Study On Outcome of Different Combination of Dexamethasone, Hyaluronidase and Placental Extract for Treatment of Oral Submucous Fibrosis

KYAMC Journal ◽  
2019 ◽  
Vol 10 (2) ◽  
pp. 77-80
Author(s):  
Md Habibul Hasan ◽  
Md Shahidul Islam ◽  
Manjur E Mahmud ◽  
Ismat Ara Haider ◽  
Fatema Begum
Keyword(s):  
Oral Mucosa ◽  
Buccal Mucosa ◽  
Oral Submucous Fibrosis ◽  
Mouth Opening ◽  
T Test ◽  
Group I ◽  
Wide Range ◽  
Intralesional Injections ◽  
Submucous Fibrosis ◽  
Placental Extract

Background: Oral submucous fibrosis is a chronic debilitating disease of the oral cavity characterized by inflammation and progressive fibrosis of the submucosal tissues. It is a precancerous condition of the oral mucosa characterized by excessive production of collagen leading to inelasticity of the oral mucosa and atrophic changes of the epithelium. A wide range of treatment including drug management, surgical therapy, and physiotherapy have been attempted till date, with varying degrees of benefit, but none have been able to cure this disease. Objectives: To evaluate the efficacy of Intralesional 'Dexamethasone Plus Hyaluronidase plus Placental extract in comparison to intralesional injections of 'Dexamethasone plus Hyaluronidase in the management of OSMF patients. Materials and Methods: Thirty patients with OSMF were randomly divided equally into two groups. Fifteen patients in 'Dexamethasone plus Hyaluronidase(Group-I)' group received biweekly intralesional injections of Dexamethasone (4mg/ml) plus Hyaluronidase 1500 IU in buccal mucosa for a period of 12 weeks. Other Fifteen patients in'Dexamethasone plus Hyaluronidase plus placental extract (Group-II)' group received biweekly intralesional injections of Dexamethasone (4mg/ml) plus Hyaluronidase 1500 IU plus placental extract in buccal mucosa for a period of 12 weeks. Parameters taken in the study were burning sensation, and mouth opening. Descriptive statistics, paired t test and unpaired t test were used for statistical analysis. Results: The pre- and post-treatment Differences were found to be statistically not significant for both the groups (p<0.001) and for both the treatment outcomes. Conclusion: In the present study, the efficacy of Intralesional 'Dexamethasone Plus Hyaluronidase plus Placental extract' showed no superiority over intralesional injections of 'Dexamethasone plus Hyaluronidase' in the management of OSMF patients. KYAMC Journal Vol. 10, No.-2, July 2019, Page 77-80

scholarly journals Comparative Study of Intralesional Dexamethasone Plus Hyaluronidase & Oral Colchicine in Patients with Oral Submucous Fibrosis

2018 ◽  
Vol 14 (2) ◽  
pp. 60-65
Author(s):  
Ganesh Prasad Neupane ◽  
Maya Rai ◽  
R. S. Rathore ◽  
V. K. Bhargava ◽  
A. K. Mahat ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Oral Mucosa ◽  
Oral Submucous Fibrosis ◽  
Mouth Opening ◽  
Study Groups ◽  
T Test ◽  
Significant Difference ◽  
Intralesional Injections ◽  
Submucous Fibrosis ◽  
Larger Sample

Introduction: Oral Submucous Fibrosis (OSMF) is a precancerous condition of the oral mucosa. It is characterized by excessive production of collagen leading to inelasticity of the oral mucosa and atrophic changes of the epithelium.Aim and objective: To evaluate the efficacy of oral Colchicine in comparison to intralesional injections of Dexamethasone plus Hyaluronidase in the management of OSMF patients.Materials and Methods: Fourty patients with OSMF were randomly divided equally into two groups. 20 patients in Dexamethasone group received biweekly intralesional injections of Dexamethasone (4mg/ml) plus Hyaluronidase 1500 IU in buccal mucosa for a period of 12 weeks. Other 20 patients in Colchicine group received oral Colchicine 0.5 mg tablets twice daily for 12 weeks. Parameters taken in the study were burning sensation, and mouth opening. Descriptive statistics, paired t test and unpaired t test were used for statistical analysis.Results and Conclusions: The pre- and post-treatment differences were found to be statistically significant for both the groups (p<0.001) and for both the treatment outcomes. When the average difference of the treatment outcomes was compared between the two study groups, statistically highly significant difference was noted (p <0.001) only in mouth opening but not in burning sensation.These encouraging results should prompt further clinical trials with Colchicine on a larger sample size to broaden the therapeutic usefulness of the drug in the management of OSMF. JNGMC,  Vol. 14 No. 2 December 2016, Page: 60-65

scholarly journals Hearing Efficiency in Oral Submucous Fibrosis: A Clinical Study

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.

scholarly journals CLINICAL ASSESSMENT OF OCCURRENCE OF ORAL SUBMUCOUS FIBROSIS IN PATIENTS FROM PATNA DENTAL COLLEGE & HOSPITAL

2019 ◽  
Vol 3 (10) ◽  
Author(s):  
Dr. Tanoj Kumar ◽  
Anurag Rai ◽  
Dr. Minti Kumari ◽  
Dr. Shweta Rai ◽  
Dr. Avanindra Kumar ◽  
...  
Keyword(s):  
Oral Mucosa ◽  
Clinical Assessment ◽  
Histopathological Examination ◽  
Oral Submucous Fibrosis ◽  
Mouth Opening ◽  
Oral Pathology ◽  
Areca Nut ◽  
College Hospital ◽  
Medical College ◽  
Submucous Fibrosis

Oral submucous fibrosis is a chronic progressive scarring disease of oral cavity and oropharynx characterized by epithelial atrophy and juxta epithelial inflammatory reaction with progressive fibrosis of the lamina propria and deeper connective tissue. The resulting stiffness of the oral mucosa then causes a progressive decrease in mouth opening. Hence based on above findings the present study was planned for Clinical Assessment of Occurrence of Oral Submucous Fibrosis in Patients from Patna Medical College & Hospital. The present study was planned in Department of Oral Pathology, Patna Dental College & Hospital, Patna. Total 50 cases of the patient diagnosed with the Oral Sub mucous Fibrosis (OSMF) were evaluated in the present study. History, examination and investigation of patients were done in detail as per predesigned proforma. Histopathological examination of biopsy tissue from oral mucosa was done in patients who had taken pre-therapy and post-therapy (if and when required). X-ray of temporomandibular joint was requested (whenever needed). OSMF is a commonly occurring and widely spread premalignant condition increasingly affecting the youth. The occurrence of OSMF in gutkha chewers is far faster and more severe as compared in other forms of areca nut products chewers. The easy availability and promotions of these areca nut products especially gutkha and pan masala outside the schools colleges and social places has impacted younger population in India which has led to the increased occurrence of OSMF. Keywords: Oral Submucous Fibrosis, OSFM, gutkha, pan masala, etc.

scholarly journals Maintenance of Increased Mouth Opening in Oral Submucous Fibrosis Patient Treated with Nasolabial Flap Technique

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Milind Naphade ◽  
Bhushan Bhagat ◽  
Dwarkadas Adwani ◽  
Ranjit Mandwe
Keyword(s):  
Chronic Disease ◽  
Oral Cavity ◽  
Oral Mucosa ◽  
Oral Submucous Fibrosis ◽  
Mouth Opening ◽  
Oral Carcinoma ◽  
Nasolabial Flap ◽  
Flap Technique ◽  
Submucous Fibrosis ◽  
Malignant Changes

Oral submucous fibrosis (OSMF) is an insidious chronic disease affecting any part of the oral cavity and sometimes the pharynx with epithelial atrophy leading to stiffness of the oral mucosa, causing trismus and inability to eat. However, a more serious complication of this disease is the risk of the development of oral carcinoma. A case of OSMF reported with initial interincisal mouth opening; 8 mm which was treated surgically with nasolabial flap technique followed by active mouth opening exercises for 6 months with Hister’s jaw exerciser. The patient could maintain mouth opening of 32 mm at the end of 18-months followup. The patient was observed closely for any malignant changes in the oral cavity.

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

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.

Clinical Evaluation of Buccal Fat Pad and Nasolabial Flap for Oral Submucous Fibrosis Intraoral Defects

2020 ◽  
pp. 194338752096226
Author(s):  
Venkatesh Anehosur ◽  
Pravesh K. Singh ◽  
Punit S. Dikhit ◽  
Hitesh Vadera
Keyword(s):  
Oral Submucous Fibrosis ◽  
Mouth Opening ◽  
Nasolabial Flap ◽  
Fat Pad ◽  
Buccal Fat Pad ◽  
Scar Assessment ◽  
Group I ◽  
Submucous Fibrosis ◽  
The Mean ◽  
Group Ii

Objective: Surgical defects following fibrotomy in oral submucous fibrosis (OSMF) are difficult to manage due to relapse, and local flaps play a pivotal role in covering the defect. The purpose of this study is to compare the buccal fat pad (BFP) and nasolabial flap (NLF) for the reconstruction of intraoral defects after the release of fibrous bands in patients with OSMF. Methods: A prospective study was conducted on patients with OSMF with surgical treatment of fibrotomy excision and reconstruction of the defect with 2 options. Thirty patients with OSMF were divided into 2 groups, group I (BFP) and group II (NLF). Both groups were analyzed for preoperative and postoperative mouth opening and oral commissural width; the extraoral scar was assessed using the Stony Brook Scar Assessment Scale. The data were statistically analyzed using paired and unpaired t test. Results: Thirty patients comprising 27 (90%) male and 3 (10%) female with ages ranging between 19 and 51 years were involved. The mean preoperative and postoperative interincisal mouth opening was 12 mm and 27 mm in group I and 11 mm and 38 mm in group II, respectively, showing a significant increase in group II, and the mean preoperative and postoperative commissural width was 52 mm and 58 mm in group I and 51 mm and 60 mm in group II, respectively. Conclusion: The proposed surgical protocol for the management of OSMF found NLF superior to BFP for the reconstruction of intraoral defects after the release of fibers in patients with OSMF, with a minimal residual scar.

scholarly journals Oral submucous fibrosis: a study of qualitative and analytical treatment using intralesional injections: placental extract versus combination of steroid with hyaluronidase

2020 ◽  
Vol 6 (7) ◽  
pp. 1320
Author(s):  
Meena Vishwanath Kale ◽  
Ninad Subhash Gaikwad
Keyword(s):  
Symptomatic Relief ◽  
Oral Submucous Fibrosis ◽  
Mouth Opening ◽  
Definitive Treatment ◽  
Unknown Etiology ◽  
Intralesional Injection ◽  
Group A ◽  
Submucous Fibrosis ◽  
Group B ◽  
Placental Extract

<p class="abstract"><strong>Background:</strong> One of the premalignant conditions in oropharynx is oral submucous fibrosis (OSMF). It is a chronic debilitating condition of unknown etiology leading to fibrosis of mucosa affecting the oropharynx, esophagus and thus causes decreased mouth opening and dysphagia respectively. The disease is of multifactorial etiology with addictions, nutritional, micro elements and antioxidants deficiencies. In India males are more affected than females, due to their stress related excessive, irresponsible chewing habits. The available management is for symptomatic relief and at present there is no definitive treatment is available.</p><p class="abstract"><strong>Methods:</strong> We have studied 60 cases diagnosed with OSMF with mild to moderate restricted mouth opening. Most of patients were between 17 to 55 years of age selected by randomized clinical trial. Its management was divided into 2 groups where group A was treated with a combined intralesional regimen of injection triamcinolone 40mg and hyaluronidase 1500 IU, while group B was treated with injection of 2ml placental extract. Each group has given a single dose intralesional injection per week for six weeks.  </p><p class="abstract"><strong>Results:</strong> It was a comparative study of improvement in effectiveness on mouth opening and reduction in burning sensation of oral cavity seen in group A regimen than group B. Those having persistent trismus, needed surgery.</p><p class="abstract"><strong>Conclusions:</strong> No effective treatment available but along with intralesional injection can give symptomatic relief. In addition, cessation of habits, antioxidants oral hygiene helps in improvement of OSMF.</p>

an Role of Yashtimadhu Siddha Til Tail Kawalgriha in the Management of Oral submucous fibrosis.(osmf)

2020 ◽  
Vol 8 (05) ◽  
Author(s):  
GOVIND VITTHALRAO SHINDE Shinde
Keyword(s):  
Buccal Mucosa ◽  
Oral Submucous Fibrosis ◽  
Mouth Opening ◽  
Control Group ◽  
Trial Group ◽  
Eligibility Criteria ◽  
Mandibular Incisor ◽  
Chronic Inflammatory Condition ◽  
Cheap Alternative ◽  
Submucous Fibrosis

ABSTRACT Oral submucous fibrosis (Osmf) is a chronic inflammatory condition of buccal mucosa with fibrosis,& restricted mouth opening(trismus) characterized by discoloration of buccal mucosa, intolerance to spicy foods& recurrent episodes of stomatitis.it is common in young population having the chewing habits of gutkha, pan masala, tobacco etc. It makes patients life miserable.  As it is a precancerous condition it seeks attention towards this disease. Medical treatments with minor surgical options are available with unsatisfactory results. This study was aimed at finding the safe, effective & cheap alternative remedy of osmf. This study conducted on 60 diagnosed cases of osmf fulfilling eligibility criteria randomly divided in two groups trial group 30 treated with yashtimadhu siddha til tail& control group 30 treated with til tail+saindhav kavalgriha4 for one month with weekly follow-ups .Results in both the groups were encouraging with minimal differences, mouth opening capacity & increased tolerance to spicy foods were the more appreciable results found in trial group. To get more results intervention can be extended for more periods. Before & after mouth opening capacity inter Dental distance between central maxillary & mandibular incisor teeth’s  by venire caliper, along with color of buccal mucosa, pliability of mucosa, cheek retraction& tolerance to spices were assessed for the outcome of treatments in both the Groups. Keywords- OSMF, Fibrosis, Kawal Griha, Siddha tail ABSTRACT Oral submucous fibrosis (Osmf) is a chronic inflammatory condition of buccal mucosa with fibrosis,& restricted mouth opening(trismus) characterized by discoloration of buccal mucosa, intolerance to spicy foods& recurrent episodes of stomatitis.it is common in young population having the chewing habits of gutkha, pan masala, tobacco etc. It makes patients life miserable.  As it is a precancerous condition it seeks attention towards this disease. Medical treatments with minor surgical options are available with unsatisfactory results. This study was aimed at finding the safe, effective & cheap alternative remedy of osmf. This study conducted on 60 diagnosed cases of osmf fulfilling eligibility criteria randomly divided in two groups trial group 30 treated with yashtimadhu siddha til tail& control group 30 treated with til tail+saindhav kavalgriha4 for one month with weekly follow-ups .Results in both the groups were encouraging with minimal differences, mouth opening capacity & increased tolerance to spicy foods were the more appreciable results found in trial group. To get more results intervention can be extended for more periods. Before & after mouth opening capacity inter Dental distance between central maxillary & mandibular incisor teeth’s  by venire caliper, along with color of buccal mucosa, pliability of mucosa, cheek retraction& tolerance to spices were assessed for the outcome of treatments in both the Groups.  

scholarly journals Comparative study of intralesional injection of triamcinolone versus placental extract in cases of oral submucous fibrosis

2020 ◽  
Vol 6 (8) ◽  
pp. 1504
Author(s):  
Ankur N. Dhanani ◽  
Alpesh V. Patel ◽  
Vijay S. Laungani ◽  
Margi H. Patel ◽  
Pooja A. Sharma
Keyword(s):  
Symptomatic Relief ◽  
Oral Submucous Fibrosis ◽  
Mouth Opening ◽  
Burning Sensation ◽  
Intralesional Injection ◽  
Oral Ulceration ◽  
Therapeutic Modalities ◽  
Spicy Food ◽  
Submucous Fibrosis ◽  
Placental Extract

<p class="abstract"><strong>Background:</strong> Oral submucous fibrosis (OSMF) is a common premalignant condition caused by chewing arecanut, betel quid and gutkha with tobacco. One of the important therapeutic modalities is intralesional injection therapy. The most commonly used intralesional agents are placental extract, corticosteroids and hyaluronidase.</p><p class="abstract"><strong>Methods:</strong> Patients of OSMF (30) were randomly allocated and 15 patients were given 1 ml placental extract submucosally in each retromolar trigon weekly for 8 weeks and 15 patients were injected with 40 mg/ml of triamcinolone submucosally on each side weekly for 8 weeks. The mouth opening was measured as the inter-incisor distance by Vernier calliper at maximal active mouth opening by patient at initial visit and every follow up visit and recorded. Treatment outcome was evaluated on the basis of improvement in trismus, oral mucosal pattern and reduction in burning sensation.  </p><p class="abstract"><strong>Results:</strong> Out of 30 patients, 27 were males and 3 females. 16 patients (53.33%) were in the age group of 21-30 years. Most of patients in our study had complain of reduced mouth opening and inability to take spicy food which is 93.33% of cases followed by burning sensation in mouth 90%, oral ulceration 83.33%, dryness of mouth 30%, difficulty/pain in swallowing 13.33% and halitosis 2%. 60% of patients mouth opening was improved &gt;10 mm with triamcinolone while in placental extract 26.6%. Symptomatic relief were obtained more with injection placental extract.</p><p class="abstract"><strong>Conclusions:</strong> Triamcinolone injection has more improvement in mouth opening compared to placental extract. It was observed that injection placental extract gives good symptomatic relief in the major symptoms like burning sensation in mouth, inability to take spicy food, oral ulceration compared to injection triamcinolone.</p>

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