Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

51 questions · 65 findings · 3 reviews · Oral medicine and oral cancer

No studies found 7 · 10.8%GRADE not reported 16 · 24.6%Very low 27 · 41.5%Low 11 · 16.9%Moderate 4 · 6.2%High 0 · 0%

Antioxidants (lycopene, curcumin, Oxitard) vs Placebo or no active treatment

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

Antioxidants (lycopene, curcumin, Oxitard) led to lower difficulty in swallowing (participant-reported proxy) compared with placebo or no active treatment; GRADE not reported.

1 finding from 1 review

Systemic beta carotene or carotenoids (incl. lycopene) vs placebo or no treatment

Improvement of histological features (not improved) · People with a diagnosis of oral leukoplakia

Systemic beta carotene or carotenoids (incl. lycopene) may leads to lower improvement of histological features (not improved) compared with placebo or no treatment (low certainty).

1 finding from 1 review

Systemic beta carotene or carotenoids (incl. lycopene) vs placebo or no treatment

Malignant transformation (oral cancer development) · People with a diagnosis of oral leukoplakia

It is very uncertain whether systemic beta carotene or carotenoids (incl. lycopene) changes oral cancer development compared with placebo or no treatment (very low certainty).

1 finding from 1 review

Systemic beta carotene or carotenoids (incl. lycopene) vs placebo or no treatment

Safety of the intervention (adverse effects) · People with a diagnosis of oral leukoplakia
1 finding from 1 review
  • Interventions for treating oral leukoplakia to prevent oral cancer 2016 · Cochrane All outcomes
    5 to 12 months
    SoF 2, Safety of the intervention at 5 to 12 months: 'Systemic beta carotene did not cause any adverse effects in 1 study supplementing 10 mg/d (Nagao), and caused adverse effects of varying severity in 9% of…
    3 studies
    GRADE not reported

Systemic beta carotene or carotenoids (incl. lycopene) vs placebo or no treatment

Clinical resolution (oral lesion not completely resolved) · People with a diagnosis of oral leukoplakia
1 finding from 1 review
  • Interventions for treating oral leukoplakia to prevent oral cancer 2016 · Cochrane All outcomes
    5 to 12 months
    SoF 2, Clinical resolution (not completely resolved) at 5 to 12 months: 'The 3 studies could not be combined in meta-analysis. 2 found benefit for systemic beta carotene, and 1 did not.' No GRADE rating. Effects text…
    3 studies
    GRADE not reported

Dietary supplements (alpha lipoic acid +/- vitamins/lycopene/green tea; hypericum; Catuama; lycopene) vs placebo

Relief of burning/discomfort (symptom relief; pain intensity) · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
1 finding from 1 review
  • Interventions for treating burning mouth syndrome 2016 · Cochrane All outcomes
    short-term (up to 3 months)
    SoF5 Dietary supplements vs placebo. Symptom relief short-term: insufficient or contradictory evidence regarding benefit of any evaluated dietary supplement; 628 participants (12 RCTs); very low. Subgroups: ALA without…
    12 studies · 628 participants
    Very low

Physiotherapy (tongue-spatula jaw exercises) vs No active treatment (control)

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 physiotherapy (tongue-spatula jaw exercises) changes maximal mouth opening (interincisal distance) compared with no active treatment (very low certainty).

1 finding from 1 review

Intralesional steroid injection plus adjunctive treatment vs steroid injection

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

Intralesional steroid injection plus adjunctive treatment showed no clear difference in maximal mouth opening (interincisal distance) compared with intralesional steroid injection alone (low certainty).

2 findings from 1 review

Topical curcumin gel 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)

It is very uncertain whether topical curcumin gel changes maximal mouth opening (interincisal distance) compared with topical aloe vera gel (very low certainty).

1 finding from 1 review

Buccal fat pad pedicle plus placental extract vs Buccal fat pad pedicle alone

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 buccal fat pad pedicle plus placental extract changes maximal mouth opening (interincisal distance) compared with buccal fat pad pedicle alone (very low certainty).

1 finding from 1 review

Vasodilator 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 vasodilators (isoxsuprine, xanthinol nicotinate) changes maximal mouth opening (interincisal distance) compared with placebo or no active treatment (very low certainty).

2 findings from 1 review

Buccal fat pad graft vs Extended nasolabial flap

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 buccal fat pad graft changes maximal mouth opening (interincisal distance) compared with extended nasolabial flap (very low certainty).

3 findings from 1 review

Pentoxifylline vs multivitamin and mineral supplement

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
  • Rajendran 2006 (pentoxifylline 14 vs multivitamins 15): reported increased interincisal distance in the pentoxifylline group but no baseline data, so change could not be determined; excluded from meta-analysis.
    1 study · 29 participants
    GRADE not reported

Oxitard (antioxidant) 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)

Oxitard (antioxidant) may leads to higher maximal mouth opening (interincisal distance) compared with aloe vera gel (low certainty).

1 finding from 1 review

Spirulina vs Oxitard (antioxidant)

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

Spirulina may leads to lower maximal mouth opening (interincisal distance) compared with oxitard (antioxidant) (low certainty).

1 finding from 1 review

Intralesional steroid injections vs Alternative medicinal treatments

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

Intralesional steroid injections showed no clear difference in maximal mouth opening (interincisal distance) compared with alternative medicinal treatments (low certainty).

2 findings from 1 review

Abdominal dermal fat graft vs Nasolabial flap

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 abdominal dermal fat graft changes maximal mouth opening (interincisal distance) compared with nasolabial flap (very low certainty).

2 findings from 1 review

Levamisole vs Antioxidant (Antoxid)

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 levamisole changes maximal mouth opening (interincisal distance) compared with antioxidant (Antoxid) (very low certainty).

2 findings from 1 review