Oral Submucus Firosis

Oral Submucus Firosis

Answer. OSMF is defined as “An insidious chronic disease affcting any part of oral cavity and sometime pharynx.

Although occasionally preceded by and/or associated with vesicle formation, it is always associated with juxtaepithelial inflammatory reaction followed by firoelastic changes in lamina propria, with epithelial atrophy leading to stiffess of oral mucosa and causing trismus and inability to eat.” Pindborg (1966)

Oral Submucus Firosis Etiology

• The OSMF is caused due to:
• Excessive consumption of red chillies.
• Excessive “areca nut” chewing.
• Nutritive deficiency
• Immunological factors
• Genetic factors
• Protracted tobacco use
• Patient with deficiency of micronutrients.
• Use of lime with areca nut
  

Oral Submucus Firosis Clinical Features

•  It is caused during 20 to 40 years of age.
• Females are affcted more than males.
• In OSMF firotic changes are frequently seen in buccal mucosa, retromolar area, uvula, tongue, etc.
• Initially patient complains of burning sensation in the mouth, particularly during taking hot and spicy foods.
• There can be excessive salivation, decreased salivation and defective gustatory sensation.
•  In initial phase of disease palpation of mucosa elicits a “wet leathery” feeling.
•  In advanced stage the oral mucosa loses its resilience and becomes blanched and stif and thereby causing trismus.
• Palpation of mucosa often reveals vertical firous bands.
  

Oral Submucus Firosis Histopathology

Microscopically OSMF reveals following features:

• Overlying hyper keratinized, atrophic epithelium often shows flattening and shortening of rete pegs.
• There can be variable degrees of cellular atypia or epithelial dysplasia.
• In OSMF dysplastic changes are found in epithelium which include nuclear pleomorphism, sever inter­cellular edema, etc.
• Stromal blood vessels are dilated and congested and there can be areas of hemorrhage.
•  Underlying connective tissue stroma in advanced stage of disease shows homogenization and hyalinization of collagen fiers.
•  Decreased number of firoblastic cells and narrowing of blood vessels due to perivascular firosis are present.
•  There can be presence of signet cells in some cases.

Oral Submucus Firosis Treatment

• Stoppage of all causing habits.
• Definitive treatment of OSMF includes intralesional injection of collagenase, corticosteroids and firinolysin, etc.
• Systemic administration of steroids in severe cases.