Benefit of Using Muscle Relaxants in the Routine Treatment Protocol of Oral Submucosal Fibrosis: A Pilot Study

Abstract

The aim of this present work is to describe the nature and extent of fibrosis within muscle and to correlate this with the mouth opening (MO) in OSE patients and to prove our results in improvement of mouth opening in patients with OSMF with use of ''muscle relaxants'' along with other modalities of treatment . The study was conducted on 40 patients who visited our outpatient department with grade 3 (\19 mm) mouth opening. 20 of these patients underwent the routine treatment protocol of weekly injection of hyaluronidase with hydrocortisone and antioxidant capsules with added lycopene for 1 month. The remaining test subjects in addition to the routine injections and antioxidants were given skeletal muscle relaxants like thiocolchicoside or chlorzoxazone. The mouth opening (interincisal distance of maxillary and mandibular incisors at maximum possible mouth opening) was measured and graded as follows: grade 1 ([40 mm), grade 2 (20-39 mm) and grade 3 (\19 mm) with the help of vernier callipers after the study period of 1 month. 17 out of the 20 test patients who received muscle relaxants in addition to the routine protocol showed marked improvement with shift from grade 3 (\19 mm) to grade 1 ([40 mm) i.e. a greater than 20 mm improvement in mouth opening. Using muscle relaxants as a adjuvant therapy in the routine protocol of treatment of oral submucosal fibrosis will not only cater and halt the problem of fibrosis but also will take care of the muscle spasm and inflammation which also inadvertently contribute to the restricted mouth opening. We found excellent improvement on adding muscle relaxants to the routine protocol which was not just an objective but also a subjective success.

Limited mouth opening in oral submucous fibrosis: reasons, ramifications, and remedies

“…, gray box). An indication that individuals consuming alcohol tend to have wider MO , and a substantial improvement in the MO in patients with OSF using muscle relaxants , offers important leads (Fig. , gray box).…”

“…Normally injured muscle initiates repair of myofibers via proliferation of satellite cells , which then form the myoblasts, and these differentiate into myocytes. The fusion of myocytes controls the formation of myofibers and the completion of muscle repair (Fig.…”

Clinical evaluation of the role of tulsi and turmeric in the management of oral submucous fibrosis: A pilot, prospective observational study

“…The remaining 20 test subjects, in addition to the routine injections and antioxidants, were given skeletal muscle relaxants like thiocolchicoside or chlorzoxazone. [ 15 ] Seventeen out of the 20 test patients who received muscle relaxants in addition to the routine protocol showed marked improvement with shift from grade 3 (<19 mm) to grade 1 (>40 mm) that is a greater than 20 mm improvement in mouth opening. [ 15 ] Karemore TV et al ., evaluated the effect of newer antioxidant lycopene in the treatment of oral submucous fibrosis.…”

Histopathological Changes in Oral Submucous Fibrosis: Updated Review

“…Normally, injured muscle initiates the repair of myofibers via proliferation of satellite cells [5,16], which then form the myoblasts, and these differentiate into myocytes. The fusion of myocytes controls the formation of myofibers and the completion of muscle repair.…”