Efficacy of betamethasone, hyaluronidase and its combination on mouth opening, burning sensation and QOL in patients with OSF

Abstract Introduction: Oral Submucous Fibrosis (OSMF) is a precancerous condition characterized by limited mouth opening, burning sensation, stiffness, and blanching of the oral mucosa induced by areca nut eating. With any of the current therapy regimens, complete regression of the illness has not been accomplished in all patients. Curcumin is a yellow pigment found in curry powder that has antioxidant, anti-inflammatory, and pro-apoptotic properties. As a result, interventional research was conducted to determine the efficacy of Collaper RTu a proprietary collagen-curcumin based product in patients with OSMF.Setting and design: Forty patients with clinically and histologically confirmed Oral Submucous Fibrosis participated in a randomized open label interventional research. Method & materials: For the research, forty patients with clinically and histologically verified Oral Submucous Fibrosis were randomly assigned to one of two groups. The first group was given a weekly intralesional injection of 4 mg Dexamethasone and 1500 I.U Hyaluronidase, whereas the second was given two Collagen-Curcumin pills (Collaper Rtu 60mg Collagen with 100 mg Curcumin) every day for three months. On a weekly basis, the improvement of burning sensation, interincisal distance, and tongue protrusion was assessed.Results: From early to late stages, the burning feeling improved in both groups. Collaper Rtu was found to eliminate the burning feeling. In groups 1 and 2, the mean increase in interincisal distance was 3.13 mm and 1.25 mm, respectively. The interincisal distance improved significantly in both groups by the end of the first month. When compared to group 2, group 1's tongue protrusion recovered faster at the conclusion of the first month. Conclusion: Collaper RTu is useful and effective in lowering the burning feeling in people with early OSMF.

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Hearing Efficiency in Oral Submucous Fibrosis: A Clinical Study

Indian Journal of Otolaryngology and Head & Neck Surgery ◽

10.1007/s12070-020-02246-5 ◽

2020 ◽

Author(s):

J. S. Shah ◽

Nutan Lunagariya

Keyword(s):

Oral Mucosa ◽

Conductive Hearing Loss ◽

Oral Submucous Fibrosis ◽

Hearing Threshold ◽

Mouth Opening ◽

Burning Sensation ◽

Areca Nut ◽

Gradual Reduction ◽

Submucous Fibrosis ◽

Conductive Hearing

Abstract Oral Submucous fibrosis (OSMF) is a chronic insidious disease of oral mucosa that occurs due to areca-nut chewing, consumption of chillies, autoimmunity and genetic predisposition. The disease starts with burning sensation and inability to tolerate spicy foods with gradual reduction in mouth opening due to fibrosis of the oral mucosa. The extension of fibrosis into the naso pharynx leads to reduction in hearing efficiency. As very few studies had been done to evaluate the hearing disability in OSMF patients, this study had been undertaken to prove the same. To evaluate hearing efficiency in patients with Oral Submucous Fibrosis of various grades of severity. Presentation includes 30 patients of osmf with various grades and evaluated for hearing efficacy by audiometry. Hearing threshold was compared in different grades of osmf. The present study revealed a significant association between OSMF and hearing deficit. Involvement of the palatal muscles with OSMF may decrease the patency of the Eustachian tube, leading to conductive hearing loss. Therefore, the protocol for managing OSMF patients should include ENT consultation and treatment for hearing deficit in order to increase the success rate of treatment.

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EFFICACY OF ANTIOXIDANT WITH ALOE VERA GEL VERSUS INTRA-LESIONAL STEROIDS IN THE MANAGEMENT OF ORAL SUBMUCOUS FIBROSIS - A PROSPECTIVE COMPARATIVE STUDY

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71isuppl-3.7921 ◽

2021 ◽

Vol 71 (Suppl-3) ◽

pp. S526-29

Author(s):

Muhammad Tahir ◽

Asim Abbas ◽

Faiz Ul Hassan Nawaz ◽

Mohsin Raza ◽

Atif Rafique ◽

...

Keyword(s):

Comparative Study ◽

Lipoic Acid ◽

Oral Submucous Fibrosis ◽

Aloe Vera ◽

Mouth Opening ◽

Burning Sensation ◽

Alpha Lipoic Acid ◽

Aloe Vera Gel ◽

Prospective Comparative Study ◽

Submucous Fibrosis

Objective: To compared efficacy of alpha lipoic acid (antioxidant medication) and aloe vera gel together versus intralesional steroids (hydrocortisone) in management of oral submucous fibrosis by evaluating post treatment clinical features of mouth opening and burning sensation. Study Design: A prospective comparative study. Place and Duration of Study: Department of ENT, Combined Military Hospital, Malir Karachi, from Jul 2018 to Mar 2020. Methodology: Twenty-eight patients were involved in the research and were distributed into two groups, I and II. Alpha lipoid acid with aloe vera gel was given in group I and hydrocortisone was given in group II. Burning sensation and mouth opening were recorded both at start and at monthly interval later on for three consecutive months. The data collected were statistically analyzed by using SPSS-22. Results: A significant lessening in burning sensation (p<0.001) and improvement in mouth opening were noticed in both groups. However, comparison between alpha lipoic acid with aloe vera gel group versus hydrocortisone group showed almost similar results. Conclusion: Alpha lipoic acid and aloe vera gel can significantly improve oral submucous fibrosis clinically. So, these can be utilized as an alternative option in cases where intralesional steroid is poorly tolerated or is contraindicated.

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Effectiveness of Pentoxifylline Therapy for Management of Oral Submucous Fibrosis

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v19i1.40228 ◽

2022 ◽

Vol 19 (1) ◽

pp. 51-54

Author(s):

Dwarika Prasad Bajgai ◽

Bela Agrawal ◽

Abadhesh Yadav

Keyword(s):

Oral Submucous Fibrosis ◽

Mouth Opening ◽

Burning Sensation ◽

Oral Disease ◽

Medical College ◽

Adjacent Structures ◽

Group A ◽

Submucous Fibrosis ◽

Group B

Introduction: Oral submucous fibrosis is a chronic oral disease characterized by progressive buildup of constricting collagen bands in the cheeks and adjacent structures of the mouth due to chewing of areca nut. This can severely restrict mouth opening and tongue movement causing pain and burning sensation in the mouth. Aims: This study evaluates the efficacy of pentoxifylline in the management of oral submucous fibrosis. Methods: A hospital-based study, conducted in the dental outpatient department of Nepalgunj Medical College from October 2019 to September 2020. Forty-nine patients who were diagnosed histopathologically with oral submucous fibrosis were included. The patients were divided into two groups. In group A, patients were given, 200 mg thrice daily for first 30 days, then dose hiked to 400 mg thrice daily for two more months. Group B patients received treatment with multi-vitamin capsules (B-complex one capsule before sleep daily) for three months. All patients were followed up for six months and were assessed for maximum inter-incisor opening, pain on opening of mouth and burning sensation. Results: There was no statistical difference in mouth opening at baseline and first follow up. The mouth opening was significantly more in group A compared to group B from second follow up which persisted till third follow up (p <0.05). Pain and burning sensation significantly reduced in group A compared to group B from 2nd follow up which persisted till 3rd follow up (p <0.05). Few patients had nausea, dyspepsia and vomiting during treatment in group A which resolved within a few days without the need for cessation of the drug. Conclusion: Pentoxifylline can bring about significant clinical improvements in the symptoms of oral submucous fibrosis like mouth opening, pain and burning sensation, thereby improving the quality of life of the affected individuals.

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Comparative study of rebamipide & betamethasone in managing stomatopyrosis in oral submucous fibrosis (OSMF) patients

Journal of Oral Medicine Oral Surgery Oral Pathology and Oral Radiology ◽

10.18231/j.ijooo.2021.049 ◽

2021 ◽

Vol 7 (3) ◽

pp. 157-160

Author(s):

Md. Asdullah ◽

Nasir A Salati ◽

Masood H Khan ◽

R K Tiwari ◽

Pradhuman Verma ◽

...

Keyword(s):

Indian Subcontinent ◽

Oral Submucous Fibrosis ◽

Age Groups ◽

Mouth Opening ◽

Standard Of Care ◽

Burning Sensation ◽

Intralesional Injection ◽

Vas Score ◽

Group I ◽

Potentially Malignant

Oral sub mucous fibrosis (OSF) is commonly seen in the Indian subcontinent affecting individuals of all age groups. It is a potentially malignant disorder caused almost exclusively by the use of smokeless form of tobacco products. The malignant transformation rates vary from 3 to 19%. The standard of care (SOC) in managing OSF includes habit cessation, intralesional steroid and hyaluronidase injections, and mouth opening exercises. To evaluate the efficacy of rebamipide to reduce the oral burning sensation associated with OSMF as compared to coventional Betamethasone intralesional injection.After providing information about the study and obtaining consent, these individuals were divided into two groups of 15 each using random sampling method. Patients in the rebamipide group (group I) were prescribed 100 mg tablets of rebamipide thrice a day for 21 days. The other 15 patients (group II) were given SOC, intralesional betamethasone injection 4 mg/mL once a week for 4 weeks. Visual analog scale (VAS) with 11 points (0–10) was used to assess burning sensation in the first visit, and change in the burning sensation was assessed after every 7th day on VAS in both the groups.: The improvement in the VAS score in each visit was significant (p < 0.05) in the 1st, 2nd, 3rd, and 4th visit. The VAS score between the 4th and 5th visit failed to reach a statistically significant level (p > 0.05). The VAS score was significantly different between the rebamipide and betamethasone group (p > 0.05) in third & fourth visit. Our results showed that rebamipide was equally efficacious if not better than the betamethasone intralesional injections.

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Oral Submucous Fibrosis: A Review on Etiopathogenesis, Diagnosis, and Therapy

International Journal of Molecular Sciences ◽

10.3390/ijms20122940 ◽

2019 ◽

Vol 20 (12) ◽

pp. 2940 ◽

Cited By ~ 15

Author(s):

Yin-Hwa Shih ◽

Tong-Hong Wang ◽

Tzong-Ming Shieh ◽

Yu-Hsin Tseng

Keyword(s):

Oral Submucous Fibrosis ◽

Mouth Opening ◽

Burning Sensation ◽

Therapeutic Interventions ◽

Future Research ◽

Oral Health Literacy ◽

Diagnostic Biomarkers ◽

Submucous Fibrosis ◽

Underlying Mechanisms

Oral submucous fibrosis (OSF) is characterized by abnormal collagen deposition. It is a precancerous disorder and transforms into a malignant tumor in 1.5–15% of all cases. Symptoms include submucous fibrosis, ulceration, xerostomia, a burning sensation, and restricted mouth opening. All of these greatly interfere with patient quality of life. The present review introduces OSF from a molecular perspective and summarizes what is known about its underlying mechanisms, diagnostic biomarkers, and therapeutic interventions. In addition to the aggressive treatment of OSF, its prevention is also important. Future research should, therefore, focus on improving the oral health literacy of the patients susceptible to OSF.

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A Clinico-Demographic Evaluation of Patients with Oral Submucous Fibrosis: a Cross Sectional Study

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i1331262 ◽

2021 ◽

pp. 22-29

Author(s):

Abdul Bari Memon ◽

Aneela Atta Ur Rahman ◽

Kashif Ali Channar ◽

Naresh Kumar

Keyword(s):

Significant Relationship ◽

Oral Submucous Fibrosis ◽

Maxillofacial Surgery ◽

Mouth Opening ◽

Burning Sensation ◽

University Hospital ◽

Oral And Maxillofacial Surgery ◽

Aged Patients ◽

Cross Sectional ◽

Submucous Fibrosis

Aim: To evaluate the Clinico-Demographic variables in patients of Oral Submucous Fibrosis Study Design: Descriptive Cross Sectional Place and Duration of Study: Department of Oral and Maxillofacial Surgery, Liaquat Medical University Hospital from December 2017 to February 2019. Methodology: The recruitment of patients was done after the clinical diagnosis of oral sub mucous fibrosis (OSMF) patients. The demographic information and associated factors were recorded on the proforma. Mouth opening (MO) was measured between upper and lower central incisors with vernier caliper. Burning sensation (BS) and pain were measured using Visual Analog Scale (VAS). The data were analyzed by SPSS Version-16. Results: Male and female were (66%) and (34%) respectively. The mean age was 41.04±11.24. The frequency of gutka usage was 44% and 43% followed by betel nut as 21% and 23% in functional stages as per Inter Incisal Mouth Opening (IIMO-2) and (IIMO-3) respectively. The BS was shown as severe 49% and 40% followed by moderate as 32% and 37% in functional stages IIMO-2 and IIMO-3 respectively whereas pain was shown as severe 82% and 18% and as moderate 63% and 37% in functional stage M2 and M3 respectively showed statistically significant relationship (p=0.041). Conclusion: Males were more affected and middle aged patients were more involved. Majority of patients were using gutka and had 3rd functional stage of mouth opening. The burning sensation and pain were the most common clinical complains. There was significant relationship of functional stages with pain.

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Tulasi a magical herb and a boon for management of oral submucous fibrosis: a clinical study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20174644 ◽

2017 ◽

Vol 5 (11) ◽

pp. 4719 ◽

Cited By ~ 1

Author(s):

G. Madhulatha ◽

N. Vijayalaxmi ◽

T. Harshavardhan

Keyword(s):

Oral Submucous Fibrosis ◽

Mouth Opening ◽

Modern Medicine ◽

Burning Sensation ◽

Rank Test ◽

P Value ◽

Signed Rank ◽

Signed Rank Test ◽

Submucous Fibrosis

Background: Plants are a good source of drugs in traditional and modern medicine. One among these plants is “tulasi” The queen of herbs” which is used in ayurveda for its diverse properties like antioxidant, analgesic, anti-inflammatory, antidiabetic, and others. It belongs to labiate family and is the most sacred and valued in traditional culture of India. AIMS of the study was to evaluate the efficacy of Tulasi in the treatment of OSMF.Methods: The study included 20 individuals, females and males of age group 20-50yrs who visited the outpatient department who were diagnosed clinically as having OSMF, categorized according to pindborg’s classification. Patients were asked to apply 500mg of Tulasi medicine paste (Tulasi powder mixed with glycerine) twice daily for 1month and were recalled for follow up every week for 1month. All the clinical parameters - mouth opening, burning sensation, pain with the lesion and others were evaluated and recorded in specially designed proforma.Results: Friedman test and wilcoxon signed rank test was used for statistical evaluation. Significant improvement with P value <0.05 was noticed in burning sensation, mouth opening and pain associated with the lesion.Conclusions: The study concludes that Tulasi can be used as a main treatment modality in the management of patients with OSMF.

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Comparative study of rebamipide & betamethasone in managing stomatopyrosis in oral submucous fibrosis (OSMF) patients

Journal of Oral Medicine Oral Surgery Oral Pathology and Oral Radiology ◽

10.18231/j.jooo.2021.049 ◽

2021 ◽

Vol 7 (3) ◽

pp. 157-160

Author(s):

Md. Asdullah ◽

Nasir A Salati ◽

Masood H Khan ◽

R K Tiwari ◽

Pradhuman Verma ◽

...

Keyword(s):

Indian Subcontinent ◽

Oral Submucous Fibrosis ◽

Age Groups ◽

Mouth Opening ◽

Standard Of Care ◽

Burning Sensation ◽

Intralesional Injection ◽

Vas Score ◽

Group I ◽

Potentially Malignant

Oral sub mucous fibrosis (OSF) is commonly seen in the Indian subcontinent affecting individuals of all age groups. It is a potentially malignant disorder caused almost exclusively by the use of smokeless form of tobacco products. The malignant transformation rates vary from 3 to 19%. The standard of care (SOC) in managing OSF includes habit cessation, intralesional steroid and hyaluronidase injections, and mouth opening exercises. To evaluate the efficacy of rebamipide to reduce the oral burning sensation associated with OSMF as compared to coventional Betamethasone intralesional injection.After providing information about the study and obtaining consent, these individuals were divided into two groups of 15 each using random sampling method. Patients in the rebamipide group (group I) were prescribed 100 mg tablets of rebamipide thrice a day for 21 days. The other 15 patients (group II) were given SOC, intralesional betamethasone injection 4 mg/mL once a week for 4 weeks. Visual analog scale (VAS) with 11 points (0–10) was used to assess burning sensation in the first visit, and change in the burning sensation was assessed after every 7th day on VAS in both the groups.: The improvement in the VAS score in each visit was significant (p < 0.05) in the 1st, 2nd, 3rd, and 4th visit. The VAS score between the 4th and 5th visit failed to reach a statistically significant level (p > 0.05). The VAS score was significantly different between the rebamipide and betamethasone group (p > 0.05) in third & fourth visit. Our results showed that rebamipide was equally efficacious if not better than the betamethasone intralesional injections.

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COMPARE TO INTRALESIONAL THERAPY AND PHYTOCHEMICAL BASED SYSTEMIC DRUG THERAPY IN ORAL SUBMUCOUS FIBROSIS-CLINICOPHAMACOLOGICAL STUDY

10.36106/ijsr/1802207 ◽

2021 ◽

pp. 1-3

Author(s):

Swapnil Srivastava ◽

Krishna Singh ◽

Dharmendra Gupta ◽

Monu Yadav

Keyword(s):

Drug Therapy ◽

Curcuma Longa ◽

Oral Submucous Fibrosis ◽

Mouth Opening ◽

Burning Sensation ◽

Tongue Protrusion ◽

Intralesional Therapy ◽

Wide Range ◽

Submucous Fibrosis ◽

Systemic Drug

Introduction: Oral sub-mucous fibrosis (OSMF) is characterized by abnormal collagen deposition. It is a precancerous disorder and transforms into a malignant tumor in 1.5–15% of all cases. Symptoms include submucous fibrosis, ulceration, xerostomia, a burning sensation restricted mouth opening and restricted tongue protrusion followed by oral mucosal blanching and uvla deviation. All of these greatly interfere with patient quality of life. Curcuma longa has been used for thousands of years as a remedy in the traditional Indian and folk medicine for the cure of a large variety of illnesses, such as inflammation, infectious diseases, and gastric, hepatic, and blood disorders. Curcumin is a major isolated polyphenol from the rhizome of turmeric (Curcuma longa). It has a wide range of pharmacological effects such as antioxidant, anti-inflammatory, antimicrobial, antitumor, and hepatoprotective activities. In our study curcumin used in OSMF as a systemic drug therapy and compare with intra-lesional therapy that’s widely used in OSMF Aims and objective: To check the efficacy of systemic drug therapy (curcumin longa) in OSMF, and compare with intra-lesional therapy (Dexamethasone with Hyaluronidase) in OSMF. Material and method 100 patients with clinically proven Oral Submucous Fibrosis were selected for the study and were randomly divided into 2 groups. The first group was treated with weekly Intralesional injection of 4 mg Dexamethasone & 1500 I.U Hyaluronidase and the second group by oral administration of two Curcumin tablets (Turmix 300 mg) per day for 4 months each. Improvement of burning sensation, interincisal distance, tongue protrusion and ulceration was evaluated on a weekly basis and compare to initial visit to end of treatment duration. Statistical analysis and Results: Burning sensation improved in both the groups from early to late stages. Complete Resolution of burning sensation was noted with Turmix early compare to intra-lesional therapy. The mean increase in inter-incisal distance or mouth opening was more compare to systemic drug therapy. The inter-incisal distance improved in both the groups gradually, but not more significant results at systemic drug therapy the end of both therapies. Tongue protrusion showed greater recovery at the end of last stmonth in group 1 when compared with group 2. Conclusion: Turmix is beneficial and effective in reducing burning sensation in early OSMF Patients so we can concluded on the basis of symptomatic relief systemic drug therapy with phyto-chemical based drug given better results compare to intralesional therapy.

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