Comparative evaluation of Injection dexamethasone with Hyaluronidase and Injection Platelet Rich Plasma (PRP) in Management of Oral Submucous Fibrosis (OSMF)- A randomized controlled trial.

Oral submucous fibrosis (OSMF) is a potentially malignant condition of the oral cavity resulting in increasing loss of tissue mobility, marked rigidity, and eventual restricted ability to open the mouth. It may progressively affect the entire oral cavity, and occasionally the pharynx. It has a strong link to areca nut (betel nut) chewing. The other proposed etiological factors include excessive chilly consumption, vitamin B12 and iron deficiency, tobacco ingestion, smoking, autoimmunity, and genetic and environmental factors. 

Treatment of oral submucous fibrosis is based on medical and surgical management along with physiotherapy, Conventional medical management includes avoidance of irritating substances like betel chewing, tobacco ingestion or smoking, etc., and involves regular administration of corticosteroids, either via submucosal injections or topical application. Corticosteroids have been considered the first-choice agent for the management of OSMF, However, continuous and prolonged use is associated with many systemic adverse effects such as bad taste, nausea, facial swellings, dryness, mucosal atrophy, candidal infection, granuloma formation, hypersensitivity reactions, delayed wound healing, and in later stages; hypothalamus pituitary adrenal suppression. Therefore, it is the need of an hour to establish an effective and efficient treatment modality for OSMF with lesser or no adverse effects.

Platelet-rich plasma is the autologous component of the plasma and contains higher concentrations of platelets, growth factors, and cytokines than the basal level. Platelet-rich plasma (PRP) is a simple, efficient, and minimally invasive method. Platelet-rich plasma is an element of whole blood, prepared through centrifugation to a concentrated form. Platelet-rich plasma acts by inducing the platelets to secrete pro-inflammatory mediators and growth factors. These, in turn, initiate the cascade of wound healing and bring about tissue remodeling.

This randomized controlled trial aims to compare the efficacy of the Injection dexamethasone and Hyaluronidase with the Injection of platelet-rich plasma (PRP) in the Management of Oral Submucous Fibrosis. By assessing parameters such as Mouth Opening (Interincisal distance), Burning Sensation (VAS Score), and Cheek flexibility. The study aims to evaluate the potential of PRP in alleviating symptoms and improving the condition of patients with OSMF.