Evaluation of Different Treatment Modalities in Oral Submucous Fibrosis

Abstract

Background: A prospective randomized study was carried out to establish a standard surgical protocol for patients with advanced cases of oral submucous fibrosis (OSMF) and to assess the post-operative mouth opening following various surgical treatment modalities.
Materials and Methods: A total of 15 patients having interincisal distance (IID) less than or equal to 20 mm were treated surgically for OSMF. Patients with pre-operative IID between 16 and 20 mm were treated with bilateral fibrotomy, surgical removal of all the 3rd molars and grafting of the raw defect. Patients with pre-operative IID between 6 and 15 mm were treated with the above procedure along with bilateral intraoral coronoidectomy with temporalis muscle myotomy. However if pre-operative IID was ≤5 mm, than coronoidectomy and temporalis muscle myotomy were done from the extraoral approach along with other procedures.
Results and Observation: The results were then evaluated comparing the pre-operative and the post-operative IID measurements and followed up for 18 months with vigorous mouth opening exercises. The mean pre-operative IID was 13 mm, the mean intraoperative IID was 40 mm, and the mean 6 month IID was 33 mm, and the mean 18 month IID was 35 mm. In two patients where extraoral approach was used, there were pain and swelling in the preauricular area which took long time to resolve.
Conclusion: All the patients showed satisfactory epithelialization, sustained mouth opening and minimum wound contracture but patients cooperation in the form of discontinuation of habit and aggressive post-operative physiotherapy are utmost important to get a satisfactory outcome of all the efforts.