Effect of glycyrrhizin and sappan wood extract on chemically-induced oral mucosal ulcer: An in vivo animal study

Introduction: Stomatitis is the most common oral mucosal lesions characterized by round ulcers with yellow-white color and usually heals up to 14 days. Many recent studies have demonstrated that glycyrrhizin (GL) and C. sappan extract (CSE) exhibits anti-inflammatory, anti-ulcer and antioxidant action but no study has demonstrated the effect on the oral mucosal ulcer. Objectives: To evaluate the effect of GL and CSE in experimentally chemically induced oral mucosal ulcers using rats. Methods: Male Sprague-Dawley rats were randomly distributed into seven groups: the control group, the comparison group of 0.1% triamcinolone acetonide (TCA), a single treatment group of 3% GL and 3% CSE, combination groups of 3% GL + CSE (1:1, 1:2, 2:1). The oral ulcer model was induced by 15 μL of 50% acetic acid. The clinical healing was evaluated by measuring the ulcer size and body weight from day 0-14 and evaluate the leukocyte number on days 0, 4, 9 and 14. Histological examination was conducted at the end of the treatment. Results: The group of 0.1% TCA and GL:CSE (2:1) showed greater ulcer closure (>80%) and decreased leukocyte number since day 4 (p<0.05). Body weight loss was observed after ulcer initiation and started to increase after day 4 of treatment. While the histological examination showed similar tissue regeneration profile only from the GL:CSE (2:1) group with the healthy oral mucosa. Conclusion: Combination treatment of GL:CSE (2:1) enhanced the closure of oral mucosal ulcer and demonstrate complete tissue regeneration.