{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:29:08Z","timestamp":1786739348746,"version":"build-2736575974"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["J Int Soc Prev Community Dent"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>bstract<\/jats:sc>\n                  <\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>\n                      Recurrent aphthous ulcers (RAU) and plaque-induced gingivitis are among the prevalent pediatric oral conditions. Standard treatments such as chlorhexidine (CHX) and topical corticosteroids have limitations, including unpleasant taste, staining, and poor adherence. This study evaluated HyaluHerb, a novel alcohol-free gel containing 0.2% hyaluronic acid (HA),\n                      <jats:italic toggle=\"yes\">Aloe vera<\/jats:italic>\n                      , and polyphenol-rich herbal extracts (\n                      <jats:italic toggle=\"yes\">Myrtus communis<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Populus euphratica<\/jats:italic>\n                      ). The present study was aimed to evaluate the efficacy and safety of novel HyaluHerb for treating RAU and gingivitis in children.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This was a single-center, double-blind, randomized controlled trial. Cohort A (RAU,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 99) compared HyaluHerb, HA-only gel, and placebo gel, applied four times daily for 7 days. Cohort B (gingivitis,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 168) used a double-dummy design to compare HyaluHerb gel, HA-only gel, placebo gel (all twice daily), and 0.12% CHX rinse (twice daily) for 14 days. Primary outcomes were time to ulcer healing and pain score (Cohort A), and change in Gingival Index [gingival index (GI), Cohort B].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In Cohort A, HyaluHerb significantly accelerated ulcer healing versus placebo (median 5.3 vs. 7.2 days; hazard ratio = 1.73, 95% confidence interval [CI]: 1.16\u20132.59;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.007) and reduced pain by day 3 (2.5 vs. 4.0;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). In Cohort B, HyaluHerb reduced gingival inflammation more than placebo (adjusted difference in \u0394GI = \u22120.20; 95% CI: \u22120.33 to \u22120.07;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.004). In an exploratory comparison with CHX (not powered for noninferiority), the adjusted mean difference in GI change (HyaluHerb \u2212 CHX) was +0.10, with a one-sided 95% upper confidence bound of +0.15 (prespecified margin), and a supportive per-protocol estimate of +0.14. HyaluHerb demonstrated higher acceptability (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and minimal staining (4.8%) compared with CHX (59.5%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>HyaluHerb is an effective, well-tolerated, child-friendly treatment for acute pediatric RAU and plaque-induced gingivitis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jispcd.jispcd_220_25","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T08:00:36Z","timestamp":1779868836000},"page":"318-329","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["HyaluHerb Pediatric Oral Gel for Recurrent Aphthous Ulcers and Plaque-Induced Gingivitis in Children: A Two-Cohort Randomized Controlled Trial"],"prefix":"10.4103","volume":"16","author":[{"given":"Samah F.","family":"Mohamed-Ali","sequence":"first","affiliation":[{"name":"Department of Pediatric, Orthodontic and Preventive Dentistry, College of Dentistry, Al-Mustansiriya University, Baghdad, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed A.","family":"Jasim","sequence":"additional","affiliation":[{"name":"Department of Operative Dentistry, College of Dentistry, Al-Mustansiriya University, Baghdad, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huda E.","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Pediatric, Orthodontic and Preventive Dentistry, College of Dentistry, Al-Mustansiriya University, Baghdad, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"CIT0001-20260626","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1034\/j.1600-051X.2002.290504.x","article-title":"Periodontal diseases in the child and adolescent","volume":"29","author":"Oh","year":"2002","journal-title":"J Clin Periodontol"},{"key":"CIT0002-20260626","doi-asserted-by":"crossref","first-page":"2690","DOI":"10.3390\/diagnostics14232690","article-title":"Gingivitis and its causes in children aged 3\u20137 years","volume":"14","author":"Olczak-Kowalczyk","year":"2024","journal-title":"Diagnostics"},{"key":"CIT0003-20260626","doi-asserted-by":"crossref","first-page":"918","DOI":"10.5005\/jp-journals-10005-2900","article-title":"The efficacy of Populus euphratica and Myrtus communis herbal mouthwash on gingivitis in pediatric patients diagnosed clinically and with photometric CIELab analysis: An in vivo randomized double-blind clinical study","volume":"17","author":"Mohamed-Ali","year":"2024","journal-title":"Int J Clin Pediatr Dent"},{"key":"CIT0004-20260626","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1080\/09546634.2017.1422079","article-title":"Recurrent aphthous ulceration: A review of potential causes and novel treatments","volume":"29","author":"Saikaly","year":"2018","journal-title":"J Dermatolog Treat"},{"key":"CIT0005-20260626","doi-asserted-by":"crossref","first-page":"564","DOI":"10.12968\/denu.2015.42.6.564","article-title":"Management of recurrent aphthous stomatitis in children","volume":"42","author":"Montgomery-Cranny","year":"2015","journal-title":"Dent Update"},{"key":"CIT0006-20260626","doi-asserted-by":"crossref","first-page":"197","DOI":"10.53469\/jcmp.2025.07(01).37","article-title":"Research progress on Traditional Chinese Medicine treatment of recurrent oral ulcers in children","volume":"7","author":"Lv","year":"2025","journal-title":"J Contemp Med Pract"},{"key":"CIT0007-20260626","doi-asserted-by":"crossref","first-page":"e549","DOI":"10.4317\/medoral.23573","article-title":"Photobiomodulation therapy for the management of recurrent aphthous stomatitis in children: Clinical effectiveness and parental satisfaction","volume":"25","author":"Bardellini","year":"2020","journal-title":"Med Oral Patol Oral Cir Bucal"},{"key":"CIT0008-20260626","doi-asserted-by":"crossref","first-page":"9966750","DOI":"10.1155\/2022\/9966750","article-title":"Flavonols and flavones as potential anti\u2010inflammatory, antioxidant, and antibacterial compounds","volume":"2022","author":"Chagas","year":"2022","journal-title":"Oxid Med Cell Longev"},{"key":"CIT0009-20260626","doi-asserted-by":"crossref","first-page":"1538311","DOI":"10.3389\/fphar.2025.1538311","article-title":"Exploring the antimicrobial, anti-inflammatory, antioxidant, and immunomodulatory properties of Chrysanthemum morifolium and Chrysanthemum indicum: A narrow review","volume":"16","author":"Liang","year":"2025","journal-title":"Front Pharmacol"},{"key":"CIT0010-20260626","doi-asserted-by":"crossref","first-page":"114","DOI":"10.3390\/ph15020114","article-title":"Antioxidant\u2013anti-inflammatory evaluation of a polyherbal formula","volume":"15","author":"Grigore","year":"2022","journal-title":"Pharmaceuticals"},{"key":"CIT0011-20260626","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1124\/pharmrev.124.000951","article-title":"Drug-drug interactions and synergy: From pharmacological models to clinical application","volume":"76","author":"Calzetta","year":"2024","journal-title":"Pharmacol Rev"},{"key":"CIT0012-20260626","doi-asserted-by":"crossref","first-page":"2744","DOI":"10.1016\/j.ijbiomac.2022.10.055","article-title":"Application of hyaluronic acid in tissue engineering, regenerative medicine, and nanomedicine: A review","volume":"222","author":"Saravanakumar","year":"2022","journal-title":"Int J Biol Macromol"},{"key":"CIT0013-20260626","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.actbio.2019.03.032","article-title":"Synergistic regenerative effects of functionalized endometrial stromal cells with hyaluronic acid hydrogel in a murine model of uterine damage","volume":"89","author":"Kim","year":"2019","journal-title":"Acta Biomater"},{"key":"CIT0014-20260626","doi-asserted-by":"crossref","first-page":"106017","DOI":"10.1016\/j.jddst.2024.106017","article-title":"Synthesis and characterization of aloe vera and hyaluronic acid-infused agar-agar\/gelatin-based biopolymeric gel for potential skincare applications","volume":"100","author":"Aizaz","year":"2024","journal-title":"J Drug Delivery Sci Technol"},{"key":"CIT0015-20260626","doi-asserted-by":"crossref","first-page":"152996","DOI":"10.1016\/j.phymed.2019.152996","article-title":"Therapeutic potential of Aloe vera\u2014A miracle gift of nature","volume":"60","author":"Kumar","year":"2019","journal-title":"Phytomedicine"},{"key":"CIT0016-20260626","doi-asserted-by":"crossref","first-page":"S244","DOI":"10.1080\/10408398.2018.1496320","article-title":"Biomedical applications of Aloe vera","volume":"59","author":"Gao","year":"2019","journal-title":"Crit Rev Food Sci Nutr"},{"key":"CIT0017-20260626","doi-asserted-by":"crossref","first-page":"2626","DOI":"10.3390\/molecules26092626","article-title":"Effects of Aloe vera flower extract and its active constituent isoorientin on skin moisturization via regulating involucrin expression: In vitro and molecular docking studies","volume":"26","author":"Razia","year":"2021","journal-title":"Molecules"},{"key":"CIT0018-20260626","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1007\/s10787-024-01631-8","article-title":"Herbal remedies for oral and dental health: A comprehensive review of their multifaceted mechanisms including antimicrobial, anti-inflammatory, and antioxidant pathways","volume":"33","author":"Anwar","year":"2025","journal-title":"Inflammopharmacology"},{"key":"CIT0019-20260626","doi-asserted-by":"crossref","first-page":"94","DOI":"10.31351\/vol29iss1pp94-114","article-title":"UPLC-ESI-MS\/MS and various chromatographic technique for identification of phytochemicals in Populus euphratica Oliv. leaves extract","volume":"29","author":"Ezghayer MA","year":"2020","journal-title":"Iraqi J Pharm Sci"},{"key":"CIT0020-20260626","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1186\/s12870-025-06288-1","article-title":"Combined transcriptomic and metabolomic analysis revealed the salt tolerance mechanism of Populus talassica \u00d7 Populus euphratica","volume":"25","author":"Liu","year":"2025","journal-title":"BMC Plant Biol"},{"key":"CIT0021-20260626","doi-asserted-by":"crossref","first-page":"100205","DOI":"10.1016\/j.bioflm.2024.100205","article-title":"Myrtus communis leaf compounds as novel inhibitors of quorum sensing-regulated virulence factors and biofilm formation: In vitro and in silico investigations","volume":"8","author":"Khadraoui","year":"2024","journal-title":"Biofilm"},{"key":"CIT0022-20260626","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1111\/jcpe.13104","article-title":"Implementation of the new classification of periodontal diseases: Decision\u2010making algorithms for clinical practice and education","volume":"46","author":"Tonetti","year":"2019","journal-title":"J Clin Periodontol"},{"key":"CIT0023-20260626","doi-asserted-by":"crossref","first-page":"6561","DOI":"10.1007\/s00784-021-04180-4","article-title":"Efficacy of hyaluronic acid for recurrent aphthous stomatitis: A systematic review of clinical trials","volume":"25","author":"Al-Maweri","year":"2021","journal-title":"Clin Oral Investig"},{"key":"CIT0024-20260626","doi-asserted-by":"crossref","first-page":"2522","DOI":"10.3390\/biomedicines12112522","article-title":"Hyaluronic acid combined with ozone in dental practice","volume":"12","author":"Rosa","year":"2024","journal-title":"Biomedicines"},{"key":"CIT0025-20260626","doi-asserted-by":"crossref","first-page":"106","DOI":"10.3390\/biom9030106","article-title":"Plant-derived bioactives in oral mucosal lesions: A key emphasis to curcumin, lycopene, chamomile, Aloe vera, green tea and coffee properties","volume":"9","author":"Salehi","year":"2019","journal-title":"Biomolecules"},{"key":"CIT0026-20260626","doi-asserted-by":"crossref","first-page":"10061","DOI":"10.3390\/ijerph191610061","article-title":"Clinical effectiveness of herbal oral care products in periodontitis patients: A systematic review","volume":"19","author":"Chatzopoulos","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"CIT0027-20260626","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.jconrel.2024.03.051","article-title":"ROS-responsive sprayable hydrogel as ROS scavenger and GATA6+ macrophages trap for the prevention of postoperative abdominal adhesions","volume":"369","author":"Huang","year":"2024","journal-title":"J Control Release"},{"key":"CIT0028-20260626","doi-asserted-by":"crossref","first-page":"154824","DOI":"10.1016\/j.phymed.2023.154824","article-title":"A systematic review of natural products for skin applications: Targeting inflammation, wound healing, and photo-aging","volume":"115","author":"Fernandes","year":"2023","journal-title":"Phytomedicine"},{"key":"CIT0029-20260626","doi-asserted-by":"crossref","first-page":"35949","DOI":"10.1021\/acsami.4c03217","article-title":"Application of in situ mucoadhesive hydrogel with anti-inflammatory and pro-repairing dual properties for the treatment of chemotherapy-induced oral mucositis","volume":"16","author":"Kang","year":"2024","journal-title":"ACS Appl Mater Interfaces"},{"key":"CIT0030-20260626","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.2147\/DDDT.S449370","article-title":"Natural and synthetic drugs approached for the treatment of recurrent aphthous stomatitis over the last decade","volume":"18","author":"Vitamia","year":"2024","journal-title":"Drug Des Devel Ther"},{"key":"CIT0031-20260626","doi-asserted-by":"crossref","first-page":"193","DOI":"10.2147\/DDDT.S446949","article-title":"Plants with anti-ulcer activity and mechanism: A review of preclinical and clinical studies","volume":"18","author":"Prayoga","year":"2024","journal-title":"Drug Des Devel Ther"},{"key":"CIT0032-20260626","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/s12906-023-03886-0","article-title":"Efficacy and safety of topical 0.1% cannabidiol for managing recurrent aphthous ulcers: A randomized controlled trial","volume":"23","author":"Umpreecha","year":"2023","journal-title":"BMC Complement Med Ther"},{"key":"CIT0033-20260626","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/s12906-020-2812-1","article-title":"Effectiveness of herbal oral care products in reducing dental plaque and gingivitis\u2014A systematic review and meta-analysis","volume":"20","author":"Janakiram","year":"2020","journal-title":"BMC Complement Med Ther"},{"key":"CIT0034-20260626","first-page":"1153","article-title":"Evaluation of mouthwash containing Citrus hystrix DC., Moringa oleifera Lam. and Azadirachta indica A. Juss. leaf extracts on dental plaque and gingivitis","volume":"10","author":"Buakaew","year":"2021","journal-title":"Plants (Basel, Switzerland)"},{"key":"CIT0035-20260626","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.identj.2022.01.005","article-title":"Chlorhexidine in dentistry: Pharmacology, uses, and adverse effects","volume":"72","author":"Poppolo Deus","year":"2022","journal-title":"Int Dent J"},{"key":"CIT0036-20260626","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s00784-018-2761-y","article-title":"Efficacy of chlorhexidine rinses after periodontal or implant surgery: A systematic review","volume":"23","author":"Solderer","year":"2019","journal-title":"Clin Oral Investig"},{"key":"CIT0037-20260626","doi-asserted-by":"crossref","first-page":"7202831","DOI":"10.1155\/2022\/7202831","article-title":"Minor recurrent aphthous ulcer management with hyaluronic acid gel in an Italian cohort: A double\u2010blind randomized clinical trial","volume":"2022","author":"Savadori","year":"2022","journal-title":"Biomed Res Int"},{"key":"CIT0038-20260626","doi-asserted-by":"crossref","first-page":"1542408","DOI":"10.3389\/fmed.2025.1542408","article-title":"Requirements and special considerations for drug trials with children across six jurisdictions: 1. Clinical trial application review in the regulatory approval process","volume":"12","author":"Stewart","year":"2025","journal-title":"Front Med"}],"container-title":["Journal of International Society of Preventive and Community Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jispcd.jispcd_220_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T19:28:15Z","timestamp":1786735695000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jispcd.jispcd_220_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":38,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jispcd.jispcd_220_25","relation":{},"ISSN":["2231-0762","2250-1002"],"issn-type":[{"value":"2231-0762","type":"print"},{"value":"2250-1002","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-12-11","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-19","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}