Submucous Fibrosis Research Articles

Single-cell transcriptomic analysis of gingivo-buccal oral cancer reveals two dominant cellular programs.

Oral squamous cell carcinoma of the gingivo-buccal region (OSCC-GB) is the most common cancer among men in India, and is associated with poor prognosis and frequent recurrence. Cellular heterogeneity in OSCC-GB was investigated by single-cell RNA sequencing of tumors derived from the oral cavity of 12 OSCC-GB patients, 3 of whom had concomitant presence of a precancerous lesion (oral submucous fibrosis [OSMF]). Unique malignant cell types, features, and phenotypic shifts in the stromal cell population were identified in oral tumors with associated submucous fibrosis. Expression levels of FOS, ATP1A, and DUSP1 provided robust discrimination between tumors with or without the concomitant presence of OSMF. Malignant cell populations shared between tumors with and without OSMF were enriched with the expression of partial epithelial-mesenchymal transition (pEMT) or fetal cell type signatures indicative of two dominant cellular programs in OSCC-GB-pEMT and fetal cellular reprogramming. Malignant cells exhibiting fetal cellular and pEMT programs were enriched with the expression of immune-related pathway genes known to be involved in antitumor immune response. In the tumor microenvironment, higher infiltration of immune cells than the stromal cells was observed. The T cell population was large in tumors and diverse subtypes of T cells with varying levels of infiltration were found. We also detected double-negative PLCG2+ T cells and cells with intermediate M1-M2 macrophage polarization. Our findings shed light on unique aspects of cellular heterogeneity and cell states in OSCC-GB.

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.

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.

Role of osteopontin in oral epithelial dysplasia, oral submucous fibrosis and oral squamous cell carcinoma.

Inflammatory cells and cytokines in the chronically injured mucosa promote fibrosis in the oral submucous fibrosis (OSF) fibrotic milieu. Osteopontin (OPN) is a wound-healing mediator that upregulates the inflammatory response and is involved in the malignancy and fibrosis of multiple organ systems. We investigated the expression of OPN in oral potentially malignant disorders (OPMDs) and oral squamous cell carcinomas (OSCCs) to determine its role in the malignant transformation and fibrosis of oral tissues. The expression of OPN in OPMDs and OSCCs was compared and correlated, and the role of OPN as a fibrotic mediator in OSF was explained. A total of 30 cases of normal mucosa and OPMDs (mild dysplasia, severe dysplasia, OSF and OSCCs) were studied by purposive sampling. In these groups, OPN immunoreactivity was examined and correlated with clinical findings. In mild dysplasia, OPN expression was restricted to the basal cell layer with moderate staining intensity. In severe dysplasia, it was extremely intense and extended throughout the epithelium. In the OSF, OPN expression was moderate in the perinuclear areas of the basal cell layer. The expression of OPN was very strong in OSCC. A flow diagram explaining the profibrotic role of OPN in OSF has been provided. A positive role of OPN in both pathogenesis and malignant transformation of OPMDs and OSCC has been demonstrated.

Langerhans cell expression in oral submucous fibrosis: An immunohistochemical analysis.

Langerhans cells (LCs) are dendritic cells (DCs) of the epithelium which play a role in an array of oral lesions from gingivitis to oral cancer. Oral submucous fibrosis (OSMF), a potentially malignant disorder (PMD), is an insidious chronic disease with juxta-epithelial inflammatory changes leading to fibrosis. LCs may play a part in the ongoing inflammatory dysregulation of OSMF. The study was aimed at elucidating the distribution of LCs in varying grades of OSMF. A retrospective study using 18 cases of OSMF, graded using haematoxylin and eosin (H&E)-stained section. Immunohistochemistry was performed using polyclonal anti-CD1a antibodies to identify LCs in six cases of normal tissue and 18 samples of OSMF. The distribution of LCs among the various grades and normal mucosa analysed using Student's t-test. LC population in the OSMF was significantly higher when compared to the normal epithelium (p < 0.001). Within the grades, the advanced stage had more LCs than the other stages. The increase in LCs might indicate the role of antigenic exposure in turn leading to cell-mediated immunity in OSMF. Thus, the fibrosis in OSMF might have a direct link to LCs.

Jiawei Danxuan Koukang Alleviates Arecoline Induced Oral Mucosal Lesions: Network Pharmacology and the Combined Ultra-High Performance Liquid Chromatography (UPLC) and Mass Spectrometry (MS).

Arecoline is one of the main toxic components of arecoline to cause oral mucosal lesions or canceration, which seriously affects the survival and life quality of patients. This study analyzed the mechanism of Jiawei Danxuan Koukang (JDK) in alleviating arecoline induced oral mucosal lesions, to provide new insights for the treatment of oral submucosal fibrosis (OSF) or cancerosis. Metabolomics was applied to analyze the composition of JDK and serum metabolites. The active ingredients of JDK were analyzed by the combined ultra-high performance liquid chromatography and mass spectrometry. The target network of JDK, metabolites and OSF was analyzed by network pharmacology, and molecular docking. Oral mucosal lesions and fibrosis were analyzed by HE and Masson staining. Cell differentiation, proliferation and apoptosis were detected. The expressions of α-SMA, Collagen I, Vimentin, Snail, E-cadherin, AR and NOTCH1 were detected by Western blot. Arecoline induced the gradual atrophy and thinning of rat oral mucosal, collagen accumulation, the increase expressions of fibrosis-related proteins and Th17/Treg ratio. JDK inhibited arecoline-induced oral mucosal lesions and inflammatory infiltration. Arecoline induced changes of serum metabolites in Aminoacyl-tRNA biosynthesis, Alanine, aspartate and glutamate metabolism and Arginine biosynthesis pathways, which were reversed by M-JDK. Quercetin and AR were the active ingredients and key targets of JDK, metabolites and OSF interaction. Arecoline promoted the expression of AR protein, and the proliferation of oral fibroblasts. Quercetin inhibited the effect of arecoline on oral fibroblasts, but was reversed by AR overexpression. Arecoline induced NOTCH1 expression in CAL27 and SCC-25 cells, and promoted cell proliferation, but was reversed by M-JDK or quercetin. JDK improved the arecoline-induced OSF and serum metabolite functional pathway. Quercetin targeted AR protein to improve arecoline-induced OSF. JDK and quercetin inhibited arecoline-induced NOTCH1 protein expression in CAL27 and SCC-25 cells to play an anti-oral cancer role.

Evaluation of Platelet Parameters in Oral Submucous Fibrosis and Oral Squamous Cell Carcinoma in a Background of Oral Submucous Fibrosis.

The role of platelet parameters as markers of inflammation in various diseases is now in limelight. The interaction between cancer cells and platelets is a well-established phenomenon. Oral submucous fibrosis (OSMF) is a premalignant disorder with a malignant transformation rate of 2-8%. This study aimed to evaluate platelet parameters in OSMF and oral squamous cell carcinoma (OSCC) in the background of OSMF. This cross-sectional study was performed using secondary data retrieved between January 2019 and December 2019 in the Department of Oral Pathology and the Hematology Laboratory. The data retrieved included 44 histopathologically proven OSCC in a background of OSMF (group III) and 36 OSMF (group II). The haematological parameters of these selected cases were retrieved from the Sysmex XN-1000 automated hematology analyser database. A control group (group I) comprises 50 subjects with normal (negative/unflagged) haematological parameters. All data were statistically analysed using SPSS 20.0. The significance level of tests was set at 5%. The mean platelet volume (MPV) (9.60 [±0.95] P < 0.001), platelet distribution width (PDW) (10.45 [±1.9], P < 0.001), platelet large cell ratio (PLCR) (21.70 [±7.98], P < 0.001), and the ratio of mean platelet volume to total platelet count (MPV/PLT) (0.03 [0.01], P < 0.001) were lower in group III when compared to the other two groups. Platelet parameters may be used as indices in the OSCC in the background of OSMF. However, large-scale prospective studies are necessary to evaluate the utility of these parameters during the malignant transformation of OSMF, thereby encouraging prompt treatment to prevent morbidity and mortality.

Expression of Salivary HIF-1α Levels Among the Clinical Stages of Oral Submucous Fibrosis

Background: Oral Submucous Fibrosis (OSMF) is defined as severe submucosal fibrosis and decreased vascularity, resulting in a compromised blood supply leading to hypoxia of tissues. The key biomarker involved is Hypoxia Inducible Factor-1α (HIF-1α). The objective of this research was to analyze the expression of HIF-1α in saliva samples of individuals across the clinical stages of OSMF and healthy controls. Methods: This case-control study consisted of 120 participants, 60 patients had different clinical stages of OSMF and 60 healthy controls. Samples of saliva were collected and quantification of salivary samples was done using ELISA. Kolmogorov-Smirnov test assessed data normality. Kruskal Wallis test was applied to assess the association between salivary HIF-1α levels and clinical stages of OSMF. The Kendall Tau correlation test was used to assess the relationship between different stages of OSMF and salivary HIF-1α levels. Results: The comparison of HIF-1α expression in different stages of OSMF and healthy controls was done. In comparison, it was found that HIF-1α expression increased significantly (p=0.00) in patients than controls. The expression was increased with stages, stage I (16.84 ± 9.74), stage II (19.51 ± 7.99), stage III (24.43 ± 7.49), and stage IV (28.92 ± 5.12), respectively. The odd ratio indicates for every progressive stage, the odds for high salivary HIF-1α levels increase by 1.63 times. Conclusion: Levels of salivary HIF-1α showed increased expression with the progressive stages of OSMF. This variation in the levels of salivary HIF-1α suggests its possible role as an early non-invasive detective marker in the assessment of disease progression.

The expression of Th17/Treg in oral submucosal fibrosis carcinogenesis and the significance in the development of mucosal lesions.

It targets to explore the expression of Th17/Treg in oral submucous fibrosis (OSF) carcinogenesis and its significance in the development of mucosal lesions. In this research, 100 patients with OSF who visited our hospital for surgical treatment from March 2020 to April 2022 were selected. Based on pathological examination results, the patients were divided into 27 patients with oral leukoplakia (OK) group, 14 patients with oral lichen planus (OLP) group, 9 patients with oral squamous cell carcinoma (OSCC) group, and 50 patients with OSF group. It adopted flow cytometry (FC) to calculate the ratio of peripheral blood Th17 cells and Treg cells in four groups, and the Th17/Treg ratio was calculated; The area of oral mucosal lesions (OML) from patients was collected. It needs to compare the differences in Th17/Treg ratio and OML area among four groups and determine the correlation between indicators. ROC curve was used to analyze the diagnostic threshold of the Th17/Treg ratio for carcinogenesis. Except for the OK and OLP, it had statistical significance differences in Th17, Treg cells, and Th17/Treg ratio (P<0.001); The area of OML in the OK, OLP, and OSCC was higher than that in the simple OSF, with statistical significance (P<0.001); Th17 (%), Treg (%), and Th17/Treg all had direct ratio with the area of OML; The area of OML has directed ratio with the development of mucosal lesions (r>0, P<0.05); The areas under the ROC curve for patients with OSF combined with OK, OLP, or OSCC with Th17 (%), Treg (%), Th17/Treg, and OML area were 0.560, 0.986, 0.936, and 0.466, respectively. The expression of Th17/Treg is elevated in oral submucosal fibrosis and carcinogenesis. When mucosal lesions progress or become cancerous, the Th17/Treg ratio increases accordingly, and it has more clinical value than the increase in the OML area.

Exploring Possible Diagnostic Precancerous Biomarkers for Oral Submucous Fibrosis: A Narrative Review.

Oral submucous fibrosis (OSF) stands as a progressive oral ailment, designated as a potentially malignant disorder. OSF has gained widespread recognition as a significant precursor to malignant transformation. In the pursuit of dependable, straightforward, and non-invasive diagnostic measures for the early detection of oral malignant progression, research has delved into potential diagnostic biomarkers of OSF. This comprehensive review delves into current investigations that explore the correlation between various biomarkers and OSF. The molecular biomarkers of OSF are categorized based on cytology and sampling methods. Moreover, this review encompasses pertinent studies detailing how these biomarkers are acquired and processed. Within this scope, we scrutinize four potential biomarkers that hold the promise of facilitating the development of diagnostic tools for detecting early-stage OSF.

Evaluation of Iron Deficiency in OSMF patients: A Cross-sectional Study

Oral submucous fibrosis is a type of chronic oral pathological ailment, which is having insidious onset. It possesses high rate of malignant transformation, which gets accentuated by pernicious oral habits like chewing of areca nut in betel. OSMF predisposes to marked hematological abnormalities, leading to anemia and reduction in levels of serum iron and proteins. The aim of this study was to measure the hemoglobin, serum iron and protein levels among OSMF patients and also to compare these parameters with healthy controls.In the hospital-based study, among 100 study subjects, 45 OSMF patients were selected as cases, whereas 55 apparently healthy individuals were chosen as controls. The hemoglobin, serum iron and protein levels were estimated using hematological and biochemical autoanalyzers. Significantly lower levels of hemoglobin, serum iron, and protein levels were observed in OSMF patients in comparison with apparently healthy subjects.Findings of this study focus on the necessity and rationale of assessing hemoglobin, serum iron and protein amongst OSMF patients. These biochemical assessments in the precancerous condition of OSMF may help in early diagnosis and prognosis. Besides that, iron therapy should be initiated at the earliest with the initial diagnosis, which can be helpful to check further deterioration of the aforesaid premalignant condition. Further extensive studies are required for fine delineation of hematological alterations in OSMF patients.

Exosomes Derived from Human Adipose Mesenchymal Stem Cells Inhibits Fibrosis and Treats Oral Submucous Fibrosis via the miR-181a-5p/Smad2 Axis

BACKGROUND:Oral submucous fibrosis (OSF) is a chronic disease with carcinogenic tendency that poses a non-negligible threat to human health. Exosomes derived from human adipose mesenchymal stem cells (ADSC-Exo) reduces visceral and cutaneous fibroses, but their role in OSF has received little attention. The aim of this study was to investigate the effects of ADSC-Exo on OSF and elucidate the mechanism.METHODS:In brief, ADSCs were extracted from adipose tissues and subjected to flow cytometry and induction culture. Fibroblasts were isolated from human buccal mucosa and subjected to immunofluorescence. Myofibroblasts were obtained from fibroblasts induced by arecoline and identified. Immunofluorescence assay confirmed that myofibroblasts could take up ADSC-Exo. The effects of ADSC-Exo on the proliferative and migratory capacities of myofibroblasts were examined using the Cell Counting Kit-8 and scratch assay. Real-time quantitative polymerase chain reaction (qPCR) was performed to evaluate mothers against decapentaplegic homolog 2 (Smad2), Smad3, Smad7, collagen type 1 (Col1), Col3, alpha smooth muscle actin (α-SMA), fibronectin, and vimentin. Western blotting was performed to detect phospho (p)-Smad2, Smad2, p-Smad2/3, Smad2/3, Smad7, Col1, Col3, α-SMA, fibronectin, and vimentin. Furthermore, the dual-luciferase reporter assay was performed to prove that miR-181a-5p in ADSC-Exo directly inhibited the expression of Smad2 mRNA to regulate the transforming growth factor beta (TGF-β) pathway. We also performed qPCR and western blotting to verify the results.RESULTS:ADSC-Exo could promote the proliferation and migration of myofibroblasts, reduce the expressions of p-smad2, Smad2, p-smad2/3, Smad2/3, Col1, αSMA, fibronectin, and vimentin and elevated the levels of Smad7 and Col3. In addition, miR-181a-5p was highly expressed in ADSC-Exo and bound to the 3'-untranslated region of Smad2. ADSC-Exo enriched with miR-181a-5p reduced collagen production in myofibroblasts and modulated the TGF-β pathway.CONCLUSIONS:ADSC-Exo promoted the proliferative and migratory capacities of myofibroblasts and inhibited collagen deposition and trans-differentiation of myofibroblasts in vitro. miR-181a-5p in exosomes targets Smad2 to regulate the TGF-β pathway in myofibroblasts. ADSC-Exo perform antifibrotic actions through the miR-181a-5p/Smad2 axis and may be a promising clinical treatment for OSF.

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.

Prevalence of oral mucosal lesions in denture wearers with substance abuse in Mangalore taluk population

Progressive loss of tooth caused by old age or certain systemic conditions, lead to oral handicap that often require a prosthetic appliance for restoring function and aesthetics. While these prostheses require good hygiene maintenance, lack of oral health awareness, compromised dexterity and presence of substance abuse could make the dentures harbingers of certain oral mucosal conditions. The aim of this study is to evaluate the presence of oral mucosal lesions among dental prosthetic wearers and its association with habits of substance abuse. Materials and Methods: A cross sectional survey was conducted?on 1312 subjects aged 18 years and above using?a house-to-house approach to collect information regarding their prosthetic status, duration of prosthesis, usage of tobacco and oral mucosal condition. Results: The results showed a strong co-relation between substance abuse and denture wear with ulcers and denture stomatitis showing the highest prevalence rate amongst the study population. Leukoplakia and Oral Submucosal Fibrosis was seen mostly in non-denture wearers. Summary and Conclusions: According to the results, Denture wearers had a higher tendency of having oral mucosal lesions, most commonly being Ulcers and Denture stomatitis (3.2%). With the exception of leukoplakia that occurred mostly in the non denture wearers. Substsance abuse had a direct co-relation to oral mucosal lesions. Occurrence of ulcers and denture stomatitis followed by candidiasis in smoked tobacco users, while in smokeless tobacco users ulcerative lesions and denture stomatitis followed by Acute Necrotising Denture Stomatitis were most commonly noted. Clinical significance: It is essential to carry out periodic examination of the oral mucosa in denture wearers to establish a preventive protocol to eradicate the pathology caused by the use of dentures and the harmful effects of substance abuse. Key Words: Denture wear, Oral habits, Oral health, Oral mucosal lesions, Substance abuse

Mouth and oral disease classification using InceptionResNetV2 method

Digital tools have greatly improved the detection and diagnosis of oral and dental disorders like cancer and gum disease. Lip or oral cavity cancer is more likely to develop in those with potentially malignant oral disorders. A potentially malignant disorder (PMD) and debilitating condition of the oral mucosa, oral submucous fibrosis (OSMF), can have devastating effects on one’s quality of life. Incorporating deep learning into diagnosing conditions affecting the mouth and oral cavity is challenging. Mouth and Oral Diseases Classification using InceptionResNetV2 Method was established in the current study to identify diseases such as gangivostomatitis (Gum), canker sores (CaS), cold sores (CoS), oral lichen planus (OLP), oral thrush (OT), mouth cancer (MC), and oral cancer (OC). The new collection, termed "Mouth and Oral Diseases" (MOD), comprises seven distinct categories of data. Compared to state-of-the-art approaches, the proposed InceptionResNetV2 model’s 99.51% accuracy is significantly higher.

Multimodal fluorescence imaging and spectroscopic techniques for oral cancer screening: a real-time approach

The survival rate of oral squamous cell carcinoma (OSCC) patients is very poor, but it can be improved using highly sensitive, specific, and accurate techniques. Autofluorescence and fluorescence techniques are very sensitive and helpful in cancer screening; being directly linked with the molecular levels of human tissue, they can be used as a quantitative tool for cancer detection. Here, we report the development of multi-modal autofluorescence and fluorescence imaging and spectroscopic (MAF-IS) smartphone-based systems for fast and real-time oral cancer screening. MAF-IS system is indigenously developed and offers the advantages of being a low-cost, handy, non-contact, non-invasive, and easily operable device that can be employed in hospitals, including low-resource settings. In this study, we report the results of 43 individuals with 28 OSCC and 15 oral potentially malignant disorders (OPMDs), i.e., epithelial dysplasia and oral submucous fibrosis, using the developed devices. We observed a red shift in fluorescence emission spectra in vivo. We found red-shift of 7.72 ± 6 nm, 3 ± 4.36 nm, and 1.33 ± 0.47 nm in the case of OSCC, epithelial dysplasia, and oral submucous fibrosis, respectively, compared to normal. The results were compared with histopathology and found to be consistent. Further, the MAF-IS system provides results in real-time with higher accuracy and sensitivity compared to devices using a single modality. Our system can achieve an accuracy of 97% with sensitivity and specificity of 100% and 94.7%, respectively, even with a smaller number of patients (28 patients of OSCC). The proposed MAF-IS device has great potential for fast screening and diagnosis of oral cancer in the future.

A screw and wire assisted coronoidectomy procedure: A technical note

Temporomandibular joint (TMJ) ankylosis and oral submucous fibrosis (OSMF) often exhibit elongated hyperplastic coronoid processes with fibrous attachments to the temporalis muscle. In managing this condition, a vital step involves performing a coronoidotomy or coronoidectomy alongside the primary surgical procedure. While coronoidectomy is preferable due to reattachment issues, its complexity arises from the thickened and elongated coronoid process. Our technical note introduces a screw and wire assisted coronoidectomy method, found to be efficient, replicable, and time-saving.

Study of Oral Squamous Cell Carcinoma with and without Oral Submucous Fibrosis.

Oral submucous fibrosis (OSMF) is a precancerous condition associated with areca nut chewing. Arecoline which isa component of areca nut is considered a carcinogen. The OSMF in patients with oral squamous cell carcinoma (OSCC) indicatesareca nut-induced carcinogenesis. The molecular pathway for oral carcinogenesis caused by areca nut is discrete and considereda different clinicopathological entity. Thus the present study aims to study and compare the demographics, risk factors, and clinicalcharacteristics of OSCC patients with and without OSMF. It was a retrospective study done by medical record review. About 40OSCC cases were selected, of which 20 were with OSMF, and 20 were without OSMF. Demographic data, risk factors includinghistory of habits such as areca nut chewing, tobacco, etc., and clinical characteristics such as anatomical location, extent, tumorsize, and lymph node metastasis were noted, and data were analyzed. The mean age of OSCC cases with OSMF was younger thanthose without OSMF. The study groups did not observe a significant difference in habit type and duration. Most OSCC patientswith OSMF were younger than those OSCC without OSMF. The buccal mucosa was the most common anatomical locationinvolved with ulcers- proliferative growth in both study groups. The incidence of multiple sites and lymph node enlargementinvolvement is higher in OSCC without OSMF compared to those with OSMF. There was no significant difference concerninghistopathological changes between OSCC with and without the OSMF group.

Histomorphometric analysis of angiogenesis in oral submucous fibrosis and oral squamous cell carcinoma associated with oral submucous fibrosis

Background: Oral submucous fibrosis (OSMF), now worldwide acknowledged as the disease of “Southeast Asia and Indian subcontinent”, has the utmost malignant transformation prevalence amongst oral precancerous disorders. Increased vascularity that is neoangiogenesis has been observed in the superficial connective tissue region of pre-cancerous lesions showing dysplasia. This could be an initial occurrence of the carcinogenesis process. The aim of this study will be to analyse neoangiogenesis by examining immunoexpression of CD105 in OSMF, and OSCC with OSMF cases. Methods: The project will comprise 30 normal oral mucosa samples (group I), 30 clinicopathologically diagnosed cases of OSMF (group II), and on the basis of association of OSMF, 30 surgically operated and histopathologically diagnosed cases of OSCC associated with OSMF (group III). Hematoxylin and eosin stains will be used for routine staining procedures and immunohistochemistry for the expression of CD105. Oral epithelial dysplasia (OED) cases of OSMF will be categorized into two groups, low-risk epithelial dysplasia (LRED) and high-risk epithelial dysplasia (HRED). The micro vessel density (MVD), total microvessel area (TVA), and mean microvessel area (MVA) are within and surrounding the tumor tissue sections immunostained with the CD105 antibody will be determined. ANOVA will be applied for evaluation of the mean scores of MVD, TVA, and MVA of groups II and III. The obtained score will be compared with different parameters of OSCC (TNM stage, lymph node metastasis, and histopathological grades). Conclusions: We postulate the progressively increased vascularity with the disease progression from LRED to HRED and further its transformation to invasive oral squamous cell carcinoma This increased vascularity will be evident by enhanced MVD, TVA and mean MVA, which is expressed by CD105 immunoexpression. This observation will emphasize the significance of neoangiogenesis in cases of OSMF with epithelial dysplasia and its further progression to OSCC.

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.