Oral Submucous Fibrosis Patients Research Articles

HIF-1Α IN SALIVA: A PROMISING BIOMARKER FOR EARLY DIAGNOSIS OF ORAL SUBMUCOUS FIBROSIS AND ITS MALIGNANT POTENTIAL

Oral submucous fibrosis (OSF) is a chronic condition with a high risk of transforming into oral squamous cell carcinoma (OSCC). Identifying reliable biomarkers for early diagnosis and monitoring of OSF is crucial for malignancy prevention. Objective: This study evaluates the expression of Hypoxia Inducible Factor-1α (HIF-1α) in saliva as a potential biomarker for OSF. Methods: Study was a cross-sectional study conducted in Karachi. The study was completed in 6 months from July 2023 to December 2023 and Sixty-five OSF patients participated in the study, providing saliva samples analyzed for HIF-1α expression using immunohistochemically (IHC). Clinic pathological features, including age, gender, body mass index (BMI), and etiological factors (tobacco, smoking, areca nut), were documented. Relationships between clinical symptoms (burning sensation, pain, ulceration, and dry mouth), fibrosis severity, and HIF-1α staining intensity in blood vessels and fibroblasts were assessed. Results: The study population included 68.3% males and 31.7% females, with a mean age of 32.56±4.12 years. Tobacco use (47.7%) was the most common etiology. HIF-1α expression was significantly elevated in fibroblasts compared to blood vessels, with mild staining in 54.2% of blood vessels and 49.8% of fibroblasts. Increased HIF-1α expression correlated with more severe OSF symptoms, indicating a higher risk of malignant transformation. Conclusion: HIF-1α is a promising biomarker for early diagnosis and assessment of malignant potential in OSF. Early detection and monitoring could improve clinical management and reduce OSCC risk, warranting further research for validation and therapeutic targeting.

Psychological problems and their impact on oral mucosal disease patients’ quality of life: A cross-sectional study in the Chinese population

ObjectivesWe aimed to investigate the presence of common psychological factors (i.e., stress, depression, anxiety) and their impact on the Oral health-related quality of life (OHRQoL) in patients diagnosed with four oral mucosal diseases (OMDs): recurrent aphthous ulcers (RAU), oral lichen planus (OLP), oral leukoplakia (OLK), and oral submucous fibrosis (OSF). MethodsA total of 229 patients with clinically diagnosed OMDs were enrolled in this study, consisting of 55 RAU, 68 OLK, 50 OLP, and 56 OSF patients. The patients were statistically analyzed for psychological problems and OHRQoL using the Visual Analog Scale (VAS)､ the 5-item Oral Health Impact Profile (OHIP-5) and the Depression Anxiety Stress Scale-21 (DASS-21) scales. ResultsThere were 229 valid questionnaires collected, consisting of 83 females and 146 males with a mean age of 45.24 (SD = 11.88) years. Multiple regressions between DASS-21 scores and OHIP-5 scores revealed generally negative impacts of psychological problems on OHRQoL, with depression on OLP (β = 0.47), OLK (β = 0.65) and OSF (β = 0.38), stress on RAU (β = 0.29), OLP (β = 0.72), OLK (β = 0.38) and OSF (β = 0.60), and anxiety on OLP (β = 0.33), OLK (β = 0.49) and OSF (β = 0.51). ConclusionsPsychological problems like depression, stress, and anxiety were found to be prevalent in OMDs patients and adversely affected their OHRQoL. The results support the biopsychosocial medical model in the treatment of OMDs patients. Clinical significanceThe present study reinforced the crucial roles of psychological factors in impacting OMDs patients' OHRQoL. Therefore, it is necessary to monitor patients’ psychological status and OHRQoL using questionnaires like DASS-21 and OHIP-5. Followed by psychological interventions, the treatment is expected to be enhanced.

Cytotoxicity in Tobacco Chewers: Insights from Buccal Cytome Analysis in Botad, Gujarat: A Cross-Sectional Study

Introduction: Oral submucous fibrosis (OSMF) is a significant public health concern linked to tobacco consumption, particularly affecting rural populations in Gujarat. This condition, which can lead to serious health complications, underscores the urgent need for awareness and intervention strategies in these areas. The primary aim of this study was to investigate the prevalence of OSMF among tobacco chewers in rural Botad, focusing on identifying cellular abnormalities through buccal cytome analysis. Materials and Methods: A proforma-based approach was employed to collect data from OSMF patients. The study included buccal cytome analysis to assess cellular abnormalities among tobacco chewers, with a particular focus on those consuming mava and pan masala. Additionally, physical observations were made to correlate perinatal health with pre-cancerous lesions. Results: The findings revealed a predominance of OSMF in male patients from rural areas, highlighting a significant lack of awareness regarding the risks associated with tobacco use. Buccal cytome analysis indicated notable cellular abnormalities, especially among mava and pan masala consumers, suggesting heightened cytotoxicity. The study also found major abnormalities in tobacco chewers using lime. Conclusion: This study underscores the critical need for early detection, intervention, and public health initiatives to combat the prevalence and adverse effects of OSMF among tobacco chewers in rural Botad. Addressing this preventable condition is essential for improving community well-being and reducing the burden of tobacco-related health issues..

Assessment of the role of coronoid in restrictive jaw disorders and physiologic mandibular movements

Introduction: Restricted mouth opening has major health implications, such as malnutrition, difficulty in speech, and poor oral hygiene resulting in a functional shortage of the masticatory system. Reduced mouth opening can occur due to trismus, as in the oral submucous fibrosis (OSMF) condition. Excision of fibrous bands in OSMF leads to reestablishment of the mouth opening. Other than trismus, temporomandibular joint (TMJ) ankylosis is another common condition that causes fibrosis or bony ankylosis between articular surfaces. Coronoidectomy is a useful procedure that various authors nowadays apply. It is the most popular surgical procedure used as a conventional method of treatment, which includes the detachment of temporalis muscle. Materials and Methods: A group of 15 patients with OSMF and TMJ ankylosis with written informed consent were selected for the study and were operated on under general anesthesia. Preoperative and postoperative assessment was done for bite force management, measuring and comparing mandibular movements, and the electromyography (EMG) study. Results: Statistical analysis shows the increase in maximum mouth opening and lateral excursions in OSMF and TMJ ankylosis patients on the seventh, 15th, 90th days, and six months postoperatively treated either without coronoidectomy and with coronoidectomy; however, there was no significant difference was found in mean EMG and bite force readings in both groups. Conclusion: The present study concludes that the coronoidectomy not only increases the mouth opening, but masticatory efficacy is also improved with an increase in mandibular movements postoperatively in patients with OSMF and TMJ ankylosis.

Plasma fibrinogen degradation products with salivary coagulopathy in OSMF among Indians.

Oral submucous fibrosis (OSMF) produces changes localized to oral cavity. Hence, it is reasonable to assume that saliva may have an important role in its etiology. This prospective case control study included 37 patients with OSMF which were compared with age and gender matched healthy controls. Salivary coagulopathy procedures as described by Chatuvedi et al. and quantification of plasma fibrinogen degradation products using a commercially available kit were carried out. The obtained data was analyzed using Chi-square tests and Tukey HSD test. The salivary coagulopathy was strongly indicated in saliva of OSMF patients and was dependent on the severity of disease. There were also increased levels of plasma fibrinogen degradation products compared to the controls and were found to have a statistically significant correlation with increasing clinical grades of oral submucous fibrosis (p≤ 0.05).

Salivary Profile in Oral Submucous Fibrosis: A Scoping Review.

Diagnosing oral submucous fibrosis (OSMF) is invariably challenging. The disease can be detected after reaching its final stage and requires complex treatment. Changes in its salivary profile can be used as a reference to see this disorder and as a basis for diagnostic prediction. This study is aimed to analyze the salivary profile as a diagnosis marker in patients with OSMF. The study using Preferred Reporting Items for Systematic Reviews and Meta-analyses was conducted using PubMed, Science Direct, and Scopus databases. A thorough literature search between 1991 and 2023 was performed. Twenty-eight full-text articles were reviewed in detail. Twenty-eight articles were included; a total of 929 patients of OSMF and 826 controls were found. The scoping review showed that levels of salivary protein (including lactate hydrogenase, immunoglobulin G, immunoglobulin A, S1007A protein, 8-hydroxydeoxyguanosine, 8-isoprostane, malondialdehyde, matrix metalloproteinase-12, salivary C-reactive protein, fibrinogen producing factor, salivary miRNA-21, and salivary lipids [cholesterol, high-density lipoprotein, triglyceride) were higher in OSMF. Meanwhile, trace elements (vitamin C, vitamin E, iron, zinc, and magnesium) were lower; only copper was higher in OSMF patients. Alteration in salivary components such as protein, lipid, and trace elements detection can be a basis for providing a noninvasive supportive examination and thus be used as a diagnosis marker of OSMF.

Estimation of the Salivary Copper Levels in Oral Submucous Fibrosis Condition: An In Vivo Study.

The aim of the present study was to estimate the salivary copper levels in oral submucous fibrosis (OSMF) condition. A total of 60 individuals of which an equal number of 30 each in normal healthy control group as well as in clinically and histopathologically (the biopsy was done once after the clinical confirmation of OSMF in the patient) confirmed patients of OSMF were included in the study group. Total of 51 males and 9 females were considered for the present study and the age distribution of these groups ranged from a minimum of 21 years to a maximum of 74 years. Unstimulated whole saliva was collected from the patient followed by the conventional biopsy practice. The collected saliva was then subjected for the analysis of copper levels. Trace element copper was estimated by using Digital Semiautomatic Analyzer with the help of copper kit. The clinical mouth opening of OSMF was estimated. Analysis of variance (ANOVA) and Tukey HSD post hoc test was used analyze the data wherein the participants were grouped into age ranges of 20-30, 31-40, 41-50, and >60 years. The mean salivary copper level among OSMF and control groups with respect to age in 20-30 years was 55.98 ± 15.50 and 30.87 ± 7.70, in 31-40 years was 63.96 ± 21.13 and 32.95 ± 4.56, in 41-50 years was 50.11 ± 6.83 and 30.46 ± 3.28, and >60 years was 45.65 and 13.67 µg/dL, respectively. The mean salivary copper levels among OSMF and Control groups with respect to males were 55.60 ± 15.27 and 31.18 ± 6.97 and among females were 67.0 ± 24.25 and 30.06 ± 5.77 µg/dL, respectively. The mean salivary copper levels with histopathological grades in very early stage was 47.18 ± 5.73, in early stage was 49.22 ± 7.65, in moderately advanced was 73.53 ± 10.62 and in OSMF with mild dysplasia was 79.98 ± 16.27 µg/dL, respectively. The mean salivary copper levels in individuals with clinical mouth opening more than 35 mm was 45.65 ± 6.57, in 25-35 mm was 48.94 ± 21.60, in 15-25 mm was 70.54 ± 3.52 and in less than 15 mm was 81.50 ± 16.66, respectively. The present study concluded that salivary trace element levels could be used as potential diagnostic and prognostic markers in patients with OSMF. Trace elements are involved in many different physiological and metabolic processes in humans, either directly or indirectly. Copper is involved in vital biochemical activities like different redox and free radical formation and in maintaining cellular proton homeostasis. It is also associated with the processing of oxygen and a component of arecanut in all forms, which is implicated in the etiology of OSMF. How to cite this article: Gupta R, Jayanti I, Das A, et al. Estimation of the Salivary Copper Levels in Oral Submucous Fibrosis Condition: An In Vivo Study. J Contemp Dent Pract 2024;25(5):498-502.

Assessment of the Efficacy of Orally Administered Lycopene in Improving the Mean Maximum Incisal Opening in Individuals Suffering from Oral Submucous Fibrosis

Objective: To compare the effectiveness of orally administered lycopene versus a placebo in increasing mean maximum incisal opening in patients with oral submucous fibrosis (OSF). Methodology: This randomized controlled trial, conducted at the Oral and Maxillofacial Surgery Department of Lahore Medical and Dental College from January to July 2020, enrolled 68 eligible patients. Two groups were formed: Group 1 (received oral lycopene) and Group 2 (received placebo). A block size of 4 was utilized for patient allocation, alternating between groups until the sample size was met. Both groups underwent a comprehensive 3-month treatment plan, including habit cessation and daily physiotherapy involving tongue spatula insertion between teeth (with spatula replacement). Only Group 1 received an additional 40mg oral lycopene daily. Follow-up appointments occurred monthly for 3 months, measuring maximal incisal opening with a Vernier Caliper. Results: Baseline incisal opening was 25.39 ± 2.92 mm in Group 1 and 25.23 ± 3.03 mm in Group 2. At the 3-month mark, Group 1 showed an incisal opening of 31.71 ± 2.84 mm, while Group 2 had 28.31 ± 2.98 mm. The mean change in incisal opening was 6.32 ± 0.96 mm for Group 1 and 3.08 ± 0.90 mm for Group 2. Group 1 exhibited a significantly higher mean change in incisal opening compared to Group 2 (p=<0.001). Conclusion: Lycopene administration is more effective than a placebo in improving mouth opening in OSF patients. Therefore, lycopene should be considered as a treatment option to enhance maximal incisal opening and improve the quality of life for individuals with OSF. Keywords: Maximum incisal opening, Oral submucous fibrosis, lycopene orally, Nutt eating

New physiotherapy device for interincisal mouth opening in oral submucous fibrosis patients: A pilot study

Objectives: It is estimated that 0.2–0.5% of Indians suffer from oral submucous fibrosis. The states of Gujarat, Bihar, Madhya Pradesh, and Maharashtra are the most severely impacted by this illness. Antioxidants, effective physiotherapy exercises, and topical corticosteroid injections are among the treatment options available for oral submucous fibrosis (OSMF). Despite being widely used, there are few studies assessing the effectiveness and patient compliance of the conventionally used technique for physiotherapy in patients with OSMF, such as ice cream sticks, tapered screws, and Heister jaw opener. Material and Methods: A device for physical rehabilitation that may be used at home was made using 3D printing technology. Ten patients participated in a pilot study that was carried out. These patients participated in the device’s pilot testing to assess the mechanical features and its ability to improve interincisal mouth opening, comfort (pain and control), and enjoyment. Comfort [Pain, comfort, control] with device use, ease of use [Portability] and satisfaction with device use. Results: A statistically significant (P < 0.0006) improvement in the mean mouth opening of OSMF patients was shown by quantitative data. After 1 month of use, there was a 1.8 mm difference in mouth opening. This implies that the device worked well for these people. Based on feedback, the majority of patients reported that the device was comfortable, easy to use, and showed satisfaction with the device use. Conclusion: It was found that people with OSMF can open their mouth more with the use of a new physiotherapy device. In addition to pharmacological therapy, this pilot study needs more investigation with a bigger sample size and a randomized control trial. Considering that this method of managing OSMF seems to be effective.

TUSC3, p53 and p21 genetic association with development of oral submucous fibrosis and oral squamous cell carcinoma among addictive tobacco chewers of Pakistan

BackgroundThis study delves into the intricate landscape of oral cancer, a global concern with a high incidence in Asian countries. We focus on oral squamous cell carcinoma (OSCC), primarily driven by the consumption of betel nut and its derivatives. OSCC often arises from premalignant lesions like oral submucous fibrosis (OSF). In Pakistan, OSCC is prevalent among men due to various addictive substances, including smokeless tobacco and chewing materials. Mutations in tumor suppressor genes, such as TP53 and p21, play crucial roles in this malignancy’s development. We also explore the involvement of TUSC3 gene deletion in OSCC and OSF.MethodsIn this study we investigated demographics, TUSC3 gene expression, deletion analysis, and TP53 and p21 genetic alterations in OSCC and OSF patients (blood and tissue of 50 samples in each condition) who had tobacco derivates usage history. The association analysis was carried out mainly through PCR based genotyping.ResultsThe study’s patient cohort (OSCC and OSF) displayed a wide age range from 13 to 65 years (Mean = 32.96 years). Both conditions were more prevalent in males, with a male-female ratio of approximately 2.5:1. Chewing habits analysis revealed high frequencies of gutka use in both OSF and OSCC patients. TUSC3 expression analysis in OSCC cell lines indicated significant downregulation. Genotyping showed no TUSC3 deletion in OSF cases, but a deletion rate of over 22% in OSCC tissue samples. Analysis supported a significant association of TUSC3 deletion with OSCC development but not with OSF. Polymorphism in p53 exon 4 and p21 (rs1801270) were significantly associated with both OSCC and OSF, adding to their pathogenesis. Our findings further revealed a strong correlation between TUSC3 deletion and the excessive use of tobacco and related products, shedding light on the genetic underpinnings of OSCC development.ConclusionsNotably, our study provides a crucial insight into genetic aspects underlying OSCC and OSF in response of addictive consumption of areca nut, betel quid, and tobacco derivatives. A significant association between TUSC3 deletion and OSCC development, along with polymorphisms in TP53 and p21, underscores the importance of further research into the molecular mechanisms driving oral cancer progression for improved diagnosis and treatment outcomes.

Analysis of salivary alpha-L-fucosidase and salic acid among oral sub-mucous fibrosis patients.

The salivary concentrations of alpha L fucosidase (AFU) and salic acid (SA) in oral submucous fibrosis patients and compare it with healthy controls is of interest to dentists. 40 patients of OSMF and 40 healthy controls were included. Estimation of AFU and SA in saliva and serum was carried out in every patient. The serum level of AFU was 37.4±26.8 in OSMF patients and saliva level of AFU was 35.4±14.5. The serum level of AFU was 19.2±4.3 in control group and saliva level of AFU was 35.4±14.5 in control group. The serum level of SA was 20.32±2.71 in OSMF patients and saliva level of SA was 18.21±2.40. The serum level of SA was 4.89 ±1.17 in control group and saliva level of SA was 3.13 ±1.04 in control group. Estimation of concentration of SA and AFU in saliva can be effective biomarker in diagnosis of OSMF.

Expression profile of diagnostic genes in oral submucous fibrosis

Oral Submucous Fibrosis (OSMF) is a chronic precancerous disorder of the oral mucosa caused by chewing of areca nut and its other variants. Chewing of areca nuts leads to dysregulated expression of specific genes, leading to various premalignant or malignant disorders. This study aimed to determine the differential expression of the diagnostic genes (MYH6, TNNT3, MYL1, and TPM2) in healthy controls and OSMF patients using saliva and tissue samples, determining the histopathological grade of the clinical samples. A total of 20 patients were included in the study and were divided into two groups: Group I consisted of 10 healthy patients (control group) and Group II consisted of 10 OSMF patients. Unstimulated whole saliva samples were collected from both groups, and the tissue samples were divided into two parts: one for RT-qPCR analysis and the other for histopathological assay. The expression profile of genes concerning OSMF saliva and tissue samples was significantly upregulated compared to the healthy control, and all the clinical samples of the study were categorized into histopathological grade 1. The findings of this study concluded that these genes can be referred to as diagnostic genes for OSMF in early and very early clinical samples, and saliva can be used as a promising diagnostic tool for early OSMF studies.

Complication Of Intralesional Hyaluronidase Injection DuringTreatment Of Oral Submucous Fibrosis: A Case Report

Aims and background: Oral submucous fibrosis (OSMF) is a potentially malignant condition of oral cavity. Optimal dosage of local injection of corticosteroids with hyaluronidase is an effective treatment. Case description: A 34 years’ old male, diabetic patient reported with reduced mouth opening. He had a tobacco chewing habit. He was thoroughly examined and diagnosed with OSMF. Due to diabetes, he was advised only hyaluronidase injection. After 4 sessions of intralesional injection, he started developing facial edema after every session that subsided within 48-72 hours. Conclusion: The present report is to discuss a complication of intralesional hyaluronidase therapy. Clinical significance: Hyaluronidase can be administered without corticosteroid in OSMF patients with diabetes keeping in mind the adverse reactions that could happen and how to manage them when encountered.

Verrucous carcinoma on lateral tongue in association with oral submucous fibrosis: A rare case report

Oral verrucous carcinoma (VC) is a rare tumor, which a clinical variant of well differentiated oral squamous cell carcinoma characterized by exophytic growth or cauliflower like growth in appearance. It establishes in older individuals, who has habit of chronic tobacco chewing and predominance in males. Oral submucous fibrosis (OSMF) is a chronic, insidious, potentially malignant disorder associated with betel nut chewing habit. The development of oral squamous cell carcinoma (OSCC) is seen in one-third of the OSMF patients, but the development of VC is rarely seen in such patients. In the literature a very few cases of OSMF with VC are reported. Here, we present such a rare case in a 25 years old female patient with VC in conjunction with OSMF.

Evaluation of the Importance of Genetic Polymorphisms in Genes Expressing Cancer-Metabolizing Enzymes (Cyp1a1 and Gstm1) in Oral Submucous Fibrosis.

Genetic polymorphisms are common and contribute significantly to human illnesses. This study was carried out to evaluate the importance of genetic variations in the genes expressing cancer-metabolizing enzymes (CYP1A1 and GSTM1) in individuals experiencing oral submucous fibrosis (OSMF). Based on the clinical and histological characteristics of OSMF, 40 patients were chosen for the study; 10 of these patients had considerable polymorphism and malignant transformation; therefore, they were placed in a different group. After receiving written agreement, 30 normal subject patients were also picked for the study. For both normal and OSMF patients, tissue samples and 2 ml of peripheral venous blood were drawn from the arm vein and placed in a heparinized test tube. Electrophoresis on 0.8% agarose gel was used to verify genomic DNA. The GSTM1 polymorphism, CYP1A1 polymorphism was 10.41% and 15.27% in normal subjects. The GSTM1 polymorphsm, CYP1A1 polymorphism was 16.21% and 8.14% in early OSMF. The GSTM1 polymorphsm, CYP1A1 polymorphism was 20.31% and 28.56% in moderate OSMF. The GSTM1 polymorphsm, CYP1A1 polymorphism was 8.12% and 12.54% in moderate OSMF. Finally, GSTM1 polymorphism was 60.47% in OSMF+ CA, while CYP1A1 polymorphism was 40.21%. The GSTM1 gene polymorphism and CYP1A1 gene polymorphism were maximum in OSMF+ CA category. There is a significant role of genetic variations in the genes expressing cancer-metabolizing enzymes (CYP1A1) and GSTM1 in individuals experiencing OSMF.

Evaluation of Candidal Species in Oral Submucous Fibrosis and Oral Lichen Planus: A Microbiological Study

Background: Candida is opportunistic microorganisms in oral cavity, causes oral candidiasis. The presence of candida and subspecies in oral premalignant lesions may intensify the infection and transform pre malignant lesions into cancer. Objective: To isolate various types of candida species, among Oral submucous fibrosis (OSMF) and Oral lichen Planus (OLP) patients. Methodology: Total 60 individuals included and grouped as; OSMF (n=20) group A, Lichen Planus (n=10); group B and Controls (n=30) group C. Results: The higher candida carriage revealed in OSMF+ OLP groups (23.3%) as compared to controls (10%). The species level findings showed 13.3% of candida albicans in OSMF+ OLP and 6.7% in controls, candida krusei 6.7% in OSMF+ OLP and 3.3% in controls and non candida albicans were 10% in OSMF+ OLP and 6.7% in control group respectively. Conclusion: This basic understanding of candida species and their association with potentially malignant disorders will help in better interventions, so as to restrict the lesion before it transform in to malignancy.

Electromyography Analysis of the Masseter Muscle's Activity in the Management of Oral Submucous Fibrosis.

Introduction Oral submucous fibrosis (OSMF) is a persistent, collagen metabolic disorder distinguished by the presence of fibrosis of the connective tissue stroma in the oral mucosa with a higher malignant potential rate for oral cancer. This study aimed to analyze the utility of electromyography (EMG) as the prognostic assessment tool in the management of OSMF with conventional intralesional corticosteroid therapy. Materials and methods This study included 20 OSMF cases of age range 20 to 80 years without systemic comorbidities to assess pre-treatment and post-treatment changes with intralesional corticosteroid therapy as an intervention and to determine if it could be assessed using electromyographic study. Clinical and histopathological grading of OSMF was done. The five clinical parameters were evaluated for measuring treatment prognosis. Among them, mouth opening, tongue protrusion, and burning sensation assessments were quantitative parameters, and palpable fibrotic bands and mucosa colour were qualitative parameters. As OSMF involves changes in muscle plane in moderately advanced and advanced cases, EMG was used as an assessment tool for measuring muscle activity. Among the muscles of mastication, the masseterand temporalis were selected for evaluation. Twenty age and gender-matched healthy controls were required for this study as there are no standardized normal values for amplitude and onset of activity in muscle analysis. The EMG activity of the right and left temporalis and masseter muscles were recorded using surface electrodes and were correlated with five clinical assessment parameters. Results In the right masseter, the rest amplitude of 1.6010 µV of the OSMFwas statistically significant (p-value: 0.050) when compared with 4.1275 µV of the control. The clench amplitude of 133.370 µV of the OSMFwas statistically significant (p-value: 0.062) when compared with 94.310 µV of the control. In the left masseter, the rest amplitude of 1.6695 µV of the OSMFwas statistically significant (p-value 0.066) when compared with 2.5735 µV of the control. In the left masseter, the onset of muscle action of 62.670 ms of the OSMFwas statistically significant (p-value: 0.017) when compared with 131.835 ms of the control. The clench amplitude differences in the right masseter of 133.370 µV pre-treatment, and 102.775 µV post-treatment were statistically significant (p-value: 0.007). The clench amplitude in the left masseter of 102.535 µV pre-treatment, and 92.090 µV post-treatment were statistically significant (p-value: 0.036). The correlation was seen between tongue protrusion and rest amplitude in the right masseter in OSMF (r = 0.376, p-value: 0.023). Conclusion There was a correlation between tongue protrusion and rest amplitude in the right masseter muscle in OSMF patients before treatment. In the right and left masseter, during rest, the amplitude of the OSMF group was lesser than that of the control group. During clench, in the right masseter, the amplitude of the OSMF group was higher than that of the control group. During clench in the left masseter, the onset of muscle action was lesser in the OSMF group than in the control group. After treatment, there was a reduction in clench amplitude in OSMF patients from their pretreatment values signifying muscle relaxation and a better onset of muscle action.

Role of Antioxidant Vitamins in Oral Submucous Fibrosis: A Narrative Review.

Oral submucous fibrosis (OSMF) has a high rate of malignant transformation and is an insidious chronic inflammatory disease. Though this disorder seems to be multifactorial in origin, betel quid chewing appears to be the main etiologic factor. Various treatment strategies have been attempted but none proven to cure the disorder because of its multimodal pathogenesis. Reactive oxygen species (ROS) appear to have a role in cancer formation. As OSMF is an oral premalignant disorder and found to be associated with carcinogens like areca nut and tobacco, it is believed to have some relationship with ROS. Tissue damage due to ROS along with other mechanisms may result in the complex pathophysiology of OSMF. The antioxidant system in the body helps to prevent damage caused by highly reactive ROS and helps in the repair of tissues. To study the levels of oxidative stress and antioxidant vitamins in OSMF condition, the present review was done. We carried out a thorough literature search to identify original reports and studies determining the status of oxidative stress and antioxidant vitamins in OSMF condition using several databases including Google Scholar, PubMed, and Scopus. Our review observed that the oxidative stress increased in the condition of OSMF as shown by an increase in malonaldehyde (MDA) and a decrease in antioxidant vitamins like vitamin A, vitamin C, and vitamin E. Also, after the intake of antioxidant vitamins, there was symptomatic improvement in OSMF patients. With the help of identifying oxidative stress and antioxidant status, we can assess the clinical stage of OSMF and can develop a comprehensive treatment plan.

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.

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.