Functional outcome of two different grafting techniques in the surgical management of oral submucous fibrosis: a comparative evaluation.

Objective: To evaluate the functional efficacy of two different grafting techniques following the fibrotomy among subjects with oral submucous fibrosis (OSMF).

Design: Forty consecutively treated OSMF subjects between 20 and 40 years who had grades 3 and 4a OSMF and mouth opening < 15 mm were included in the present study. All the subjects were randomly divided into two groups. In Group I, all the subjects received a buccal pad of fat sandwiched with a nasolabial flap following fibrotomy. In contrast, Group II subjects received a buccal pad of fat combined with a collagen graft. The effect of two different surgical protocols on mouth opening was evaluated clinically before the surgery (T) and 1 month (T), 6 months (T), and 12 months (T) after the surgery.

Results: In Group I subjects, the mouth opening increased significantly (P < 0.001) from 10.90 ± 1.971 mm at T to 34.25 ± 3.127 mm at T, but reduced marginally to 32.15 ± 3.422 mm at T, and 31.30 ± 3.358 mm at T. In Group II, the mouth opening increased significantly (P < 0.001) from 10.85 ± 1.725 mm at T to 28.90 ± 3.059 mm, 29.10 ± 2.808 mm, and 28.20 ± 2.285 mm at T, T, and T respectively. At the end of 12 months of follow-up, the mean value improvement in the mouth opening (T-T) was 20.4 ± 3.5 mm and 17.3 ± 2.9 mm in Groups I and II, respectively, and the difference was statistically significant (P = 0.006).

Conclusion: The buccal pad of fat sandwiched with a nasolabial flap for the reconstruction following fibrotomy had a slightly better beneficial effect on the postoperative mouth opening among OSMF subjects.