Emancipators in oral sub mucous fibrosis: An update

Oral submucous fibrosis is a chronic insidious oral mucosal condition causing trismus and reduced mouth opening and it is affecting predominantly Indian and other Asians. The treatment of trismus requires combination of pharmacological agents, surgical therapy and physiotherapy, the latter is essential for preventing relapse due to postoperative inactivity and scarring as well as for improvement of mouth opening. Computerized literature search was performed from 1993 till 2021 to select eligible articles from the following databases: PUBMED [MEDLINE], SCOPUS, SCIENCE DIRECT, and COCHRANE DATABASE using specific keywords. The search was limited to articles published as full text in English, which were screened by two reviewers for eligibility.This article describes in depth about various appliances, devices used in oral submucous fibrosis. The devices can be used along with pharmacological and surgical treatment modalities or can be used alone. Mouth exercise is also well-established method to improve mouth opening and also to prevent postsurgical relapse. This article is one of the rare article that describes all the appliances together either directly used or indirectly used for the case of microstomia due to oral sub mucous fibrosis.

Mean Lipid Profile among Patients Suffering from Oral Sub-mucous Fibrosis Reporting in a Tertiary Care Hospital of Karachi, Pakistan: A Descriptive Study

Background: Oral Submucous Fibrosis is a potent pre-malignant condition of Oral cavity, which is prevalent in South Asian countries, due to social habit of pan, gutka, areca nut and betel quid chewing, which is mostly practiced in South-East Asia. A decreased pattern of lipid profile has been observed in literature in many precancerous conditions, this study is based on observation of lipid profile pattern among Oral submucous fibrosis patients in relation with age, gender, body mass index and duration of disease. Objective: A descriptive study to determine mean lipid profile values among oral sub-mucous fibrosis patients. Study Design: Descriptive (cross-sectional) study. Settings: Department of Oral & Maxillofacial Surgery, Abbasi Shaheed Hospital-Karachi Pakistan. Duration: 1st January 2017 till 30th June 2017, for a period of six months. Methodology: Oral Sub-mucous Fibrosis (OSMF) patients, who also met with inclusion criteria of study were selected. Lipid Profile values of TC (total cholesterol), HDL (high density lipids), LDL (low density lipids) and triglycerides were observed among OSMF patients in relation to duration of disease, their different age groups, gender and body mass index (BMI). Results: Out of 104 clinically diagnosed patients of OSMF, 34 females and 70 were males. Mean age was 38.9, most of the patients were in the age group of 20-40 years. Mean and standard deviation of TC, triglycerides, LDL and HDL was 132.19±13.29, 142.25±8.71, 101.87±17.57 and 30.43±2.56 respectively. Conclusion: Results of this study revealed that there is no significant change in pattern of lipid profile among OSMF patients in relation to their different age groups, gender and BMI, but an inverse relation does exist between lipid panel and duration of disease.

A potential protection of melatonin on pathogenesis of oral sub-mucous fibrosis (OSMF) : a current update

Oral submucous fibrosisis (OSMF) is a clinical condition of the oral cavity which is caused predominantly by areca nut consumption. This fibrotic condition affects almost all parts of the oral cavity and can cause significant reduction in mouth opening, thereby, resulting in functional impairment. The other potential risk of OSMF is its malignant transformation into oral squamous cell carcinoma, which occurs in a significant number of afflicted patients. Extensive researches have been conducted to understand the pathogenesis of OSMF for identification of tangible therapeutic modalities. To date, there is no effective therapeutic modality for this disorder. It is well known that melatonin has a potent anti-fibrotic, anti-oxidant, and pro-angiogenic effects. The therapeutic potential of melatonin on OSM cannot be ignored. In this article we have explored the potential mechanisms of melatonin as an adjuvant in the prevention and treatment of OSMF.

A REVIEW ON BUCCO-ADHESIVE DRUG DELIVERY SYSTEMS FOR ORAL SUB-MUCOUS FIBROSIS: CHALLENGES, OPPORTUNITIES AND FUTURE PERSPECTIVES

Oral sub-mucous fibrosis (OSF) is a chronic, insidious disease which might affect the oral cavity (oral mucosa) including pharynx and larynx. Numerous approaches and anticancer molecules have been explored in the literature to treat OSF with different modes of action. However, complete cure for OSF is limited due to the lack of an ideal carrier for safe and effective delivery of potent drug moieties. There are several challenges such as anatomical or histological barriers and appropriate animal model need to be explored and optimized to develop the efficient treatment for oral sub-mucous fibrosis. Constant progression in the development of new formulations has led to the effective management of the disease associated with the mucosa using mucosal or muco-adhesive drug delivery systems. Muco-adhesive drug delivery systems (such as gel and patches) have gained unique position as drug cargoes. Therefore, present review is an attempt to contemplate on OSF in terms of pathogenesis, currently available treatment shaving their mode of action, major challenges encountered during treatment, usefulness/feasibility of muco-adhesive dosage forms, opportunities/future scope of muco-adhesive drug delivery in OSF and recent developments in the delivery of various anti-cancer drugs in the treatment of OSF.