www.rxdentistry.co.

in
CLINICO PATHOLOGICAL
FEATURES SUBMUCOUS
FIBROSIS
 DEFINITION

It is an insidious chronic disease

affecting any part of the oral

cavity and sometimes the pharynx.

(Bulletin of World Health Organization, 1994)

 EPIDEMIOLOGY

 Incidence of OSMF in subcontinent is 0.2-

0.5% of population.

 Prevalence by gender varies from 0.2-2.3%

in males and 1.2-4.57% in females.

(International Journal of Dental Clinics 2011(1): 21-24 Oral sub mucous fibrosis : Correlation of

clinical grading to various habit factors)

www.rxdentistry.co.in
www.rxdentistry.co.in
Classification(Funtional)

 Khanna and Andrade in 1995 developed a group

classification system for the surgical management of
trismus:[6]
 Group I: Earliest stage without mouth opening
limitations with an interincisal distance of greater
than 35 mm.
 Group II: Patients with an interincisal distance of 26-
35 mm.
 Group III: Moderately advanced cases with an
interincisal distance of 15-26 mm. Fibrotic bands are
visible at the soft palate, and pterygomandibular raphe
and anterior pillars of fauces are present.

www.rxdentistry.co.in
 Group IVA: Trismus is severe, with an interincisal
distance of less than 15 mm and extensive fibrosis
of all the oral mucosa.

 Group IVB: Disease is most advanced, with

premalignant and malignant changes throughout
the mucosa.

www.rxdentistry.co.in
Clinically signs of OSMF can be grouped as:

 Stage I : Stage of stomatitis &

vesiculation

 Stage ll : Stage of fibrosis

 Stage III : Stage of sequelae

complication
 Etiopathogenesis

www.rxdentistry.co.in
Jacob BJ, Straif K, Thomas G, Ramadas K, Mathew B,Zhang ZF,
Rangaswamy S, Hashibe M.: Betel quid without tobacco as a risk factor for
oral precancers.Oral Oncology, 2012; 40:697–704.
www.rxdentistry.co.in
 S

Svakumar GC, Sahana S. Clinical staging of Oral Submucous fibrosis: A review. Int J Oral-Med Sci. 2011; 10(3): 216-9.
www.rxdentistry.co.in
Ekayanaka RP , Tilakaratne WM. Oral submucous fibrosis: Review on mechnisms of pathogenesis and malignant transformation. J
Carcinogene Mutagene. 2013; S5: 002.
www.rxdentistry.co.in
www.rxdentistry.co.in
www.rxdentistry.co.in
www.rxdentistry.co.in
CLINICAL FINDINGS
 Prodromal symptoms :
 Burning sensation on eating spicy food
 Ulceration or recurrent stomatitis
 Dryness of mouth.
 Later

 Difficulty in opening mouth

 Inability to whistle, blow
www.rxdentistry.co.in
www.rxdentistry.co.in
 DIAGNOSIS IS BASED ON :

 Palpable bands and restriction-of mouth opening.

 Severe burning sensation of mouth, aggravated by

use of even moderate spicy food.

 Biopsy report characteristically showing

histopathologically
www.rxdentistry.co.in
Malignant
Transformation

www.rxdentistry.co.in
Ekayanaka RP , Tilakaratne WM. Oral submucous fibrosis: Review on mechnisms of pathogenesis and malignant transformation. J
Carcinogene Mutagene. 2013; S5: 002.
www.rxdentistry.co.in
www.rxdentistry.co.in
www.rxdentistry.co.in
www.rxdentistry.co.in
www.rxdentistry.co.in
MANAGEMENT
 MANAGEMENT
 Various modalities of treatment have
been tried.
1.Restriction of habits/ Behavioral
therapy
2.Medicine therapy
3.Surgical therapy.
4.Oral Physiotherapy
 CONSERVATIVE TREATMENT :

 Antioxidants

 Intralesional injections of hyaluronidase.

 Use of Placentrix 2ml solution at interval

of 3 days in five divided region

 Topical application of 4% Acetic acid

(variable) 3 times daily.

www.rxdentistry.co.in
 SURGICAL TREATMENT

 Fibrotomy

 Cryosurgery

 Laser treatment
References
 1.Pindborg JJ. Oral submucous fibrosis: a review. Ann Acad Med Singapore. 1989
Sep;18(5):603-7. View Abstract
 2.Khanna JN, Andrade NN. Oral submucous fibrosis: a new concept in surgical
management. Report of 100 cases. Int J Oral Maxillofac Surg. 1995 Dec;24(6):433-9.
 3.Kakar PK, Puri RK, Venkatachalam VP. Oral submucous fibrosis--treatment with
hyalase. J Laryngol Otol. Jan 1985;99(1):57-9.
 4.Rajendran R, Rani V, Shaikh S. Pentoxifylline therapy: a new adjunct in the
treatment of oral submucous fibrosis. Indian J Dent Res. Oct-Dec 2006;17(4):190-8.
 5.Haque MF, Meghji S, Nazir R, Harris M. Interferon gamma (IFN-gamma) may
reverse oral submucous fibrosis. J Oral Pathol Med. Jan 2001;30(1):12-21.
 6.Krishnamoorthy B, Khan M. Management of oral submucous fibrosis by two different
drug regimens: A comparative study. Dental Research Journal 2013;10(4):527-532.
 7.Kumar A, Bagewadi A, Keluskar V, Singh M. Efficacy of lycopene in the management
of oral submucous fibrosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Feb
2007;103(2):207-13.