Effectiveness of Lycopene Combined With Intralesional Hyaluronidase Versus Lycopene Monotherapy in the Management of Oral Submucous Fibrosis: A Systematic Review
Preeti Parameswaran Nair, Ganiga C. ShivakumarBackground:
Oral submucous fibrosis (OSMF) represents a chronic, progressive disorder for which a multitude of therapeutic modalities have been explored. Nevertheless, the corpus of evidence remains equivocal, and definitive conclusions regarding treatment efficacy are elusive.
Objective:
To compare the efficacy of lycopene alone with a combination of intralesional hyaluronidase and lycopene in the treatment of OSMF.
Methods:
This systematic review was registered in PROSPERO and carried out as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A thorough search of PubMed/MEDLINE, Google Scholar, Science Direct, DOAJ, and the Cochrane Library was performed for studies published in the last two decades. Of 233 records, four were included in the qualitative synthesis.
Results:
Lycopene monotherapy and the combined regimen alleviated trismus and oral dysesthesia; however, adjunctive intralesional hyaluronidase showed greater improvement in trismus. Still, the studies had important weaknesses in their methods—especially poor concealment of group assignments and the risk of bias in how participants were selected.
Conclusion:
The lycopene–hyaluronidase drug approach produced modestly greater improvements in both mouth opening and burning sensation compared to lycopene monotherapy, indicating a slight overall advantage of the combination therapy. Larger, well-designed randomized controlled trials are needed to establish more conclusive evidence.