Comparative Evaluation of Reconstructive Methods in Oral Submucous Fibrosis.

Abstract

Oral submucous fibrosis is a chronic, progressive, scarring, precancerous condition of oral mucosa which on progression causes severe trismus. To compare and evaluate the efficiency of buccal fat pad, platysmal mucocutaneous flap, nasolabial flap, collagen membrane graft, split thickness skin graft and temporoparietal fascia in reconstruction of surgical defect created by excision of fibrous bands in oral submucous fibrosis. After 6months of follow-up, the interincisal mouth opening was 40.0mm in case of buccal pad fat, 24.5mm in temporoparietal fascia flap group, 33.8 in collagen membrane graft group, 34.5mm in platysma flap group, 34.7mm in nasolabial flap group, 29.3mm in split thickness skin graft. ANOVA statistical analysis for postoperative interincisal distance at various time intervals and between pre-, intra- and postoperative interincisal distances were carried out which showed the results were significant at p value < 0.05 in all groups. No postoperative complications were noted in buccal fat pad group, split thickness skin graft group and collagen membrane group. However, platysmal group had flap necrosis and temporoparietal flap group patients had to undergo a second debulking procedure after one month. From our study, we concluded buccal fat pad yields superior results with respect to postoperative mouth opening and related complications.