DOI: 10.4103/jioh.jioh_236_26 ISSN: 0976-7428

Role of Punica granatum in the Management of Oral Mucosal Lesions: A Systematic Review

Kishorwara Ramamoorthy, Thirupamburam Natarajasundaram Uma Maheswari, Devika S. Pillai
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Abstract

Objective:

To systematically evaluate the therapeutic efficacy of Punica granatum (pomegranate) as an effective, sustainable intervention for the management of oral mucosal lesions.

Methods:

This systematic review (PROSPERO: CRD420251022911) adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The sampling method consisted of a comprehensive literature search across PubMed, Google Scholar, and Scopus for data published up to December 2025. The final sample included five randomized controlled trials (RCTs). Grouping consisted of comparing P. granatum interventions against standard care or placebo controls. The study method involved rigorous full-text screening, data extraction, and quality appraisal. Due to methodological heterogeneity among the studies, a descriptive statistical synthesis was applied to evaluate clinical outcomes rather than a meta-analysis.

Results:

Out of 2303 initially identified records, five RCTs were included after the removal of duplicates and ineligible records. Four studies reported favorable clinical outcomes following P. granatum -based interventions, particularly in recurrent aphthous stomatitis (RAS), oral lichen planus, and denture-associated oral conditions. Regarding the risk of bias, three studies exhibited a low risk, while two were rated as moderate risk, primarily due to limitations in blinding protocols.

Conclusion:

Current evidence suggests that P. granatum may have preliminary, condition-specific therapeutic potential, particularly in RAS. However, superiority or equivalence to established conventional therapies has not been established. Further well-designed RCTs are required to determine its clinical efficacy and therapeutic role.

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