HOW TO FIND ORAL SUBMUCOSAL FIBROSIS IN A PATIENT?

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 ORAL SUBMUCOUS FIBROSIS

DEFINITION

SIRSAT AND PINDBORGS :

An insidious chronic disease affecting any part of oral cavity and sometimes pharynx,occasionally preceded by /associated with vesicle formation and always associated with juxta epithelial inflammatory reaction followed by hyalinisation of lamina propria with epithelial atrophy leading to stiffness of oral mucosa and progressive limitation in mouth opening

  • In 1952,SG JOSHI coined the term oral submucous fibrosis 

ETIOLOGY:

  • Arecanut
  • Chilli
  • Genetic
  • Autoimmunity 
  • Composition of arecanut :alkaloid,flavonoid 

predisposing factors :Nutritional deficiency 

RATE OF INCIDENCE:

1984  - 4.5%

1990 - 7.6%

2000  - 13.33%



PATHOGENESIS:

  1. Oral mucosa
  2. Betel quid habit 
  3. Constant irritation
  4. Chronic inflammation
  5. Activated t-cell and macrophage at the site 
  6. Transforming growth factor : Increases collagen production,Decreases collagen degradation
  7. Increased collagen production 
  8. FIBROSIS 
  9. Increase in cytokines (interleukin-6,interferon gamma,tumour necrosis factor)




CLINICAL FEATURES :

AGE: 20-40 YEARS

GENDER:MALE:FEMALE 

                     4:1

SITE: Buccal mucosa ,soft palate ,uvula ,floor of mouth,gingiva,tongue 

  • Sunken face appearance 
  • Localised ,diffuse,reticular :type of blanching 
  • Uvula : bud,hockey 
  • Depapillation of tongue 
  • Trismus (restricted mouth opening )
  • Angular cheilitis
  • Burning sensation 
  • Pallor of mucosa
  • Palpable vertical bands 

INITIAL STAGES:

  • Vesicles
  • Petechiae
  • Melanosis
  • Xerostomia


   HOW TO FIND ORAL SUBMUCOUS FIBROSIS IN A PATIENT ?

1)History of betel quid

2)According to concern criteria 

  • Palpable vertical bands 
  • Mucosal texture -tough,leathery 
  • Blanching of mucosa

3)LABORATORY INVESTIGATION:

  • Decreased hemoglobin ,iron,vitamin b complex
  • increased erythrocyte sedimentation rate 
  • HEMATOLOGICAL 
  • IRON
  • SERUM IRON
  • ESR


TREATMENT:

  • 5A : ASK,ADVISE,ASSIST(2),ARRANGE 
  • Blood promoting agent 
  • Antoxid capsule:beta-carotene,zinc sulphate,copper sulphate ,monohydrated selenium dioxide 

STAGE 1: ANTOXID CAPSULE

STAGE 2: ANTOXID CAPSULE +STEROID 



  • STEROID: Dexamethasone 4 mg 

  • Suppress inflammatory reaction there by preventing fibrosis by decreasing fibroblastic proliferation 

Hyaluronidase 1500 mg (0.5ml) weekly twice daily for 4 - 8 weeks 

  • Fibrinolytic enzyme
  • Decrease collagen formation
  • Decrease viscosity of intercellular substance 

Curcumine +gingely oil -massage 

  • Antioxidant,anti-inflammatory,Fibrinolytic,inhibit collagen synthesis ,promotes apoptosis 

  • licostar-selenium,licopine,calcium,carotenoid,zinc,wheat germ oil 

    licopine -8 mg twice daily for 3 months

  • Bright red carotenoid pigment 
  • Tomato,watermelon,red chilli 
  • Antioxidant activity 
  • Inhibit cancer cell proliferation
  • Growth factor stimulation,restore gap function
  • Laser
  • Surgery
  • Chemotherapy 




AIM OF THIS POST ;

Today we started with definition of oral submucous fibrosis,then etiology,rate of incidence,pathogenesis,clinical features,how to find oral submucous fibrosis patient then finally we discussed about treatment options .hope this post would have been informative ,if this post helped you then do let me know in the comment section below as this would motivate me to post more such content .Stay connected through instagram as well to receive updates on recent post .

CONTACT DETAILS:

EMAIL:stencildent@gmail.com

INSTAGRAM:stencildent 

                           THANK YOU 




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