Oral Submucous Fibrosis: A Review on Different Treatment Modalities

Abstract

Background: Oral Submucous Fibrosis (OSMF) is a chronic, debilitating condition affecting the oral mucosa, leading to significant functional impairment. It is primarily induced by the chronic use of areca nut and its commercial products. The disease is characterized by juxta-epithelial inflammation and progressive fibrosis of the submucosal tissues, resulting in severe trismus, pain, and burning sensation in the mouth. Objective: This review aims to systematically assess and synthesize the available literature on the various treatment modalities for OSMF, evaluate their effectiveness, and identify areas requiring further research. Methods: A comprehensive search was conducted across multiple databases including PubMed, Scopus, Web of Science, and Google Scholar using keywords such as "Oral Submucous Fibrosis," "OSMF treatment," and "fibrosis management." Studies published in English without any restriction on publication date were included. The review process involved screening titles and abstracts, followed by a full-text review. The quality and relevance of studies were assessed, focusing on study design, sample size, methodological rigor, and impact on clinical practice. Quantitative data were extracted and synthesized where available. Results: The search yielded a total of 150 studies, of which 45 met the inclusion criteria and were analyzed. Treatment modalities varied widely, including pharmacological interventions (corticosteroids, hyaluronidase, placental extracts), physical therapies (EZbite, acrylic splints, hyperbaric oxygen therapy), surgical techniques (fibrotomy, various flap reconstructions), and emerging therapies (stem cell treatment, omega-3 supplementation). Surgical interventions showed a success rate of 60-70% in improving mouth opening, while pharmacological treatments reported a 50-60% reduction in symptoms such as burning sensation and pain. The use of stem cells and omega-3 showed promising preliminary results but lacked extensive clinical trials. Conclusion: The treatment of OSMF requires a multidisciplinary approach, combining pharmacological, physical, and surgical modalities. While current treatments show varying degrees of effectiveness, there is a need for more randomized controlled trials to establish the efficacy of emerging therapies. Future research should focus on developing less invasive and more targeted treatments to improve patient outcomes.