Occurrence Of Oral Submucous Fibrosis Research Articles

Salivary and serum levels of lactate dehydrogenase in oral submucous fibrosis: A meta-analysis.

The occurrence of oral submucous fibrosis (OSF) is often accompanied by an increase in lactate dehydrogenase (LDH) levels. In this meta-analysis, we compared the salivary and serum levels of LDH levels between OSF patients and controls. A comprehensive search was conducted in PubMed, Embase, Web of Science, and Cochrane Library from the establishment of the database to June 2023, and the quality of the studies was checked by the Newcastle-Ottawa Quality Assessment scale. The mean difference (MD) and 95% confidence interval (CI) were calculated using RevMan 5.4 software. A total of 28 studies were retrieved from the database, and we included 5 studies in this meta-analysis. The salivary LDH level of OSF patients was higher than healthy controls (MD: 423.10 pg/L 95%CI: 276.42-569.77 pg/mL, P < .00001), the serum LDH level of OSF patients was also higher than that of healthy controls (MD: 226.20 pg/mL, 95%CI: 147.71-304.69 pg/mL, P < .00001). This meta-analysis showed that salivary and serum LDH levels were higher in OSF patients than in healthy controls, suggesting that LDH may be a potential biomarker for OSF.

Evaluation of dermatoglyphics patterns as predisposition factor for occurrence of oral submucous fibrosis: A hospital-based case–control study

Background: One of the key factors in the prevention of the disease is the identification of the risk factors early in life. Based on multifactorial causation of oral submucous fibrosis (OSMF), apart from habit history, the genetical predisposition may be considered as an important risk factor in the occurrence of OSMF disease. The dermatoglyphic pattern may prove a salient genetic marker for the determination of OSMF as both are having similar intrauterine development period. Objectives: To find out and compare the association between dermatoglyphics and OSMF. Materials and Methods: The present study was conducted on total 108 subjects divided in three groups where Group A was subjects with OSMF, Group B was subjects with tobacco related habits but without OSMF, and Group C was healthy controls. Fingerprint patterns of both hands were recorded and classified into whorls, loops and arches. Results: The loop pattern was significantly higher in subjects having OSMF (Group A) as compared Group B and Group C in general as well as for left and right hands. The maximum prominence of loop patterns was noted in the little finger among the subjects with OSMF. Results for subjects with OSMF and without OSMF under five years of having tobacco chewing habits had also clearly demonstrated prominence of loop patterns in the subjects with OSMF. Conclusion: The results of our study show that there is a staunch possibility of genetically determined factors in the form of loop finger prints can be responsible for the occurrence of OSMF.

DNA methyltransferase 3A induces the occurrence of oral submucous fibrosis by promoting the methylation of the von Hippel-Lindau.

Oral submucous fibrosis (OSF) is associated with malignant disorders. DNA methyltransferase 3A (DNMT3A) is a DNA methylesterase reported to be upregulated in multiple organs and shown to inhibit fibrosis. However, the detailed effect of DNMT3A on OSF remains unclear. To mimic OSF in vitro, oral fibroblasts were exposed to arecoline and molecular biological experiments were performed to detect the function of DNMT3A in OSF. We found that von Hippel-Lindau (VHL) was downregulated and highly methylated in OSF. Arecoline remarkably increased the viability, invasiveness, and migration of oral fibroblasts, but upregulation of VHL partially reversed these effects. DNMT3A induces DNA hypermethylation in the VHL promoter, and VHL markedly inhibits the level of tenascin-C (TNC) by inducing the ubiquitination of TNC. TNC reversed the inhibitory effect of VHL upregulation on the differentiation of oral fibroblasts into myofibroblasts. DNMT3A induces OSF by promoting methylation of the VHL promoter. Hence, our study provides novel insights into the discovery of novel strategies that can be employed against OSF.

Evaluation of Serum Lipid Profile in Patients Suffering from Oral Submucous Fibrosis

Objective: To evaluate and compare the levels of plasma total cholesterol, low density lipoprotein, very low density lipoprotein, high density lipoprotein and triglycerides among the oral sub mucous fibrosis patients and control group. Design of the Study: It’s a comparative study done with simple random sampling. Study Settings: The study was done at Oral pathology department of Fatima Jinnah Dental College and Hospital from 01-04-2017 to 30-09-2017. Material and Methods: This research was conducted on 30 clinically diagnosed cases of OSMF and 30 healthy controls. The total lipid profile including triglycerides, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol and very low density lipoprotein cholesterol was evaluated. Results of the Study: CTSS The serum lipid values were decreased considerably in the cases than in the controls. Conclusion: There is a converse affiliation between lipid profile and occurrence of oral submucous fibrosis. Consequently the reduced lipid values may be used as a valuable tool in the premature detection of oral submucous fibrosis. Keywords: Oral squamous cell carcinoma, lipids, premalignant condition

EVALUATION OF FACTORS RESPONSIBLE FOR THE OCCURRENCE OF ORAL SUBMUCOUS FIBROSIS IN PATIENTS REFERRED TO DARBHANGA MEDICAL COLLEGE AND HOSPITAL

Oral submucous fibrosis (OSF) is a chronic progressive and irreversible disease affecting the oral, oropharyngeal, and sometimes the esophageal mucous. OSF is a disease that causes changes similar to those of systemic sclerosis (scleroderma) but limited to oral tissues. The disease is seen in those from the Indian subcontinent and from many parts of South-East Asia. It causes significant morbidity (in terms of loss of mouth function as tissues become rigid and mouth opening becomes difficult) and mortality (when transformation into squamous cell carcinoma occurs). The introduction of chewing tobacco containing areca nut into the market has been associated with a sharp increase in the frequency of OSF. Hence based on above findings the present study was planned for Evaluation of Factors Responsible for the Occurrence of Oral Submucous Fibrosis in Patients Referred to Darbhanga Medical College and Hospital.&#x0D; The present study was carried out in the Department of Dentistry, Darbhanga Medical College and Hospital Laheriasarai, Darbhanga Bihar. In the present study 30 cases of the oral submucous fibrosis were enrolled.&#x0D; Oral submucous fibrosis (OSMF) is a chronic insidious disease affecting any part of the oral cavity and sometimes the pharynx. Although, occasionally preceded by or associated with vesicle formation, it is always associated with a juxta-epithelial inflammatory reaction. It is important that preventive efforts be carried out by the concerned authorities and public health professionals in establishing tobacco cessation clinics and tobacco awareness education in such masses (especially the young generation) along with a long standing and a close knit motivation program that enables our future generations to come to avoid the menace of tobacco and its subsequent health effects.&#x0D; Keywords: Oral submucous fibrosis, OSF, oral cavity, Bihar.

Network-based identification of signature genes KLF6 and SPOCK1 associated with oral submucous fibrosis.

The molecular mechanism of oral submucous fibrosis (OSF) is yet to be fully elucidated. The identification of reliable signature genes to screen patients with a high risk of OSF and to provide oral cancer surveillance is therefore required. The present study produced a filtering criterion based on network characteristics and principal component analysis, and identified the genes that were involved in OSF prognosis. Two gene expression datasets were analyzed using meta-analysis, the results of which revealed 1,176 biologically significant genes. A co-expression network was subsequently constructed and weighted gene modules were detected. The pathway and functional enrichment analyses of the present study allowed for the identification of modules 1 and 2, and their respective genes, SPARC (osteonectin), cwcv and kazal like domain proteoglycan 1 (SPOCK1) and kruppel like factor 6 (KLF6), which were involved in the occurrence of OSF. The results revealed that both genes had a prominent role in epithelial to mesenchymal transition during OSF progression. The genes identified in the present study require further exploration and validation within clinical settings to determine their roles in OSF.

CLINICAL ASSESSMENT OF OCCURRENCE OF ORAL SUBMUCOUS FIBROSIS IN PATIENTS FROM PATNA DENTAL COLLEGE &amp; HOSPITAL

Oral submucous fibrosis is a chronic progressive scarring disease of oral cavity and oropharynx characterized by epithelial atrophy and juxta epithelial inflammatory reaction with progressive fibrosis of the lamina propria and deeper connective tissue. The resulting stiffness of the oral mucosa then causes a progressive decrease in mouth opening. Hence based on above findings the present study was planned for Clinical Assessment of Occurrence of Oral Submucous Fibrosis in Patients from Patna Medical College &amp; Hospital.&#x0D; The present study was planned in Department of Oral Pathology, Patna Dental College &amp; Hospital, Patna. Total 50 cases of the patient diagnosed with the Oral Sub mucous Fibrosis (OSMF) were evaluated in the present study. History, examination and investigation of patients were done in detail as per predesigned proforma. Histopathological examination of biopsy tissue from oral mucosa was done in patients who had taken pre-therapy and post-therapy (if and when required). X-ray of temporomandibular joint was requested (whenever needed).&#x0D; OSMF is a commonly occurring and widely spread premalignant condition increasingly affecting the youth. The occurrence of OSMF in gutkha chewers is far faster and more severe as compared in other forms of areca nut products chewers. The easy availability and promotions of these areca nut products especially gutkha and pan masala outside the schools colleges and social places has impacted younger population in India which has led to the increased occurrence of OSMF.&#x0D; Keywords: Oral Submucous Fibrosis, OSFM, gutkha, pan masala, etc.

Oral Sub mucous Fibrosis and Tobacco Use among Slum Dwellers of Bhopal City, India

Background: Oral sub mucous fibrosis is a chronic insidious disease of the oral mucosa. Oral Sub mucous fibrosis (OSMF) is a pre-cancerous condition predominantly seen among betel quid chewers, areca nut chewing, tobacco smoking and chewing. The slum dwellers are more prone to chewing habits. Hence this study was undertaken to analyze the tobacco use and its association with OSMF among the slum dwellers of Bhopal City. Objective: To study the prevalence of oral sub mucous fibrosis and its relation with tobacco use among slum dwellers in Bhopal city, India. Materials and Methods: The study was conducted to evaluate the tobacco related practices amongst the slum dwellers and its impact on oral health. The study included residence of chola road. A self-designed printed questionnaire form was used to collect the data. The questions included demoFigureic details, the habit of tobacco consumption and the frequency of tobacco consumption. Results: Tobacco habit is common among the slum dwellers of Bhopal City and it does not have a significant association with the occurrence of Oral Sub mucous Fibrosis in this population (p>0.05). Conclusions: The habit of tobacco consumption has an impact on the occurrence of OSMF among the slum dwellers of Bhopal City.

Molecular Pathology of Malignant Transformation of Oral Submucous Fibrosis.

Oral submucous fibrosis (OSF) is prevalent mostly in Southeast Asia, particularly in the Indian subcontinent. Chewing betel nuts and betel leaves, with or without tobacco, has been associated with OSF. Betel quid contents including guvacine, arecoline, guvacoline, arecaidine, and chavibetol are considered to play an important part in the occurrence of OSF. Transformation of OSF to squamous cell carcinoma (SCC) is variable, but up to 13% conversion of OSF to SCC has been reported. Various genetic and molecular mechanisms impact the malignant transformation of OSF, causing changes in the cell cycle, DNA, keratinocytes, and keratin; tumor-cell proliferation and survival; angiogenesis; fibrosis through epithelial-mesenchymal transitions (EMTs), and tissue hypoxia. All are reviewed here, including potential biomarkers for malignant transformation of OSF. These interactions are not fully understood, but a critical mass of knowledge is building up to ultimately allow the understanding of all mechanisms involved.

Oral submucous fibrosis: Comparing clinical grading with duration and frequency of habit among areca nut and its products chewers

To evaluate the effect of frequency, duration and type of areca nut products on the incidence and severity of oral submucous fibrosis (OSMF). Patients with the limited mouth opening and associated blanched oral mucosa with palpable fibrous bands were included in this study. Biopsies were done and the informed consent was taken from each patient included in this study. The tissues were taken from the affected areas and then studied histopathologically. The data was analysed statistically using X(2)-test. In this present prospective study done in 197 subjects (189 males and 8 females) who were screened and diagnosed clinically having OSMF with age ranging from 22 to 61 years with mean 38.8 years. Gutkha-chewing habit alone was identified in 58 subjects and those associated with gutkha and tobacco were 33 with mean age of 28.2 years and 32.3 years, respectively. The number of people getting affected with OSMF is more associated with gutkha and areca nut with the P-value of the analysis ranging from 0.05 to 0.01. The occurrence of OSMF is related to areca nut and its products. The duration and frequency of its use and type of areca nut product has effect on the incidence and severity of OSMF. Gutkha and pan masala have more deleterious and faster effects on oral mucosa. The gutkha-chewing habit along with the other habits does not have any significant effect on the rate of occurrence and incidence and severity of the OSMF.

A cross sectional study of oral submucous fibrosis in central India and the effect of local triamcinolone therapy.

The use of processed arecanut is on the increase. In the impending danger of increased occurrence of oral submucous fibrosis and subsequent oral cancer following this habit is colossal. So an attempt is made to clinically evaluate the condition and to evaluate the effect of triamcinolone on this condition. Using the clinical data collected from the patients presenting in the ENT OPD of NSCB Medical College Hospital, Jabalpur, a cross sectional study was done and the effect of intralesional triamcinolone on this condition is noted by biweekly submucosal injections of 40mg triamcinolone for 12weeks and followed up for 1year. The effect of therapy was evaluated subjectively by improvement in symptoms and objectively by increase in mouth opening. The age of occurrence and sex predilection also showed a significant change with more young males being affected by the condition. There was no significant correlation between effect of triamcinolone therapy and duration of addiction but a significant correlation (P<0.0001) was noted with the frequency of addiction per day. A significant improvement in mouth opening is observed following local triamcinolone therapy. The results imply that the exposure and the frequency of chewing habits, and not mere the duration that is significant in producing the condition and affecting the treatment outcome. Local triamcinolone therapy has good effect in the initial stages of the disease. The fact that more youngsters are being affected needs serious consideration.

Oral submucous fibrosis: study of 1000 cases from central India

Very few reports have been published on the gender specificity of oral submucous fibrosis (OSF) in relation to habit patterns and the severity of disease in the world literature. The purpose of the study was to ascertain the gender specificity for different habits and severity of OSF. A hospital-based cross-sectional study on various habit patterns associated with OSF was performed in Nagpur over a 5-year period. A total of 1000 OSF cases from 266,418 out patients comprised the study sample. The male-to-female ratio of OSF was 4.9:1. Occurrence of OSF was at a significant younger age group (<30 years) among men when compared with women (OR = 4.62, 3.22-6.63, P = 0.0001). Reduced mouth opening, altered salivation and altered taste sensation were found to be significantly more prevalent in women when compared with men. Exclusive areca nut chewing habit was significantly more prevalent in women (OR = 44.5, 25.4-79.8, P = 0.0001). Whereas significant increase for Gutkha (Areca quid with tobacco) (OR = 2.33, 1.56-3.54, P = 0.0001) and kharra/Mawa (crude combination of areca nut and tobacco) (OR = 6.8, 4.36-11.06, P = 0.0001) chewing was found in men when compared with women. There is a marked difference in literacy, socioeconomic status, areca nut chewing habits, symptoms and disease severity in women when compared with men in the central Indian population.

Oral Sub‐mucous fibrosis (OSMF): a study of associated habits and their impact

Objective. To determine the incidence of associated habits in patients with OSMF. The relationship between the different habits and the severity of the disease.Design. Cross‐sectional Survey.Setting. Tertiary Referral Centre.Participants. Adult patients with OSMF.Outcomes Measured. (1) Association of different habits with OSMF. (2) Duration of chewing before onset of symptoms related to OSMF. (3) Severity of OSMF with respect to different chewing habits.Results. A total of 500 patients with OSMF were included in this study over 2‐year period. Except 3 patients (0.6%) rest all gave history of one of these chewing habits–(Pan‐Masala is a mixture of Arecnuts, Lime, Catechu and undisclosed sweetening and Flavouring agents). 432 (86.4%) of Pan‐Masala with Tobacco, 56 (11.2%) of only Tobacco, 8 (1.6%) of only Betel Nut, 1 (0.2%) of pan‐Masala without Tobacco. Smoking Tobacco had no statistically significant effect on the incidence of OSMF in any of these groups. In the above mentioned order the other associated factors were respectively. The mean duration of chewing before onset of symptoms in years 3.28, 3.95, 8.37 and 10. The proportion of patients with &lt;2 finger mouth opening was 249/432 (57.63%), 28/56 (50%), 3/8 (37.5%), 0 (0%).Conclusion. The occurrence of OSMF is strongly associated with the habit of chewing Pan‐Masala with Tobacco and less so with only Tobacco or Betel Nut. Patients consuming Pan‐Masala with Tobacco develop this disease earlier then chewers of Tobacco and Betel Nut. Restriction of mouth opening is worst with Pan‐Masala with Tobacco.References 1 Ariyawardana A., Athukorala A.D., Arulanandam A. (2006) Effect of betel chewing, tobacco smoking and alcohol consumption on oral sub‐mucous fibrosis: a case‐control study in Sri Lanka. J Oral Path &amp; Med35, 197–2012 Ranganathan K., Devi M.U., Joshua E., Kirankumar K., Saraswathi T.R. (2004) Oral sub‐mucous fibrosis: a case‐control study in Chennai, South India. J Oral Path &amp; Med33, 274–277

Strong association between areca nut use and oral submucous fibrosis

DesignA case–control study was carried out in Chennai, South India.Participant selectionAll subjects (cases and controls) were recruited from the outpatient department of Ragas Dental College and Hospital, Chennai. The cases were patients who had either reported for treatment of oral submucous fibrosis (OSF) or who had been diagnosed with OSF during routine oral examination. The clinical diagnosis was confirmed by biopsy in every case using established criteria. The control patients were chosen using a random selection method, in which every fifth patient of the outpatient department would be included. These individuals had no oral lesions other than periodontal disease associated with a chewing or smoking habit. One control was then selected for each case, matched by age (±2 years) and gender. All chewers in case and control groups used some form of areca nut at least once a day.Data analysisThe habits of cases and controls were classified into various categories without any overlap. Statistical tests were performed to find out if there was any significant difference in the duration, frequency and intensity of all habits between cases and controls. Univariate binary logistic regression was used to ascertain the significance of risk factors for the cases.ResultsA total of 185 consecutive patients with OSF were assigned corresponding age- and sex-matched controls. The male to female ratio of OSF cases was 9.9:1.0. All areca nut products were associated with OSF (Table 1), with the risk being greatest for pan masala (processed areca nut without betel leaf; odds ratio, 81.5). This was followed by areca nut plus alcohol use (odds ratio, 69.9). Smoking and alcohol, together or on their own, did not show any correlation with the occurrence of OSF but their concurrent use along with processed areca nut increased the risk of OSF (P<0.05). Both duration and intensity of habit showed a statistically significant difference between the cases and controls (P<0.002 and P<0.005, respectively). There was no significant difference in the frequency of chews per day between the cases and controls.Table 1 Areca nut habits and Odds ratiosFull size tableConclusionsThe present study confirms the strong association between areca nut use and OSF and between OSF and the increasing use of pan masala.

C5 Oral submucous fibrosis in paediatric patients

Presenting complaint: This case report relates to two paediatric patients, aged 11 and 13 years, referred to the Birmingham Dental Hospital with limited oral opening. In both instances, this limitation of opening was of unknown duration but thought to be progressive in nature by the referring agent.Clinical management: On examination, the inter‐incisal opening was found to be approximately 15–20 mm. On questioning, a betel chewing habit was identified in both patients. The mucosa was found to be pale and taut in nature. Both patients and parents were counselled on the adverse effects of betel chewing and the possibility of tissue changes as a result. Symptomatic relief was provided with benzydamine hydrochloride and biopsies of the affected sites were carried out. A histological diagnosis of oral submucous fibrosis was made in both instances.Discussion: Oral submucous fibrosis is recognized as a pre‐malignant condition. It is thought to be associated with an epithelial inflammatory reaction and subsequent fibro‐epithelial change. This can lead to epithelial atrophy and later mucosal stiffening. The occurrence of oral submucous fibrosis in younger patients is extremely uncommon. This case report highlights the importance of investigating the social history of presenting patients and the need to improve patient and parent education in relation to the habit of betel nut chewing.

HLA-antigens in oral submucous fibrosis.

HLA-typing was carried out on 122 areca nut chewers who attended hospitals for complaints unrelated to the habit. The subjects were South Africans of Indian extraction. The study did not include haplotypes. Palpable fibrous bands in the mouth indicated oral submucous fibrosis. The subjects were divided into 4 groups based on specific oral symptoms and signs. Groups A and B were without fibrous bands. Group A (47 subjects) included those with one or no symptoms while group B (28 subjects) suffered from 2 to 7 oral symptoms. Group C (17 subjects) had oral symptoms and represented early or mild oral submucous fibrosis and exhibited at least one discrete palpable fibrous band. Group D (30 subjects) were classic oral submucous fibrosis cases with multiple bands. The high occurrence of oral submucous fibrosis in this study group (39%) is similar to the occurrence in comparable age groups reported earlier in South Africa and is conceivably due to the higher age range of the subjects and their relatively long exposure to the areca nut. We were unable to demonstrate a specific pattern of HLA-antigen frequencies in chewers with or without the disease. Furthermore, there were no differences between the study population and the controls. It is concluded that there is not necessarily a HLA-associated susceptibility in oral submucous fibrosis.