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Context: Oral submucous fibrosis (OSMF) is a chronic insidious oral potentially malignant disorder characterized by increased collagen deposition and reduced collagen degradation causing burning sensation and difficulty in mouth opening. Aim: To assess the efficacy of topical Tulsi (Ocimum sanctum) paste for the management of OSMF. Settings and Design: Institution?based clinical trial. Materials and Methods: The study included a total of 60 OSMF patients categorized into three Groups A, B and C (20 in each) depending on the severity according to Lai DR et al. classification. The patients were advised for topical Tulsi paste application and were evaluated for the reduction in the burning sensation and improvement in mouth opening every month for 3 subsequent months using the numeric pain rating scale (NRS) and a Vernier calliper, respectively. Statistical Analysis: The baseline and 3?month recordings were subjected to inter? and intra?group statistical analysis using Kruskal–Wallis analysis of variance (ANOVA), Mann–Whitney U, one?way ANOVA, Tukey’s multiple post?hoc and Wilcoxon matched?pairs tests. Results: There was a reduction in the burning sensation and improvement in the mouth opening in all three groups. The reduction in the burning sensation was statistically significant among all the groups (P < 0.05) and the NRS scores after 3 months among the three groups were not statistically significant (P > 0.05). There was a statistically significant difference (P < 0.05) in the improvement of mouth opening between Group A and B; A and C; but not between B and C. Conclusion: Tulsi paste showed a significant reduction in the burning sensation and improvement of the mouth opening thereby proving to be a safe and promising medicament for OSMF
ABSTRACT
@#Oral submucous fibrosis is a chronic, occult and progressive potentially malignant disease that seriously affects the oral function and quality of life of patients. The oral burning sensation and limitation of mouth opening are the main reasons for patients to see a doctor. At present, the main treatment for oral submucosal fibrosis is still drug therapy. To provide ideas and references for the clinical treatment of oral submucosal fibrosis, this article reviews the mechanism, therapeutic effect and characteristics of common Chinese and Western medicine in the treatment of oral submucosal fibrosis. The results of the literature review show that salvia miltiorrhiza, aloe, lycopene, curcumin and other traditional Chinese medicine and Western medicine are effective in the treatment of oral submucosal fibrosis; in addition, Taohong Siwu Decoction combined with Western medicine and other combinations of traditional Chinese and Western medicine are effective and reduce side effects, and clinicians can choose appropriate drugs according to the patient’s main symptoms and general condition. In the future, researchers can study more combinations of traditional Chinese and Western medicine to treat oral submucosal fibrosis.
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@#Dental practitioners may encounter various oral mucosal diseases. Oral lesions can be the early manifestation of many systemic diseases. Mucous membrane pemphigoid (MMP) is a chronic, auto immune vesiculobullous lesion involving the mucocutaneous structures. It is important for a dental surgeon to be aware of oral presentations of MMP. Early and accurate diagnosis of this rare clinical entity is essential for the effective management of the lesions which may reduce or lessen disease progression. Present case report highlights the clinical presentations of MMP affecting the oral mucosa along with diagnostic features.
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Aims and objectives The purpose of the study was to clinically evaluate the efficacy of oral pentoxifylline 400mg tablets in comparison to intra-lesional injections of dexamethasone (4 mg/ml), hyaluronidase 1, 500 IU and 0.5 ml of lignocaine 2% and a combination of the two in the management of oral sub-mucous fibrosis (OSF) patients. Materials and methods The study population consisted of randomly selected 75 patients with OSF. Patients were divided into three groups. A total of 25 patients were allocated each in dexamethasone group, dexamethasone and pentoxifylline group and pentoxifylline group. Dexamethasone group received weekly intra-lesional injections of dexamethasone (4 mg/ml), hyaluronidase 1, 500 IU and 0.5 ml of lignocaine 2% for a period of 12 weeks. Pentoxifylline group received oral pentoxifylline 400-mg tablets thrice daily for 12 weeks. Dexamethasone and pentoxifylline group received both the drugs. Parameters taken in the study were burning sensation and mouth opening. Results In the present study, improvement in the patients symptomatic parameters were statistically significant (p < 0.001) within groups (intra-group comparison), but not significant (p > 0.001) when compared between the groups (inter-group comparison). Conclusion Study found that the parameters like burning sensation and mouth opening showed statistically significant improvement for all the drug groups. The drug pentoxifylline showed similar improvement in the clinical parameters as that of dexona. For this reason, pentoxifylline can be indicated as a good alternative treatment for OSF in patients in whom dexamethasone is contraindicated, or those who cannot make frequent visits for intra-lesional injections.
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Background: Oral Submucous Fibrosis is a potentially malignant disorder well known for its chronic and resistant nature. The conservative drug treatment that is currently available for this disorder is clearly inadequate. Objective: The study was done to evaluate the efficacy of oral lycopene therapy when used in combination with conventional intralesional steroid therapy in the management of oral submucous fibrosis. Methods: Thirty patients with oral submucous fibrosis (grade III and IV) were included and randomly divided into 2 groups consisting of 15 each: Group A (oral lycopene with biweekly intralesional steroids and hyaluronidase), Group B (biweekly intralesional steroids and hyaluronidase alone). Mouth opening and burning sensation were recorded from baseline to 6 weeks. Cases were followed up to 3 and 6 months. Results: We observed a complete relief of burning sensation in all patients of both the groups, There was significant increase in mouth opening among both groups. The patients in the group B had increased moth opening than the group A patients.The results were statistically significant Conclusion: Lycopene in combination with intralesional steroids and Hyaluronidase, is highly efficacious in improving the mouth opening and reducing other symptoms in patients with Oral Submucous Fibrosis. No side effects were reported with its usage.
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Plummer–Vinson syndrome (PVS) is a condition that can occur in people with long-term iron-deficiency anemia. It is a triad of dysphagia, iron deficiency anemia, and upper esophageal web(s). The post-cricoid web is associated with high-risk of development of squamous cell carcinoma of the esophageal region. Predominantly affected are middle-aged women in developing countries. Oral manifestations play an important part of the diagnosis of PVS. Timely diagnosis and treatment of this syndrome is important. An interesting case of PVS with typical clinical, oral and radiological findings previous to and post management of the syndrome are discussed in this report. It also includes a review of literature.
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Erosive lichen planus (LP) is a clinical form of oral LP characterized by the bilateral presentation of erosive and erythematous areas in the oral cavity usually the buccal mucosa with predominance in middle aged females with undue stress factors. In this article, we are giving a case report of a 56-year-old female patient who came to our Department of Oral Medicine and Radiology with a chief complaint of burning sensation of the mouth to hot and spicy food. The diagnosis was given as erosive LP. We also aim to review the literature and management of the lesion with reference to the same.
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The aim of the present study was to investigate the clinical efficacy of herbal medicines (1 gm tulsi and 1 gm turmeric mixed in glycerine base) for the treatment of oral submucous fibrosis (OSMF). Forty‑one patients in the age group of 17- 56 years without any systemic complications were included in the study. The patients were treated with medicines, which were to be applied 3-4 times a day. Blood samples were collected before and after treatment to screen for any systemic changes due to these medications. Burning sensation and mouth opening were recorded before and after treatment. Patients were followed up on monthly subsequent visits for three months. Changes in the burning sensation on visual analogue scale (VAS) scale and difference in the mouth opening were analyzed statistically. A statistically significant improvement was seen in both burning sensation and mouth opening. Tulsi and turmeric offers a safe and efficacious combination of natural products available for symptomatic treatment of OSMF.
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A 67 year-old women who suffered from painful palms and soles with burning sensation for 2 years was treated. At first, she visited the department of dermatology and then consulted our department. The authors considered these symptoms as already being described in the great classic <i>Kinkiyoryaku </i>(<i>Chin Keiu Yao Lueh</i>). We then prescribed shokenchuto, which resulted immediate clinical improvement. The authors have again realized that the classical textbook is based on proper clinical observations that are useful today.
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We reported two cases successfully treated with sano-to (Senkin-Ho). Case 1 was a 63-year old female, who visited our department in December 2004 complaining of polyarthralgia, a burning sensation in the hands and feet, irritability and chilliness. We prescribed sano-to (Senkin-Ho). The visual analogue scale (VAS) decreased from 100 mm on the first visit to 23 mm 10 months later in October 2005. Case 2 was a 62-year old female, who came to our department complaining of whole body pain in August 2004. Various Kampo medicines were tried but proved ineffective, and in June 2005 she was hospitalized. At that time, in addition to whole body pain, she complained of a burning sensation in her feet, psychological anxiety, and chillness. We prescribed sano-to (Senkin-Ho). After 2 months, her VAS decreased from 80 mm to 20 mm. We consider that sano-to (Senkin-Ho) should be prescribed more actively when patients suffer from painful diseases accompanied with subjective symptoms such as a burning sensation in the hands and feet, psychological symptoms, and chilliness.