Evaluating the Quality of Life of Patient Receiving Intralesional Injection Vs Systemic Antioxidants in the Management of Oral Submucous Fibrosis – An Observational Study

Abstract

Introduction: Oral Submucous Fibrosis (OSMF) is a chronic, progressive, and potentially malignant disorder affecting the oral cavity, primarily in South Asian populations. It is characterized by the stiffening and fibrosis of the submucosal tissues, leading to significant morbidity with symptoms such as burning sensations, difficulty in eating, and limited mouth opening. The pathogenesis of OSMF is multifactorial, with areca nut chewing being the most commonly implicated risk factor. Managing OSMF is challenging due to its complex nature and the resistance of the fibrotic tissue to treatment. This study aims to evaluate and compare the quality of life outcomes in OSMF patients receiving intralesional injections versus systemic antioxidants using the Oral Health Impact Profile-14 (OHIP-14) questionnaire.

Methods: This observational study included 100 OSMF patients who were divided into two groups: Group 1 (n=50) received intralesional injections of triamcinolone acetonide, and Group 2 (n=50) received systemic antioxidants such as lycopene and beta-carotene. Data on clinical severity and quality of life were collected at baseline and post-treatment using the OHIP-14 questionnaire. Statistical analyses were performed to compare pre-treatment and post-treatment scores within and between the groups.

Results: Both treatment groups showed significant improvements in quality of life post-treatment. The intralesional injection group demonstrated a greater reduction in OHIP-14 scores compared to the systemic antioxidant group, indicating better outcomes in terms of physical pain, physical disability, and functional limitation. Specifically, the intralesional injection group had mean OHIP-14 scores reduced from 18.4 to 8.4, while the systemic antioxidant group showed a reduction from 16.8 to 9.2. Gender-wise distribution revealed a higher prevalence of OSMF among males (73%) compared to females (27%). Age-wise distribution indicated the highest prevalence in the 31-40 years age group (37%).

Conclusion: Both intralesional injections and systemic antioxidants are effective in improving the quality of life for OSMF patients. However, intralesional injections may offer superior benefits in reducing physical pain, physical disability, and functional limitation. Further research with larger sample sizes and longer follow-up periods is necessary to confirm these findings and optimize treatment protocols for OSMF.