Department of Oral Medicine & Radiology, MGV's KBH Dental College & Hospital, Nashik, Maharashtra, India.
Clin Oral Investig. 2013 Jun;17(5):1375-82. doi: 10.1007/s00784-012-0824-z. Epub 2012 Aug 15.
The aim of the study was to compare the effectiveness of vasodilator isoxsuprine to dexamethasone with hyaluronidase injections and physiotherapy in the treatment of oral submucous fibrosis.
Forty patients with oral submucous fibrosis were randomly assigned into three groups. Group A patients (n = 15) received 10 mg isoxsuprine tablets four times per day, group B (n = 15) biweekly dexamethasone with hyaluronidase intralesional injections, and group C (n = 10) placebo tablets. In addition, all patients were instructed physiotherapy exercises. The treatment time was 6 weeks and patients were followed-up for 4 months thereafter. The effect of the treatment was evaluated by measurements of inter-incisal distance and oral burning sensation and evaluation of histological findings of the diseased mucosa.
Mouth opening increased and burning sensation decreased significantly in all groups, but the effects were significantly greater in groups receiving either oral isoxsuprine or dexamethasone with hyaluronidase injections in addition to physiotherapy. The decrease in burning sensation occurred more rapidly in patients receiving intralesional dexamethasone with hyaluronidase. Histological improvement was not observed in any of the groups.
Oral isoxsuprine as well as dexamethasone with hyaluronidase injections combined to physiotherapy alleviate symptoms of oral submucous fibrosis significantly more efficiently than physiotherapy alone.
Oral isoxsuprine can be considered as a new candidate drug for the treatment of oral submucous fibrosis. Physiotherapy exercises provide relief of symptoms and should be instructed to all patients.
本研究旨在比较血管扩张剂异舒吉与曲安奈德联合透明质酸酶注射和物理疗法治疗口腔黏膜下纤维化的疗效。
将 40 例口腔黏膜下纤维化患者随机分为三组。A 组(n=15)患者每天口服 10 mg 异舒吉片 4 次,B 组(n=15)患者每两周接受曲安奈德联合透明质酸酶皮损内注射,C 组(n=10)患者给予安慰剂片剂。此外,所有患者均接受物理治疗。治疗时间为 6 周,随后随访 4 个月。通过测量切牙间距离和口腔烧灼感以及评估病变黏膜的组织学发现来评估治疗效果。
所有组的张口度均增加,烧灼感均明显减轻,但接受异舒吉或曲安奈德联合透明质酸酶注射加物理治疗的组效果明显更大。接受皮损内曲安奈德联合透明质酸酶注射的患者烧灼感减轻更快。所有组均未观察到烧灼感减轻。
口服异舒吉和曲安奈德联合透明质酸酶注射联合物理疗法治疗口腔黏膜下纤维化的疗效明显优于单纯物理疗法。
口服异舒吉可被视为治疗口腔黏膜下纤维化的一种新候选药物。物理治疗可以缓解症状,应指导所有患者进行。