Mucoadhesive Drug Delivery Systems for Oral Chronic Inflammatory Mucosal Diseases. The Future is Already Present. A Systematic Review

Background Oral lichen planus (OLP) and recurrent aphthous stomatitis (RAS) are considered the most painful oral inflammatory diseases, with high global prevalence and significant impacts on patients' quality of life. In the last decades, researchers have been exploring mucoadhesive drug delivery systems (MDDS) to improve drugs safety and efficacy through optimized formulations for enhancing patients compliance while addressing the limitations of semisolid products. Objective To assess the clinical efficacy of different MDDS (e.g., tablets, films, and patches) in treating OLP or RAS by a revision of the literature. Methods According to PRISMA guidelines, the study assessed the remission of signs and symptoms in terms of decreasing burning sensation, pain severity, and lesion size. The protocol was registered on the PROSPERO database (CRD42024603173) and records identified by Medline/PubMed/Scopus. Results Thirteen observational studies involving humans affected by OLP or RAS were included. The absence of standardized therapies in terms of MDDS, drug, and dosing regimen was highlighted. All MDDS offered several benefits, including prolonged drug release, protection from mechanical irritation, and pain and inflammation reduction. MDDS improved patients' adherence by minimizing daily applications and systemic side effects. Conclusions MDDS may represent a promising option for both OLP and RAS treatments, addressing key limitations of traditional formulations.