Background: Various treatment strategies have been proposed in the literature for the management of oral submucous fibrosis (OSMF) but most of these modalities have been associated with relapse. This prospective clinical trial evaluated the efficacy of intralesional injection of Triamcinolone acetonide (40mg/ml) and hyaluronidase (1500IU) with regular oral physiotherapy exercises in 30 subjects of clinically diagnosed Oral submucous fibrosis patients. Material & Method: 30 subjects of clinically diagnosed grade II OSMF following informed consent and total habit counselling and cessation, were given biweekly injection (18 injections) of Triamcinolone Acetonide and hyaluronidase for a total period of 9 weeks and followed up for 16 weeks. All subjects were advised adjunctive oral physiotherapy exercise for mouth opening and cheek flexibility. Clinical improvement was evaluated by visual analog scale for pain/burning sensation, interincisal mouth opening, cheek flexibility and tongue protrusion in mm. Results: 24 out of 30 subjects completed the protocol with clinical improvement in burning sensation as, 7.98±2.55 (p=0.000, t = 11.071) and mean interincisal mouth opening, 0.4583±0.83297 mm( p=0.000, t=-5.324). Cheek flexibility 0.2 mm left and 0.41 mm right side improvement (p= >0.05)and tongue protrusion 1.37 mm improvement (p=>0.05) , did not show any improvement in all subjects. Conclusion: Intralesional Triamcinolone Acetonide and hyaluronidase biweekly injections with oral physiotherapy shows promising result in symptomatic relief of burning sensation and increase in interincisal mouth opening in OSMF subjects.
Keywords: Oral submucous fibrosis, trismus, triamcinolone acetonide, hyaluronidase, oral physiotherapy