Alterations in expression of retinoid receptor beta and p53 in oral submucous fibrosis

Areca nut in pathogenesis of oral submucous fibrosis: revisited

BACKGROUND

Oral submucous fibrosis is a disease due to a chronic, insidious change in fibro-elasticity, characterized by burning sensation in the oral cavity, blanching, and stiffening of the oral mucosa and oropharynx leading to trismus and inability to open the mouth. The symptoms and signs depend on the progression of the lesions and number of affected sites. It is predominantly seen in Indians and other Asians. Once the disease has developed, there is neither regression nor any effective treatment. It is considered as a pre-malignant stage of oral cancer, and the reported risk of malignant transformation varies from 2.3-7.6%.

CONCLUSIONS

The common etiological factor considered for this unremitting disease is use of areca nut; however, the precise mechanism still remains elusive and controversial. A wide range of treatment consisting of drugs, surgical therapy, and physiotherapy have been attempted till date, with varying degrees of benefit, but none of them have proved to be a cure for this disease. This field remains open for clinical trials and research. This paper aims to give an overview on the role of areca nut in the pathogenesis and malignant potential of oral submucous fibrosis.

Artificial dermis as the substitute for split-thickness skin graft in the treatment of oral submucous fibrosis

OBJECTIVES

The aim of this study was to investigate the viability of artificial dermis as a substitute for split-thickness skin graft in the treatment of oral submucous fibrosis (OSF).

METHODS

The study was conducted on 21 patients who had undergone surgical treatment of trismus caused by OSF. Artificial dermis grafts were used to repair the surgical defects after surgery on the fibrous bands. The changes in the interincisal distances (IDs) were analyzed in the preoperative, intraoperative, and postoperative stages. All the patients were followed up for at least 3 months.

RESULTS

All the patients habitually chewed betel nuts. The overall success rate was 100% without any or only partial graft loss. There were no reports of immunologic reactions or significant complications. The mean preoperative, intraoperative, and final follow-up IDs were 15.5, 35, and 25 mm, respectively. Evaluation of the changes in the IDs revealed statistically significant differences between the values recorded at the different stages.

CONCLUSIONS

Artificial dermis may be an alternative to split-thickness skin grafts in patients with OSF with moderate trismus.