title: Effectiveness of Aloe Vera and Antioxidant along with Physiotherapy in the Management of Oral Submucous Fibrosis. Evaluation of efficacy of aloe vera in the treatment of oral submucous fibrosis – a clinical study The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials Clinicobiochemical evaluation of turmeric with black pepper and nigella sativa in management of oral submucous fibrosis-a double-blind, randomized preliminary study. Efficacy of aloe vera gel as an adjuvant treatment of oral submucous fibrosis. Comparison of therapeutic response of lycopene and curcumin in oral submucous fibrosis: A randomized controlled trial.
abstract: BACKGROUND Oral submucous fibrosis ( OSMF ) is a well-established precancerous condition affecting the oral mucosa . It is a disease that causes significant morbidity ( in terms of loss of mouth function as tissues become rigid and mouth opening becomes difficult ) and mortality ( when transformation into squamous cell carcinoma occurs ) . AIM The aim of the study is to compare the efficacy of Aloe vera with antioxidant when given along with physiotherapy in the management of OSMF . MATERIAL S AND METHODS Forty patients presenting with clinical signs and symptoms of OSMF were included for the study after informed consent . Group A included 20 patients who received Aloe vera gel ( forever living gel ) along with physiotherapy . Group B included 20 patients who received antioxidant capsules twice daily for 3 months along with physiotherapy exercises four times in a day . The following parameters , that is , burning sensation , mouth opening , tongue protrusion and cheek flexibility were recorded at each visit . RESULTS Majority of the participant enrolled were in the age range of 30 to 35 years . Improvement in all the parameters was seen with the individuals receiving Aloe vera gel in comparison to antioxidants . CONCLUSION So , Aloe vera being a soothing , simple and safe mode of treatment along with proper habit restriction can be considered to be an effectual protocol in the management of OSMF . The analgesic effects of Aloe vera with the physiotherapy exercises provide better results in reducing burning sensation and improving mouth opening , tongue protrusion and cheek flexibility in comparison to antioxidants BACKGROUND Oral submucous fibrosis is a chronic disease , treatment of which has largely been symptomatic . Aloe vera has immunomodulatory , anti-inflammatory , wound healing , antioxidant , and antineoplastic activities . All such properties of aloe vera suggest the possibility of its use in the management of oral submucous fibrosis . METHODS Seventy-four patients of oral submucous fibrosis were r and omly divided into 2 groups . Group A patients were treated with systemic ( juice ) and topical aloe vera ( gel ) for 3 months . Group B patients were treated with intralesional injection of hydrocortisone and hyaluronidase for 6 weeks with antioxidant supplements for 3 months . Patients were assessed for reduction in burning sensation and increase in mouth opening , cheek flexibility , and tongue protrusion at an interval of 1 , 2 , and 3 months . RESULTS Both the groups showed statistically significant improvements in all the study parameters at the end of study period ( P < 0.001 ) . The clinical response to aloe vera was comparable to that of intralesional injections of hydrocortisone and hyaluronidase with antioxidant supplementation . CONCLUSION The study concludes that aloe vera can be an alternative , safe , and effective treatment regime in the management of oral submucous fibrosis . Long-term follow-up studies with larger sample size are recommended Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more OBJECTIVE To investigate the effectiveness of turmeric with black pepper and nigella sativa in oral submucous fibrosis ( OSMF ) . STUDY DESIGN Forty OSMF patients were r and omly divided into two groups . The study was performed under a double-blind , r and omized design . Group A received turmeric with black pepper and group B received nigella sativa for 3 months .  Clinical evaluation was done every 15 days . Patients ' serum superoxide dismutase ( SOD ) levels were assessed before and after treatment and also compared with healthy controls . The response to treatment was analyzed using analysis of variance , paired t test , and unpaired t test . RESULTS After the treatment , groups A and B showed 3.85 ± 0.22 mm and 3.6 ± 0.07 mm improvement in mouth opening , respectively ( P < .01 ) ; 87.90 % and 78.91 % reduction in burning sensation , respectively ( P < .01 ) ; and + 0.62 U/mL and + 0.74 U/mL improvement in serum SOD levels , respectively ( P < .05 ) . The maximum mouth opening achieved was 8 mm in group A and 7 mm in group B. The mean pretreatment SOD level for controls and patients was 3.61 ± 0.24 U/mL in group A and 2.63 ± 0.18 U/mL in group B. CONCLUSION Turmeric with black pepper and nigella sativa  improved mouth opening , burning sensation , and SOD levels in the present OSMF study patients ; however , further investigations are needed OBJECTIVE Definitive therapy is not defined for the management of oral submucous fibrosis ( OSMF ) . This study evaluated the efficacy of aloe vera gel as an adjuvant treatment of OSMF . STUDY DESIGN A double-blind , placebo-controlled , parallel-group r and omized controlled trial was conducted on 60 subjects with OSMF divided into medicinal treatment ( submucosal injection of hyaluronidase and dexamethasone , n = 30 ) and surgical treatment ( n = 30 ) categories . Each category was r and omly divided into groups A ( with aloe vera , n = 15 per category ) and B ( without aloe vera , n = 15 per category ) . Follow-up assessment for various symptoms was performed , and results were analyzed using paired and unpaired Student t tests . RESULTS The group receiving aloe vera had a significant improvement in most symptoms of OSMF ( P < .01 ) compared with the non-aloe vera group , in both the medicinal and surgical categories . CONCLUSIONS Aloe vera gel was effective as an adjuvant in treatment of OSMF OBJECTIVES To evaluate and compare the therapeutic response of lycopene and curcumin with placebo in patients suffering from oral submucous fibrosis ( OSMF ) and to correlate the habit variables of smoked and smokeless tobacco products in OSMF . METHODS A r and omized placebo-controlled parallel clinical study was conducted on ninety OSMF patients , who were divided into three treatment groups using computer-generated r and omization . Group A patients ( n = 30 ) were given curcumin tablet ( 300 mg ) twice daily , Group B patients ( n = 30 ) received lycopene capsules ( 8 mg ) twice daily , and for Group C ( n = 30 ) , placebo capsules were given once daily for a period of six months . Both the participant and outcome assessor were blinded . Pre- and post-treatment comparison of mouth opening , burning sensation , tongue protrusion , and cheek flexibility was analyzed at periodic follow-up of 9 months . RESULTS The overall improvement in mouth opening , burning sensation , tongue protrusion , and cheek flexibility was 3.9 ± 4.9 mm , 4.8 ± 2.6 , 5.0 ± 7.2 mm , & 0.36 ± 0.71 mm , respectively , for curcumin and 4.1 ± 4.2 mm , 5.0 ± 2.3 , 2.4 ± 3.5 mm , & 0.66 ± 0.80 mm , respectively , for lycopene with the p value < 0.05 . CONCLUSION Statistically significant improvement in clinical findings was observed in both curcumin and lycopene treatment groups in comparison with placebo . However , the therapeutic efficacy of curcumin and lycopene was found to be almost equal in OSMF patients
target: The results of meta- analysis showed statistically significant differences between aloe vera and control groups in alleviating pain/burning sensation at the end of the first and second month , in favor of aloe vera , but no significant differences were found at the end of the third month .
  With regard to objective clinical outcomes , no statistically significant differences were found between the groups .
  Aloe vera has a promising effect in reducing pain/burning sensation and clinical improvement in patients with OSF .
background: The management of oral submucous fibrosis ( OSF ) is quite challenging , and as yet , no effective therapy is available for its management .
  The present systematic review and meta- analysis sought to assess the effectiveness of aloe vera in alleviating pain and clinical signs of OSF .