Pathogenesis of oral submucous fibrosis. Relationship to risk factors associated with oral cancer

Abstract

Oral submucous fibrosis (OSF) is a chronic disease of the oral mucosa characterized by inflammation and a progressive fibrosis of the lamina propria and deeper connective tissues. It is a condition predominantly seen among people of Indian origin, and an epidemiologic survey done a decade ago showed no less than 250,000 cases in India, a figure that must have increased sharply. OSF is a condition with a high risk of malignant transformation; to date, no conclusive etiologic agent has been identified, although plenty of data have been generated on various aspects of the disease. These include genetic, carcinogenic, immunologic, viral, nutritional, and autoimmune possibilities, all of which also have been implicated in the development of oral cancer. This article reviews existing evidence on the pathogenesis of OSF and its relation to oral cancer and suggests a possible multifactorial model to explain the disease process.

Oral cancer in the UK: to screen or not to screen

“…Oral submucous ®brosis (OSMF) is a chronic disease of the oral mucosa which occurs predominantly among people of Indian origin and occasionally among other Asians. Sporadic cases have been reported among non-Asians (Europeans) [68,69]. The prevalence of OSMF in India ranges from 0.2 to 1.2% [70].…”

Evaluation of Fibrotic Changes in OSMF:A Retrospective Study Using Special Stains and Polarizing Microscopy

“…The risk factors associated with the development of cancer in OSMF needs to be understood. [18] In some cases the submucosal layer can show fibrosis prior to lamina propria involvement in the early stage of OSMF. [2] In such cases the clinical manifestations of xerostomia [19] leading to candidal colonization, [20,21] decay, early muscular involvement leading to reduction in mouth opening, alterations in the epithelium can occur leading to lethal consequences.…”

“Bilateral Coronoidotomy in Conjunction With Submucous Fibrous Bands Release As A Treatment Modality for Oral Submucous Fibrosis”

“…9 Pillai et al 10 also concluded in his review that the etiology is unknown but is probably multifactorial. Main contributing factor as thought by Jayanthi et al 11 , is the use of pan which typically consists of areca nut, tobacco and crude lime wrapped in betel leaf. The onset of this condition is insidious, majority of patients with OSMF present with prodromal symptoms such as burning sensation in the mouth when consuming spicy food, appearance of blisters especially in the palate.The hallmark of the disease is submucosal fibrosis that affects most parts of the oral cavity, pharynx and upper third of the oesophagus.…”