Study of Efficacy of Intraoral Submucosal Injections of Corticosteroids and Placentrex in the Management of Oral Submucous Fibrosis (original) (raw)
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Treatment of Oral Submucous Fibrosis: A Case Report
Background: Oral submucous fibrosis (OSF) is a progressive and inflammatory mucosal fibrosis disease with cancerous tendency. Even though the exact etiology and pathogenesis of OSF have not yet been elucidated totally, the currently recognized pathogenic factor is areca nut. The typical symptoms of OSF patients with limited mouth opening directly affect life quality. Treatments focus on reducing inflammation and improving mouth opening to improve a patient's quality of life. Steroids and corticosteroids are used to treat OSF for a long time because of preventing inflammatory response, reducing fibroblast proliferation, and alleviating collagen deposition. It was also reported that Chinese medicine formulas such as salvia/miltiorrhiza have certain effects in OSF treatment by means of activating blood circulation, removing blood stasis and softening the stiffen oral mucosa. Case Presentation: This case report describes the patient with limited month opening and the 3 years history of chewing areca nuts. The diagnosis of oral submucous fibrosis was confirmed with histopathological examination. With the combined treatment of sublingual compound Danshen dropping pills and topical triamcinolone acetonide for mouth rinse, the patient achieved curative effects of obviously improved mouth opening and soften oral mucosa. And the mechanism of the treatment was discussed. Conclusions: The combined treatment of topical triamcinolone acetonide and sublingual compound Danshen dropping pills may get good effects for OSF patients but need further study.
Intralesional injections in oral submucous fibrosis - A series of case reports
Journal of Medicine, Radiology, Pathology and Surgery, 2018
Oral submucous fibrosis (OSMF) is a chronic insidious disease and is well-recognized as a premalignant condition. It is a collagen-related disorder associated with betel quid chewing and characterized by progressive hyalinization of the submucosa. It is a wellrecognized potentially malignant condition of the oral and oropharyngeal mucosa with initial inflammation followed by progressive fibrosis of the underlying connective tissues. The aim of this article is to report three cases of OSMF which was treated with intralesional injection of corticosteroids, hyaluronidase, and local anesthesia which showed remarkable improvement in the clinical symptoms.
ORAL SUBMUCOUS FIBROSIS – A SHORT REVIEW
Oral Submucous fibrosis (OSMF) is a well-known debilitating precancerous condition of oral cavity which results due to chewing tobacco, areca nuts and its related products. It is an irreversible condition with very high malignant potential. There is a dire need to curb this common but avoidable condition that is increasingly observed in the younger age groups which leads to early development of oral cancer. The purpose of this article is to comprehend OSMF in totality and help the health professionals to get acquainted with the possible etiology, clinical features, differential diagnosis and current treatment modalities of OSMF along with the planning of promotive and preventive research to elucidate the solutions to the problem.
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2020
Background: 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.Methods: 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...
Oral Submucous Fibrosis: Review on Etiopathogenesis and Treatment Modalities
Journal of Oral Sign, 2013
Oral submucous fibrosis (OSMF) is a chronic incidious disease of the oral mucosa characterized by inflammation and a progressive fibrosis of the lamina propria and deeper connective tissues. It is a condition predominantly seen among people of Indian subcontinent and areca nut chewing has been strongly associated with the onset and progression of the disease. Various other etiologic factors like genetic, immunologic, nutritional, autoimmune have been also implicated in the pathogenesis of the disease. With the easily availability and effective economic pricing of commercial available areca nut the frequency of the disease has increased by many folds in the developing nations. Various treatment modalities are now available but the cessation of the habit should be prime importance during the treatment planning. The treatment of patient of OSMF depends on the degree of involvement. The aim of this paper is to discuss about the various factors involved in the etiopathogenesis of the dis...
Clinical profile and oral sub mucous fibrosis
Nepalese Journal of ENT Head and Neck Surgery, 2017
Oral submucous fibrosis (OSMF) is an insidious precancerous disease affecting the oral cavity, pharynx and upper digestive tract. OSMF is a debilitating but preventable oral disease. In 1952, Schwartz coined the term atrophica idiopathica mucosa oris to describe an oral fibrosing disease which he discovered in five Indian women from Kenya. 1 Joshi subsequently coined the term oral submucous fibrosis (OSMF). 2 From the end of last century, papers are being published and researches are being conducted and its pathogenetic significance especially as a precancerous lesion is being highly discussed. The transformation rate is as high as 7.6% making OSMF one of the most important precancerous conditions of the oral region. 3 Oral submucous fibrosis is a disease due to a chronic, insidious change in fibro elasticity, characterized by burning sensation in the oral cavity, blanching, and stiffening of the oral mucosa and oropharynx leading to trismus and inability to open the mouth. The symptoms and signs depend on the progression of the lesions and number of affected sites. 4,5 Oral submucous fibrosis (OSMF) is mostly seen in the Southeast Asia. Although nutritional deficiencies 6 and immunological processes may play a part in the pathogenesis, the available epidemiological evidence indicates that chewing betel quid (containing areca nut, tobacco, slaked lime or other species) is an important risk factor for OSMF. 4,7,9 Gutkha is widely used which is the preparation of crushed areca nut tobacco, catechu, paraffin, slaked lime and sweet or savory flavorings The severity of trismus can be classified into three grades, depending on the maximal mouth opening (MMO) between upper and lower incisor teeth edges distance. Grade 1 is MMO between 40 and 25 mm; Grade 2 is MMO between 25 and 10 mm; and Grade 3 is MMO less than 10 mm. 10 A wide range of treatment consisting of drug management, surgical therapy, and physiotherapy have been attempted till date; with varying degrees of benefit, but none of them have proved to be a cure. This field remains open for clinical trials and research. 4 The drugs used to treat OSMF were categorized into steroids, enzymes, cardiovascular drugs, antioxidants, vitamins and microelements. There are few high-quality studies available and the present drug treatments are in general empirical and treat only symptoms. 4 Together with a cessation of the betel quid chewing habit before and after therapy, these treatment regimens combined with daily mouth opening exercises were found to be necessary to manage OSMF cases in early and advanced stages of progression. 11 This paper aims to provide an overview on clinical profile of patients with OSMF and its association with different local preparations taken orally. Objectives: Oral submucous fibrosis (OSMF) is an insidious precancerous disease mostly seen in the Southeast Asia. This paper aims to study on clinical profile of patients with OSMF Material and Methods: This cross sectional study was done in department of ENT and HNS, Nepalgunj Medical College and Teaching Hospital. In outpatient department patients with OSMF were ask to fill up a questionnaire that included identification of patient, occupation, their symptoms and habit of taking betel quid or paan, gutkha, etc. Oral cavity was examined and lesion along with its extent and severity was noted. Intra lesional steroid and antioxidant and physiotherapy were main stay of treatment. Results: There were total 136 patients (98 male and 38 female) from 15th Dec 2013 to 15th Jan 2015. Age of patient ranged from 16 years to 53 years and average being 25.6years. Most common preparation taken was gutkha 131(96.3%) followed by betel nut, betel quid etc. Only 24(17.6%) were taking these preparations for less than 1 year. Common presenting complaints were difficulty in opening mouth followed by burning sensation and dryness of mouth. Clinically, the extent of fibrous band was found to be more commonly involving soft palate, pillars and buccal mucosa. Isolated involvement of different region of oropharynx or oral cavity was less common. Correlation of grade of trismus and average duration of taking these different preparations was highly significant. (p=0.008) Conclusions: Oral submucous fibrosis is commonly associated with intake of gutkha having dose dependent relationship with trismus. Further studies are required why only a small fraction of those using betel quid develop the disease.
Oral Submucous fibrosis: New technique for management-A Case Report
IJDSIR : Dental Publication Service, 2020
Oral submucous fibrosis (OSF) is the chronic disease of the oral mucosa which is painful and crippling. It is well known as being potentially malignant. Disorder which is specifically associated with the use of arcanut in different ways. It features inflammation and progressive fibrosis of the tissue is submucosal. The disease pathogenesis involves numerous factors such as arecanut chewing, chillies, nutritional deficiencies and genetic processes. An attempt is made through this article to update the awareness of aetiology and its therapeutic and surgical management which Improves life expectancy of OSFM patients.
Oral submucous fibrosis: an update
Clinical, Cosmetic and Investigational Dermatology, 2015
Oral submucous fibrosis (OSF) is a premalignant condition caused by betel chewing. It is very common in Southeast Asia but has started to spread to Europe and North America. OSF can lead to squamous cell carcinoma, a risk that is further increased by concomitant tobacco consumption. OSF is a diagnosis based on clinical symptoms and confirmation by histopathology. Hypovascularity leading to blanching of the oral mucosa, staining of teeth and gingiva, and trismus are major symptoms. Major constituents of betel quid are arecoline from betel nuts and copper, which are responsible for fibroblast dysfunction and fibrosis. A variety of extracellular and intracellular signaling pathways might be involved. Treatment of OSF is difficult, as not many large, randomized controlled trials have been conducted. The principal actions of drug therapy include antifibrotic, anti-inflammatory, and antioxygen radical mechanisms. Potential new drugs are on the horizon. Surgery may be necessary in advanced cases of trismus. Prevention is most important, as no healing can be achieved with available treatments.
Oral submucous fibrosis, an incidious chronic precancerous condition of oral cavity mainly occurs in Indian sub continent. The incidence varies from 0.2 to 0.5% in India with higher percentage in our place (Hyderabad) due to increased habits of chewing gutka, eating chilies and hard roti. The exact etiology is still obscure, but many factors have been thought. It manifests as, burning sensation and inability to eat. Various agents have been tried in treatment but none is promising. In the present prospective study, an attempt has been made to study the effect of placenta extract in the management of oral submucous fibrosis with no significant side effects. It has no contra indications and can be used in early stages of oral submucous fibrosis with good results and effect is long standing.