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Comparative efficacy and safety of sclerosing agents in oral and maxillofacial venous malformations: a systematic review and meta-analysis.

Created on 14 Aug 2026

Authors

Sibgutulah Rashid, Rudra Deo Kumar, Somansh Goyal, Shivendra Choudhary

Published in

Oral surgery, oral medicine, oral pathology and oral radiology. Jul 09, 2026. Epub Jul 09, 2026.

Abstract

To compare the efficacy and safety of different sclerosing agents used in the management of oral and maxillofacial venous malformations through a systematic review and meta-analysis.
A comprehensive search of electronic databases and clinical trial registries was conducted from inception to July 2025 following PRISMA guidelines. Comparative randomized and non-randomized studies evaluating two sclerosants with a minimum follow-up of 2 months were included. Risk of bias was assessed using RoB 2 and ROBINS-I, and certainty of evidence was evaluated using GRADE. Meta-analysis was performed where appropriate.
Six comparative studies involving 425 patients were included. Bleomycin, sodium tetradecyl sulfate (STS), pingyangmycin, polidocanol, ethanol, and sodium morrhuate were evaluated. Bleomycin demonstrated higher response rates and a more favorable safety profile than STS; however, pooled analysis of three studies (n = 120) showed a non-significant trend favoring bleomycin (OR, 2.88; 95% CI: 0.51-16.19) with very low-certainty evidence. Polidocanol and pingyangmycin showed promising efficacy in limited studies, whereas ethanol was associated with higher complication rates.
Current comparative evidence is limited and heterogeneous, precluding recommendation of any single sclerosant as superior. Treatment should be individualized, and well-designed randomized controlled trials are needed to establish comparative efficacy and safety.

PMID:
42595587
Bibliographic data and abstract were imported from PubMed on 14 Aug 2026.

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