Efficacy of Pharmacological Therapies for the Management of Oral Submucous Fibrosis: An Umbrella Review of Meta‐Analyses

BACKGROUND: The cumulative evidence from meta-analyses on interventions for oral submucous fibrosis (OSF) remains uncertain in terms of strength, precision, and quality. This umbrella review synthesizes the current evidence on available interventions and assesses the certainty. METHODS: We searched PubMed, Scopus, Epistemonikos, and CINAHL for meta-analyses on OSF interventions. The effect sizes of the outcome measures were used to assess the credibility employing a random-effects model, and the evidence quality was analyzed using the GRADE criteria. RESULTS: Nine meta-analyses encompassing 64 randomized controlled trials were included, detailing 72 associations between available interventions and health outcomes in OSF. Only 17 of the 72 assessed associations were statistically significant (p ≤ 0.05). Lycopene was shown to be statistically effective in improving mouth opening in both the short-term (1-3 months) and long-term (6 months) follow-ups. The evidence regarding other interventions and outcomes remains inconclusive. Using GRADE, 9 associations were supported by low-quality evidence. The remaining 63 associations were substantiated as very low-quality evidence. CONCLUSION: No pharmacological intervention for oral submucous fibrosis is supported by evidence exceeding low certainty, with most evidence rated as very low certainty. This underscores the need for robust long-term studies on other interventions rather than additional meta-analyses.