Multiple myeloma (MM) is a malignancy of plasma cell origin. It often has a multicentric origin within the bone. It makes about 1% of all malignancies and 15% of all hematologic malignancies. There is a monoclonal proliferation of abnormal plasma cells in this disease that arise from a single malignant precursor that has undergone uncontrolled mitotic division. These cells in turn produce one type of immunoglobulin light chain, either kappa or lambda. Unifocal, monoclonal proliferation of plasma cells is called plasmacytoma. Hereby, we present a case of a 65-year-old female patient who presented with a swelling of the mandible. The uniform sheets of plasma cells in the histopathology punched out radiolucencies in skull radiograph and the blood picture of anemia and hypercalcemia, confirmed the case as MM.

Introduction: Antioxidants relieve the signs and symptoms of oral submucous fibrosis by decreasing the load of free radicals. Aim: The aim of this systematic review was to retrieve and analyse clinical studies investigating systemic antioxidants in the management of OSMF. Material and method: Literature was searched in electronic search engines from 1995 to 2015. The identified titles / abstracts were independently screened according to set criteria for selection of abstracts. The full -text articles retrieved were assessed for eligibility and the eligible studies were assessed for qualitative and quantitative evidence. 9 full text articles were selected and assessed for eligibility. 6 full text articles were eligible for qualitative and quantitative analysis. Meta -analysis was done for mouth opening. Results: The extracted data resulted in 207 subjects using systemic antioxidants. Meta -analysis of the combined data of the studies administering systemic antioxidants as a single entity or in combination with intralesional corticosteroids (n=121) as compared to other interventions (n=121) did not depict significant improvement in mouth opening (SMD = -1.446; 95% CI = -3.332 to -0.439) with significant test of heterogeneity (p = 0.0001 < 0.05). Meta -analysis of the combined data of all the interventional groups (n=207) and control groups (n=203) which depicted that systemic antioxidants as a single entity or in combination with intralesional steroids significantly improve mouth opening v/s controls (SMD = -1.235; 95% CI = -2.263to -0.206) with a significant test of heterogeneity (and p = 0.0001 < 0.05). Conclusion: Although the meta -analysis indicates that antioxidants appear to be effective in management of OSMF, the high degree of heterogeneity and limited amount of data in this systematic review and meta -analysis does not provide a credible evidence to support these observations.

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