New Intraoral Appliance for Trismus in Oral Submucous Fibrosis- Case report
Dr Nallan C. S. K. Chaitanya at the Department of Oral Medicine and Radiology, Panineeya Institute of Dental Sciences, Hyderabad, India, and colleagues have reported a case of use of New Intraoral Appliance for Trismus in Oral Submucous Fibrosis. The case has been published in the Journal of Case Reports in dentistry.
Trismus refers to the condition where an individual is unable to open the mouth, occurs due to various causes ranging from simple, nonprogressive to potentially life-threatening. It is the most common sequelae of various pathological processes leading to a compromised nutritional state in addition to physical and psychological disabilities. Therapeutic interventions are available to relieve trismus, which ranges from oral usage of pharmacological agents to intralesional steroid therapy. Intraoral appliance therapy can be employed as an alternative or adjuvant treatment for radiotherapy-induced fibrosis and autoimmune disorders such as scleroderma, psychogenic trismus, and oral submucous fibrosis, decreasing the adverse effects associated with other pharmacological interventions. A novel intraoral appliance—"Nallan C-H"—has been developed and tried for trismus producing better results.
A male patient, aged 39 years, presented to a private clinic with a chief complaint of difficulty in mouth opening since one and half years. The patient had a habit of chewing gutka for the past eight years. It was observed that there is a noticeable decline in the mouth opening of 17 mm (intercanine distance) and tongue protrusion of 10 mm. On intraoral examination, generalized blanching of the oral mucosa with greyish black pigmentation was seen. And also, multiple vertical palpable fibrous bands with loss of elasticity and leathery in texture were noticed. OSMF was diagnosed, and the patient was treated with conventional intralesional steroid injections. Since the patient has been under similar treatment for over a period of time with no recognizable change or relief, he requested for alternative therapy. Intraoral appliance therapy was considered, and prior consent was obtained from the patient. The patient was duly provided with necessary precautions regarding the usage of appliance and weekly follow-up without discontinuing the treatment. The treatment was carried out for a total period of 8 weeks and a follow-up of two months after completion of the therapy.
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