title: Intralesional corticosteroids as a treatment for restricted mouth opening in oral submucous fibrosis.
abstract: OBJECTIVE
  Oral submucous fibrosis (OSF) is a chronic debilitating disease of the oral mucosa, associated with an increased risk of malignancy. The primary objective of this study was to evaluate the effectiveness of intralesional corticosteroid injection as a treatment modality for OSF. We also studied the correlation between the treatment outcome and a number of individual variables.
  
  
  METHODS
  A total of 230 histologically confirmed patients with OSF were included in the study, of which 116 patients with a 30 mm or less interincisal mouth opening were subjected to intralesional injections of 40 mg methylprednisolone at monthly intervals for 6 consecutive months. The effect of the treatment was assessed by evaluating the degree of improvement in mouth opening.
  
  
  RESULTS
  All patients included in the study had a history of chewing areca nut. In paired comparison, statistically significant difference (t = -8.78; df = 115; P < .001) was observed in mouth opening over a period of 12 months in the patients who had corticosteroid injections.
  
  
  CONCLUSIONS
  Intralesional corticosteroid injection is one of the most widely implemented interventions for OSF at present, particularly for those patients with palpable fibrous bands. The present study provides justification for the use of corticosteroids in improving mouth opening.
authors.affiliation: Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka. Electronic address: Wmtilak@pdn.ac.lk.
authors.forename: Wanninayake M
authors.initials: WM
authors.lastname: Tilakaratne
authors.affiliation: Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka.
authors.forename: Rasika P
authors.initials: RP
authors.lastname: Ekanayaka
authors.affiliation: Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka.
authors.forename: Manjula
authors.initials: M
authors.lastname: Herath
authors.affiliation: Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka.
authors.forename: Ruwan D
authors.initials: RD
authors.lastname: Jayasinghe
authors.affiliation: Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka.
authors.forename: Mohaideen
authors.initials: M
authors.lastname: Sitheeque
authors.affiliation: National Cancer Control Programme, Ministry of Health, Maharagama, Sri Lanka.
authors.forename: Hemantha
authors.initials: H
authors.lastname: Amarasinghe
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D001114:Areca / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D009914:Oral Submucous Fibrosis / Q000139:chemically induced / Q000188:drug therapy*; D016896:Treatment Outcome; D014313:Trismus / Q000188:drug therapy*
chemical_list: D000305:Adrenal Cortex Hormones; D008775:Methylprednisolone