DOI QR코드

DOI QR Code

Clinical Efficacy of a Mouth-Exercising Device Adjunct to Local Ointment, Intra-Lesional Injections and Surgical Treatment for Oral Submucous Fibrosis: a Randomized Controlled Trial

  • Patil, Pravinkumar (Division of Clinical Dentistry, School of Dentistry, International Medical University) ;
  • Hazarey, Vinay (Department of Oral Pathology, Government Dental College and Hospital) ;
  • Chaudhari, Rekha (Department of Oral Pathology, Government Dental College and Hospital) ;
  • Nimbalkar-Patil, Smita (Department of Orthodontics, Faculty of Dentistry, MAHSA University)
  • Published : 2016.04.11

Abstract

Background: Oral physiotherapy or mouth exercise is considered to be an adjunct but mandatory treatment modality for oral submucous fibrosis (OSMF). This study planned to evaluate the clinical efficacy of a newly designed mouth exercising device (MED) in OSMF patients receiving local ointment, intra-lesional drugs and surgical treatment. Materials and Methods: A total of 231 OSMF patients were selected and treated with basic regime including topical corticosteroids, oral antioxidants and the icecream-stick exercise regime and allotted randomly to two equal groups A and B. Group-A patients were additionally given MED. Subgroups A1 and B1 patients with an inter-incisal distance (IID) 20-35mm were not given any additional therapy; subgroup A2 and B2 patients (IID 20-35mm) were treated additionally with intra-lesional injections. Subgroups A3 and B3 with IID<20mm were managed surgically. IID was measured at baseline and at 6 months recall. The change in IID measurements was calculated and statistically analyzed using 2-way ANOVA and Tukeys multiple post hoc analysis. Results: Average improvement in IID after six months of recall visits was observed to be 8.4 mm in subgroup-A1 (n-53) compared to 5.5 mm in B1(n-50) (p<0.01). The IID improvement in subgroup-A2 was found to be 9.3mm (n-46) compared to 5.1 mm in B2 (n-48) (p<0.01). In the surgery group, mouth opening improvement was observed to be 9.6 mm in subgroup A3 (n-18) compared to 4.8 mm for B3 (n-16) (p<0.01). Conclusions: Use of the MED appears to be effective for increasing oral opening in OMSF patients in conjunction with local, injection and/or surgical treatment.

Keywords

References

  1. Angadi PV, Rao S (2010). Management of oral submucous fibrosis: an overview. Oral Maxillofac Surg, 14, 133-42. https://doi.org/10.1007/s10006-010-0209-x
  2. Arora PK, Deshpande M (2010). Effect of ultrasound and jaw opening exercises in cases of oral submucous fibrosis. Indian J Physiother Occup Ther, 4, 45-7.
  3. Aziz SR (2010). Coming to America: betel nut and oral submucous fibrosis. J Am Dent Assoc, 141, 423-8. https://doi.org/10.14219/jada.archive.2010.0194
  4. Bierman W (1954). Ultrasound in the treatment of scars. Arch Phys Med Rehabil, 35, 209-14.
  5. Cox S, Zoellner H (2009). Physiotherapeutic treatment improves oral opening in oral submucous fibrosis. J Oral Pathol Med, 38, 220-6.
  6. Farrand P, Rowe RM, Johnston A, et al (2001). Prevalence, age of onset and demographic relationships of different areca nut habits amongst children in Tower Hamlets, London. Br Dent J, 190, 150-4.
  7. Hashibe M, Sankarnarayanan R, Thomas G, et al (2002). Body mass index, tobacco chewing, alcohol drinking and risk of oral sub mucous fibrosis in Kerala, India. Cancer Causes Control, 13, 55-64. https://doi.org/10.1023/A:1013991025848
  8. Heller F, Wei FC, Chang YM, et al (2005). A non-tooth-borne mouth-opening device for postoperative rehabilitation after surgical release of trismus. Plast Reconstr Surg, 116, 1856-9. https://doi.org/10.1097/01.prs.0000191178.21552.7f
  9. Lai DR, Chen HR, Lin LM, et al (1995). Clinical evaluation of different treatment methods for oral submucous fibrosis. A 10-year experience with 150 cases. J Oral Pathol Med, 24, 402-6. https://doi.org/10.1111/j.1600-0714.1995.tb01209.x
  10. Le PV, Gornitsky M, Domanowski G (1996). Oral stent as treatment adjunct for oral submucous fibrosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 81, 148-50. https://doi.org/10.1016/S1079-2104(96)80404-5
  11. Patil PG, Patil SP (2012). Novel mouth-exercising device for oral submucous fibrosis. J Prosthodont, 21, 556-60. https://doi.org/10.1111/j.1532-849X.2012.00874.x
  12. Pindborg JJ, Sirasat SM (1966). Oral submucous fibrosis. Oral Surg Oral Med Oral Pathol, 22, 746-79.
  13. Sinor PN, Gupta PC, Murti PR (1990). A case control study of oral submucous fibrosis with special reference to the etiologic role of areca nut. J Oral Pathol Med, 19, 94-98. https://doi.org/10.1111/j.1600-0714.1990.tb00804.x
  14. Van Beekvelt MC, Shoemaker JK, Tschakovsky ME, et al (2001). Blood flow and muscle oxygen uptake at the onset and end of moderate and heavy dynamic forearm exercise. Am J Physiol Regul Integr Comp Physiol, 280, 1741-7. https://doi.org/10.1152/ajpregu.2001.280.6.R1741
  15. Van Wyk CW, Seedat HA, Phillips VM (1990). Collagen in submucous fibrosis: an electron microscopic study. J Oral Pathol Med, 19, 182-7. https://doi.org/10.1111/j.1600-0714.1990.tb00821.x

Cited by

  1. Current protocols in the management of oral submucous fibrosis: An update vol.46, pp.6, 2017, https://doi.org/10.1111/jop.12583
  2. A New Intraoral Appliance for Trismus in Oral Submucous Fibrosis vol.2018, pp.2090-6455, 2018, https://doi.org/10.1155/2018/1039391