Comparison of Triamcinolone Versus Platelet Rich Plasma Injection for Improving Trismus in Oral Submucous Fibrosis

Authors

  • Amer Sabih Hydri
  • Iqbal Hussain Udaipurwala
  • Nadeem Ahmed Sheikh
  • Sana Muhammad Sadiq
  • Sohail Aslam
  • Syed Muhammad Asad Shabbir bukhari

DOI:

https://doi.org/10.51985/JBUMDC2019104

Keywords:

Injection, Oral Sub Mucosal Fibrosis, Platelet rich Plasma, Trismus, Triamcinolone.

Abstract

Objective: To compare the effect of Triamcinolone versus Platelet Rich Plasma (PRP) injection intraorally for improving
trismus in Oral Submucous Fibrosis (OSMF).
Study Design and setting: Randomized double-blind comparative study, conducted at ENT department of PNS Shifa
Hospital, Karachi from 1st June 2015 to 30th June 2016.
Methodology: Eighty patients with trismus due to oral submucous fibrosis were divided randomly into two groups, ‘A’
and ‘B’ of 40 patients each. In Group A, Inj. Triamcinolone 40mg (1 ml) was injected into the sub-mucosal plane in the
retro-molar trigone area and into the fibrous bands along the soft palate on multiple sites, weekly for 6 weeks. In group B
Inj. PRP 1ml weekly was administered for 6 weeks along the same site. Vernier calipers were used to precisely measure
the Maximum Interincisal Distance (MIID) in cms before and after the treatment.
Result: There was a male preponderance in the study group with a male to female ratio of 5.1:1. In group ‘A’ mean pretreatment
MIID was 2.3±0.7 cms, while in group ‘B’, it was 2.2± 0.5 cms. After completion of 6 weeks treatment the mean
MIID improved in group ‘A’ to 3.08 ± 0.8cms, and in group ‘B’ to 3.22± 0.5cms. The mean improvement in MIID in group
‘A’ was 0.783± 0.25cms compared to 1.01± 0.05 cms in group ‘B’ (p < 0.05).
Conclusion: Intraoral injection of PRP is more effective than Triamcinolone in improving trismus due to OSMF.

References

Ray JG, Ranganathan K, Chattopadhyay A. Malignant

transformation of oral submucous fibrosis: Overview of

histopathological aspects. Oral Surg Oral Med Oral Pathol

Oral Radiol. 2016;122:200–9.

Chattopadhyay A, Ray JG. Molecular pathology of malignant

transformation of oral submucous fibrosis. J Environ Pathol

Toxicol Oncol. 2016;35:193–205.

Rajendran R. Oral submucous fibrosis: etiology, pathogenesis

and future research. WHO Bull OMS. 1994;72(6):986–996

Murti P.R., Bhonsle R.B., Gupta P.C., Daftary D.K., Pindborg

J.J., Mehta F.S. Etiology of oral submucous fibrosis with

special reference to the role of areca nut chewing. J Oral

Pathol Med. 1995; 24(4):145–152.

Babu S., Bhat R.V., Kumar P.U. A comparative clinicopathological

study of oral submucous fibrosis in habitual

chewers of pan masala and betel quid. Clin Toxicol. 1996;

:317–322.

Auluck A, Rosin MP, Zhang L. Oral Submucous Fibrosis; a

clinically benign but potentially malignant disease: Report of

cases and review of literature. www.cda-adc.ca/jcda/vol-

/issue-8/735.html [PUBMED]

Chole RH, Gondivkar SM, Gadbail AR, Balsaraf S, Chaudhary

S, Dhore SV, et al. Review of drug treatment of oral submucous

fibrosis. Oral Oncol. 2012; 48:393–8.

Pandya S, Chaudhary AK, Singh M, Singh M, Mehrotra R.

Correlationof histopathological diagnosis with habits and

clinical findings in oralsubmucous fibrosis. Head Neck Oncol.

; 1:10.

Ceena DE, Bastian TS, Ashok L, Annigeri RG. Comparative

study ofclinic functional staging of oral submucous fibrosis

with qualitativeanalysis of collagen fibers under polarizing

microscopy. Indian J DentRes. 2009; 20(3):271–276.

Patil S, Maheshwari S. Proposed new grading of oral

submucous fibrosisbased on cheek flexibility. J Clin Exp

Dent. 2014; 6(3):e255–e258.

Gupta M, Pachauri A, Singh SK, Ahuja R, Singh P, Mishra

SSS. Recent Advancements in Oral Submucous Fibrosis

Management: An Overview. Bangladesh J Dent Res Educ.

; 4(2):88-90.

Albanese A, Licata ME, Polizzi B, Campisi G. Platelet-rich

plasma (PRP) in dental and oral surgery: from the wound

healing to bone regeneration. Immun Ageing. 2013;10(1):23.

Lin SL, Tsai CC, Wu SL, Ko SY, Chiang WF, Yang JW. Effect

of athrocentesis plus platelet-rich plasma and platelet-rich

plasma alone in the treatment of temporomandibular joint

osteoarthritis: A retrospective matched cohort study. Medicine

(Baltimore)2018;97(16):e0477.

Marx RE. Platelet-rich plasma: evidence to support its use.

J Oral Maxillofac Surg 2004; 62:489-96.

Dyavanagoudar SN (2009) Oral Submucous Fibrosis: Review

on Etiopathogenesis. J Cancer Sci Ther 1: 072-077.

doi:10.4172/1948-5956.1000011[Internet]

Yoithapprabhunath TR, Maheswaran T, Dineshshankar J,

Anusushanth A, Sindhuja P, Sitra G. Pathogenesis and

therapeutic intervention of oral submucous fibrosis. J Pharm

Bioallied Sci. 2013; 5(Suppl 1): S85–S88.

Chole RH, Patil R. Drug treatment of oral sub mucous fibrosis

– a review. Intl J Contemp Med Resr. 2016;3(4):996-998.

James L, Shetty A, Rishi D, Abraham M. Management of

Oral Submucous fibrosis with Injection of Hyaluronidase and

Dexamethasone in grade III Oral Submucous fibrosis: A

retrospective study. J Int Oral Health 2015; 7(8):82-85.

Gupta J, Srinivasan SV , Jonathan D M. Effiacy of

betamethasone, placental extract and hyaluronidase in the

treatment of OSMF: A comparative study. e-Journal

dentistry;2012;2(1).[Internet]

Yadav M, Aravinda K, Saxena VS, Srinivas K, Ratnakar P,

Gupta J, Sachdev AS, Shivhare P. Comparison of curcumin

with intralesional steroid injections in Oral Submucous Fibrosis

– A randomized, open-label interventional study. J Oral Biol

Craniofac Res. 2014; 4(3): 169–173.

Shaikh AH, Ahmed S, Siddique S, Iqbal N, Hasan SMU,

Zaidi SJA, Ali A. Oral submucous fibrosis; Study of cases

reported at Dow international medical college hospital in

karachi, Pakistan. Professional Med J, 2019;26(2):275-81.

Hazarey VK, Erlewad M, Mundhe KA,Ughade SN. Oral

submucous fibrosis: study of 1000 cases from central India.

J Oral Pathol Med 2007; 36: 12–7

Naik SM, Appaji MK, Ravishankara S,Goutham MK, Devi

NP, Mushannavar AS, Naik SS. Comparative study of

intralesional Triamcinolone Acetonide & hyaluronidase vs

Placental extract in 60 cases of Oral submucous fibrosis. Int

J Head Neck Surg 2012; 3(2): 59-65.

Patel TL, Singh S. Comparative evaluation of treatment of

Oral submucous fibrosis with intralesional injections of

Dexamethasone and hyaluronidase with Triamcinolone

Acetonide and hyaluronidase. J Cont Med A Dent 2015;3(3):

-34.

Daga D, Singh RK, Pal US, Gurung T, Gangwar S. Efficacy

of oral colchicine with intralesional hyaluronidase or

triamcinolone acetonide in the Grade II oral submucous

fibrosis. Natl J Maxillofac Surg. 2017;8(1):50-54. doi:

4103/njms.NJMS_5_17.[PUBMED]

Amer Sabih Hydri, Iqbal Hussain Udaipurwala, Nadeem Ahmed Sheikh, Sana Muhammad Sadiq et.al.

JBUMDC2020;10(1):58-62 Page-61

Singh D, Shashikanth MC, Misra N, Agrawal S. Lycopene

and intralesional betamethasone injections in the management

of oral submucous fibrosis . J Indian Acad Oral Med Radiol

[serial online] 2014 [cited 2016 Sep 1];26:264-8. Available

from: http://www.jiaomr.in/text.asp?2014/26/3/264/145000

Ferrari M, Zia S, Valbonesi M. A new technique for

hemodilution, preparation of autologous platelet-rich plasma

and intraoperative blood salvage in cardiac surgery. Int J Artif

Organs. 1987;10:47–50.

Marx RE. In: Tissue Engineering: Applications in Maxillofacial

Surgery and Periodontics. Lynch SE, Genco RJ, Marx RE,

editor. Chicago: Quintessence; 1999. Platelet-rich plasma: a

source of multiple autologous growth factors for bone grafts;

pp. 71–82.

Robert E. Marx, DDS. Platelet-Rich Plasma (PRP): What Is

PRP and What Is Not PRP?Implant Dentistry, 2001; 10(4):

Dayanand AA, Selvam NP. Lycopene in the management of

oral submucous fibrosis. Asian J Pharm Clin Res, 2013; 6(3):

Downloads

Published

2021-07-29

How to Cite

Hydri, A. S. ., Udaipurwala, I. H. ., Sheikh, N. A. ., Sadiq, S. M. ., Aslam, S. ., & bukhari, S. M. A. S. . (2021). Comparison of Triamcinolone Versus Platelet Rich Plasma Injection for Improving Trismus in Oral Submucous Fibrosis. Journal of Bahria University Medical and Dental College, 10(1), 58–62. https://doi.org/10.51985/JBUMDC2019104

Issue

Section

Original Articles