The awareness of such a condition among oral physicians can help in timely diagnosis and. Definition it is an insidious chronic disease affecting any part of the oral cavity and sometimes the pharynx. Surgical treatment of osmf have mentioned the sectioning of fibrous bands bilaterally,although various authors have proposed different graftdressing materials for wound coverage,here we used collagen sheet as a wound dressing material to cover the surgical defect. Management of oral submucous fibrosis by different. Oral submucus fibrosis surgical treatment with co laser.
A 30yearold male presented with a complaint of reduced mouth. Instruct patients regarding the importance of discontinuing the habit of chewing betel quid. Oral submucous fibrosis osmf, a chronic debilitating condition of the mouth, has been known since the times of sushruta as vidari. Surgical management of oral submucous fibrosis in an edentulous. The various treatment modalities are mainly medical, surgical, or a combination of both. If the disease is detected at a very early stage, cessation of the habit is sufficient.
The main aim of treatment is to relieve the symptoms and improve the mouth opening. However, a more serious complication of this disease is the risk of the development of oral carcinoma. Excision of fibrotic bands was the primary procedure. Surgical intervention in osmf seemed to follow a predictable treatment plan. Most patients with oral submucous fibrosis present with moderatetosevere disease. A total of 10 patients of oral submucous fibrosis were admitted and surgically treated in our hospital with due permission of the ethical committee. Surgical excision of fibrous along with pedicled buccal fat pad graft.
Adequate surgical release of fibrous bands results in bilateral defects in buccal mucosa, which tends to contract and shrink if left to heal by secondary intention. Although, occasionally preceded by or associated with vesical formation, it is always associated with a juxtaepithelial inflammatory reaction followed by fibroelastic changes of lamina propria with epithelial atrophy, leading to stiffness of oral mucosa and. While the role of physiotherapy has been highlighted in the conservative management, its importance in postsurgical cases to avoid scar contracture and. Fibrotic bands in the region of pterygomandibular raphe, and faucial pillars were identified by light palpation, and under local anesthesia, a release was done with ercr. Various treatment modalities are available to manage reduced mouth opening caused due to osmf. The treatment depends on the level of clinical involvement.
Several classifications based on clinical and histological features, have been put forth by various researchers, based on different aspects of osmf. As the medical treatment of osmf is yet not standardized, the purpose of the present case study was to explore the effectiveness of osteopathic manipulative treatment omt in patients with osmf. Management of oral submucous brosis by different surgical. Oral submucous fibrosis osmf is a potentially malignant disorder of the oral cavity. Index definition history keywords pathogenesis clinical features laboratory findings classification treatment 3. Learning points oral submucous fibrosis osmf causes reduced mouth opening and adversely affects the quality of the life as the sufferers have difficulty in eating, which greatly affects their oral and general health. Oral submucous fibrosis causes, symptoms, treatment and. The general treatment consists of biopsy, stoppage of habits, treatment of anemia, vitamin supplements and removal of third molars, if it is required. Moderatetosevere oral submucous fibrosis is irreversible. Use of diode lasers in treatment of oral submucous fibrosis. Surgical fibrolysis and skin grafts in the management of oral. Medical treatment is symptomatic and predominantly aimed at improving mouth movements.
The treatment strategies sumit bhateja1, geetika arora2. A total of 96 patients with oral submucous fibrosis have received four regimens of treatment local dexamethasone, local hyaluronidase, local combination of dexamethasone and hyaluronidase, and local placental extract. The surgical treatment essentially comprises bilateral sectioning of fibrous bands with or without coronoidectomy besides the use of other modalities as nasolabial flaps,2. The surgical methods essentially comprise of bilateral sectioning of fibrous bands with or without coronoidectomy followed by covering of the surgical defect. Oral submucous fibrosis is defined as an insidious chronic disease affecting any part of the oral cavity and sometimes the pharynx. However, in advanced cases, no choice is left but surgical management. R crri,saveetha dental college and hospitals, chennai abstract. Various procedures and graft material have been utilised with differing success rates. Oral submucous fibrosis and the role of curcumin in its treatment. Latest treatmet modality of osmf is lasers, the hyaline bands are excised with the help of lasers which is a very good alternative to traditional surgical therapy but a bit costly and most of the osmf patients who have come to me were not in a position to afford laset therapy.
Gupta retrospective comparison of surgical treatment modalities in 100 patients with oral submucous fibrosis oral surg oral med oral pathol oral radiol endod, 107 2009, pp. A new concept in surgical management sanjay asnani 1, uma mahindra 2, rakesh oswal 3. Two woundcovering materials in the surgical treatment of. Gupte, et al autogenous buccal fat pad in the treatment of oral submucous fibrosis 49 international journal of scienti. Excision of oral submucous fibrosis and reconstruction with full. The surgical management of this condition involves excision of the fibrotic bands and interpositional grafts to retain the increased oral opening. A decision was made to surgically enhance the mouth opening with the use of ercr.
The aim of our study was to evaluate the effectiveness of buccal fat pad bfp in the management of oral submucous fibrosis osmf. Different authors have suggested variety of treatment modalities and have claimed success rates. Surgical correction of oral submucous fibrosis offer better outcome than conservative management. Medical surgical treatment is necessary for moderate to severe cases. The non surgical line of treatment includes usage of gold, iodides, hyluronidase, placental extract, and steroids like hydrocortisone and triamcinolone, vitamins, iron supplements. Scribd is the worlds largest social reading and publishing site. A wide range of treatment including drug therapy, surgical therapy, and physiotherapy have been attempted till date, with varying degrees of benefit, but none have been able to cure this disease. Various surgical treatment options adopted for remedying this condition include simple excision of fibrous bands and creating lingual pedicle and nasolabial flaps. This paper is aimed towards evaluating, best non surgical method for the treatment for osmf patients who do not prefer invasive surgical methods. Surgical modalities are reserved for more progressive. Role of collagen membrane in the treatment of advanced stage. Oral submucous fibrosis osmf is an insidious chronic disease affecting any part of the oral cavity and sometimes the pharynx with epithelial atrophy leading to stiffness of the oral mucosa, causing trismus and inability to eat.
Non surgical approaches in treatment of osf article pdf available in iosr journal of dental and medical sciences 11. Yeh7 was the first to reort the use of bfp for the wound created during surgery of osmf and got good results. By using intralesional method, there may be the following disadvantages. Autogenous buccal fat pad in the treatment of oral submucous. However, osmf has been refractory to most of the medical treatment modalities tried. Sixtyeight subjects with clinicopathologically diagnosed osmf were included in the study which was conducted from march, 20 to july, 20. A 30yearold male presented with a complaint of reduced mouth opening with burning sensation while eating spicy food for 4 years. Retrospective records of 30 patients of osmf treated with bfp with atleast a year of followup were analyzed. Surgical excision of fibrous bands along with fresh ammonia graft. Evaluating the efficacy of pentoxifylline in the treatment of oral submucous fibrosis. Oral submucus fibrosis surgical treatment with co 2 laser. Oral submucous fibrosis osmf is a highrisk precancerous condition characterised by slowly progressive chronic fibrotic disease of the oral cavity and oropharynx, in which the oral mucosa loses its elasticity and develops fibrous bands, which ultimately leads to difficulty in opening the mouth.
Sep 21, 2018 the aim of our study was to evaluate the effectiveness of buccal fat pad bfp in the management of oral submucous fibrosis osmf. This prospective study was done on cases of clinically diagnosed oral submucous. Surgical excision of fibrous bands along with split thickness skin graft. Dec 25, 2014 the search words osmf, surgical interventions in osmf, flaps and grafts in treatment of osmf were employed for retrieval of data. The painful treatment procedure may discourage the patient to seek treatment. Oral submucous fibrosis is a chronic debilitating disease characterized by. A number of conservative and surgical treatment options have been suggested for this potentially malignant disorder arakeri and brennan, 20. Comparative efficacy of newer antioxidants spirulina and. Surgical fibrolysis and skin grafts in the management of. Oral submucous fibrosis, a clinically benign but potentially. Oral submucous fibrosis osmf is a chronic insidious disease affecting any part of the oral cavity and sometimes the pharynx. Herein, we report a case of a man with osmf requiring construction of. Cn yogishwarappa and abh ishek vijayakumar surgica l management of oral submucous fibrosis 215. Multiple methods have been described and each has significant disadvantages.
Vascularized lymph node transfer vlnt is a surgical treatment for lymphedema. Use of diode lasers in treatment of oral submucous. Effectiveness of osteopathic therapy in the treatment of oral. Adequate surgical release of fibrous bands results in bilateral defects in buccal mucosa, which tends to contract and. The treatment of patients with oral submucous fibrosis depends on the degree of clinical involvement. Comparison of mouth opening with different nonsurgical. The surgical treatment essentially comprises bilateral sectioning of fibrous bands with or without coronoidectomy besides the use of. Effectiveness of osteopathic therapy in the treatment of. Osmf can be managed by medicinal or surgical means, which constitutes two broad categories of its management. Current protocols in the management of oral submucous. Surgical management of osmf with coronoidectomy and buccal.
Materials and methods the present study was conducted in the department of oral medicine and. Oral submucous fibrosisa case report medcrave online. Apr 18, 20 home remedies for oral submucous fibrosis ii. Key words such as osmf and treatment, treatment modalities for osmf and management of. Capsule oxitard was administered to all patients at a dose of 2 capsules twice daily for a period of 3 months. Lai dr divided osmf into 4 groups in 1995 based on interincissal distance4 where group d consists of patients with mouth opening less than 20 mm. Jun 18, 2018 the treatment of patients with oral submucous fibrosis depends on the degree of clinical involvement. Surgical management of oral submucous fibrosis using.
Patient education and counseling is one of the foremost important step in the management of osmf which includes. Nov 24, 2012 oral submucous fibrosis surgical treatment surgery may be required if the fibrosis continues to progress despite all the above treatments and the interincisal distance gets below 2 cm. A total of 25 patients consented for surgical treatment. Oraoral submucous fibrosis osmf is a chronic, insidious, disabling disease of oral mucosa, oropharynx, and rarely, the larynx affecting millions of people worldwide with a prevalence rate of 0. Novel mouthexercising device for oral submucous fibrosis. The surgical protocol includes fibrotomy, coronoidectomy and removal of all third molars 10. Oral submucous fibrosis osmf is a disease of unknown etiology. Surgical management of oral submucous fibrosis with the. The experience of the others who used versatile, vascular tongue flaps in the oral cavity after cancer clearance, prompted us to attempt this new technique in the present series with gratifying results. Dec 25, 2014 oral submucous fibrosis osmf is a potentially malignant disorder of the oral cavity.
In india osmf is observed in bihar, maharashtra, gujarat and madhya pradesh 3. Oral submucous fibrosis is a chronic, complex, premalignant 1% transformation risk condition of the oral cavity, characterized by juxtaepithelial inflammatory reaction and progressive fibrosis of the submucosal tissues the lamina propria and deeper connective tissues. Classification system for oral submucous fibrosis jiaomr and predominantly aimed at improving mouth movements. Surgical management consisted of resection of fibrous bands, bilateral temporalis. All these patients had advanced oral submucous fibrosis. The advantages or disadvantages of these classifications. This study was carried out to determine the safety and efficacy of oxitard in the treatment of osmf. Physiotherapy via interocclusal force application is the mainstay for surgical treatment. Surgical management of oral submucous fibrosis with seagull. A case of osmf reported with initial interincisal mouth opening. As the disease progresses, the jaws become rigid to the point that the person is unable to open the mouth. It results in difficulty to open the mouth and can be disabling to the patient. Oral submucous fibrosis is a chronic insidious disease which was previously designated as a premalignant condition but presently categorized under potentially malignant disorders who 2005.
Patients were divided into groups based on the stages of osmf. We employed the usage of autologous buccal pad of fat. Over the years, osmf has been classified based on either clinical or histological or both features of the disease. Medical and surgical treatment options for oral submucous. There lack of guidelines for choosing the surgical procedures. Classifications based on clinical features of osmf are. The various treatment modalities used to cure the disease are corticosteroids, hyaluronidase, placenta extract, ifn, microwave diathermy and surgical treatment options which include excision of fibrotic tissues and covering the defect with graft 4. Many osmf treatment protocols have been proposed to alleviate the signs and symptoms of the disorder and there is overwhelming evidence that as areca nut is primary cause, stopping its use may have a considerable effect on symptoms rather than reversing pre. An analysis of the treatment modalities, the reason for the selection of a particular modality, the organization of the sample selection and the followup periods including the proclaimed success.
All patients signed an informed consent form before surgery. Oral submucous fibrosis osmf, a chronic debilitating condition of the mouth, has been treated both surgically and nonsurgically, but non surgical methods yield inconsistent results. The surgical treatment is the mainstay treatment of osmf. The treatment being mostly symptomatic various surgical treatments have been described for improvement of mouth opening along with cessation.
Use of nasolabial flap in the management of oral submucous. Use of buccal fat pad for treatment of oral submucous fibrosis. Oral sub mucous fibrosis osmf is a chronic, insidious, disabling disease of oral mucosa, oropharynx, and rarely, the larynx affecting millions of people worldwide with a prevalence rate of 0. Oral submucous fibrosis, skin grafts, surgery, trismus. Osmf, the oral mucosa is already atrophied and inflammed. Oral submucous fibrosis is one of the leading potentially malignant disorders prevailing in india. Surgical excision of the fibrotic bands can be attempted but it is observed that such surgical intervention aggravate the condition. The primary cause leading to trismus in osmf may be fibrosis and fibrous band formation in the oral mucosa. Surgical management of oral submucous fibrosis using buccal. In our cases, the treatment success was achieved by all the three surgical methods including buccal fat pad graft, tongue flap graft and temporalis muscle flap graft.
The diagnosis and staging of osmf is an important aspect for a clinician as it affects the treatment and the prognosis 24,25. However surgical intervention is the only treatment available in the extremely advanced cases of oral submucous fibrosis. All patients were males and their ages ranged from 21 to. Use of buccal fat pad for treatment of oral submucous. Surgical management of oral submucous fibrosis with. This is a break through in the surgical management of osmf, where other treatment modalities failed. Osmf is associated with impaired nutritional status, therefore, various investigators have supplemented the patients. At a very early stage, cessation of the habit is adequate. Effectiveness of long term supervised and assisted. Oral submucous fibrosis osf, globally accepted as an indian disease, has one of the highest rates of malignant transformation. Oral submucous fibrosis osmf is a disease characterized by a severe progressive fibrosis of the oral cavity. Pdf classification system for oral submucous fibrosis. Oral submucous fibrosis osmf is a highrisk premalignant condition predominantly seen in the indian subcontinent.
Maintenance of increased mouth opening in oral submucous. Surgical management of oral submucous fibrosis scholar science. Various types of treatment modalities include conservative methods, medical management, and invasive methods like surgical elimination of the fibrotic bands and combined therapy. Management of oral submucous fibrosis by different surgical. Treatment modality should be chosen based on broad thinking of the versatility and applicability to obtain more successful results with less patient discomfort. It is indicated in patients with severe trismus andor biopsy results. Laser treatment video for oral submucous fibrosis part 1. Oral submucous fibrosis and the role of curcumin in its. Treatment no known treatment for osf is effective, although some conservative and surgical interventions may result table 1 summary of oral submucous fibrosis cases reported in western countries country ethnic origin of patient number of cases reported canada3 india 2 canada4 india 1 canada5 india 3 united kingdom6 bangladesh 1.
Surgical management of osmf with coronoidectomy and. The aim of the present study was to compare the efficacy of spirulina and lycopene in the management of osmf. Surgical management consisted of resection of fibrous bands, bilateral temporalis myotomy. Complete details of surgery were explained to the patients and informed consent was obtained from each patient.
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