Comparative Study of Intralesional Triamcinolone Acetonide and Hyaluronidase vs Placental Extract in 60 Cases of Oral Submucous Fibrosis

Background: Oral submucous fibrosis (OSMF) is a common premalignant condition caused by chewing arecanut, betel quid and gutkha with tobacco. Its medical treatment is not yet fully standardized, although the optimal doses of its medical treatment is in the form of triamcinolone acetonide combined with hyaluronidase or intralesional placental extract. Objectives: We compared the efficacy of intralesional triamcinolone acetonide combined with hyaluronidase in group A vs placental extract in group B. Design: Comparative case series analysis series study with random allocation of 60 patients equally into two groups. Materials and methods: Patients of OSMF (60) were randomly allocated into two groups A and B. Group A (n = 30) patients received combination of triamcinolone acetonide (10 mg/ml) + hyaluronidase (1,500 IU) at weekly intervals for 8 weeks. Group B (n = 30) patients received 2 ml of placentrex injection intralesionally at weekly interval for 8 weeks. Treatment outcome was evaluated on the basis of improvement in trismus, oral mucosal pattern and reduction in burning sensation. Results: Trismus improvements in group A with combination of triamcinolone acetonide + hyaluronidase were significantly better to that in group B where placentrex was used. No significant difference in results in the two groups were observed as far as improvement in oral mucosal pattern and burning sensation were compared in the two groups. Conclusion: Combination of triamcinolone acetonide and hyaluronidase intralesionally is more effective than placental extract intralesionally in treatment of OSMF. But placental extract injections are cost-effective. No side effects were seen in both study groups.