Altered elemental profile as indicator of homeostatic imbalance in pathogenesis of oral submucous fibrosis

Evaluation of Copper Levels in Dental Calculus of OSF Patients with Chewing Dried Areca-Nut Quids in Hunan Province of Mainland China

Dental calculus is a potential material that can be used for assessing chronic exposure to trace heavy metals in oral cavity as it is a long-term reservoir. The aim of this study was to investigate the correlation between dental calculus copper levels and risk of oral submucous fibrosis (OSF) due to chewing dried areca-nut quids in Mainland China. This study included 34 OSF (grade 1) sufferers with dried areca-nut quids chewing as the patient group and 23 healthy individuals without areca-nut chewing as the control group. The dental calculus sample was obtained from all 57 participants and evaluated by inductively coupled plasma mass spectrometry (ICP-MS) for dental calculus level of copper. This work revealed that the mean copper level of dental calculus was significantly higher in OSF (grade 1) sufferers with areca-nut chewing than those in healthy individuals without areca-nut chewing (p < 0.001). This work provided an evidence to support that there may be a positive correlation between elevated levels of copper in dental calculus caused by chewing dried areca-nut quids and an increased risk of developing OSF in Mainland China.

Zinc, Copper, and Iron in Oral Submucous Fibrosis: A Meta-Analysis

Oral submucous fibrosis (OSF) is a potentially malignant disorder which causes fibrosis and inflammation of the oral mucosa. Studies have reported altered levels of trace elements in oral submucous fibrosis subjects, but findings have been inconsistent. The objective of this research is to perform a meta-analysis to summarize studies that report zinc (Zn), copper (Cu), and iron (Fe) in patients, with and without OSF. A literature search of Embase, PubMed, Cochrane Library, and Web of Science electronic databases was conducted for studies up to January 2017. A total of 34 reports met the inclusion criteria. The standardized mean difference was utilized as the effect size. The robust variance estimation method was chosen to handle dependency of multiple related outcomes in meta-analysis. There was a significant increase in the levels of Cu (effect size = 1.17, p value < 0.05, 95% confidence interval (CI): 0.164–2.171) and a significant decrease in levels of Zn (effect size = −1.95, p value < 0.05, 95% CI: −3.524 to −0.367) and Fe (effect size = −2.77, p value < 0.01, 95% CI: −4.126 to −1.406) in OSF patients. The estimation of Zn, Cu, and Fe levels may serve as additional biomarkers in the diagnosis and prognosis of OSF along with the clinical features.

Salivary copper and zinc levels in oral pre-malignant and malignant lesions

Recent technological advances have made saliva as a tool for diagnosis of many things; among them are hormone imbalances, liver function, immunodeficiency and even cancer.

Autofluorescence spectroscopy of betel quid chewers and oral submucous fibrosis: A pilot study

Context:

Oral lesions related to the use of commercially available tobacco (gutkha) is going to pose a major challenge for health care providers in India. Therefore, techniques that are useful for mass screening of the public for early identification of pre-cancerous lesions and conditions are necessary to overcome this challenge.

Aims:

To identify the differences in autofluorescence spectra of normal oral mucosa, mucosa of betel quid chewers, and mucosa of oral sub mucous fibrosis.

Materials and Methods:

Group I consist of 15 individuals with clinical diagnosis of oral submucous fibrosis, Group II consists of 18 individuals without oral submucous fibrosis, having the habit of betel quid (gutkha) chewing and Group III consists of 18 normal individuals without the habit of betel quid chewing. Both males and females were included in the study with their age ranging from 18 to 53 years. In vivo fluorescence spectra were obtained using an optical fibre probe attached to Fluoromax-2 spectrofluorometer in the Department of Medical Physics, Anna University, Chennai, India.

Statistical Analysis Used:

Fisher's Chi square test was used for statistical analysis. Probability value (P value) was also obtained to discriminate the statistical differences between the three groups.

Results:

The averaged emission and excitation spectra of oral submucous fibrosis was significantly less compared to normal mucosa and betel quid chewers. The statistical findings showed significant differences (P<0.001) between oral submucous fibrosis and the other two groups.

Conclusions:

Fluorescence spectroscopy can be used effectively for diagnosing the individuals affected by OSMF. However, this technique was unable to discriminate the betel chewers mucosa from normal individuals.

Correlation of trace elemental profiles in blood samples of Indian patients with leukoplakia and oral submucous fibrosis

In order to ascertain possible correlation between alterations in trace elemental profile and the progression or regression of two most common potentially malignant disorders affecting oral cavity, namely oral submucous fibrosis and leukoplakia, blood from 60 patients from each group of patients as well from 30 healthy individuals was analyzed for elemental profiling employing EDXRF technique. Out of the 16 detected elements (K, Si, Ca, V, Cr, Ni, Mn, Fe, Cu, Zn, Se, Br, Rb, Sr, Co, and Pb), Mn, Fe, Zn, Br, and Co showed remarkable alteration in their profile in both leukoplakia and oral submucous fibrosis patients with respect to the normal healthy individuals. While Zn, Br, and Fe reflected similar changes--showing gross depletion in both the diseased groups, Mn and Co depicted inverse pattern of alterations in their concentrations in the two types of precancerous disorders when compared to the control subjects.

Zinc and vitamin A can minimise the severity of oral submucous fibrosis

We report a case of a 24-year-old man who presented with a complaint of reduced mouth opening and a burning sensation. On examination, he was clinically diagnosed with oral submucous fibrosis (OSF). Following routine biopsy and histopathological confirmation of OSF, the patient was supplemented with zinc acetate along with vitamin A and was followed up for 4 months. Following treatment the patient reported increased mouth opening and a reduced burning sensation. Histopathologically re-epithelialisation was evident along with the appearance of normal rete pegs. The data for mouth opening, collagen content and epithelial thickness of six other cases similarly treated are also presented, showing a significant increase in mouth opening and epithelial thickness and decrease in collagen content. We propose the use of zinc acetate and vitamin A for the management of OSF.

Automated classification of cells in sub-epithelial connective tissue of oral sub-mucous fibrosis-an SVM based approach

Quantitative evaluation of histopathological features is not only vital for precise characterization of any precancerous condition but also crucial in developing automated computer aided diagnostic system. In this study segmentation and classification of sub-epithelial connective tissue (SECT) cells except endothelial cells in oral mucosa of normal and OSF conditions has been reported. Segmentation has been carried out using multi-level thresholding and subsequently the cell population has been classified using support vector machine (SVM) based classifier. Moreover, the geometric features used here have been observed to be statistically significant, which enhance the statistical learning potential and classification accuracy of the classifier. Automated classification of SECT cells characterizes this precancerous condition very precisely in a quantitative manner and unveils the opportunity to understand OSF related changes in cell population having definite geometric properties. The paper presents an automated classification method for understanding the deviation of normal structural profile of oral mucosa during precancerous changes.

Performance analysis of different wavelet feature vectors in quantification of oral precancerous condition

This paper presents an automatic method for classification of progressive stages of oral precancerous conditions like oral submucous fibrosis (OSF). The classifier used is a three-layered feed-forward neural network and the feature vector, is formed by calculating the wavelet coefficients. Four wavelet decomposition functions, namely GABOR, HAAR, DB2 and DB4 have been used to extract the feature vector set and their performance has been compared. The samples used are transmission electron microscopic (TEM) images of collagen fibers from oral subepithelial region of normal and OSF patients. The trained network could classify normal fibers from less advanced and advanced stages of OSF successfully.

A novel wavelet neural network based pathological stage detection technique for an oral precancerous condition

AIM

To describe a novel neural network based oral precancer (oral submucous fibrosis; OSF) stage detection method.

METHOD

The wavelet coefficients of transmission electron microscopy images of collagen fibres from normal oral submucosa and OSF tissues were used to choose the feature vector which, in turn, was used to train the artificial neural network.

RESULTS

The trained network was able to classify normal and oral precancer stages (less advanced and advanced) after obtaining the image as an input.

CONCLUSIONS

The results obtained from this proposed technique were promising and suggest that with further optimisation this method could be used to detect and stage OSF, and could be adapted for other conditions.