Comparative Study of Clinical Staging of Oral Submucous Fibrosis with Qualitative Analysis of Collagen Fibres Under Polarized Microscopy

Document Type: Original Research

Authors

Dept. Of Oral Pathology and Microbiology, Padm. Dr. D. Y. Patil Dental College and Hospital, Navi Mumbai, India.

10.7508/ijp.2015.02.005

Abstract

Background & Objectives: Oral submucous fibrosis (OSMF) is a condition where excessive deposition of dense collagen fibers occurred in the connective tissue of oral mucosa. An alteration of collagen necessitates an in depth understanding of collagen in oral tissues as no breakthrough studies have been reported. Therefore the aim was to correlate the clinical, functional and histopathological staging and to analyze the polarization colors and thickness of the collagen fibers in different stages of OSMF using picrosirius red stain under polarizing microscopy so as to assess the severity of disease. Methods: The study was conducted in the department of Oral Pathology and Microbiology at Padm. Dr. D. Y Patil Dental and Hospital, Navi Mumbai, India (2012-13). A sample size was of a total 40 subjects, of which 30 patients had OSMF, and 10 were in control group. Clinical, functional and histopathological staging were done depending upon definite criteria. Collagen fibers were analyzed for polarizing colors and thickness. Further clinical, functional and histopathological stages as well as qualitative parameters of collagen fibers were compared. Results: The correlation  between  clinical and functional staging was not significant (P>0.05) whereas the comparison of the functional staging with histopathological staging was more reliable (P<0.01) as an indication to the severity of the disease rather than clinical staging. One-way ANOVA analysis showed highly significant correlation between functional staging and polarization colors and thickness of collagen fibers (P<0.001). Conclusion: The  qualitative  change  in  the  collagen  fibers  of  OSMF  patients  using  polarized microscopy would help to assess its role in diagnostic evaluation, to determine the prognosis of the disease as well as to provide useful predictive treatment modalities to them.

Keywords


  1. More CB, Gupta S, Joshi J, Varma SN. Classification System for Oral Submucous Fibrosis. J Indian Aca Oral Med Radio l2012;24(1):24-9.
  2. Rajendran R, Sivapathasundharam B. Shafer’s Textbook of Oral Pathology. 6th ed. Noida:Elsevier;2009.
  3. Khan S, Chatra L, Prashanth SK, Veena KM, Rao PK. Pathogenesis of oral submucous fibrosis. J Can Res Ther 2012;8(2):199-03.
  4. Goel S, Ahmed J, Singh MP, Nahar P. Oral Submucous Fibrosis: A Clinico-Histopathological Comparative Study in Population of Southern Rajasthan. J Carcinogene Mutagene 2010;1(2):108-11.
  5. Junqueira LCU, Bignolas G, Brentani RR. A simple and sensitive method for the quantitative estimation of collagen. Anal Biochem 1979;94(1):96-9.
  6. Pindborg JJ, Sirsat SM. Oral submucous fibrosis. Oral Surg Oral Med Oral Pathol 1966;22(6):764-79.
  7. Rooban T, Saraswathi TR, Al Zainab FH, Devi U, Elizabeth J, Ranganathan K. A light microscopic study of fibrosis involving muscle in oral submucous fibrosis. Indian J Dent Res 2005;16(4):131-4.
  8. Haider SM, Merchant AT, Fikree FF, Rahbar MH. Clinical and functional staging of OSMF. Br J Oral MaxillofacSurg 2000;38(1):12-5.
  9. Gupta SC, Yadav YC. MISI an etiologic factor in oral submucous fibrosis. Ind J Otolaryngol 1978;30(1):5-6.
  10. Cox SC, Walker DM. Oral Submucous fibrosis: A review. Aust Dent J 1996;41(5):294-9.
  11. Wahi PN, Luthra UK, Kapur VL. Submucous fibrosis of oral cavity- Histomorphological studies. Br J Cancer 1966;20(4):676- 87.
  12. Pindborg JJ, Bhonsle RB, Murti PR, Gupta PC, Daftary DK, Mehta FS. Incidence and early forms of  oral  submucous  fibrosis.  Oral  Surg  Oral  Med  Oral Pathol1980;50(1):40- 4.
  13. Sinor PN, Gupta PC, Murti PR, Bhonsle RB, Daftary DK, Mehta FS, et al.A case-control study of  oral  submucous  fibrosis  with  special  reference to the etiologic role of areca nut. J Oral Pathol Med 1990;19(2):94-8.
  14. Maher R, Lee AJ, Warnakulasuriya KAAS, Lewis JA, Johnson NW. Role of areca nut in the causation of oral submucous fibrosis: a case control study in Pakistan. J Oral Pathol Med 1994;23(2):65-9.
  15. Seedat HA, Van Wyk CW. Betel-nut chewing and  submucous  fibrosis  in  Durban.  S  Afr  Med  J 1988;74(12):568-71.
  16. Ranganathan K, Devi MU, Joshua E, KiranKumar K,  Saraswathi  TR.  Oral  submucous  fibrosis:  a  casecontrol study in Chennai, South India. J Oral Pathol Med 2004;33(5):274-7.
  17. KiranKumar K, Saraswathi TR, Ranganathan K, Devi  UM,  Elizabeth  J.  Oral  submucous  fibrosis:  A clinico-histopathological study in Chennai. Indian J Dent Res 2007;18(3):106-11.
  18. Pandya S, Chaudhary AK, Singh M, Singh MN, Mehotra R. Correlation of histopathological diagnosis with  habits  and  clinical  findings  in  oral  submucous fibrosis Head Neck Oncol 2009;1(1):1-10.
  19. Sharma R, Raj SS, Miahra G, Reddy YG, Shenava S, Narang P. Prevalence of Oral Submucous Fibrosis in Patients visiting Dental College in Rural Area of Jaipur, Rajasthan. J Indian Aca Oral Med Radiol 2012;24(1):1-4.
  20. Shah N, Kumar R, Singh MK. Hematological and Histological studies in Oral Submucous Fibrosis. JIDA 1993;64(12):383-8.
  21. Singh M, Chaudhary AK, Pandya S, Debnath S, Singh MN, Singh PA, et al.Morphometric Analysis in Potentially Malignant Head and Neck Lesion: Oral Submucous Fibrosis. Asian Pac J Cancer Prev 2010;11(1):257-60.
  22. Junqueira LCU, Bignolas G, Brentani RR. Picrosirius staining plus polarization microscopy, a specific method for collagen detection in tissue section. Histochem J 1979;11(4):447-55.
  23. Pindborg JJ, Mehta FS, Gupta PC, Daftary DK. Prevalence  of  oral  submucous  fibrosis  among  59,915 Indian villagers. Br J Cancer 1968;22(4):646-54.
  24. Khanna JN, Andrade NN. Oral submucous fibrosis: a new concept in surgical management– Report of 100 cases. Int J Oral MaxillofacSurg 1995;24(6):433-9.
  25. Johnson NW, Maher R, Trivedy C, Warnekulasureiya S. The Clinical Condition and Pathology of Oral Submucous fibrosis. Oral Dis 1997;3(4):278-9.
  26. Junqueira LCU, Montes GS, Sanchez EM. The influence  of  tissue  section  thickness  on  the  study  of collagen by the Picrosirius – polarization method. Histochem 1982; 74(1):153-6.
  27. Shivakumar GC, Sahana S. Clinical Staging of Oral Submucous Fibrosis: A Review. Int J Oral-Med Sci 2011;10(3):216-9.