A comparative physicochemical and pharmacological evaluation of dexamethasone sodium phosphate and betamethasone sodium phosphate mucoadhesive gels for the treatment of oral submucous fibrosis in rats

Abstract The present study is aimed to formulate steroidal oral mucoadhesive gels of dexamethasone sodium phosphate and betamethasone sodium phosphate. Six gel formulations each of dexamethasone sodium phosphate and betamethasone sodium phosphate prepared using two different polymers carboxymethyl cellulose sodium and hydroxypropyl methylcellulose, in variable proportions. All the formulations subjected for assessment of various physicochemical parameters and mechanical properties. The formulations BSP5 and DSP5, both containing 1.25 % carboxymethyl cellulose sodium, 1.25 % hydroxypropyl methylcellulose, exhibiting mucoadhesive strength of 12.300 ± 0.004 and 12.600 ± 0.01, adhesiveness of 28.04 ± 00 and 30.02 ± 00, cohesiveness of 28.04 ± 00 and 30.02 ± 00, drug release of 86.869 ± 0.380 % and 88.473 ± 0.457 % respectively were considered as promising ones and were further subjected for stability studies and in vivo study in male albino rats. Formulation DSP5 upon oral application for 4 months in arecoline induced oral submucous fibrosis rats, showed more than 80 % reduction in fibrosis as compared with BSP5 which showed nearly 50 % reduction. These results were concluded on the basis of histopathological profile and weight gain among the experimental animals during in vivo study. Hence, DSP5 by minimizing the painful injuries and morbidities justifies being suitable noninvasive model for OSMF treatment.

Use of Nasolabial Flap in the Management of Oral Submucous Fibrosis – A Clinical Study.

Oral submucous fibrosis is a chronic debilitating disease associated with restricted mouth opening and poor oral hygiene. The treatment aims at good release of fibrosis and to provide long term results in terms of mouth opening. Various local grafts have been used to cover the buccal mucosal defects after the fibrotic bands are released in oral submucous fibrosis. Successful use of inferiorly based nasolabial flaps in the management of oral submucous fibrosis is projected. A total of 10 histologically proven cases of oral submucous fibrosis having a mouth opening of less than 20 mm were surgically treated .The procedure involved (1) bilateral release of fibrotic bands (2) measurement of intra-operative interincisal distance (greater than 35 mm achieved in all patients after release of bands) (3) covering the defects with inferiorly based nasolabial flap. All patients had post-operative physiotherapy, and were followed up regularly for one year. All flaps healed without evidence of infection, dehiscence, or necrosis. Results were assessed by comparing the pre-operative & pos-toperative maximum mouth opening. The inferiorly based nasolabial “islanded” flaps provide reliable coverage of defects of the buccal mucosa and improves mouth opening.