Efficacy of Platelet-rich Plasma in Management of Oral Submucous Fibrosis: A Systematic Review and Meta-analysis

Abstract

Background: Oral submucous fibrosis (OSMF) is a long-standing, disabling, potentially malignant oral condition mostly observed across South Asian populations. Existing treatment modalities mainly provide symptomatic relief with limited influence on disease progression. As an autologous biological preparation rich in growth factors, platelet-rich plasma (PRP) has recently introduced a novel regenerative approach aimed at optimizing treatment efficacy for patients with OSMF. Objective: To systematically assess the effectiveness of PRP in the management of OSMF, with particular focus on improvements in mouth opening and burning sensation compared with conventional therapeutic approaches. Materials and Methods: A comprehensive literature search up to June 2025 was conducted on PubMed, Cochrane Library, Turning Research into practice, and gray literature sources following the PRISMA framework (PROSPERO ID: CRD420251082062). We selected comparative clinical investigations and randomized controlled trials evaluating PRP treatment for OSMF. Quantitative data were pooled using a random-effects model to determine mean differences with 95% confidence intervals, while heterogeneity across studies was appraised with the l 2 test. Results: Eight eligible studies, comprising five randomized controlled trials and three comparative non-randomized studies, were included in the review. PRP was evaluated against conventional interventions including triamcinolone, hyaluronidase, and curcumin. Most studies reported improvements in mouth opening following PRP therapy, whereas findings related to burning sensation and pain were inconsistent. Meta-analysis of two randomized controlled trials ( n = 154) demonstrated a significant improvement in mouth opening with PRP, while no statistically significant benefit was observed for burning sensation or pain compared with conventional therapies. Conclusion: Available evidence suggests that PRP has the potential to improve mouth opening when used as an adjunctive therapy in patients with OSMF. However, its effectiveness in reducing burning sensation and pain remains uncertain due to limited and heterogeneous evidence. Future adequately powered randomized controlled trails trials using standardized treatment protocols and longer follow-up are needed to better define the role of PRP in OSMF management.