Oral sub mucous fibrosis

Oral sub mucous fibrosis is a chronic debilitating disease of the oral cavity
characterized by inflammation and progressive fibrosis of the submucosal
tissues (lamina propria and deeper connective tissues). Oral sub mucous fibrosis results in
marked rigidity and an eventual inability to open the mouth. Oral Sub mucous Fibrosis (OSMF)
is a potentially malignant disorder.
Osmf was first described by Schwartz in 1952 as “Atropica idiopathica mucosae oris” and later
by Jens J. Lindborg in 1966 as “an insidious, chronic disease that affects any part of the oral
cavity and sometimes the pharynx. (OSMF) now is traditionally described as “a chronic,
insidious, scarring disease of the oral cavity, often with involvement of the pharynx and the
upper esophagus”.
Clinically: it is sometimes associated with, the formation of vesicles, but always associated
with a juxta epithelial inflammatory reaction followed by fibroelastic change of the lamina
propria and epithelial atrophy that leads to stiffness of the oral mucosa and causes trismus and
an inability to eat”. OSMF is also characterized by reduced movement and depapillation of the
tongue, blanching and leathery texture of the oral mucosa, progressive reduction of mouth
opening, and shrunken uvula. Other terms used to describe OSMF include idiopathic
scleroderma of the mouth, juxta epithelial fibrosis, idiopathic palatal fibrosis, diffuse oral sub
mucous fibrosis, and sclerosing stomatitis
Epidemiology, etiology and risk factor: Although the etiopathogenesis of this disease is
multifactorial, with Millions of individuals affected, especially in South and South East Asian
countries with a more female predominance. The main risk factor is believed to be areca nut
chewing. Contributory risk factors suggested includes chewing of smokeless tobacco, high
intake of chilies, toxic levels of copper in foodstuffs and masticatories, vitamin deficiencies, and
malnutrition resulting in low levels of serum proteins, anemia and genetic predisposition. Due to
its high morbidity and high malignant transformation rate, constant efforts have been made to
develop effective management of osmf.
Diagnosis: solid biopsies are necessary to assist with clinical diagnoses and therapeutic
planning. In histological staging/classification, the number and distribution of fibroblasts,
collagen fibers, inflammatory cells, and blood vessels are used to determine whether OSF is at
an early, intermediate, or advanced stage. Moreover, biomarkers such as proteins, mRNAs, and
non-coding RNAs are applied towards OSF staging and classification.
The treatment of OSMF: depends on the degree of disease progression and clinical
involvement. At early stages, stopping habit and nutritional supplements are done. At
moderate stages, conservative treatment such as intralesional injections along with medical
treatment is provided. At advanced stages, surgical interventions are neede
REFERENCES

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