Mucous Fibrosis Research Articles

The Role of Lipid Peroxidation Products in the Development of Oral Sub Mucous Fibrosis- A Cross-Sectional Survey

The Role of Lipid Peroxidation Products in the Development of Oral Sub Mucous Fibrosis- A Cross-Sectional Survey

Hematological profile of OSMF patients with increasing severity

Haematological profile of patients with oral sub mucous fibrosis (OSMF) and its correlation with the severity of OSMF is evaluated. The study comprised of sixty participants with clinical diagnoses. They were divided into smaller groups based on the OSMF stage. Sixty age and gender matched healthy controls were chosen among patients presenting for routine hematological examinations and free of systemic illnesses. Assessment of iron, hemoglobin, and red cell indices in all study participants was carried out. It was observed that the values of haematological tests like (Hb (g/dL), PCV, MCV (fl), MCH, MCHC, Iron (mg/dL) and Vitamin B12 (pg/Ml) was greater in normal subjects as compared to OSMF patients. Values were found to decrease further as the severity (staging) of OSMF increased among OSMF patients. The findings were statistically significant showing decrease in the values of different haematological parameters as the stage of OSMF progressed from stage I to stage III.

Effectiveness of Triamcinolone and Hyaluronidase in Alleviation of Clinical Spectrum in Patients with Oral Sub Mucous Fibrosis

Effectiveness of Triamcinolone and Hyaluronidase in Alleviation of Clinical Spectrum in Patients with Oral Sub Mucous Fibrosis

Up regulation of serum L fucose glycoprotein as a diagnostic biomarker for dysplasia in oral sub mucous fibrosis patients

Glycoproteins, essential for cellular functions, contain monosaccharides like Levo-fucose, crucial for cell communication. Recent research highlights serum L-fucose as a potential biomarker for early detection of malignancies. Typically, serum L-fucose levels are low but rise with malignancy. This study evaluates serum L-fucose as an early biomarker in oral submucous fibrosis (OSMF) patients. AimAssess serum L-fucose's diagnostic potential for dysplasia in OSMF patients. ObjectivesDetermine the Association between Serum L Fucose Glycoprotein Levels and Dysplasia in OSF Patients.Evaluate the Diagnostic Accuracy of Serum L Fucose Glycoprotein as a Biomarker for OSF-Related Dysplasia. MethodologyOver a span of two years, this study encompassed 80 subjects, aged between 18 and 60 years, who were clinically and histopathologically identified as OSMF patients, with or without dysplastic alterations. From each participant, 5 ml of blood was collected. Following centrifugation to separate the serum, the samples were analyzed to determine the levels of Levo-fucose. Statistical analysisUsing SPSS (version 17.0), serum L-Fucose levels of the case group were compared to the control group using ANOVA. Frequencies were analyzed with the chi-square test, and Tukey’s Test was used for multiple comparisons. Significance was set at p < 0.01. ResultsThe analysis revealed a statistically significant disparity in the mean serum L-Fucose levels between the two groups (p < 0.01). Notably, Group II patients (those with OSMF and dysplasia) exhibited markedly elevated mean serum L-fucose levels. ConclusionElevated serum L-Fucose levels were observed in OSMF patients with dysplasia. Harmful habits, especially gutkha chewing, were linked to Oral Squamous Cell Carcinoma onset. Serum L-fucose can be a reliable marker for evaluating precancerous conditions.

Magnetic Sectional Denture for Microstomia Patient with Oral Submucous Fibrosis

This article presents a case report of a patient with oral sub mucous fibrosis and subsequent microstomia , that resulted in restricted mouth opening. A magnetic sectional denture was planned for the maxillary arch to overcome the problem and a conventional denture was planned for the mandibular arch. Primary impressions were made, followed by sectional maxillary special trays for border molding. The record bases for the maxillary arch was fabricated in heat cure by incorporating magnets of 3mm diameter on the anterior alveolar ridge and middle part of mid palatal raphe region, and 5 mm magnet towards the posterior most part of mid palatal raphe region. The jaw relation was carried out, followed by teeth setting and wax try in. Finally the maxillary denture was processed in two sections and denture insertion was done. Satisfactory retention was achieved and phonetics was restored.

Comparative Evaluation of Plasma Fibrinogen Degradation Product and Salivary Fibrin Precipitating Factor in Oral Submucous Fibrosis Patients and Betel Quid Chewers.

Estimation and correlation of plasma fibrinogen degradation product (FDP) and salivary fibrin precipitating factor (FPF) in oral sub mucous fibrosis (OSMF) patients, betel quid chewers without OSMF and healthy individuals. The study aims to evaluate whether FDP and FPF can be used as a marker for development and progression of OSMF and whether there is any correlation between the two. The study included 163 subjects grouped into three categories, Group 1, which included 54 control patients, Group 2, which included 55 betel quid chewers, and Group 3, which included 54 clinically confirmed OSMF patients. All of them were subjected to the estimation of plasma FDP and salivary FPF. FDP was present in 52 (96.3%) patients in Group 3, 2 (3.6%) patients in Group 2, and 1 patient in Group 1 (1.9%). FPF was positive in eight patients. The correlation of FDP and FPF was done by Fisher's exact test and was found to be statistically nonsignificant. In the present study, FDP was positive in 52 (96.3%) OSMF patients; hence, FDP may be used as an early indicator of OSMF. FDP was found to be positive in two patients with a habit of chewing betel quid without OSMF. It may be hypothesized that these patients are more likely to develop OSMF. Hence, the estimation of FDP may be used as a diagnostic test to predict an impending OSMF before it could manifest itself clinically. FPF was negative in some OSMF patients, may be because it is below the detectable range.

The Effect of Patient's Age and duration and Frequency of Tissue Abusive Habit on Severity of Oral Sub Mucous Fibrosis

The effect of patient’s age and duration, frequency of tissue abusive habit on the severity of oral submucous fibrosis (OSMF): A pilot study. The study was conducted in the department of oral medicine and radiology in the dental institution. Fifty clinically diagnosed OSMF patients were included in the study. Specific information was recorded using a survey form which included questions related to the duration and frequency of tissue abusive habits. The severity of OSMF was recorded as per Chandramani et al. classification (clinical and functional staging). All obtained data were statistically analyzed. (1) There is a moderate positive correlation of increase in age with reduction in mean interincisal distance in a patient with OSMF (r = 0.456 and P &lt; 0.05). There is a weak positive and weak negative correlation of patient’s age with clinical and functional staging of OSMF, respectively. (2) With increase in the duration of habit, we found a weak positive correlation with incisal age also functional staging and strong positive correlation with clinical staging. (3) As the frequency of habit increases correlation of frequency with clinical and functional staging is weak positive. (1) In patients with OSMF, there is a moderate association present between increases in age with reduced interincisal distance. There is a weak correlation between the patient’s age and severe grades of clinical staging of OSMF. (2) With increase in the duration of habit clinical grading of OSMF becomes more severe. (3) There is a weak association between the frequency of habit with clinical and functional staging of OSMF.

Comparative Evaluation of Nasolabial Flap, Buccal Fat Pad and Platysma Myocutaneous Flap for Reconstruction of Oral Sub Mucous Fibrosis Defects

Comparative Evaluation of Nasolabial Flap, Buccal Fat Pad and Platysma Myocutaneous Flap for Reconstruction of Oral Sub Mucous Fibrosis Defects

Role of Tobacco Consumption Habits in the Causation of Precancerous Lesions: A Cross Sectional Study

Oral carcinoma is quite common and increasing trend in India and worldwide. Smoking and smokeless tobacco both are increasing worldwide. The common oral precancerous lesions are oral leukoplakia, erythroplakia, nicotina palati and oral sub mucous fibrosis (OSMF). Screening is best tool to find out such lesions. The current study is conducted to know the prevalence of tobacco consumption and also to examine oral cavity of tobacco consumer to detect precancerous lesions among the staff. Method: The present study was cross sectional study carried out tertiary care hospital staff. The study was conducted over a period of 6 month from May 2017 to October 2017. Ethical clearance for study was obtained from Institutional Ethical Committee. The staff members of class 3 and class 4 of hospital were taken as a study participants involving both of sex and who provided written informed consent. Sample of 120 staff members were enrolled for the study from provided sampling frame with the use of random sampling method. Study participants with previous history of hospital admission for any systemic illness, immunodeficiency or immunosuppressive patients, and participants who already diagnosed to have malignant cancer lesions in any part of body were excluded. Result: Of 120 study participants, 40% were belongs to 31 – 40 years of age group and majority were male (80%) and belonged to Hindu (90.83%) religion. The prevalence of tobacco consumption in any of form is 85%; of them 43.33% used smokeless tobacco and 10.83% used to with smoking and 30.83% had both forms of tobacco. Oral Sub Mucosal Fibrosis (OSMF) was the most common (70.58%) precancerous lesion found in the present study, followed by leukoplakia (16.67%). Conclusion: Current study revealed the high prevalence. There is urgent need to plan de-addiction at various level. Also those having the precancerous lesion need to warn and treat accordingly.

Management of Oral Sub Mucous Fibrosis Using Three Different Flaps: Superficial Temporal, Nasolabial Flap, Buccal Fat Pad Flap Along with Active Physiotherapy- A Comparative Study.

To assess the efficacy of different flaps along with active physiotherapy for comprehensive management of OSMF. A total of 33 patients of oral submucous fibrosis were admitted and surgically treated. All patients were diagnosed with bilateral oral submucous fibrosis of buccal mucosa. All the patients had advanced oral sub mucous fibrosis with interincisal distance less than 20mm. Eleven patients were treated with buccal pad of fat, eleven with nasolabial flap and eleven patients were treated with temporo-parietal fascia flap. Physiotherapy was started from the 5th postoperative day and the patients were followed regularly for one year to measure maximum interincisal distance. There was a significant corelation between post-operative mouth opening and regular physiotherapy, exercise and quitting of the habit irrespective of type of reconstruction flap used. On the basis of the result obtained from this study, significant improvement in mouth opening was seen in patients who performed aggressive physiotherapy irrespective of the flap used. Thus we conclude along with the surgical treatment, post-operative physiotherapy and cessation of habit are of equal importance for good prognosis in OSMF patients.

Non-Surgical Management of Mouth Opening in Oral Sub Mucous Fibrosis: A Network Meta-Analysis

Background and Aim Oral cancer is one of the most preventable cancers with a typical sequence of emergence as a potentially malignant disorder promotion and transformation into cancer. Oral submucous fibrosis OSMF is a potentially malignant disorder in which the mucosa stiffens and patients have trouble opening their mouth thus affecting their quality of life. Early therapeutic intervention yields better results. However oral submucous fibrosis has never been successfully treated by any single medication so far. Practitioners have tried various combinations of the drugs with variable results. Hence we conducted this meta-analysis to assess which treatment modality gives a better result with regard to improvement in mouth opening in OSMF patients.Methods Electronic search for articles published in various journals were undertaken through various search engines till October 2021. About 29 articles were selected which had performed randomized control trials of various drugs on oral submucous fibrosis. Frequentist network meta-analysis was performed using R studio software and effective treatment ranking was derived.Results According to the treatment ranking generated relative to mouth opening the most effective treatment was the intralesional steroid and hyaluronidase with vitamin E supplementation and the intralesional steroid and hyaluronidase with lycopene being the second best.Conclusion This network meta-analysis has analyzed the efficacy of various drug regimens used in the management of oral submucous fibrosis which can be implemented by the practitioners in the management of initial stages of oral submucous fibrosis thus preventing its progression into oral cancer.

Oral Sub mucous fibrosis (OSMF): A Review from Ayurveda Perspective.

Background: Oral sub mucous fibrosis (OSMF) a chronic progressive disorder of oral cavity characterized by inflammation and progressive fibrosis of the sub mucosal tissues. Reported data published revealed an estimate of 5 million OSMF patients in India and increased over past four decades from 0.03% to 6.42%, seen commonly in younger 20-40 years age group. In Ayurvedic classical texts, no any direct references about the disease quoted, can be considered as Anukta Vyadhi (Unexplained disease) and on understanding the disease condition OSMF can be considered as Vata Pradhana Tridoshaja Mukharoga Vyadhi which needs management locally and systemically. Material and Methods:Ayurvedic literature, modern texts as well as the data web-based search engines, journal, were used to search for relevant literature and information. Result:Habit of areca nut or betel quid and tobacco chewing, excessive consumption of chilies, autoimmunity, genetic, environmental factor and dietary deficiencies are the main etiological factors. Excessive and constant use Kashaya, Katu Rasa, Ruksha, Tikshna and Ushna Dravyas, lead toDosha Prakopa and Vikruta Dhatu formation corresponding to biochemical abnormalities/functional abnormalities and structural defects. So Vata-Pitta Pradhana Tridosha alleviating local as well as systemic treatment should be done. Conclusion:The fundamental principles of Ayurvedashouldbe applied for achieving regain of the normalcy of oral mucosaand restoring the normal function by its preventive and curative approach.

The Taq 1 polymorphism of Vitamin D receptor gene is associated with oral cancer and preoral cancer in North Indian population.

Oral cancer is known as one of the most common cancers, with a poor prognosis, related to delayed clinical diagnosis, either due to the lack of particular biomarkers related to the disease or costly therapeutic alternatives. In this study association of single nucleotide polymorphism (Taq1, T>C) in Vitamin D receptor gene with oral cancer and pre oral cancer was studied. Total 230 patients of precancerous oral lesions (Leukoplakia 70, Oral Sub mucous fibrosis 90, Lichen Planus 70), 72 oral cancer patients and 300 healthy control subjects were genotyped by PCR-RFLP methods. Chi-square test was used for calculation of genotype and allele frequencies. Mutant genotype CC as well as C allele were found to significantly decrease the risk of oral disease (P value=0.04, OR=0.60 and P value=0.02, OR=0.75 respectively). In particular, compared to non smokers, smokers with TC & CC genotypes were at decrease risk of oral diseases (P value=0.0001, OR=0.04). The mutant allele genotype CC as well as the mutant allele C showed protective association with leukoplakia (P value=0.01, OR=0.39 & P value=0.009, OR=0.59 respectively). However, individual with CC genotype had developed high cell differentiated grade at diagnosis (OR= 3.78, P value= 0.008). This study concludes that VDR (Taq1) polymorphism is associated with oral cancer and pre oral cancer susceptibility in North Indian population.

A Case on Oral Submucous Fibrosis (OSMF)

Oral sub mucous fibrosis (OSMF) is a chronic, insidious, disabling disease of oral mucosa, oropharynx, and rarely, the larynx affecting millions of people worldwide with a prevalence rate of 0.4% in Indian rural population. It results in difficulty in the mouth opening and can be disabling to the patient. It needs a timely diagnosis and thus appropriate treatment can be administered depending on the degree of involvement. A case of oral sub mucous fibrosis occurring in a 55 year old male patient is presented in this article.

Estimation of Serum Iron in the Patients of Oral Submucous Fibrosis

Objective: To compare the serum levels of iron in Oral Submucous Fibrosis (OSMF) and normal healthy subjects. Subject and Methods: A total of 120 patients with symptoms and signs suggestive of OSMF equally divided into two groups named group A and B. Patients satisfying the insertion norms and those who has oral sub mucous fibrosis and the control group who are willing to get participate and getting done their blood tests for other purpose were asked for additional iron serum test for our research purpose. The demographic and medical factors like gender, pain, age, and medical record was known and logged in proforma. Diagnosis was done on clinical basis and was categorized according to progress then blood sample was obtained. The data was examined using SPSS version 20.0. Results: Control group's descriptive (standard/healthy) statistics indicate the mean iron levels of iron 94.13 ug/dl, while standard deviations are 17.57ug/dl. On the 1st day, 2nd day and 3rd day serum levels are examined, which reveal the mean values of 28.02, 22.81 and 24.0 ug/dl, respectively. The findings indicate a greater average of iron (17.57) in the healthy group (group B), while considerably less mean of iron level (6.47) in patients who have OSMF (group A). Conclusion: The study concluded that OSMF have lower levels of the iron in the serum while higher levels in the healthy group. Keywords: Serum Iron Level, Oral Submucous Fibrosis, Estimation

Bibliometric Analysis of Scientific Productions Regarding Use of Turmeric in the Management of Oral Submucous Fibrosis

Oral cancer is the 12th most commonly occurring cancer in females and the 6th in males. Oral sub mucous fibrosis (OSMF) considered as one of the high-risk precancerous conditions, linked with areca nut chewing. The aim of present bibliometric analysis was to put forward a summary of countries, universities, authors, journals, and research data related to use of turmeric as a therapeutic consideration in potentially malignant disorders (PMDs) and oral submucous fibrosis (OSMF). Methodology: Studies related to use of turmeric as a therapeutic consideration in PMDs and OSMF published in PubMed indexed journals from 2011 to 2021 were extracted from the Science Citation Index expanded core database. Data and research publications of numerous authors, journals, universities, and countries were retrieved and quantitatively analyzed applying the R-Studio biblioshiny package. The core data set comprised of overall 334 journals, as well as books. 724 documents were recognized. Top 20 PubMed indexed journals were selected which publish the data regarding medicinal properties of turmeric. 20 universities were also analyzed regarding treatment of turmeric. Average years from publication are 4.8 years. Results: A total of 724 documents were extracted. These documents were derived from 2011-2021. The number of documents/publication researches steadily increased from 2011 till 2018. Conclusion: This research includes data of 10 years, therefore, this bibliometric research of contribution of turmeric in oral submucous fibrosis and potential malignant disorders will provide complete knowledge during these years. This will provide an insight for new research projects across the globe.

Topical Herbal Therapeutic Formulation used in the Management of Oral Potentially Malignant Disorders – A Systematic Review

Background: Oral potentially malignant disorders (OPMDs) are divided into two groups precancerous lesions, a benign lesion with morphologically altered tissue, which has a greater than normal risk of transforming into malignancy, and precancerous conditions, a disease or patient's habit that does not necessarily alter the appearance of local tissues but is associated with a greater or normal risk of precancerous lesion or cancer development in that tissue. Aim: This systematic review aims to evaluate the effectiveness of topical herbal therapeutics in the management of potentially malignant oral disorders. Objective: Primary objective was to evaluate the efficiency of tulsi, aloe vera, and turmeric in the management of OPMDs, and the secondary objective was to determine the herbal therapeutic response in patients with oral leukoplakia oral sub, mucous fibrosis, and lichen planus. Data Sources and Search Methods: The search was done using the MeSH [medical subject headings] terms and keyword search in the electronic databases, namely Pub Med and Google Scholar. The studies included in this systematic review were identified by a comprehensive search from the electronic search engines like Pub Med Advanced search (from April up to January 2021) and Google scholar. The search yielded 39 articles out of which 11 articles were only included based on the inclusion criteria. Data Collection and Analysis: All the studies included were based on the data extraction and analysis of the studies for quality. The outcome measure evaluated the reduction in burning sensation, mouth opening, and clinical resolution of the lesion. Results: A total of 39 articles were included in this systematic review from electronic searches using Pub Med advanced search and Google scholar. Conclusion: For management of oral submucous fibrosis topical aloe vera gel showed 90% of complete clinical response, oral lichen planus topical tulsi and turmeric gel showed 90% complete clinical response, and only two studies were conducted on oral leukoplakia which had a high risk of bias; hence, this systematic review does not yield to a piece of conclusive evidence for the management of oral leukoplakia using topical herbal therapeutics.

Oral Senescence: From Molecular Biology to Clinical Research

Cellular senescence is an irreversible cell cycle arrest occurring following multiple rounds of cell division (replicative senescence) or in response to cellular stresses such as ionizing radiation, signaling imbalances and oxidative damage (stress-induced premature senescence). Even very small numbers of senescent cells can be deleterious and there is evidence that senescent cells are instrumental in a number of oral pathologies including cancer, oral sub mucous fibrosis and the side effects of cancer therapy. In addition, senescent cells are present and possibly important in periodontal disease and other chronic inflammatory conditions of the oral cavity. However, senescence is a double-edged sword because although it operates as a suppressor of malignancy in pre-malignant epithelia, senescent cells in the neoplastic environment promote tumor growth and progression. Many of the effects of senescent cells are dependent on the secretion of an array of diverse therapeutically targetable proteins known as the senescence-associated secretory phenotype. However, as senescence may have beneficial roles in wound repair, preventing fibrosis and stem cell activation the clinical exploitation of senescent cells is not straightforward. Here, we discuss biological mechanisms of senescence and we review the current approaches to target senescent cells therapeutically, including senostatics and senolytics which are entering clinical trials.

Evaluation of Clinical Profile and Various Treatment Modalities in Oral Sub Mucous Fibrosis in North India: Our Experience.

Oral submucous fibrosis is a chronic disease affecting oral cavity and sometimes the pharynx. Etiology seems to be local irritants such as capsaicin, tobacco, areca nut and spicy foods. The main concern in this is the management of trismus and burning sensation of the oral mucosa. The aim of this study was to compare various medical treatment protocol of OSMF. 210 patients were divided randomly in 3 groups. In Group A, patients were given biweekly intralesional Hyaluronidase/Dexamethasone for 6weeks. Group B patients were given tablet Pentoxifylline 400mg TDS.Group C patients were given Eprisone hydrochloride. All three groups were given Lycopene 10,000 mcg for period of 6weeks. All patients were given topical Triamcelone for local application. The examinations for mouth opening were repeated at weekly intervals for a period of 6weeks.The most common complaint was burning sensation in 75.98% cases, difficulty in mouth opening in77.45% and difficulty in swallowing food in 61.76% cases. Group A showed improvement in 41.17% cases presenting with burning sensation followed by decreased mouth opening 39.70%. Group B showed improvement in 45.58% burning sensation, 17.64% with decreased mouth opening. Group C showed improvement in 48.52% patients having pain with spicy food, 32.35% with decreased mouth opening and 17.64% with difficulty in swallowing. We conclude that patients which received intralesional dexamethasone and hyaluronidase along with oral Lycopene showed better clinical and symptomatic improvement, and at present appears to be best non-surgical treatment.

Assessment of quality of life of patients with oral sub mucous fibrosis before and after treatment with topical curcumin

Background and aim: Oral Submucous Fibrosis (OSMF) is potentially pre-malignant condition of the oral cavity with a high malignant transformation rate. The condition not only affects the oral function of the patients but has a huge impact on their social and psychological wellbeing affecting the overall quality of life. To evaluate the effectivity of the treatment assessing the quality of the life of these patients before and after treatment is of utmost importance but till now has not been an integral part of the management strategy. This study was carried to assess the change in quality of life before and after treatment with curcumin in patients with OSMF. Methods: Quality of life was assessed before and after 3 months of treatment with topical curcumin in 50 patients with OSMF using European Organization for Research and Treatment of Cancer Quality of Life head and neck Questionnaire (EORTC QLQ35). Results: At the end of 3 months there was significant (p &lt; 0.05) change in the quality of life of patients with OSMF as suggested by assessment of the multi-item and single item scale used in the questionnaire. Conclusion: The study emphasizes the use of assessing Quality of life as an integral part of treatment strategy for OSMF and suggests curcumin as a promising treatment modality for patients with OSMF.