Can we discuss the real scenario of medical treatment vis-a-vis efficacy of different drugs with their merits & demerits over one another as well as a practical comparison with surgical modalities. Personal experiences are more than welcomed over papers as I am highly skeptical of the results.
Our treatment plan should always be based on current literature and not on any one individuals opinion on treatment.Thats the best way forward.The current literature suggests that once mouth opening has started to diminish and decrease due to osmf,medical line of treatment has little or no value.
I think that you should test always the patient nutritional status.
Conditions like Iron deficiency anemia, vitamin B complex deficiency may play a role in disease. The literature suggests that atrophic oral mucosa is more susceptible to the effects of chilies and betel nuts.
As far as the medical treatment of OSMF is concerned, correction of any underlying nutritional deficiency is of paramount importance. Cessation of any deleterious habits is also equally important. Surgical treatment should be the last option and should be resorted when the mouth opening is below 15mm. Usually the prognosis is good for medical treatment when the mouth opening is around 20mm. Combining steroids with Hyaluronidase and giving it intralesionally in 3 to 4 areas will atleast give you additional 7 to 8mm of mouth opening. Since the fibroblasts are permanently modified to produce modified collegen . It is always going to recur. But still the medical treatment can be repeated. Stem Cell Therapy is another viable choice. Anti Oxidants can be given as adjuvants.
Dear Vibhuti Kail.
-correction of underlying etiology followed by combination of steriods with hyaluronidase will give good results.
@Dr. Roy, thank you for answering. This question remains in my after having gone through the literature as well as having dealt with patients... Most of the studies are from the Indian Subcontinent for obvious reasons and I dare say the authenticity of which is questionable sometimes. I genuinely am interested in the general opinion ergo this question
OSMF rationally is an irreversible phenomenon and medical role plays here from prolonging the malignant transformation.first and foremost thing is cessation of the habit and improve the lifestyle of the patient with a balanced and healthy diet. added to itplan with chemopreventive agents.(no 100% results)
A very important question. The condition is very common in our sub-continent and difficult to manage especially when prosthodontic rehabilitation is required in such patients.
Well evidence based treatment should be followed i believe. There is no single treatment and there are variations seen in the literature also. I find this one as a good read .... hope it helps.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3793419/
@Dr. Riyaz, thank you for the quantification!
@Dr. Rashid, precisely! Honest evidenced based studies are totally needed.
@Dr. Riyaz, thank you for the quantification!
@Dr. Rashid, precisely! Honest evidenced based studies are totally needed.
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