Efficacy of the holy basil in the treatment of oral submucous fibrosis: a systematic review and meta-analysis

INTRODUCTION. The review aimed to evaluate the therapeutic efficacy of holy basil (ocimum sanctum) in managing oral submucous fibrosis (OSMF), focusing on its impact on clinical symptoms such as burning sensation, mouth opening, tongue protrusion, cheek flexibility, blanching, and fibrosis. MATERIALS AND METHODS. A comprehensive search was conducted across PubMed-Medline, Scopus, Embase, Cochrane Library and Google Scholar from the earliest available date upto 5th April, 2025. Studies included were randomized controlled trials (RCTs) and observational studies involving patients diagnosed with OSMF, assessing the efficacy of holy basil in any formulation (such as extract or oil) on clinical symptoms. Both Two reviewers independently performed data extraction and quality assessment using the Cochrane RoB 2.0 and ROBINS-I tools. Where appropriate, a metaanalysis (MA) was performed, where summarized raw mean (MRAW) standardized mean differences (SMDs) were calculated. RESULTS. A total of 7 studies met the inclusion criteria, comprising 5 observational and 2 experimental studies conducted in India between 2017 and 2023. The MA demonstrated significant improvements in maximal mouth opening with MRAW = 36.14 mm; 95% confidence interval [CI]: 22.3–49.98) and reduction in burning sensation (SMD = 2.6; 95% CI: 1.94–3.25) in patients receiving holy basil-based treatments. Substantial heterogeneity was noted for mouth opening outcomes (I²= 96%), whereas the results for burning sensation were relatively consistent across studies (I²< 50%). Secondary outcomes, such as cheek flexibility, were reported in only one study, restricting broader generalization. CONCLUSIONS. The findings suggest that Holy Basil, administered in various formulations, shows promising potential in improving key clinical symptoms such as maximal mouth opening, burning sensation, and tongue protrusion.