Drug treatment for oral submucous fibrosis: a systematic review

Abstract

Objective The aim of this review is to evaluate the different medicinal interventions available for the management of oral submucous fibrosis (OSF). Materials and methods We searched a comprehensive electronic search on PubMed, Web of Science, and Cochrane Library databases for articles related to OSF patients treated with medications from December 2011 to September 2022. GRADE system was used to evaluate the evidence quality. Results Twenty-nine randomized controlled trials (RCTs), six non-RCT studies were included, and the use of drugs for OSF treatment were evaluated. The main outcomes were improvement in mouth opening, burning sensation, cheek flexibility, and tongue protrusion. Drugs like steroids, hyaluronidase, pentoxifylline, lycopene, curcumin, dpirulina, aloe vera, omega3, oxitard, allicin, colchicine have been used. It was found that drugs with evidence high quality were SMI combined with triamcinolone acetonide, lycopene, pentoxifylline, curcumin, and aloe vera, and those with evidence moderate quality were allicin, colchicine, omega 3, and oxitard. Conclusion Based on the results of our comprehensive analysis, for long-term treatment, we found lycopene with low side effects, whereas for relieving the symptoms of severe burning sensation, aloe vera is the most effective. Although the resent review has made some progress, drug therapy for OSF remains unclear, and more high-quality RCTs are needed to identify better treatments for OSF.