Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,218 questions · 1,325 findings · 34 reviews · Oral medicine and oral cancer

No studies found 164 · 12.4%GRADE not reported 841 · 63.5%Very low 209 · 15.8%Low 72 · 5.4%Moderate 38 · 2.9%High 1 · 0.1%

Hydrocortisone plus hyaluronidase (intralesional) vs Intralesional steroid plus hyaluronidase injections

Maximal mouth opening (interincisal distance) · People of any age with a confirmed diagnosis, by clinical examination and biopsy, of oral submucous fibrosis (OSF)
1 finding from 1 review
  • Singh 2010 (hydrocortisone+hyaluronidase 50 vs triamcinolone+hyaluronidase 50): mouth opening reported categorically (trismus) rather than as continuous data, precluding quantitative analysis; authors found no…
    1 study · 100 participants
    GRADE not reported

Antioxidant capsules vs Topical aloe vera gel

Maximal mouth opening (interincisal distance) · People of any age with a confirmed diagnosis, by clinical examination and biopsy, of oral submucous fibrosis (OSF)
1 finding from 1 review
  • Sudarshan 2012 (topical aloe vera 10 vs antioxidant capsules 10): reported improvement in interincisal distance but no baseline data, so change could not be determined; excluded from meta-analysis.
    1 study · 20 participants
    GRADE not reported

Pentoxifylline vs multivitamin and mineral supplement

Severity of oral/mucosal burning pain/sensation · People of any age with a confirmed diagnosis, by clinical examination and biopsy, of oral submucous fibrosis (OSF)
1 finding from 1 review
  • Rajendran 2006 concluded the intervention reduced pain, but pain intensity evaluations were inadequately defined and from interview data, making mean scores difficult to interpret.
    1 study · 29 participants
    GRADE not reported

Pentoxifylline vs Placebo or no active treatment

Burning sensation (VAS 0-100) · People of any age with a confirmed diagnosis, by clinical examination and biopsy, of oral submucous fibrosis (OSF)

It is very uncertain whether pentoxifylline changes burning sensation (VAS 0-100) compared with placebo or no active treatment (very low certainty).

1 finding from 1 review

Oral cancer patients (cases) vs Healthy controls

Periodontitis (clinical attachment loss) · Adults in case-control studies (oral cancer patients vs healthy controls)

Clinical attachment loss was significantly greater in oral cancer patients than controls (SMD 1.94, 95% CI 0.22-3.66), though heterogeneity was very high (I2=96.7%); ungraded.

1 finding from 1 review

Oxitard (antioxidant) vs Topical aloe vera gel

Difficulty in swallowing (participant-reported proxy) · People of any age with a confirmed diagnosis, by clinical examination and biopsy, of oral submucous fibrosis (OSF)

Oxitard (antioxidant) led to lower difficulty in swallowing (participant-reported proxy) compared with aloe vera gel; GRADE not reported.

1 finding from 1 review

Pentoxifylline vs Spirulina

Maximal mouth opening (interincisal distance) · People of any age with a confirmed diagnosis, by clinical examination and biopsy, of oral submucous fibrosis (OSF)

Pentoxifylline may leads to lower maximal mouth opening (interincisal distance) compared with spirulina (low certainty).

1 finding from 1 review

Hydrocortisone plus hyaluronidase (intralesional) vs Placebo or no active treatment

Maximal mouth opening (interincisal distance) · People of any age with a confirmed diagnosis, by clinical examination and biopsy, of oral submucous fibrosis (OSF)

It is very uncertain whether hydrocortisone plus hyaluronidase (intralesional) changes maximal mouth opening (interincisal distance) compared with placebo or no active treatment (very low certainty).

1 finding from 1 review

Intralesional triamcinolone vs Intralesional salvianolic acid B

Maximal mouth opening (interincisal distance) · People of any age with a confirmed diagnosis, by clinical examination and biopsy, of oral submucous fibrosis (OSF)

It is very uncertain whether intralesional triamcinolone changes maximal mouth opening (interincisal distance) compared with intralesional salvianolic acid B (very low certainty).

1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment

Plaque · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)

In randomized trials, clear aligners probably reduce plaque accumulation versus fixed appliances, though the subgroup estimate is imprecise and its CI crosses no effect (SMD -1.79, 95% CI -3.63 to 0.04; moderate certainty).

6 findings from 1 review
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Surgery vs Radiotherapy alone

Adverse events associated with treatment · Adults with oropharyngeal cancer
1 finding from 1 review

Clear aligners (Invisalign / thermoformed aligners) vs Conventional orthodontic appliance treatment

White spot lesion incidence · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries)

Most studies reported a lower incidence of white spot lesions with clear aligners than fixed appliances, but heterogeneous assessment methods precluded meta-analysis (ungraded).

1 finding from 1 review

Elective radical (comprehensive) neck dissection vs Elective selective neck dissection

Total mortality · Adults with oral cavity cancer
1 finding from 1 review

Elective neck dissection (at time of primary tumour resection) vs Therapeutic (delayed) neck dissection

Adverse events associated with treatment · Adults with oral cavity cancer (tongue or floor of mouth) and clinically negative neck nodes

Elective neck dissection (at time of primary tumour resection) probably leads to higher adverse events associated with treatment compared with therapeutic (delayed) neck dissection (moderate certainty).

1 finding from 1 review

Sentinel node biopsy (neck dissection only if biopsy positive) vs Elective neck dissection

Recurrence · Adults with oral cavity or oropharyngeal cancer
1 finding from 1 review