Comparative effectiveness of medicinal interventions for oral submucous fibrosis: A network meta-analysis

source extracted confidence: high 2026-04-09
#humans #oral-submucous-fibrosis #antioxidants #hyaluronoglucosaminidase #steroids

Comparative effectiveness of medicinal interventions for oral submucous fibrosis: A network meta-analysis

Rai et al., 2023 | J Stomatol Oral Maxillofac Surg | Systematic Review

Citation

Rai Arpita, Shrivastava Priyanshu Kumar, ... Ul Haque Zeya. Comparative effectiveness of medicinal interventions for oral submucous fibrosis: A network meta-analysis. J Stomatol Oral Maxillofac Surg. 2023-Jun;124(3):101423. doi:10.1016/j.jormas.2023.101423

Abstract

OBJECTIVES: This network meta-analysis presents an exhaustive description and comparison of the available medical interventions for the management of oral submucous fibrosis (OSMF). MATERIALS AND METHODS: A systematic review and network meta-analysis was conducted after registration with PROSPERO. (PROSPERO ID CRD42022303441). Databases (PubMed, Cochrane, EMBASE, Web of Science, and others) were searched for randomized clinical trials (RCT) trials from inception till September 2022 for the medical interventions in OSMF. The primary outcome was the improvement in mouth opening. The secondary outcomes were improvement in burning sensation, tongue protrusion, and cheek flexibility. The interventions were ranked according to their efficacy based on the surface under the cumulative ranking. RESULTS: 47 studies including 2393 patients were assessed for quantitative analysis. For mouth opening, the combined treatment with steroid, hyaluronidase, and antioxidant was most effective [MD, 7.05 (95%CI 1.76,12.34)], followed by the combination of oral antioxidants with injectable steroids, [MD, 3.80 (95%CI -0.44,8.03)]. Additionally, the combined treatment with steroid, hyaluronidase, and antioxidant was most effective in reducing the burning sensation [MD, -8.62(-10.95,-6.30)], followed by aloe vera [MD, -8.45(-10.40,-6.49)] and pentoxifylline [MD -7.57(-9.46,-5.68)]. For tongue protrusion, curcumin was most effective followed by antioxidants. Most of the drugs used were reported to cause negligible or mild adverse effects. CONCLUSION: This network meta-analysis reported the efficacy of medicinal interventions in OSMF patients compared to the placebo in the improvement of mouth opening and burning sensation, and cheek flexibility. The methodological quality of included RCTs was low. Well-designed studies are recommended to obtain strong evidence.

Key Findings

47 studies including 2393 patients were assessed for quantitative analysis. For mouth opening, the combined treatment with steroid, hyaluronidase, and antioxidant was most effective [MD, 7.05 (95%CI 1.76,12.34)], followed by the combination of oral antioxidants with injectable steroids, [MD, 3.80 (95%CI -0.44,8.03)]. Additionally, the combined treatment with steroid, hyaluronidase, and antioxidant was most effective in reducing the burning sensation [MD, -8.62(-10.95,-6.30)], followed by aloe ve

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 2393
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Oral Submucous Fibrosis
  • Antioxidants
  • Hyaluronoglucosaminidase
  • Steroids

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Systematic Review, Journal Article, Network Meta-Analysis
  • Vertical: curcumin

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09