Title: Tracking OSMF treatment framework: Diagnostic protocols with treatment planning and case reflections
Abstract:
Oral submucous fibrosis is a premalignant condition caused by betel nut chewing. OSMF can lead to squamous cell carcinoma, a risk that is further increased by concomitant tobacco consumption. OSMF is a diagnosis which is based on clinical symptoms and confirmed by histopathology. Hypovascularity leading to blanching of the oral mucosa, staining of teeth and gingiva, burning sensation, and trismus are major symptoms. Major constituents of betel quid are arecoline and copper, which are responsible for fibroblast dysfunction and fibrosis. A variety of extracellular and intracellular signaling pathways might be involved. Treatment of OSMF is difficult, as not many large, randomized controlled trials have been conducted. The principal actions of drug therapy include antifibrotic, anti-inflammatory, and antioxygen radical mechanisms. Potential new drugs are on the horizon. Surgery may be necessary in advanced cases of trismus. The surgical management of this condition involves excision of the fibrotic bands and interpositional grafts to retain the increased oral opening. Various procedures and graft material have been utilised with differing success rates.Prevention is most important, as only minimal healing can be achieved with available treatments.
