A comparative study on the use of antioxidants and intralesional steroid infiltration in oral submucous fibrosis

Background: Oral submucous fibrosis (OSMF) affects all age groups in Orissa. Rampant use of tobacco, gutka, and betel chewing made it a significant public health problem. Various modalities of treatments have been tried to ameliorate consequences of disease including antioxidants, local and systemic steroid, physiotherapy alone or with assisted devices, placental extract injection, and split skin grafting with varying success rate. Objective: The objective of the study was to compare effect of antioxidants and intralesional steroid infiltration in OSMF. Materials and Methods: Hospital-based prospective study was carried out among fifty patients presenting with OSMF. Only Stage two patients with Grade 2 and 3 trismus were included. History, clinical examination, and punch biopsy were taken. They were divided into two groups of 25 each irrespective of age and sex. Patients in Group A were given injection hyaluronidase (1500 IU) mixed with triamcinolone (40 mg/ml). It was injected submucosally once a week for 8 weeks over multiple sites in oral cavity. Patients in Group B were given oral antioxidant capsule (containing lycopene 4 mg, zinc 7.5 mg, and selenium 35 mg) once daily for 8 weeks. All patients were followed up for 8–12 weeks at weekly intervals and then monthly once for 1 year. Results: Majority belonged to 26–35 years. Majority were consuming areca nut with Pan (52%). Burning sensation on taking food and trismus were common symptoms. Most common sign was fibrosis (70%). Injection hyaluronidase (1500 IU) mixed with triamcinolone (40 mg/ml) injected submucosally once a week for 8 weeks over multiple sites was significantly effective in trismus compared to oral antioxidant capsule daily once for 8 weeks. Conclusion: Injection hyaluronidase (1500 IU) mixed with triamcinolone (40 mg/ml) injected submucosally once a week for 8 weeks over multiple sites was more effective than oral antioxidant capsule daily once for 8 weeks