A Digital Cephalometric Study on The Morphometric Evaluation of Soft Palate in Oral Submucous Fibrosis

Abstract

Objective: Oral submucous fibrosis (OSMF) is a chronic precancerous condition affecting the oral cavity, which is progressive and characterised by burning sensation and fibrotic change leading to restriction of mouth opening. This study evaluated the morphology of soft palate in different stages of OSMF patients using digital lateral cephalogram and compare it with healthy individuals. Methods: The study included 60 subjects, who were grouped as 30 OSMF and 30 healthy subjects from the same geographic population. Digital lateral cephalograms were taken with Planmeca Proline XC (Oy, Helsinki, Finland). Soft palate morphology was evaluated using Lateral Cephalogram, and the results were analysed statistically. Results: Leaf-shaped (Type 1) soft palate was commonly seen in the control group and stage I and II OSMF. Stage III OSMF patients presented with a butt-shaped (Type 3) soft palate. As the disease progressed, there was a conversion of Type 1 variety of soft palate to Type 3 variety. There was a gradual reduction in the length of the soft palate in the anteroposterior direction in OSMF patients compared to the control group. Conclusion: Early cephalometric diagnosis of soft palate changes may play a pivotal role in the overall management of OSMF.

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“…However, in contrast to our study, Kotlarek et al saw a significant difference in the shape of the palate and the age of the subject [11]. Dimensions of the soft palate influences velopharyngeal functions such as eating, deglutition, speaking, and breathing abnormalities of the soft palate can be observed in patients with cleft palates, abnormal velum, submucous cleft palates, excessively large tonsils or adenoids, webbing of the posterior tonsillar pillars, obstructive sleep apnea, skeletal craniofacial malocclusions, and oral mucosal conditions such as Oral submucous fibrosis [4,5]. Increased length of soft palate is an airway factor significantly associated with obstructive sleep apnea.…”

“…Other common disorders encountered due to soft palate defect are obstructive sleep apnea which is characterized by repeated collapse of upper airway during sleep. Similarly, in Oral submucous fibrosis, the soft palate undergoes fibrosis resulting in reduced function [3][4][5]. Analyses of the various morphological patterns of the soft palate such as its shape, form, length, and width are therefore required to mark as indicators of potential risk factor of velopharyngeal insufficiency and function.…”

“…Studies have shown velar shapes to vary across ethnicity and race [10]. Soft palate patterns have been classified qualitatively as "straight," "rattail," "crook," "S," "butt," and "leaf' shaped [4], with the "Rat tail "and "Butt' patterns being the ones most commonly encountered. Studies of different patterns of the soft palate such as its shape, length and width, offer clues to potential risk factors of velopharyngeal incompetence, for instance, the length of the soft palate is a significant causative factor in obstructive sleep apnea.…”