Resection of fibrous bands, extraction of third molars, bilateral coronoidotomy, masticatory muscle myotomy and comparison of collagen membrane and buccal fat pad graft in surgical management of stage III, IV oral submucous fibrosis

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Original Article

Author Details : Juhi Shabnam Bandekeri, Mohammed Viquar Ahmed*, Mohammed Ali R Patel

Volume : 7, Issue : 1, Year : 2021

Article Page : 15-19

https://doi.org/10.18231/j.ijmi.2021.004

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Abstract

Background: Oral submucous fibrosis is a treacherous, devastating state of the mouth bringing about critical wellbeing and social issues, which may meddle with the standard assessment of the oral depression for malignancy, satisfactory nourishing admission, dental cleanliness and discourse.
Medicines proposed for OSMF have been palliative instead of remedial. They are pointed toward improving the patient’s capacity to open the mouth, which becomes confined when more scar tissue is shaped as the illness advances. Various unions are accessible today to cover the post fibrotic discharge deformity however none of them alone gave a drawn out victories. In our investigation we looked at two modalities as they
were generally advantageous and convey less postoperative morbidity. Collagen sheet as a join to cover the careful deformity and the buccal cushion of fat turned onto the imperfection as a unite to cover it.
Aims and Objectives: The current investigation was led to assess the clinical viability of collagen film and buccal cushion of fat join for careful administration of Oral Submucous fibrosis with extraction of third molars, two-sided coronoidotomy, masticatory muscle myotomy with arrival of fibrosis and remaking by collagen layer unite in five patients and buccal fat cushion join in five patients of clinically analyzed stage III, IV Oral Submucous fibrosis with a subsequent time of a half year from September 2010 to September 2012 at Department of Oral and maxillofacial Surgery in Al Badar Rural Dental College and Hospital.
Materials and Methods: Ten patients with chief complaint of difficulty in mouth opening with no previous history of any medical or surgical line of treatment and clinically diagnosed as stage III, IV Oral submucous fibrosis were included in this study. Preoperative clinical findings, radiological investigations and maximum incisal distance were assessed for the need of surgical procedure for Oral submucous fibrosis. All the
patients underwent extraction of third molars, bilateral coronoidotomy, masticatory musclemyotomy, release and resection of fibrous bands with grafting of buccal defects with collagen membrane in five patients and with pedicled buccal fat pad graft in five patients with a 6 month follow up period. The interincisal distance was evaluated as an objective criteria at time intervals of 10th day, 1st month, 3rd  month and 6th months postoperatively. Clinically healing was assessed by means of digital photography of granulation at 14th day, epithelization at 1 month and wound contracture at 3 months post-operatively.
Results: Mean preoperative interincisal distance of 18.4mm was compared to immediate post operative interincisal distance of 37.3mm and 36.2 mm at follow up of 1 month, 34.8mm after 3 months and 35.2mm after 6 months with mean increase of 30.8mm after 6 months follow up. Healing in terms of granulation was assessed to be good in 4 out of 5 patients compared to buccal fat pad group where only 2 patients had good result. Epithelization was good in 4 patients and fair in 1 patient in collagen membrane group compared to buccal fat pad group where epithelization was predominantly fair in 3 patients and good in only 2 patients.
Conclusion: This investigation reasoned that extraction of third molars, reciprocal coronoidotomy, masticatory muscle myotomy with the resection of sinewy groups is the favored careful administration for long haul results and recreation with collagen film filled in as a superior substitute option in
contrast to buccal fat cushion, since it offered wide zone of inclusion, quicker mending and great patient acknowledgment.

Keywords: Oral Submucous Fibrosis, Collagen membrane, BFP graft, Interincisal distance.

How to cite : Bandekeri J S , Ahmed M V , Patel M A R , Resection of fibrous bands, extraction of third molars, bilateral coronoidotomy, masticatory muscle myotomy and comparison of collagen membrane and buccal fat pad graft in surgical management of stage III, IV oral submucous fibrosis. IP Int J Maxillofac Imaging 2021;7(1):15-19

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