Zainab Chaudhry1, Shalini R Gupta2, Sukhvinder Singh Oberoi3. 1. Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi, India. 2. Department of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, New Delhi, India. 3. Department of Public Health Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India.
Abstract
INTRODUCTION: Oral submucous fibrosis (OSMF) is a chronic insidious disease mainly associated with fibroelastic change of the oral mucous membrane, leading to progressive trismus and oral burning sensation. The management of OSMF is empirical, depends on staging of the condition and is combination of conservative/medical/surgical interventions. Management of moderate OSMF is more challenging as conservative and medical treatments are not effective while surgical techniques involving fibrotomy and reconstruction of resultant defect are excessive. Lasers can provide an alternative and better means for surgical fibrotomy in moderate OSMF as they are minimally invasive and have the advantage of short operating time, less hemorrhage, faster healing, less morbidity, less surgical-site scarring and relapse. Laser fibrotomy in moderate OSMF have been done under general anesthesia. MATERIALS AND METHODS: A case series of 16 cases of moderate OSMF treated with Erbium Chromium Yttrium Scandium Gallium Garnet (ErCr:YSGG) laser fibrotomy under local anesthesia in combination with cessation of habits, topical steroids, lycopene and oral physiotherapy is presented. RESULTS: The mean increase in mouth opening achieved at 1 year was 17.5 mm. The mean difference in the preoperative and 1 year mouth opening was found to be statistically significant. The mean difference in the preoperative and six-month Visual Analogue Scale scores for oral burning sensation and Oral Health Impact Profile-14 scores for assessment of oral health-related quality of life was statistically significant implying improvement. CONCLUSIONS: ErCr:YSGG laser fibrotomy under local anesthesia is a minimally invasive, cost effective, chair-side procedure and an useful adjunct in management of moderate OSMF.
INTRODUCTION:Oral submucous fibrosis (OSMF) is a chronic insidious disease mainly associated with fibroelastic change of the oral mucous membrane, leading to progressive trismus and oral burning sensation. The management of OSMF is empirical, depends on staging of the condition and is combination of conservative/medical/surgical interventions. Management of moderate OSMF is more challenging as conservative and medical treatments are not effective while surgical techniques involving fibrotomy and reconstruction of resultant defect are excessive. Lasers can provide an alternative and better means for surgical fibrotomy in moderate OSMF as they are minimally invasive and have the advantage of short operating time, less hemorrhage, faster healing, less morbidity, less surgical-site scarring and relapse. Laser fibrotomy in moderate OSMF have been done under general anesthesia. MATERIALS AND METHODS: A case series of 16 cases of moderate OSMF treated with Erbium Chromium Yttrium Scandium Gallium Garnet (ErCr:YSGG) laser fibrotomy under local anesthesia in combination with cessation of habits, topical steroids, lycopene and oral physiotherapy is presented. RESULTS: The mean increase in mouth opening achieved at 1 year was 17.5 mm. The mean difference in the preoperative and 1 year mouth opening was found to be statistically significant. The mean difference in the preoperative and six-month Visual Analogue Scale scores for oral burning sensation and Oral Health Impact Profile-14 scores for assessment of oral health-related quality of life was statistically significant implying improvement. CONCLUSIONS: ErCr:YSGG laser fibrotomy under local anesthesia is a minimally invasive, cost effective, chair-side procedure and an useful adjunct in management of moderate OSMF.
Authors: Dr Shailesh M Gondivkar; Dr Amol R Gadbail; Dr Sachin C Sarode; Dr Rima S Gondivkar; Shankargouda Patil; Dr Rahul N Gaikwad; Dr Monal Yuwanati Journal: J Oral Biol Craniofac Res Date: 2020-05-18