Soha M.Basha¹, Khuloud Al-Mugbel² and Hazar AlHarbi³

¹Associate Professor of Oral Medicine, Diagnosis, and Radiology, Basic Dental Sciences Department, Princess Nourah University, Riyadh, Saudi Arabia
²Restorative Dental Department, King Abdullah Bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
³Basic Dental Sciences Department, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia

*Corresponding Author: Hazar AlHarbi, Basic Dental Sciences Department, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.

Received: November 21, 2025; Published: November 28, 2025

Abstract

Objectives: Oral ulceration is a widespread and painful condition that affects many individuals globally. Numerous therapeutic options have been explored for its management. Alum, a traditional remedy, has shown potential in promoting wound healing.

Methods: This study aimed to evaluate the impact of topical alum on oral ulcer healing in albino rats. Thirty rats were anesthetized, and standardized ulcers were induced on the left buccal mucosa. The animals were divided into two groups; the control group did not receive any treatment, and the topical alum treated group, in which alum/vaseline paste was applied three times daily. Rats were euthanized at 2, 4, and 8 days post-ulcer induction. Buccal mucosa samples were collected, stained with hematoxylin and eosin (H&E), and examined under a light microscope at ×400 magnification for histopathological evaluation.

Results: No significant histopathological changes were observed in the control group or in the alum-treated ulcers at two days post-induction, with both showing deep ulcerative lesions characterized by complete epithelial loss and inflammatory infiltrates. In the alum-treated group, after four days, partial re-epithelialization was noted, along with mild basal cell hyperplasia, partial keratinization, and remodeling of fibrous connective tissue. By eight days, complete re-epithelialization was achieved. The underlying connective tissue demonstrated organized collagen fibers, indicating advanced scar maturation and tissue remodeling.

Conclusions: Histological examination of topical alum/vaseline application on experimentally induced oral ulceration revealed its potential as a natural topical remedy for enhancing mucosal healing. Alum promoted re-epithelialization, reduced inflammatory cell infiltration, and supported tissue remodeling and scar maturation. Result highlights alum's promising therapeutic role in oral wound management.

Keywords: Recurrent Aphthous Stomatitis (RAS); Oral Ulceration; Alum

References

1. Abdulrhman MA., et al. “The effect of honey supplementation on aphthous ulcers in Egyptian children”. Ain Shams Dental Journal12 (2022): 868-878.
2. Kannan N., et al. “Formulation and evaluation of anti-inflammatory and antioxidant activities of Glycyrrhiza glabra and Triphala-based gum paint”. Ain Shams Dental Journal 38 (2025): 307-314.
3. Tarakji B., et al. “Guideline for the diagnosis and treatment of recurrent aphthous stomatitis for dental practitioners”. Journal of International Oral Health5 (2015): 74-80.
4. Alsahaf S., et al. “Topical betamethasone and systemic colchicine for treatment of recurrent aphthous stomatitis: a randomized clinical trial”. BMC Oral Health 23 (2023): 709.
5. Xu Y., et al. “Thalidomide for management of refractory oral mucosal diseases”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology 4 (2024): 372-378.
6. Hussain A and Gallagher JE. “Recognition and management of drug-associated oral ulceration: a review”. British Dental Journal4 (2022): 221-226.
7. Fetrat AP., et al. “Natural treatment of oral aphthous ulcers: a systematic review”. Translational Biomedicine 4 (2017): 138.
8. Heydarpour F., et al. “Medicinal plants and their bioactive phytochemicals in the treatment of recurrent aphthous ulcers: a review of clinical trials”. Pharmacognosy Review23 (2018): 27-39.
9. Abdulrahman BI., et al. “Natural therapeutic agents in the treatment of recurrent aphthous ulcer: a systematic review and meta-analysis”. Annals of Dental Specialty1 (2022): 78-86.
10. Ali MA., et al. “Shibb-e-Yamani (alum): a unique drug and its utilization in Unani medicine: a physicochemical and pharmacological review”. International Journal of Research in Ayurveda and Pharmacy 8 (2017): 17-22.
11. S. Food and Drug Administration. Aluminum compounds in food and cosmetic products.
12. National Archives and Records Administration. Electronic Code of Federal Regulations. 21 CFR.
13. European Commission. Scientific Committee on Consumer Safety (SCCS). Opinion on the safety of aluminum in cosmetic products (SCCS/1662/23) (2024).
14. European Commission. Scientific Committee on Consumer Safety (SCCS). Opinion on the safety of aluminum in cosmetic products (SCCS/1613/19) (2019).
15. National Center for Biotechnology Information. PubChem Database. Aluminum potassium sulfate, CID 24856. (2019).
16. O’Neil MJ. “The Merck Index: An Encyclopedia of Chemicals, Drugs, and Biologicals”. 13^th Whitehouse Station: Merck (2001): 65.
17. Brahmachari G., et al. “Alum (KAl.SO4)2·12H2O)—an eco-friendly and versatile acid catalyst in organic transformations: a recent update”. Current Green Chemistry1 (2019): 12-31.
18. Ali ZM. “Synergistic antibacterial interaction between an alum and antibiotics on some microorganisms”. Scientific Journal of Medical Research 5 (2018): 47-51.
19. Amadi LO and Ngerebara NN. “Susceptibility profiles of alum on bacteria isolated from shellfish bivalve oyster”. International Journal of Current Microbiology and Applied Sciences1 (2017): 941-947.
20. Shahriari R., et al. “In vitro study of concentration-effect and time-course pattern of white alum on Escherichia coli O157:H7 growth”. African Journal of Traditional, Complementary and Alternative Medicines 2 (2017): 311-318.
21. Ghimire TR. “The mechanisms of action of vaccines containing aluminum adjuvants: an in vitro vs in vivo paradigm”. SpringerPlus 4 (2015): 181.
22. Zaki M., et al. “Efficacy of Amla (Emblica officinalis) and Shibe Yamani .potash alum) in the management of Candida vaginitis: a randomized standard-controlled trial”. International Journal of Reproduction Contraception Obstetrics and Gynecology4 (2017): 250-253.
23. Tang ZY., et al. “Inhibitory effect of potassium alum on smooth muscle contraction of rabbits and its mechanism’. Chinese Journal of Integrative Medicine (2014): 1-7.
24. Thomas A., et al. “Comparison of the antimicrobial efficacy of chlorhexidine, sodium fluoride, fluoride with essential oils, alum, green tea, and garlic with lime mouth rinses on cariogenic microbes”. Journal of International Society of Preventive and Community Dentistry4 (2015): 302-308.
25. Rupesh S., et al. “Comparative evaluation of the effects of an alum-containing mouthrinse and a saturated saline rinse on the salivary levels of Streptococcus mutans”. Journal of Indian Society of Pedodontics and Preventive Dentistry 3 (2010): 138-142.
26. Mohammad HH. “In vitro antibacterial activity of propolis, alum, miswak, green and black tea, and cloves extracts against Porphyromonas gingivalis isolated from periodontitis patients”. American Journal of Phytomedicine and Clinical Therapeutics2 (2013): 140-148.
27. Hamid RN., et al. “Effect of alum stone-containing mucosal adhesive patches on healing of recurrent aphthous stomatitis: a randomized double-blinded placebo-controlled clinical trial”. Dental Hypotheses3 (2025): 59-61.
28. Cavalcante GM., et al. “Experimental model of traumatic ulcer in the cheek mucosa of rats”. Acta Cir Bras3 (2011): 227-234.
29. Cho SA., et al. “Effect of granulocyte macrophage-colony stimulating factor on 5-FU–induced ulcerative mucositis in hamster buccal pouches”. Experimental and Toxicologic Pathology4 (2006): 321-328.
30. Martins MD., et al. “Healing properties of papain-based gel on oral ulcers”. Brazilian Journal of Oral Sciences2 (2011): 120-123.
31. National Research Council. “Guide for the care and use of laboratory animals”. 8^th Washington, DC: National Academies Press (2011).
32. Basha S., et al. “Histological evaluation of the effect of pure nicotine and pentoxifylline gel on oral ulcers: an experimental study”. Journal of Dental and Medical Sciences 12 (2021): 168-176.
33. Wagh H and Thakare MS. “Evaluating antimicrobial efficacy of potash alum on oral ulcers”. IJNRD8 (2024): 28-38.
34. Subramaniam P., et al. “Effect of alum mouthrinse on plaque and gingivitis: a randomized controlled trial”. Journal of Indian Society of Pedodontics and Preventive Dentistry 3 (2012): 199-203.
35. Vimala N., et al. “Role of alum in the treatment of gingivitis: a clinical study”. Indian Journal of Dental Research 4 (2011): 543-546.
36. Rafieian M., et al. “Efficacy of alum for treatment of recurrent aphthous stomatitis”. American Journal of Oral Medicine and Radiology1 (2019): 1-5.
37. Altaei MM., et al. “Efficacy of alum for treatment of recurrent aphthous stomatitis”. Journal of International Society of Preventive & Community Dentistry3 (2016): 211-215.
38. Motallebnejad M., et al. “Effect of alum on tongue wound healing in rats”. Koomesh4 (2018): 737-740.
39. Al-Anesi AM., et al. “Antimicrobial activity of toothpaste containing zinc citrate, alum, sodium fluoride, and xylitol against periodontal pathogens”. Clinical and Experimental Dental Research 2 (2024): 226-234.
40. Hoseini Esfidarjani M., et al. “Antibacterial effect of alum and its synergistic effect with Mentha on Streptococcus mutans”. Journal of Jiroft University of Medical Sciences1 (2023): 63-72.
41. Refat M., et al. “Formulation and evaluation of Yemeni potash alum as hydrophilic topical preparations against bacterial skin infections”. Journal of Medical Science3 (2022): e713.
42. Seo HS. “An experimental study of the antioxidant and anti-inflammatory effects of alum and burnt alum”. Journal of Pharmacopuncture2 (2012): 11-14.
43. Dunnill C., et al. “Reactive oxygen species and wound healing: the functional role of ROS and emerging ROS-modulating therapies”. International Wound Journal1 (2017): 89-96.
44. Dong Y., et al. “ROS-scavenging materials for skin wound healing”. Frontiers in Bioengineering and Biotechnology 11 (2023): 1304835.
45. Toma AI., et al. “Oral wound healing models and emerging regenerative therapies”. Materials15 (2021): 3924.
46. Abdel-Raouf SA., et al. “The possible healing effect of Aloe vera versus silver nanoparticles on acid-induced lip ulcers in albino rats: a histological and immunohistochemical study”. Ain Shams Dental Journal 23 (2021): 42-54.
47. Sushma R., et al. “Comparative evaluation of herbal and alum mouthrinse on plaque inhibition in children: a randomized clinical trial”. Journal of Pharmacy and Bioallied Sciences 13 (2021): S102-S106.
48. Al-Tuma N., et al. “Effect of alum stone–containing mucosal adhesive patches in recurrent aphthous stomatitis: a randomized clinical trial”. Dental Hypotheses2 (2025): 45-51.
49. Bandagi V., et al. “Efficacy of alum in recurrent aphthous stomatitis”. Journal of Indian Academy of Oral Medicine and Radiology4 (2019): 298-302.

Citation

Citation: Soha M.Bash., et al. “The Effectiveness of Alum in Treatment of Oral Ulceration: Histological Study".Acta Scientific Dental Sciences 9.12 (2025): 43-4502.

Copyright

Copyright: © 2025 Soha M.Bash., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.