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Published in: Clinical Oral Investigations 5/2013

01-06-2013 | Original Article

Vasodilator isoxsuprine alleviates symptoms of oral submucous fibrosis

Authors: Chetan J. Bhadage, Hemant R. Umarji, Karan Shah, Hannamari Välimaa

Published in: Clinical Oral Investigations | Issue 5/2013

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Abstract

Objectives

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.

Materials and methods

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.

Results

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.

Conclusions

Oral isoxsuprine as well as dexamethasone with hyaluronidase injections combined to physiotherapy alleviate symptoms of oral submucous fibrosis significantly more efficiently than physiotherapy alone.

Clinical relevance

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.
Literature
1.
go back to reference Tilakaratne WM, Klinikowski MF, Saku T, Peters TJ, Warnakulasuriya S (2006) Oral submucous fibrosis: review on aetiology and pathogenesis. Oral Oncol 42:561–568PubMedCrossRef Tilakaratne WM, Klinikowski MF, Saku T, Peters TJ, Warnakulasuriya S (2006) Oral submucous fibrosis: review on aetiology and pathogenesis. Oral Oncol 42:561–568PubMedCrossRef
2.
go back to reference Angadi PV, Rao SS (2011) Areca nut in pathogenesis of oral submucous fibrosis: revisited. Oral Maxillofac Surg 15:1–9PubMedCrossRef Angadi PV, Rao SS (2011) Areca nut in pathogenesis of oral submucous fibrosis: revisited. Oral Maxillofac Surg 15:1–9PubMedCrossRef
3.
go back to reference Rajalalitha P, Vali S (2005) Molecular pathogenesis of oral submucous fibrosis—a collagen metabolic disorder. J Oral Pathol Med 34:321–328PubMedCrossRef Rajalalitha P, Vali S (2005) Molecular pathogenesis of oral submucous fibrosis—a collagen metabolic disorder. J Oral Pathol Med 34:321–328PubMedCrossRef
4.
go back to reference Harvey W, Scutt A, Meghji S, Canniff JP (1986) Stimulation of human buccal mucosa fibroblasts in vitro by betel-nut alkaloids. Arch Oral Biol 31:45–49PubMedCrossRef Harvey W, Scutt A, Meghji S, Canniff JP (1986) Stimulation of human buccal mucosa fibroblasts in vitro by betel-nut alkaloids. Arch Oral Biol 31:45–49PubMedCrossRef
5.
go back to reference Scutt A, Meghji S, Canniff JP, Harvey W (1987) Stabilisation of collagen by betel nut polyphenols as a mechanism in oral submucous fibrosis. Experientia 43:391–393PubMedCrossRef Scutt A, Meghji S, Canniff JP, Harvey W (1987) Stabilisation of collagen by betel nut polyphenols as a mechanism in oral submucous fibrosis. Experientia 43:391–393PubMedCrossRef
6.
go back to reference Moutasim KA, Jenei V, Sapienza K, Marsh D, Weinreb PH, Violette SM, Lewis MP, Marshall JF, Fortune F, Tilakaratne WM, Hart IR, Thomas GJ (2011) Betel-derived alkaloid up-regulates keratinocytealphavbeta6 integrin expression and promotes oral submucous fibrosis. J Pathol 223:366–377PubMedCrossRef Moutasim KA, Jenei V, Sapienza K, Marsh D, Weinreb PH, Violette SM, Lewis MP, Marshall JF, Fortune F, Tilakaratne WM, Hart IR, Thomas GJ (2011) Betel-derived alkaloid up-regulates keratinocytealphavbeta6 integrin expression and promotes oral submucous fibrosis. J Pathol 223:366–377PubMedCrossRef
7.
go back to reference Angadi PV, Rao S (2010) Management of oral submucous fibrosis: an overview. Oral Maxillofac Surg 14:133–142PubMedCrossRef Angadi PV, Rao S (2010) Management of oral submucous fibrosis: an overview. Oral Maxillofac Surg 14:133–142PubMedCrossRef
8.
go back to reference Kerr AR, Warnakulasuriya S, Mighell AJ, Dietrich T, Nasser M, Rimal J, Jalil A, Bornstein MM, Nagao T, Fortune F, Hazarey VH, Reichart PA, Silverman S, Johnson NW (2011) A systematic review of medical interventions for oral submucous fibrosis and future research opportunities. Oral Dis 17(Suppl 1):42–57PubMedCrossRef Kerr AR, Warnakulasuriya S, Mighell AJ, Dietrich T, Nasser M, Rimal J, Jalil A, Bornstein MM, Nagao T, Fortune F, Hazarey VH, Reichart PA, Silverman S, Johnson NW (2011) A systematic review of medical interventions for oral submucous fibrosis and future research opportunities. Oral Dis 17(Suppl 1):42–57PubMedCrossRef
9.
go back to reference More CB, Das S, Patel H, Adalja C, Kamatchi V, Venkatesh R (2012) Proposed clinical classification for oral submucous fibrosis. Oral Oncol 48:200–202PubMedCrossRef More CB, Das S, Patel H, Adalja C, Kamatchi V, Venkatesh R (2012) Proposed clinical classification for oral submucous fibrosis. Oral Oncol 48:200–202PubMedCrossRef
10.
11.
go back to reference Khanna JN, Andrade NN (1995) Oral submucous fibrosis: a new concept in surgical management. Report of 100 cases. Int J Oral Maxillofac Surg 24:433–439PubMedCrossRef Khanna JN, Andrade NN (1995) Oral submucous fibrosis: a new concept in surgical management. Report of 100 cases. Int J Oral Maxillofac Surg 24:433–439PubMedCrossRef
12.
go back to reference Chole RH, Gondivkar SM, Gadbail AR, Balsaraf S, Chaudhary S, Dhore SV, Ghonmode S, Balwani S, Mankar M, Tiwari M, Parikh RV (2012) Review of drug treatment of oral submucous fibrosis. Oral Oncol 48:393–398PubMedCrossRef Chole RH, Gondivkar SM, Gadbail AR, Balsaraf S, Chaudhary S, Dhore SV, Ghonmode S, Balwani S, Mankar M, Tiwari M, Parikh RV (2012) Review of drug treatment of oral submucous fibrosis. Oral Oncol 48:393–398PubMedCrossRef
13.
go back to reference Kakar PK, Puri RK, Venkatachalam VP (1985) Oral submucous fibrosis—treatment with hyalase. J Laryngol Otol 99:57–59PubMedCrossRef Kakar PK, Puri RK, Venkatachalam VP (1985) Oral submucous fibrosis—treatment with hyalase. J Laryngol Otol 99:57–59PubMedCrossRef
14.
go back to reference Gupta D, Sharma SC (1988) Oral submucous fibrosis—a new treatment regimen. J Oral Maxillofac Surg 46:830–833PubMedCrossRef Gupta D, Sharma SC (1988) Oral submucous fibrosis—a new treatment regimen. J Oral Maxillofac Surg 46:830–833PubMedCrossRef
15.
go back to reference Borle RM, Borle SR (1991) Management of oral submucous fibrosis: a conservative approach. J Oral Maxillofac Surg 49:788–791PubMedCrossRef Borle RM, Borle SR (1991) Management of oral submucous fibrosis: a conservative approach. J Oral Maxillofac Surg 49:788–791PubMedCrossRef
16.
go back to reference Lai DR, Chen HR, Lin LM, Huang YL, Tsai CC (1995) Clinical evaluation of different treatmentmethods for oral submucous fibrosis. A 10-year experience with 150 cases. J Oral Pathol Med 24:402–406PubMedCrossRef Lai DR, Chen HR, Lin LM, Huang YL, Tsai CC (1995) Clinical evaluation of different treatmentmethods for oral submucous fibrosis. A 10-year experience with 150 cases. J Oral Pathol Med 24:402–406PubMedCrossRef
17.
go back to reference Kumar A, Bagewadi A, Keluskar V, Singh M (2007) Efficacy of lycopene in the management of oral submucous fibrosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 103:207–213PubMedCrossRef Kumar A, Bagewadi A, Keluskar V, Singh M (2007) Efficacy of lycopene in the management of oral submucous fibrosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 103:207–213PubMedCrossRef
18.
go back to reference Cox S, Zoellner H (2009) Physiotherapeutic treatment improves oral opening in oral submucous fibrosis. J Oral Pathol Med 38:220–226PubMedCrossRef Cox S, Zoellner H (2009) Physiotherapeutic treatment improves oral opening in oral submucous fibrosis. J Oral Pathol Med 38:220–226PubMedCrossRef
19.
go back to reference Singh M, Niranjan HS, Mehrotra R, Sharma D, Gupta SC (2010) Efficacy of hydrocortisone acetate/hyaluronidase vs triamcinolone acetonide/hyaluronidase in the treatment of oral submucous fibrosis. Indian J Med Res 131:665–669PubMed Singh M, Niranjan HS, Mehrotra R, Sharma D, Gupta SC (2010) Efficacy of hydrocortisone acetate/hyaluronidase vs triamcinolone acetonide/hyaluronidase in the treatment of oral submucous fibrosis. Indian J Med Res 131:665–669PubMed
20.
go back to reference Sharma JK, Gupta AK, Mukhija RD, Nigam P (1987) Clinical experience with the use of peripheral vasodilator in oral disorders. Int J Oral Maxillofac Surg 16:695–699PubMedCrossRef Sharma JK, Gupta AK, Mukhija RD, Nigam P (1987) Clinical experience with the use of peripheral vasodilator in oral disorders. Int J Oral Maxillofac Surg 16:695–699PubMedCrossRef
21.
go back to reference Rajendran R, Rani V, Shaikh S (2006) Pentoxifylline therapy: a new adjunct in the treatment of oral submucous fibrosis. Indian J Dent Res 17:190–198PubMedCrossRef Rajendran R, Rani V, Shaikh S (2006) Pentoxifylline therapy: a new adjunct in the treatment of oral submucous fibrosis. Indian J Dent Res 17:190–198PubMedCrossRef
22.
go back to reference Mehrotra R, Singh HP, Gupta SC, Singh M, Jain S (2011) Pentoxifylline therapy in the management of oral submucous fibrosis. Asian Pac J Cancer Prev 12:971–974PubMed Mehrotra R, Singh HP, Gupta SC, Singh M, Jain S (2011) Pentoxifylline therapy in the management of oral submucous fibrosis. Asian Pac J Cancer Prev 12:971–974PubMed
23.
Metadata
Title
Vasodilator isoxsuprine alleviates symptoms of oral submucous fibrosis
Authors
Chetan J. Bhadage
Hemant R. Umarji
Karan Shah
Hannamari Välimaa
Publication date
01-06-2013
Publisher
Springer-Verlag
Published in
Clinical Oral Investigations / Issue 5/2013
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-012-0824-z

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