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Open Access 21-09-2023 | Herpes Simplex Type 1 | Review

Supportive care and antiviral treatments in primary herpetic gingivostomatitis: a systematic review

Authors: Noemi Coppola, Tiziana Cantile, Daniela Adamo, Federica Canfora, Stefania Baldares, Francesco Riccitiello, Gennaro Musella, Michele Davide D. Mignogna, Stefania Leuci

Published in: Clinical Oral Investigations | Issue 11/2023

Abstract

Objectives

Herpes simplex virus 1 (HSV-1) is the main pathogen responsible for herpes infections. In 13–30% of the cases, primary HSV-1 leads to the primary herpetic gingivostomatitis (PHGS), often a self-limiting infection; however, it can limit the ability to drink/eat with, sometimes, the need for hospitalization. Multiple therapeutic methods have been proposed. This systematic review aims to collect and critically appraise the available evidence about the clinical management of PHGS.

Materials and methods

Literature search including three databases (PubMed, Scopus, Embase), study design, and data analysis were performed following PRISMA guidelines, according to the PICO tool (PROSPERO n° CRD42023391386). Risk of bias was assessed with RoB 2 and ROBINS-I.

Results

Five studies on a total of 364 patients (average age: 7.6 years) were identified. The treatment regimens were summarized in acyclovir; acyclovir + honey; fluids and analgesic; maalox + diphenhydramine; lidocaine; chlorhexidine (CHX); CHX + ialuronic acid; CHX + Mucosyte®; antimicrobial photodynamic therapy (aPDT); topical antiviral; topical antiviral + aPDT; and others.

Conclusions

Although PHGS is a disease with a high worldwide prevalence, the lack of consensus about therapeutic management indicates gaps in existing evidence. Most of the proposed treatment consists in symptomatic drugs with empiric regimens which are ineffective for the viral replication. The main limit to realize randomized clinical trial is due to the rapid onset and remission of the disease. In fact, the diagnostic delay, estimated in 72 h, decreases the effectiveness of any antiviral drugs.

Clinical relevance

Out of the five studies included in this systematic review, only one was able to provide some weak evidence that ACV is an effective treatment, improving healing of oral lesions and reducing duration of symptoms.

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Title: Supportive care and antiviral treatments in primary herpetic gingivostomatitis: a systematic review
Authors: Noemi Coppola
Tiziana Cantile
Daniela Adamo
Federica Canfora
Stefania Baldares
Francesco Riccitiello
Gennaro Musella
Michele Davide D. Mignogna
Stefania Leuci
Publication date: 21-09-2023
Publisher: Springer Berlin Heidelberg
Keywords: Herpes Simplex Type 1
Herpes Virus
Published in: Clinical Oral Investigations / Issue 11/2023
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-023-05250-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Supportive care and antiviral treatments in primary herpetic gingivostomatitis: a systematic review

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

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