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<p>To systematically evaluate and quantitatively synthesize the comparative effectiveness of intralesional platelet-rich plasma(PRP) versus other non-surgical injectable medical therapies in improving maximal mouth opening(MMO) and reducing burning sensation in patients with oral submucous fibrosis(OSMF). A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines and prospectively registered in PROSPERO(CRD420261294570). Electronic databases (PubMed, Scopus, Embase, Cochrane CENTRAL, and ScienceDirect) were searched up to 31 December 2025.Randomized controlled trials and non-randomized comparative studies evaluating intralesional PRP against corticosteroid-based regimens were included. Primary outcomes were change in MMO(mm) and burning sensation assessed by visual analog scale(VAS). Random-effects meta-analyses using restricted maximum likelihood estimation were performed. Adjusted indirect comparisons were conducted using the Bucher method. Certainty of evidence was assessed using GRADE. Six comparative studies (<i>n</i> = 528 participants) were included. PRP demonstrated significantly greater improvement in MMO compared with triamcinolone alone (MD = 2.64&#xa0;mm; 95% CI 1.12–4.16; <i>p</i> &lt; 0.001; I² = 35.36%) and triamcinolone plus hyaluronidase (MD = 3.09&#xa0;mm; 95% CI: 2.51–3.67; <i>p</i> &lt; 0.001; I² = 0%). For burning sensation, no statistically significant differences were observed between PRP and triamcinolone (MD = − 0.17; 95% CI −1.64 to 1.30; <i>p</i> = 0.82; I² = 95.46%) or between PRP and triamcinolone plus hyaluronidase (MD = − 0.73; 95% CI −1.58 to 0.12; <i>p</i> = 0.09; I² = 91.08%). Indirect comparison between triamcinolone alone and triamcinolone plus hyaluronidase showed no significant difference for MMO (MD = 0.45&#xa0;mm; 95% CI −1.18 to 2.08) or pain (MD = 0.40; 95% CI −0.46 to 1.26). Overall certainty of evidence ranged from moderate to very low. Intralesional PRP was associated with modest but statistically significant additional improvement in MMO compared with steroid-based injectable regimens, while demonstrating comparable effects for burning sensation. Given methodological limitations and limited geographic representation, findings should be interpreted cautiously.</p>

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Intralesional Platelet-Rich Plasma Versus Other Medical Treatment Modalities in Oral Submucous Fibrosis: A Systematic Review and Meta-analysis

  • 期刊论文

  • 发表日期：

    2026年3月26日

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  • Sibgutulah Rashid,
  • Rudra Deo Kumar,
  • Khan Sabera Kalimuddin,
  • Somansh Goyal

摘要

To systematically evaluate and quantitatively synthesize the comparative effectiveness of intralesional platelet-rich plasma(PRP) versus other non-surgical injectable medical therapies in improving maximal mouth opening(MMO) and reducing burning sensation in patients with oral submucous fibrosis(OSMF). A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines and prospectively registered in PROSPERO(CRD420261294570). Electronic databases (PubMed, Scopus, Embase, Cochrane CENTRAL, and ScienceDirect) were searched up to 31 December 2025.Randomized controlled trials and non-randomized comparative studies evaluating intralesional PRP against corticosteroid-based regimens were included. Primary outcomes were change in MMO(mm) and burning sensation assessed by visual analog scale(VAS). Random-effects meta-analyses using restricted maximum likelihood estimation were performed. Adjusted indirect comparisons were conducted using the Bucher method. Certainty of evidence was assessed using GRADE. Six comparative studies (n = 528 participants) were included. PRP demonstrated significantly greater improvement in MMO compared with triamcinolone alone (MD = 2.64 mm; 95% CI 1.12–4.16; p < 0.001; I² = 35.36%) and triamcinolone plus hyaluronidase (MD = 3.09 mm; 95% CI: 2.51–3.67; p < 0.001; I² = 0%). For burning sensation, no statistically significant differences were observed between PRP and triamcinolone (MD = − 0.17; 95% CI −1.64 to 1.30; p = 0.82; I² = 95.46%) or between PRP and triamcinolone plus hyaluronidase (MD = − 0.73; 95% CI −1.58 to 0.12; p = 0.09; I² = 91.08%). Indirect comparison between triamcinolone alone and triamcinolone plus hyaluronidase showed no significant difference for MMO (MD = 0.45 mm; 95% CI −1.18 to 2.08) or pain (MD = 0.40; 95% CI −0.46 to 1.26). Overall certainty of evidence ranged from moderate to very low. Intralesional PRP was associated with modest but statistically significant additional improvement in MMO compared with steroid-based injectable regimens, while demonstrating comparable effects for burning sensation. Given methodological limitations and limited geographic representation, findings should be interpreted cautiously.