Advances in chitosan-based materials for oral ulcer treatment

Oral ulcers are a prevalent condition globally, causing significant pain and discomfort. The unique environment of the oral cavity, characterized by its humidity and dynamic nature, in conjunction with a diverse microbiome, presents challenges for traditional treatments for oral ulcers. Chitosan has emerged as a promising therapeutic agent for this condition. This review integrates findings from 34 peer-reviewed studies conducted between 2000 and 2025, with a focus on significant chitosan-based formulations. These formulations encompass hydrogel systems, microneedle systems, nanoparticle carriers, oral films, and nanofiber scaffolds. The evidence presented indicates that these chitosan-based materials display greater efficacy compared to conventional alternatives. Nevertheless, certain limitations remain, including transient adhesion, non-selective antimicrobial activity that may disrupt the commensal microbiota, and mechanical instability under the shear forces exerted by saliva. The integration of materials science and precision manufacturing holds the potential to yield next-generation chitosan platforms. In conclusion, this review elucidates the characteristics of oral ulcers, explores the biological activities of chitosan, and examines the diverse range of chitosan-based materials. The objective is to provide researchers and clinicians with valuable insights that can aid in the development and application of novel chitosan-based therapeutic strategies for managing oral ulcers.