Oral Submucous Fibrosis: Understanding the Disease through a Case Series (original) (raw)

Oral submucous fibrosis in India: Are we progressing??

Indian Journal of Cancer, 2014

Oral submucous fibrosis (OSMF) a condition first described in the 1950s in the modern literature still remains elusive of a cure. For many years this condition had been confined to countries like India, Pakistan, Bangladesh, etc., but now this condition is being reported from Western countries as well. Inspite of intensive research over the years into the etiologic factors of OSMF, a single etiologic factor cannot be pointed out with certainty rather several causative factors have been proposed. Patients suffering with OSMF initially present with a blanched or marble-like pale mucosa, vesiculations, and also intolerance to hot and spicy food. Gradually, the patient may develop fibrous bands in the buccal and labial mucosa which causes a restriction in opening the mouth. The evidence for the various treatment modalities for OSMF is weak hence better documentation of the studies performed with standardized criteria is required. The current review aims to refresh our knowledge regarding OSMF from an Indian perspective and make a few suggestions to fill the lacunae in this field.

Clinical profile and oral sub mucous fibrosis

Nepalese Journal of ENT Head and Neck Surgery, 2017

Oral submucous fibrosis (OSMF) is an insidious precancerous disease affecting the oral cavity, pharynx and upper digestive tract. OSMF is a debilitating but preventable oral disease. In 1952, Schwartz coined the term atrophica idiopathica mucosa oris to describe an oral fibrosing disease which he discovered in five Indian women from Kenya. 1 Joshi subsequently coined the term oral submucous fibrosis (OSMF). 2 From the end of last century, papers are being published and researches are being conducted and its pathogenetic significance especially as a precancerous lesion is being highly discussed. The transformation rate is as high as 7.6% making OSMF one of the most important precancerous conditions of the oral region. 3 Oral submucous fibrosis is a disease due to a chronic, insidious change in fibro elasticity, 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. The symptoms and signs depend on the progression of the lesions and number of affected sites. 4,5 Oral submucous fibrosis (OSMF) is mostly seen in the Southeast Asia. Although nutritional deficiencies 6 and immunological processes may play a part in the pathogenesis, the available epidemiological evidence indicates that chewing betel quid (containing areca nut, tobacco, slaked lime or other species) is an important risk factor for OSMF. 4,7,9 Gutkha is widely used which is the preparation of crushed areca nut tobacco, catechu, paraffin, slaked lime and sweet or savory flavorings The severity of trismus can be classified into three grades, depending on the maximal mouth opening (MMO) between upper and lower incisor teeth edges distance. Grade 1 is MMO between 40 and 25 mm; Grade 2 is MMO between 25 and 10 mm; and Grade 3 is MMO less than 10 mm. 10 A wide range of treatment consisting of drug management, surgical therapy, and physiotherapy have been attempted till date; with varying degrees of benefit, but none of them have proved to be a cure. This field remains open for clinical trials and research. 4 The drugs used to treat OSMF were categorized into steroids, enzymes, cardiovascular drugs, antioxidants, vitamins and microelements. There are few high-quality studies available and the present drug treatments are in general empirical and treat only symptoms. 4 Together with a cessation of the betel quid chewing habit before and after therapy, these treatment regimens combined with daily mouth opening exercises were found to be necessary to manage OSMF cases in early and advanced stages of progression. 11 This paper aims to provide an overview on clinical profile of patients with OSMF and its association with different local preparations taken orally. Objectives: Oral submucous fibrosis (OSMF) is an insidious precancerous disease mostly seen in the Southeast Asia. This paper aims to study on clinical profile of patients with OSMF Material and Methods: This cross sectional study was done in department of ENT and HNS, Nepalgunj Medical College and Teaching Hospital. In outpatient department patients with OSMF were ask to fill up a questionnaire that included identification of patient, occupation, their symptoms and habit of taking betel quid or paan, gutkha, etc. Oral cavity was examined and lesion along with its extent and severity was noted. Intra lesional steroid and antioxidant and physiotherapy were main stay of treatment. Results: There were total 136 patients (98 male and 38 female) from 15th Dec 2013 to 15th Jan 2015. Age of patient ranged from 16 years to 53 years and average being 25.6years. Most common preparation taken was gutkha 131(96.3%) followed by betel nut, betel quid etc. Only 24(17.6%) were taking these preparations for less than 1 year. Common presenting complaints were difficulty in opening mouth followed by burning sensation and dryness of mouth. Clinically, the extent of fibrous band was found to be more commonly involving soft palate, pillars and buccal mucosa. Isolated involvement of different region of oropharynx or oral cavity was less common. Correlation of grade of trismus and average duration of taking these different preparations was highly significant. (p=0.008) Conclusions: Oral submucous fibrosis is commonly associated with intake of gutkha having dose dependent relationship with trismus. Further studies are required why only a small fraction of those using betel quid develop the disease.

Frequency andClinical Presentation of Oral Submucous Fibrosis

IOSR Journal of Dental and Medical Sciences

Background: Oral submucous fibrosis (OSMF) is a chronic, precancerous condition of oral mucosa characterized by juxta-epithelial inflammatory reaction along with hyalinization of lamina propria. These alterations causes fibrosis and stiffness of oral mucosa leading to limited mouth opening and related problems. Objective: To evaluate the frequency and clinical presentations of Oral Submucous fibrosis. Methods: A retrospective study conducted on patients attended to E N T outpatient department at Osmania General Hospital from January 2013 to December 2015. Patients with OSMF irrespective of age and gender were the inclusion criteria. The clinical presentations of patients were tabulated and analyzed by descriptive statistics. Results: A total number of 70 patients with OSMF were evaluated. The most commonage group was 11-25 years in the study. There were 42 male and 28 female patients with male female ratio of1.5:1The most common complaint of OSMF patients was burning sensation in oral cavity followed by decreasedmouth opening,recurrent oral ulceration and dryness of mouth. The majority of patients presented with an advanced stage of disease with grade 3 inter-incisal distance. Conclusion: OSMF is becoming a disease of younger adults with a slight male predilection. The majority of patients presents with a progressive and advanced form of disease.

Etiopathogenesis and Treatment Strategies of Oral Submucous Fibrosis

Journal of Indian Academy of Oral Medicine and Radiology, 2011

Oral submucous fibrosis (OSMF) is not only a chronic debilitating disease but a premalignant condition of the oral cavity strongly associated with betel nut and gutkha chewing, and characterized by: 1. Generalized submucosal fibrosis of the oral soft tissue, resulting in marked rigidity and progressive inability to open the mouth and restricted movements of tongue. 2. Reduction in the vasculature which appears as oral mucosal pallor. 3. Atrophy of the surface epithelium. 4. Dysphagia, which may occur in severe cases.

Oral Submucous Fibrosis-A Case Report

Advances in Cytology & Pathology, 2017

Oral sub mucous fibrosis (OSMF) is a chronic, insidious, disabling disease of oral mucosa, oropharynx, and rarely, the larynx affecting millions of people worldwide with a prevalence rate of 0.4 % in Indian rural population. It results in difficulty to open the mouth and can be disabling to the patient. The awareness of such a condition among oral physicians can help in timely diagnosis and thus appropriate treatment can be administered depending on the degree of involvement. Patients with OSMF need treatment for trismus correction, reconstructive surgery for any simultaneous oral malignancy. A case of oral sub mucous fibrosis occurring in a 35 year old male patient is presented with emphasis on the review of literature.

Clinico-Pathological Study of 170 Cases of Oral Sub-Mucous Fibrosis

Abstract Introduction: Oral sub-mucous fi brosis (OSMF) is a chronic, irreversible, disease of the oral cavity characterized primarily by burning sensation in the mouth particularly while eating spicy food and progressive development of the inability to open mouth (trismus). Very few clinico-pathological study of OSMF has been published from India and the Indian subcontinent. Materials and Methods: We carried out a retrospective hospital-based clinico-pathological study of 170 patients diagnosed with OSMF attending the outpatient department of Oral and Maxillofacial Surgical Hospital, Rajkot, India and compared our fi ndings with those fi ndings published in earlier studies. Results: In our study of 170 patients with OSMF, male:female ratio was 23.28:1. The highest incidence of OSMF was in the age group 21-30 years (mean 22.70 years), the youngest patient being 8 years old and the oldest 60 years. Inter-incisal distance (IID) varied between 00.00 CM (complete trismus) and 3.70 CMS, average IID being 2.70 CMS. The burning sensation in the mouth was the most common complaint (94.11% patients) followed by vesiculations and ulcerations (83.52% patients). Duration of disease was 2-5 years Buccal mucosa was involved bilaterally in 98.82% patients and palatal mucosa in 92.94% patients. No correlation was found between histopathological and clinical fi ndings. Conclusions: Incidence of OSMF is rising with the younger population getting involved into pathological oral habits such as tobacco and supari (Areca nut) chewing. This article gives an insight into OSMF and adds to its clinico-pathological profi le. Key words: Mouth diseases, Mouth neoplasms, Oral pathology, Oral sub-mucous fi brosis, Retrospective study

ORAL SUBMUCOUS FIBROSIS- AN OVERVIEW

TJPRC, 2014

OSMF is a chronic condition of the oral cavity which results in permanent disability. The pathogenesis is poorly understood and the disease is difficult to treat. OSMF is associated with immunological changes (altered levels of serum immunoglobulins) and the effect of treatment (especially antioxidants and levamisole) on serum Ig is not known.

Oral Submucous Fibrosis: A Clinical Review

Madridge Journal of Dentistry and Oral Surgery, 2017

Oral submucous fibrosis (OSMF) is a chronic disease affecting any part of the oral cavity. Epithelial atrophy, juxtaepithelial inflammation and fibrosis of the lamina propria are common findings. In this review we discuss various components of OSMF, including the classification, aetiology, clinical presentation, pathogenesis, and a brief overview of its management.

Demographic and Clinical Profile of Oral Submucous Fibrosis: A Retrospective Study

Journal of Pharmaceutical Research International

Aims: Assessment of risk factors and the role of habit variables such as duration and frequency in the severity of OSMF and to ascertain the association of gender predilection for different habits and severity of OSMF. Study Design: Descriptive retrospective study. Place and Duration of Study: Department of Oral Medicine and Radiology, Rural Dental College, Pravara Institute of Medical Sciences (Deemed University), Loni Bk. between January 2012 and December 2019. Methodology: This descriptive retrospective study of 1790 OSMF patients was carried out at the tertiary level dental hospital in the rural population of Western Maharashtra. The clinicodemographic data including details of habits was collected for a period of 8 years. Results: The average age of the patient in the study was 32.8 years, with 16.5:1 M:F ratio. Significantly higher proportions of females (69.6%) were illiterate and belonged to low socioeconomic status.There was a statistically significant increase for areca nu...

ORAL SUBMUCOUS FIBROSIS – A SHORT REVIEW

Oral Submucous fibrosis (OSMF) is a well-known debilitating precancerous condition of oral cavity which results due to chewing tobacco, areca nuts and its related products. It is an irreversible condition with very high malignant potential. There is a dire need to curb this common but avoidable condition that is increasingly observed in the younger age groups which leads to early development of oral cancer. The purpose of this article is to comprehend OSMF in totality and help the health professionals to get acquainted with the possible etiology, clinical features, differential diagnosis and current treatment modalities of OSMF along with the planning of promotive and preventive research to elucidate the solutions to the problem.