Comparison of Collagen Membrane and Split Thickness Skin Graft Used for Reconstruction of Buccal Mucosa in Oral Submucous Fibrosis - A Prospective Clinical Trial

Abstract

Background: Oral submucous fibrosis (OSMF) is a chronic, progressive condition marked by the gradual stiffening of oral tissues, leading to restricted mouth opening, impaired oral functions, and a heightened risk of malignant transformation. Treatment for OSMF typically involves a combination of habit cessation, medication to reduce inflammation and fibrosis, physiotherapy to maintain or increase mouth opening, and surgery in advanced cases. Early diagnosis and a multi-disciplinary approach are key to effectively managing OSMF and improving the patient’s quality of life. Split thickness skin graft are the most popular and commonly used flap in reconstructing mucosal defect left by fibrous band excision in developing countries like India where free flap expertise are not easily available and affordable by poor patients. In this study we compared split thickness skin graft and collagen membrane for reconstruction of buccal mucosa defects post fiberotomy in patients suffering from oral submucous fibrosis.

Aim: The aim of this clinical study is to compare the efficacy of Collagen membrane over split thickness skin graft used for reconstruction of buccal mucosa in patients with oral submucous fibrosis.

Materials and Methods: This study was carried out at the Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospital, Chennai in the year 2023 and 2024. based on the G* power calculation study consisted of 30 individuals which were divided into two groups containing 15 individuals in each group excluding the dropouts. Group 1 received collagen membrane for buccal mucosa reconstruction while group 2 received split thickness skin graft for buccal mucosa reconstruction. Immediate post operative mouth opening was measured by using standardized measurement scale and compared with 3 month and 6 month follow up period.

Results: It was found that the mouth opening of participants in the collagen membrane group was slightly more than the mouth opening of participants in the skin graft group with statistically significant difference of (P = 0.004) On 3rd month follow up and (P = 0.001) on 6th month follow up respectively.

Conclusion: This study concluded that Collagen membranes offer a more effective solution for increasing mouth opening and possibly enhancing overall oral function in patients with OSMF. As a result, collagen membranes could be regarded as a better choice for buccal mucosa reconstruction in the surgical treatment of OSMF.