HPV Lesions and Other Issues in the Oral Cavity Treatment and Removal without Pain

Int J Mol Sci. 2021 Oct 16;22(20):11158. doi: 10.3390/ijms222011158.


Due to different oral and dental conditions, oral mucosa lesions such as those caused by the human papilloma virus and temporomandibular joint pathologies often have to be treated by surgical, ablative or extractive procedures. The treatment and control of pain and inflammation during these procedures is essential to guarantee the patient's well-being. For the foregoing reason, a hydrogel based on sodium alginate and hyaluronic acid containing 2% of ketorolac tromethamine has been developed. We characterized it physically, mechanically and morphologically. The rheological results suggest that the formulation can be easily and gently applied. Ex vivo permeation studies show that Ketorolac Tromethamine is able to penetrate through the buccal and sublingual mucosae, in addition to being retained in the mucosae's structure. Through an in vitro test, we were able to evaluate the role that saliva plays in the bioavailability of the drug, observing that more than half of the applied dose is eliminated in an hour. The histological and cytotoxic studies performed on pigs in vivo showed the excellent safety profile of the formulation, as well as its high tolerability. In parallel, a biomimetic artificial membrane (PermeaPad®) was evaluated, and it showed a high degree of correlation with the oral and sublingual mucosa.

Keywords: Human Papilloma Virus; Ketorolac; hyaluronic acid; inflammation; oral condyloma; pain; sodium alginate.

MeSH terms

  • Administration, Oral
  • Alginates / chemistry
  • Alginates / pharmacology*
  • Animals
  • Anti-Inflammatory Agents, Non-Steroidal / pharmacology
  • Biological Availability
  • Drug Compounding
  • Drug Elimination Routes*
  • Female
  • Humans
  • Hyaluronic Acid / chemistry
  • Hyaluronic Acid / pharmacology*
  • Hydrogels / pharmacology
  • Ketorolac Tromethamine / chemistry
  • Ketorolac Tromethamine / pharmacology*
  • Mouth / virology*
  • Mouth Mucosa / virology
  • Pain / drug therapy*
  • Papillomaviridae*
  • Papillomavirus Infections / therapy
  • Swine


  • Alginates
  • Anti-Inflammatory Agents, Non-Steroidal
  • Hydrogels
  • Ketorolac Tromethamine
  • Hyaluronic Acid