Role of Collagen Impregnated with Dexamethasone and Placentrix in Patients with Oral Submucous Fibrosis

Abstract

Purpose To evaluate the versatility of the collagen membrane as both drug carrier and biologic dressing material to cover the raw wounds created after the surgical excision of fibrotic bands in oral submucous fibrosis. Materials and Methods The study comprises of ten patients. The patients of age group 20 to 50 years were selected. The collagen is reconstituted by injecting with dexamethasone and placentrix solution leaving a small overlap on to the remaining mucous membrane and the graft is sutured. Preoperative and post operative assessment was done regarding the improvement in mouth opening, decrease in burning sensation, change in colour of oral mucosa and clinically grading the extent of lesion. Results The results were found appreciable in seven patients while in the remaining three patients it showed relapse because of inadequate physiotherapy. All the ten patients were comfortable with intra oral collagen grafting. The collagen remained moist and supple intraorally, and remained in close contact with the underlying tissues, providing a strong mechanical barrier. The material was effective in attaining haemostasis, relieving pain and preventing extensive contracture. Conclusion In this study of short duration, the nature of collagen membrane was observed as both biological dressing material and drug carrier. It was found as a very suitable alternative to the other graft material mentioned for the repair of defects in the mucous membrane created by surgical excision of fibrous bands in oral submucous fibrosis.

Efficacy of collagen membrane graft in intraoral surgery - An evaluative study

“… Collagen membrane has an inherent property of haemostatic effect as it is a specific activator of platelets and helps in their adhesion to collagen fiber, aggregation[ 32 ] It has a guiding characteristic with stabilize the coagulum and enhances the early epithelial proliferation from the surrounding tissues[ 14 33 ] It is chemotactic to various cell types such as endothelial cells, fibroblasts and leads to reduced inflammatory process which reduces pain and burning sensation[ 12 14 31 ] Collagen acts as a temporary coverage for sensitive nerve endings, thereby diminishing the degree of pain[ 12 14 31 ] Collagen dressings encourage wound healing through early deposition and organization of granulation tissue and hastened the healing process[ 12 ] Can resist masticatory forces for sufficient time Easily obtainable and does not require a second operation and its associated morbidity. …”

“…It has a guiding characteristic with stabilize the coagulum and enhances the early epithelial proliferation from the surrounding tissues[ 14 33 ]…”

“…It can also be used in leukoplakia,[ 6 7 10 ] in Oral Submucous Fibrosis (OSMF)[ 8 10 11 12 13 14 15 ] in palatal defects,[ 16 17 ] in perforation of maxillary sinus membrane[ 18 19 20 ] and in palatal fistula closure. [ 21 22 23 ]…”

Effectiveness of Long Term Supervised and Assisted Physiotherapy in Postsurgery Oral Submucous Fibrosis Patients

“…To further enhance the mouth opening, a plan for bilateral coronoidectomy was decided on the operating table which further improved the mouth opening to 48 mm. The resultant defect over the buccal mucosa was covered with a collagen membrane impregnated with placental extract and hyaluronidase (Figure 3) [3]. The collagen membrane was sutured over the defect (Figure 4) and a bolster gauze was placed over it to stabilize the membrane.…”

Dexamethasone-containing bioactive dressing for possible application in post-operative keloid therapy

“…On the contrary, there are reports on the positive effects of DEX in healing process. DEX was applied with success in repair of the mucous membrane defects in oral submucous fibrosis (Raghavendra Reddy et al 2012). In that study Reddy et al have used DEX-impregnated collagen membranes to cover the raw wound created by surgical excision of fibrous bands.…”