Review of drug treatment of oral submucous fibrosis.
This study undertook a review of the literature on drug treatment of oral submucous fibrosis. An electronic search was carried out for articles published between January 1960 to November 2011. Studies with high level of evidence were included. The levels of evidence of the articles were classified after the guidelines of the Oxford Centre for Evidence-Based Medicine. The main outcome measures used were improvement in oral ulceration, burning sensation, blanching and trismus. Only 13 publications showed a high level of evidence (3 randomized controlled trials and 10 clinical trials/controlled clinical trials), with a total of 1157 patients. Drugs like steroids, hyaluronidase, human placenta extracts, chymotrypsin and collagenase, pentoxifylline, nylidrin hydrochloride, iron and multivitamin supplements including lycopene, have been used. Only systemic agents were associated with few adverse effects like gastritis, gastric irritation and peripheral flushing with pentoxifylline, and flushingly warm skin with nylidrin hydrochloride; all other side-effects were mild and mainly local. Few studies with high levels of evidence were found. The drug treatment that is currently available for oral submucous fibrosis is clearly inadequate. There is a need for high-quality randomized controlled trials with carefully selected and standardized outcome measures.
Department of Oral Medicine and Radiology, Modern Dental College and Research Centre, Indore, Madhya Pradesh, India. drchole@rediffmail.com
Revant H
RH
Chole
Shailesh M
SM
Gondivkar
Amol R
AR
Gadbail
Swati
S
Balsaraf
Sudesh
S
Chaudhary
Snehal V
SV
Dhore
Sumeet
S
Ghonmode
Satish
S
Balwani
Mugdha
M
Mankar
Manish
M
Tiwari
Rima V
RV
Parikh
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000975:Antioxidants / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D000529:Complementary Therapies; D005260:Female; D006801:Humans; D006867:Hydrolases / Q000008:administration & dosage; D008297:Male; D009914:Oral Submucous Fibrosis / Q000188:drug therapy*; D014131:Trace Elements / Q000008:administration & dosage; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage; D014815:Vitamins / Q000008:administration & dosage
D000305:Adrenal Cortex Hormones; D000975:Antioxidants; D014131:Trace Elements; D014665:Vasodilator Agents; D014815:Vitamins; D006867:Hydrolases