Jun 18, 2018 the treatment of patients with oral submucous fibrosis depends on the degree of clinical involvement. Oral submucous fibrosis, a clinically benign but potentially. These bands progressively contract so that ultimately opening is severely limited, speech becomes hypernasal due to changes in the soft palate and swallowing is disturbed. Oral submucous fibrosis osmf is a chronic, progressive disease that alters the fibroelasticity of the oral submucosa, prevalent in india and southeast asia but rare elsewhere, and characterized by burning and pain in the oral cavity, loss of gustatory sensation, the presence of blanched fibrous bands and stiffening of the oral mucosa and oropharynx leading to. Gupta s, reddy mvr, harinath bc, role of oxidative stress and antioxidants in aetiopathogenesis and management of oral submucous fibrosis, ind j clinbiochem, 19, 2004, 8. Oral submucous fibrosis osf is characterized by abnormal collagen deposition. Circulating autoantibodies are also present in some cases of oral submucous fibrosis canniff et al, 1985. Definition it is an insidious chronic disease affecting any part of the oral cavity and sometimes the pharynx. Oral submucous fibrosis osmf as a disease remains an enigma to the clinicians due to elusive pathogenesis and less well defined classification systems. Moderatetosevere oral submucous fibrosis is irreversible. Symptoms include submucous fibrosis, ulceration, xerostomia, a burning sensation, and restricted mouth opening.
The treatment is still elusive and empirical because of poorly understood etiopathogenesis, which is believed to be multifactorial including areca nut chewing, ingestion of chillies, genetic. Nov 24, 2012 oral submucous fibrosis osf is an extremely discomforting oral condition that is marked by the development of painful lesions inside the mouth that refuse to go away on their own. Induction by local painting of capsaicinan optical and electron microscopic study. The areca nut an is the primary ingredient in various bq products, and the international agency for research on cancer iarc has classified the an as a group i human carcinogen based on findings indicating that it is associated with an elevated risk for oral potentially malignant disorders opmds, such as leukoplakia, oral submucous fibrosis, erythroplakia, and lichen. It is a chronic progressive disorder and its clinical presentation depends on the stage of the disease at detection. The underlying muscles of mastication may be affected resulting in trismus and disability.
Oral submucous fibrosis osmf is a chronic, progressive, scarring, high risk precancerous condition of oral mucosa seen primarily in indian subcontinent, southeast asia, taiwan, southeast china and papua new guinea. Oral submucous fibrosis and the role of curcumin in its treatment. Jun 18, 2018 in 1952, schwartz coined the term atrophica idiopathica mucosa oris to describe an oral fibrosing disease he discovered in 5 indian women from kenya. Fibroblastic phenotype in oral submucous fibrosis a cell. Oral submucous fibrosis osmf, a precancerous condition of the oral cavity, has been studied by a number of workers in the field. The copper content of areca nut is high and the possible role of copper as a mediator of fibrosis is supported by the demonstration of up regulation of lysyl oxidase in osf biopsies.
Strong evidence exists to implicate the chewing of areca nut in the pathogenesis of the lesion. Joshi subsequently coined the termed oral submucous fibrosis osf for the condition in 1953. Gain quick access to our journal online view our journal at. Oral submucous fibrosis osmf is an insidious chronic disease affecting any part of the oral cavity and sometimes the pharynx with epithelial atrophy leading to stiffness of the oral mucosa, causing trismus and inability to eat. Oral submucous fibrosis osf is a chronic debilitating disease and a premalignant condition of the oral cavity.
Oral submucous fibrosis osmf, oral fibrosis introduction oral submucous fibrosis is a chronic disease of insidious onset featuring the deposition of fibrous tissue in the submucous layer of the palate, fauces, cheek, lips, pharynx and esophagus. Mainly in india and pakistan due to smokeless tobacco chewing of betel quid reactive but risk factor for squamous cell carcinoma early lesions show blanching, mottled, marblelike appearance. Submucous fibrosis of the palate in dietpreconditioned wistar rats. Transforming growth factor beta 1 in oral submucous fibrosis. It develops in almost all patients with chronic liver injury at variable rates depending in part upon the cause of liver disease and host factors. Three different candidal species were isolated from the osmf group c. Then, for speedier recovery, please keep on taking this medicine twice daily. A retrospective study, int oral health, 7, 2015, 8285. The mouth may feel dry with ulcers on examination, even at an early stage, the oral mucosa looks white in a marblelike pattern, either diffusely throughout the mouth or in.
Pathogenesis and therapeutic intervention of oral submucous. All of these greatly interfere with patient quality of life. Epidemiological evidences strongly indicate the association of the betel quid bq habit and osf. All patients signed an informed consent form before surgery. Oral submucous fibrosis osf is a chronic, progressive, potentially malignant condition of the oral cavity, which has the highest malignant transformation potential of 7%. Chewing habit and candidal carriage in patients with oral submucous fibrosis.
The pathogenesis of the disease is not well established. It is suggested that submucous fibrosis should be regarded as a condition that causes predisposition to the development of oral cancer. The treatment of patients with oral submucous fibrosis depends on the degree of clinical involvement. Oral submucous fibrosis and the role of curcumin in its. Oral submucous fibrosistreatment with hyalase the journal. An immunohistochemical study understanding the pathogenesis v. Index definition history keywords pathogenesis clinical features laboratory findings classification treatment 3. Transforming growth factor beta 1 in oral submucous. Oral submucous fibrosis definition of oral submucous. Editorial oral submucous fibrosis is not a premalignant lesion. The symptoms and signs depend on the progression of the lesions and number of affected sites.
It initially affects the lamina propria of the oral mucosa and as the disease progresses it involves the submucosa and the deeper tissues including muscles of the. Introduction oral sub mucous fibrosis is a peculiar disease which is considered to be a precancerous condition. Use of nasolabial flap in the management of oral submucous. It has been postulated that areca nut may also induce the development of the disease by. Oral submucous fibrosis osf is a chronic insidious disease of the oral mucosa, wellrecognized as a premalignant condition and commonly found in southern china. Oral submucous fibrosis osf, first described in the early 1950s, is a potentially malignant disease predominantly seen in people of asian decent. Apr 23, 2010 oral submucous fibrosis is a disease due to a chronic, insidious change in fibroelasticity, characterized by burning sensation in the oral cavity, blanching, and stiffening of the oral mucosa and oropharynx leading to trismus and inability to open the mouth. R crri,saveetha dental college and hospitals, chennai abstract. The areca nut an is the primary ingredient in various bq products, and the international agency for research on cancer iarc has classified the an as a group i human carcinogen based on findings indicating that it is associated with an elevated risk for oral potentially malignant disorders opmds, such as leukoplakia, oral submucous fibrosis, erythroplakia, and lichen planus and cancers of. Osmf, oral fibrosis introduction oral submucous fibrosis is a chronic disease of insidious onset featuring the deposition of fibrous tissue in the submucous layer of the palate, fauces, cheek, lips, pharynx and esophagus. Oral submucous fibrosis osmf is a disease of unknown etiology.
It is primarily caused by the habit of areca nut or gutkha chewing. It is characterised by a unique generalised fibrosis scarring of the submucosal oral soft tissues, resulting in marked rigidity of the oral mucosa leading to progressive trismus inability to open the mouth, rigidity of lips and difficulty in protruding the tongue. Oral submucous fibrosis osf is an extremely discomforting oral condition that is marked by the development of painful lesions inside the mouth that refuse to go away on their own. Oral submucous fibrosis an overview sciencedirect topics.
A total of 96 patients with oral submucous fibrosis have received four regimens of treatmentlocal dexamethasone, local hyaluronidase, local combination of dexamethasone and hyaluronidase, and local placental extract. Changthe upregulation of cyclooxygenase2 expression in human buccal mucosal fibroblasts by arecoline. Oral submucous fibrosis osf is a chronic, insidious disease that is associated with significant functional morbidity and an increased risk for malignancy. S3 presen ce of palpable fibrous bands in buccal mucosa andor oropharynx and in any other parts of oral cavity, withwithout stomatitis stage 4. Having oral submucous fibrosis does not mean you have cancer but it increases the risk of developing cancer of the mouth. There are many reports which assayed the potential of fibroblasts in the pathogenesis of oral submucous fibrosis 2. Morphometric analysis of epithelial thickness and blood. Oral submucous fibrosis a condition with increasing. The development of fibrosis is pathognomic in the potentially malignant oral disorder, oral submucous fibrosis osf. Oral sub mucous fibrosis is a crippling disease of mouth with high malignant potential that has high prevalence rate in india and south east asia. Know all about the disease, including its possible causes, symptoms, diagnosis and treatment options.
Information for patients charles clifford dental hospital. Patients are advised to do mouthopening exercises, for example, by placing ice. Most patients with oral submucous fibrosis present with moderatetosevere disease. It is a precancerous disorder and transforms into a malignant tumor in 1. Oral submucous fibrosis is a chronic insidious disease which was previously designated as a premalignant condition but presently categorized under potentially malignant disorders who 2005. Osf is believed to be a homeostatic disorder of the extracellular matrix and fibroblast proliferation. These raised levels suggest an antigenic stimulus in the absence of any infection.
Satelur, komali rajkumar, shruti krishnamurthy department of oral and maxillofacial pathology, dr. Mar 31, 2014 molecular pathogenesis of oral submucous fibrosis 1. If the disease is detected at a very early stage, cessation of the habit is sufficient. Oral submucous fibrosis causes, symptoms, treatment and. The present paper discusses in detail the effects of the components of areca nut on pathogenesis of oral submucous fibrosis. Also maintain a good amount of intakre of fresh vegetables and fruits in your diet rich in vit c like citrus fruits. However, a more serious complication of this disease is the risk of the development of oral carcinoma. Oral sub mucous fibrosis is a chronic, progressive, and. Prabhu rv, prabhu v, chatra l, shenai p, suvarna n, dandekeri s. Oral squamous cell carcinoma in background of oral submucous fibrosis. Oral submucous fibrosis osmf is a chronic disease of oral mucosa characterized by inflammation and progressive fibrosis followed by stiffening of an otherwise yielding mucosa resulting in difficulty in opening the. Morphometric analysis of epithelial thickness and blood vessels in different grades of oral submucous fibrosis neeraj gargmd and ravi mehrotra md fortis memorial research institute, gurgaon, and institute of cytology and preventive oncology. A total of 10 patients of oral submucous fibrosis were admitted and surgically treated in our hospital with due permission of the ethical committee.
Oral submucous fibrosis is a precancerous condition of the oral mucosa. Oral submucous fibrosis osf is a chronic debilitating disease and premalignant condition of the oral cavity and is a serious public health issue in india and many parts of the world. It has been established that chewing or smoking habits relating to chilli, areca nut, betel quid and tobacco, cause oral submucous fibrosis. Maintenance of increased mouth opening in oral submucous.
S4 a any one of the above stage, along with other potentially malignant disorders, e. As an example, pericentral injury is a hallmark of alcoholic hepatitis. It is a premalignant condition and has been on a constant rise either due to an increase in the habitual chewing of pan masala or a decrease in the awareness among the public of the danger of chewing pan masala. Fibrosis is a wound healing response in which damaged regions are encapsulated by an extracellular matrix or scar. Intensity of candida in the osmf and control groups. Therapeutic interventions in oral submucous fibrosis. As the disease progresses, the jaws become rigid to the point that the person is unable to open the mouth.
Oral submucous fibrosis can be seen at any age except for young children. It will interfere with the collegen synthesis and degradation causing the fibrosis. Here we are presenting two cases of oral submucous fibrosis showing malignant potential and development of oral squamous cell carcinoma. These are injected into the fibrotic bands weekly for 68 weeks with regular monitoring of mouth opening. A hospitalbased study was conducted on 75 osf cases who visited our hospital in chennai from 20002003. Relationship to risk factors associated with oral cancer. It is characterized by a generalized submucosal fibrosis. Oral submucous fibrosis osf is a precancerous condition associated with the use of areca nut in various forms.
Oral submucous fibrosis is a disease due to a chronic, insidious change in fibroelasticity, characterized by burning sensation in the oral cavity, blanching, and stiffening of the oral mucosa and oropharynx leading to trismus and inability to open the mouth. Etiopathogenesis of oral submucous fibrosis osf is been studied for long time and still a fully satisfactory explanation is not obtained. Regular follow up is therefore important to look for any changes in the mouth. Comparative study of candida in oral submucous fibrosis. Fibrosis occurs earliest in regions where injury is most severe, particularly in chronic inflammatory liver disease due to alcohol or viral infection. Jul 01, 20 oral submucous fibrosis osmf is a chronic, progressive disease that alters the fibroelasticity of the oral submucosa, prevalent in india and southeast asia but rare elsewhere, and characterized by burning and pain in the oral cavity, loss of gustatory sensation, the presence of blanched fibrous bands and stiffening of the oral mucosa and oropharynx leading to trismus and a progressive. The constituents of areca nut activate several profibrotic cytokines, chiefly transforming growth factor beta 1 tgf. Oral submucous fibrosis osmf is a chronic, insidious, disabling disease involving oral mucosa the oropharynx, and rarely the larynx. Oral sub mucous fibrosis, areca nut, malignant transformation. In contrast, for unclear reasons, patients with selflimited injury such as fulminant hepatitis do.
Mar 31, 2016 oral submucous fibrosis osmf is a chronic, progressive, scarring, high risk precancerous condition of oral mucosa seen primarily in indian subcontinent, southeast asia, taiwan, southeast china and papua new guinea. Oral submucous fibrosis current concepts in etiopathogenesis. Please stop the habit of gutkha or betel nut chewing if you have. Molecular pathogenesis of oral submucous fibrosis 1. A case of osmf reported with initial interincisal mouth opening.
The various modes of assay include light microscopy, immunohistochemical analysis, scanning electron microscopy etc. All these patients had advanced oral submucous fibrosis. Areca nut, oral submucous fibrosis, potentially malignant disorder, supari. Molecular pathogenesis of oral submucous fibrosis a. Oral submucous fibrosis is a chronic, complex, premalignant 1% transformation risk condition of the oral cavity, characterized by juxtaepithelial inflammatory reaction and progressive fibrosis of the submucosal tissues the lamina propria and deeper connective tissues.
Areca nut is the main etiological factor which is consumed as pan masala, gutka, mawa, and betel quid. Over the years, different authors have classified this condition based on clinical, histopathological or functional aspects. Compared to traditional betel quid, gutkha chewing tends to begin at a younger age and has a shorter time to the development of disease, so cases of oral submucous fibrosis have been seen as young as 11 years of age. Oral submucous fibrosis a disease with malignant potential. The available epidemiological data showed a clearcut geographical and ethnic predisposition, which suggested that certain customshabits prevalent among the population groups in southeast asia might be possible etiological factors. The first symptom of oral submucous fibrosis is a burning sensation in the mouth especially when eating spicy food, sometimes also with small blister formation. There are very few reports to correlate the clinical stage to histopathological grading in osf.