Oral Submucous Fibrosis- Correlation between Clinical Findings and Histopathological Grading

Abstract

Introduction
 Oral Submucous fibrosis (OSMF) occurs in young adults, who are in the habit of chewing tobacco mixed with areca nut and its various commercially available preparations. The disease results in progressive inability to open the mouth due to the submucosal fibrosis initiated by chronic inflammation affecting mainly oral mucosa. Authors undertook the present study to correlate the clinical features of OSMF to histopathological features and to find out aetiopathological factors of this condition.
 Materials and Methods
 A total of 123 clinically diagnosed OSMF patients, in the age range of 17 to 70 years were studied. Mouth opening was measured using a scale and was recorded in millimeters. Incisional biopsy was taken from the representative areas in the oral cavity. The patients were graded clinically and histopathologically and results were analyzed and discussed.
 Result
 Most of the patients were in the age group of 20-30 years (37.4%) with male predominance. The duration of either tobacco or areca nut chewing ranged from 1 to 35 yrs. Most patients had these habits for 6-19 yrs. Majority (55.3% & 54.5%) of the patients belonged to grade-2 (clinical grading) and intermediate grade (HPE grading) respectively. The HPE grading showed significant and direct association with duration of ill habits. The HPE grading showed significant and direct association with clinical grading (χ2=204.08, p<0.001).
 Discussion 
 The HPE grading showed significant and direct association with duration of ill habits and also with clinical findings of restriction of mouth opening and inter incisal distance. The HPE findings showed significant and direct association with clinical grading i.e. when the clinical grading increases, the histopathological grading also increases.
 Conclusion
 OSMF is a disease with a high incidence. It also carries a significant risk of transformation to oral cancer. As no effective medical and surgical treatment is available for this condition; it is desirable to diagnose OSMF at early stages.