The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 21 , ISSUE 1 ( January, 2020 ) > List of Articles


Comparison of Efficacy of Topical Curcumin Gel with Triamcinolone-hyaluronidase Gel Individually and in Combination in the Treatment of Oral Submucous Fibrosis

Ashish B Lanjekar, Rahul R Bhowate, Suparna Bakhle, Abhay Narayane, Vipul Pawar, Ranjeet Gandagule

Keywords : Hyaluronidase mucoadhesive semisolid gel, Oral submucous fibrosis, Topical curcumin mucoadhesive semisolid gel, Triamcinolone acetonide mucoadhesive semisolid gel

Citation Information : Lanjekar AB, Bhowate RR, Bakhle S, Narayane A, Pawar V, Gandagule R. Comparison of Efficacy of Topical Curcumin Gel with Triamcinolone-hyaluronidase Gel Individually and in Combination in the Treatment of Oral Submucous Fibrosis. J Contemp Dent Pract 2020; 21 (1):83-90.

DOI: 10.5005/jp-journals-10024-2726

License: CC BY-NC 4.0

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2020; The Author(s).


Aim: To study the efficacy of topical curcumin mucoadhesive semisolid gel, triamcinolone acetonide/hyaluronidase mucoadhesive semisolid gel, and a combination of both in the treatment of oral submucous fibrosis (OSMF). Materials and methods: One hundred and twenty patients diagnosed with OSMF were randomly divided into groups I, II, and III. Each patients in groups I, II, and III was given professionally prepared mucoadhesive semisolid gel of curcumin, a combination of triamcinolone acetonide and hyaluronidase mucoadhesive semisolid gel, and a combination of all three, respectively. Patients were instructed to apply the gel thrice daily for 6 weeks on buccal mucosa bilaterally using the tip of index finger. Three parameters were evaluated at the end of each week, namely, mouth opening, burning on visual analog scale (VAS), and the color of oral mucosa on the binary scale. The results were subjected to statistical analysis. Results: It was observed that the group administered the three drug combinations achieved the greatest mouth opening (mean increase 4.05 mm) as compared to the other two groups. It was observed that triamcinolone and hyaluronidase group reported reduction in burning sensation on VAS (mean difference 6) as compared to the other two groups. It was observed that group III (1% curcumin, 1% hyaluronidase and 0.1% triamcinolone acetonide combined) drug therapy showed better change in mucosa color as compared to groups I (1% curcumin) and II. Conclusion: Thus, we can conclude that curcumin has a therapeutic effect on patients diagnosed with OSMF. Maximum utilization and enhanced drug delivery were achieved with the help of a combination other two active drugs, namely, triamcinolone and hyaluronidase. Clinical significance: Curcumin role in the treatment of oral cancers and the precancer lesion is very promising.

  1. Lambade P, Dawane P, Thorat P. Oral submucous fibrosis—a treatment protocol based on clinical study of 100 patients in central india. Oral Maxillofac Surg 2015;19(2):201–207. DOI: 10.1007/s10006-014-0478-x.
  2. Burde K. Oral submucous fibrosis-an overview. Int J Dent Res Dev 2014;4:1–6.
  3. Dayanarayana U. Non surgical approaches in treatment of OSF. IOSR J Dent Med Sci 2014;13(11):63–69. DOI: 10.9790/0853-131136369.
  4. Borle RM, Borle SR. Management of oral submucous fibrosis: a conservative approach. J Oral Maxillofac Surg 1991;49(8):788–791. DOI: 10.1016/0278-2391(91)90002-4.
  5. Gupta D, Sharma SC. Oral submucous fibrosis-a new treatment regimen. J Oral Maxillofac Surg 1988;46(10):830–833. DOI: 10.1016/0278-2391(88)90043-2.
  6. Kakar PK, Puri RK. Oral submucous fibrosis—treatment with hyalase. J Laryngol Otol 1985;99(1):57–59. DOI: 10.1017/S0022215100096286.
  7. Lai DR, Chen HR, Lin LM, et al. Clinical evaluation of different treatment methods for oral submucous fibrosis. A 10-year experience with 150 cases. J Oral Pathol Med 1995;24(9):402–407. DOI: 10.1111/j.1600-0714.1995.tb01209.x.
  8. Angadi PV, Rekha KP. Oral submucous fibrosis: a clinicopathologic 122 review of 205 cases in indians. Oral Maxillofac Surg 2011;15(1):15–19. DOI: 10.1007/s10006-010-0225-x.
  9. Nanavati S, Nanavati P, Nanavati M. Clinico-pathological study of 170 cases of oral sub-mucous fibrosis. Int J Sci Study 2015;3(9):137–144. DOI: 10.17354/ijss/2015/572.
  10. Maher R, Lee AJ, Warnakulasuriya KA, et al. Role of areca nut in the causation of orai submucous fibrosis: a case-control study in Pakistan. J Oral Pathl Med 1994;23(2):65–69. DOI: 10.1111/j.1600-0714.1994.tb00258.x.
  11. Rai B, Kaur J, Jacobs R, et al. Possible action mechanism for curcumin in pre-cancerous lesions based on serum and salivary markers of oxidative stress. J Oral Sci 2010;52(2):251–256. DOI: 10.2334/josnusd.52.251.
  12. Das AD, Balan A, KT S. Comparative study of the Efficacy of curcumin and turmeric oil as chemopreventive agents in oral submucous fibrosis: a clinical and histopathological evaluation. J Indian Acad Oral Med Radiol 2012;22(2):88–92. DOI: 10.5005/jp-journals- 10011-1021.
  13. Yadav M, Aravinda K, Saxena VS, et al. Comparison of curcumin with intralesional steroid 119 injections in oral submucous fibrosis - A randomized, open-label interventional study. J Oral Biol Craniofacial Res 2014;4(3):169–173. DOI: 10.1016/j.jobcr.2014.11.003.
  14. Saran G, Umapathy D, Misra N, et al. Efficacy of lycopene and curcumin in oral submucous fibrosis patients. Indian J Dent Res 2018;29: 303–312. DOI: 10.4103/ijdr.IJDR_551_16.
  15. Krishnaswamy K. Turmeric - A potential anti-cancer agent. Amala Res Bull 1998;18:23–28.
  16. Bar-Sela G, Epelbaum R, Schaffer M. Curcumin as an anti-cancer agent: review of the gap between basic and clinical applications. Curr Med Chem 2009;17(3):190–197. DOI: 10.2174/092986710790149738.
  17. Cavallini M, Gazzola R, Metalla M., et al. The role of hyaluronidase in the treatment of complications from hyaluronic acid dermal fillers. Aesthetic Surg J 2013;33(8):1167–1174. DOI: 10.1177/1090820X13511970.
  18. Singh M, Niranjan HS, Mehrotra R, et al. Efficacy of hydrocortisone acetate/hyaluronidase vs triamcinolone acetonide/hyaluronidase in the treatment of oral submucous fibrosis. Indian J Med Res 2010;131:665–669.
  19. Panigrahi R, Maheshwari A. A prospective, randomized double blind study comparing intralesional triamcinolone acetonide and hyaluronidase combination versus triamcinolone acetonide alone in the treatment of oral submucosal fibrosis. J Pharm Biomed Sci 2014;04(04):365–370.
  20. Sharma M, Kaur M, Dar MS. Efficacy of turmeric in reducing burning sensation in oral submucous fibrosis: an observational study. Saudi J Oral Dent Res 2017;2(11):271–274.
  21. Virani D, Dangore S, Bhowate R. Assessment of utility of tulsi and turmeric in treatment of oral submucous fibrosis: a clinical study. Int J Dent Res 2018;3(1):30–33. DOI: 10.31254/dentistry.2018. 3108.
  22. Hazarey VK, Sakrikar AR, Ganvir SM. Efficacy of curcumin in the treatment for oral submucous fibrosis a randomized clinical trial. J oral Maxillofac Pathol 2015;19(2):145–153. DOI: 10.4103/0973-029X. 164524.
  23. Meshram M, Bhowate RR, Madke B, et al. Evaluation of the effect of ultrasound physiotherapy interventions in combination with local application of aloe-vera and turmeric gel in the management of oral submucous fibrosis. J Dent Investig 2018;1:16–33.
  24. Elizabeth N, Gurumani S, Ganesh Bala A, et al. A comparative study between management of oral submucous fibrosis. J Evol Med Dent Sci 2015;3(47):11344–11348. DOI: 10.14260/jemds/2014/3484.
  25. Sharma S, Pawar S, Jain UK. Development and evaluation of topical gel of curcumin from different combination of polymers formulation and evaluation of herbal gel. Int J Pharm Pharm Sci 2012;4(4): 452–456.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.