Effect of ultrasound therapy and proprioceptive neuromuscular facilitation with ultrasound therapy and conventional mouth-opening exercise in oral submucous fibrosis patients

Background. The habit of chewing tobacco leads to morbidities such as oral submucous fibrosis, trismus, and oral squamous cell carcinoma. When treated early, this premalignant condition can be effectively managed using hyaluronidase injections, ultrasound therapy, and mouth-opening exercises. This study aims to compare the effect of ultrasound therapy combined with proprioceptive neuromuscular facilitation (PNF) and conventional mouth-opening exercises in patients with oral submucous fibrosis. Method. Workers diagnosed with grade II and III oral submucous fibrosis were selected for the study. Out of 300 screened patients, 150 met the inclusion and exclusion criteria and were selected through convenience sampling. Patients with an inter-incisal distance of less than 3 cm were included. Participants were randomly assigned into two groups of 75 each, including both grade II and grade III cases. One group received conventional stretching exercises using stacked ice cream sticks between the incisors, while the other group underwent PNF techniques combined with ultrasound therapy. Both groups received ultrasound therapy. Results. There was no statistically significant difference between the post-treatment mouth-opening measurements of the conventional stretching and PNF groups. However, clinically, the improvement was more evident in the conventional group compared to the PNF-treated group. Conclusion. No significant benefit was observed from adding proprioceptive neuromuscular facilitation to the treatment of oral submucous fibrosis. However, ultrasound therapy combined with conventional mouth-opening exercises showed favorable clinical outcomes.