Is Coronoidectomy Superior to Coronoidotomy for Improving Maximum Incisal Opening in Patients With Oral Submucous Fibrosis?

PURPOSE: In the management protocol of the oral submucous fibrosis (OSMF), multiple studies have advocated that an additional step of coronoidectomy or coronoidotomy helps achieve better and more consistent postoperative results. But, there are no studies that validate if one has an advantage over the other. This study aimed to compare the outcome of the coronoidectomy with coronoidotomy for OSMF cases.

METHODS

A randomized controlled trial was designed in patients with OSMF requiring operative intervention. Patients were randomized into 2 groups based on a computer-generated randomization table: group I coronoidectomy and group II coronoidotomy. The primary predictor variables were the 2 different adjunct surgical steps - coronoidectomy and coronoidotomy. The primary outcome variable was the postoperative maximum incisal opening (MIO). Secondary outcome variables were duration of surgery and blood loss.

RESULTS

The study sample was composed of 32 patients (16 each group). Both the groups were comparable in terms of demographic profile. The MIO after surgery was comparable throughout the study between the groups. Repeated measures analysis of variance for comparison of mouth opening within the group showed that there was a significant improvement in postoperative MIO in both the groups (group I P value <.001 and group II P value 0.004). A statistically significant difference was found in the duration of the surgery (3.5 ± 0.73 hours vs 2.06 ± 0.87 hours) and blood loss (393 .75 ± 278.6 mL vs 90.62 ± 58.36 mL) with the shorter time and less blood loss in coronoidotomy compared with coronoidectomy. All these cases were followed for 1 year.

CONCLUSIONS

Coronoidotomy as an adjunctive treatment in OSMF provides comparable treatment outcome in terms of MIO compared with coronoidectomy with the added advantage of shorter operating time and less blood loss.