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History

Received: February 2024
Available Online: January 2026

Abstract

Introduction and Objective: Oral submucous fibrosis (OSF) is a progressive, chronic condition that manifests primarily with a burning sensation upon consuming spicy foods in its early stages and trismus in its advanced phase. Managing these symptoms is challenging, often requiring conservative measures in the initial stages and surgical interventions later. This study aimed to evaluate the efficacy of surgical treatment for trismus in OSF through surgical fibrolysis and split skin graft application and assess long-term outcomes.

Methods and Materials: We conducted a retrospective hospital-based study involving 25 patients selected from a cohort 170 diagnosed with OSF at the Oral and Maxillofacial Surgical Hospital, Rajkot, India. Surgery was indicated for patients with interincisal distance (IID) measurements ranging from 0.00 cm (complete trismus) to 2.5 cm, with patients exhibiting IID greater than 2.5 cm not included in surgical treatment. Comprehensive patient records were maintained, and follow-ups were conducted for at least three years postoperatively. IID measurements were taken pre-operatively, intra-operatively, immediately post-operatively, and subsequently at 6 months, 1 year, 2 years, and 3 years post-surgery.

Results: The average IID for the 25 patients preoperatively was 1.49 cm, which improved to 2.86 cm intra-operatively and 3.40 cm immediately post-operatively. Follow-up IID measurements at respective intervals were as follows: 3.51 cm at 6 months, 3.45 cm at 1 year, 3.43 cm at 2 years, and 3.44 cm at 3 years. This demonstrates an overall improvement from preoperative IID of 1.49 cm to 3.44 cm after three years. Statistical analysis revealed significant results with a p-value < 0.05.

Conclusion: The surgical excision of fibrous bands followed by split skin grafting of the buccal mucosa has shown promising long term outcomes without complications, establishing it as an effective treatment modality for trismus in OSF. A comprehensive surgical protocol for applying skin grafts in OSF is proposed.

Keywords

Oral Submucous Fibrosis, Trismus, Surgery in OSF, Skin Grafts