences with regard to the change in ulcer size and average healing time were not significant between NAC and CHX.Conclusion: Single application of NAC results in a clinically significant reduction of RAS-associated pain within one day of application and is more effective than CHX.


N-acetyl cysteine; Recurrent aphthous stomatitis; chlorhexidine; mouthwash; single application

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