Platelet-Rich Autologous Plasma in Complex Treatment of Sutton Aphthae: Clinical, Immunological and Cytomorphological Outcomes

Abstract

Objective: to assess the clinical, immunological, microbiological and cytomorphological efficacy of local platelet-rich autologous plasma (PRP) injections as an adjunct to conventional therapy for Sutton aphthae. Methods: an open-label randomized controlled study included 112 patients aged 25–60 years with severe scarring recurrent aphthous stomatitis. Conventional treatment was given to 53 patients; 59 patients additionally received 4–5 perilesional PRP injections. Lesion area, disease severity, OHIP-14-RU, salivary TNF-α, IL-2, IL-10 and lactoferrin, oral microbiota, local defense factors and cytology were evaluated through day 29 and at 90 and 180 days. Results: by day 22 the lesion area decreased to 1.90±2.23 mm² with PRP versus 6.24±1.83 mm² after conventional therapy; complete epithelialization was documented from day 29 only in the PRP group. Clinical recovery reached 49.1% versus 28.3%, recurrence frequency was 15.8% versus 76.5%, and remission duration was 7.66±0.27 versus 4.59±0.15 months. After PRP-assisted therapy, TNF-α and IL-2 decreased to 6.88±0.64 and 12.2±1.11 pg/mL, while IL-10 increased to 7.91±0.87 pg/mL. Lysozyme, phagocytic activity and sIgA approached control values, and cytology demonstrated epithelial restoration with minimal neutrophilic infiltration. Conclusion: local PRP accelerated repair, rebalanced the local inflammatory response and reduced recurrence activity without procedure-related adverse events.