Osmf presentation

oral sub mucous fibrosis

1. Student name : Fatemah Ibrahim
Oral Submucous
Fibrosis

2. Introduction
Oral submucous fibrosis is a chronic disease ( PREMALIGNANT DISORDERS)
affecting the oral mucosa, as well as the pharynx and the upper two-thirds of
the esophagus.
Although occasionally preceded by and / or associated with vesicle formation. ,
it is always associated with juxta-epithelial inflammatory reaction followed by
fiberoelastc changes of the lamina propria with epithelial atrophy leading to
stiffness of the oral mucosa and causing trismus and inability to eat .

3. The condition is caused primarily by areca nut chewing
Depending on regional customs, this nut from the Areca catechu palm tree
may be chewed alone or in combination with other substances
There is dose dependence between areca quid chewing habit and the
development of this oral mucosal disorder.
Areca nuts contain alkaloids, of which are coline seems to be a primary
etiologic factor.8
Etiology :

4. Initially, the patient may complain of a
burning sensation or intolerance to spicy
foods.
Oral examination during early disease stages
may reveal vesicles, petechiae, xerostomia,
and melanosis.
With progression of the condition, fibrosis
results in mucosal pallor, rigidity, and trismus.
Clinical finding

5. In advanced cases, submucosal fibrous
bands may be evident upon palpation of the
buccal mucosa, labial mucosa, and soft
palate.
Additional possible findings include a
shrunken uvula, depapillated tongue,
ulceration, and erythema.
Sometimes mucosal alterations can extend
into the upper esophagus.
More than 25% of the patients also exhibit
oral leukoplakias.
94
Clinical finding

7. Histopathologic
features
Oral submucous fibrosis is characterized by
the submucosal deposition of dense and
hypovascular collagenous connective tissue
with variable numbers of chronic
inflammatory cells
Epithelial changes include subepithelial
vesicles in early lesions and hyperkeratosis
with marked epithelial atrophy in older
lesions.

8. Diagnosis
The diagnosis is based on the clinical characteristics and on the patient’s report of a habit
of betel chewing
An international consensus has been reached where at least one of the following
characteristics should be present:
Palpable fibrous bands
Mucosal texture feels tough and leathery
Blanching of mucosa together with histopathologic features consistent with oral
submucous fibrosis

9. MORSICATIO BUCCARUM :
histopathologically is similar to
OSMF
ANEMIC STOMATITIS: because of
presence of Dysphagia concomitant
with OSMF, patient will have reduced
diet and hence nutritional deficiency
and finally resulting anemia
SCLERODERMA: a connective tissue
disorder resulting in trismus and
stiffness of mucosa
VERTICAL SCAR BAND: if patient
gives history of minor or major
surgical procedures
Differential diagnosis

10. Management
Patients should be advised to discontinue areca nut use .
however, once trismus has developed, habit cessation does not induce regression
of the condition.
Mild cases can be treated with intralesional corticosteroids.
Severe cases may require surgical intervention and physiotherapy, although
relapse is common.
Alternative treatments include interferon gamma, proteolytic enzymes,
pentoxyfilline, antioxidants, vitamins, and minerals.
There is risk for development of oral squamous cell carcinoma. Estimated
malignant transformation rates for oral submucous fibrosis range from 2% to 8%

11. Conclusion
In summary , the available literature indicates that the main aetiological factor
for OSMF are the constituents of areca nut , mainly Arecoline .
The use of areca nut should be avoided in commercial smokeless tobacco
products .

12. References

13. Thank you for listening !