Establishing a new staging system for oral submucous fibrosis and correlation of the proposed staging system to traditional histopathological grading: A clinico-histopathological study

Background & objectives: Oral submucous fibrosis (OSF) is a potentially malignant disorder of the oral cavity leading to reduction in mouth opening. Mouth opening assessment is used as one of the methods to assess the severity of the disease. In this study the normal maximum mouth-opening capaci...

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Main Authors: Shaul Hameed K., Laxmikant Chatra, Prashanth Shenai
Format: Article
Language:English
Published: Springer 2019-10-01
Series:Saudi Dental Journal
Online Access:http://www.sciencedirect.com/science/article/pii/S1013905218307600
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author Shaul Hameed K.
Laxmikant Chatra
Prashanth Shenai
author_facet Shaul Hameed K.
Laxmikant Chatra
Prashanth Shenai
author_sort Shaul Hameed K.
collection DOAJ
description Background & objectives: Oral submucous fibrosis (OSF) is a potentially malignant disorder of the oral cavity leading to reduction in mouth opening. Mouth opening assessment is used as one of the methods to assess the severity of the disease. In this study the normal maximum mouth-opening capacity of an individual is considered in assessing the reduction in mouth opening. This study was done to establish a new clinical staging pattern in OSF and to evaluate the relationship between the proposed staging system and traditional histopathological grading system of OSF. Materials and methods: The study included 50 clinically diagnosed OSF patients. Normal mouth opening was established by measuring three-finger index (TFI). Existing maximum mouth opening was established by measuring the interincisal distance. Presence of palpable vertical bands was recorded. Histopathological grading was done according to Pindborg and Sirsat. Percentage of reduction in mouth opening (PRMO) was calculated and the mean of PRMO in different clinical and histopathological stages was analysed by fisherman’s extract test. A new staging pattern for OSF was proposed from the data. Results: PRMO was assessed at different clinical stages. A range between 16% and 47% was obtained, and statistically the p value of <0.001 was very highly significant. Similarly, a range between 17% and 45.6% was obtained when PRMO was assessed at different histopathological grading; again the statistical value was very highly significant with a p value of <0.001. Conclusion: With the data obtained from our study, the following clinical staging pattern can be adapted: stage I indicates that the PRMO is <30%, Stage II between 30–45%, and stage III >45%. Hence it may be appropriate to asses the disease severity and stage by assessing the degree of disability (i.e., mouth opening reduction considering the individual normal mouth opening ability). The determination of PRMO may be a useful tool in this direction. Keywords: Maximum mouth opening, Three finger index, Percentage of reduction in mouth opening, Vernier caliper, Grading of oral submucous fibrosis
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spelling doaj-art-b8d7d65685be4984a10cdfdfb179167a2025-08-20T02:19:07ZengSpringerSaudi Dental Journal1013-90522019-10-0131444545010.1016/j.sdentj.2019.04.003Establishing a new staging system for oral submucous fibrosis and correlation of the proposed staging system to traditional histopathological grading: A clinico-histopathological studyShaul Hameed K.0Laxmikant Chatra1Prashanth Shenai2Department of Oral and Maxillofacial Radiology, College of Dentistry, Qassim University, Al-Qassim, Saudi Arabia; Corresponding author at: Department of Oral and Maxillofacial Radiology, College of Dentistry, Qassim University, Buraydh, Al-Qassim 52571, Saudi Arabia.Department of Oral Medicine and Radiology, Yenepoya Dental College, Yenepoya University, Mangalore, Karnataka, IndiaDepartment of Oral Medicine and Radiology, Yenepoya Dental College, Yenepoya University, Mangalore, Karnataka, IndiaBackground & objectives: Oral submucous fibrosis (OSF) is a potentially malignant disorder of the oral cavity leading to reduction in mouth opening. Mouth opening assessment is used as one of the methods to assess the severity of the disease. In this study the normal maximum mouth-opening capacity of an individual is considered in assessing the reduction in mouth opening. This study was done to establish a new clinical staging pattern in OSF and to evaluate the relationship between the proposed staging system and traditional histopathological grading system of OSF. Materials and methods: The study included 50 clinically diagnosed OSF patients. Normal mouth opening was established by measuring three-finger index (TFI). Existing maximum mouth opening was established by measuring the interincisal distance. Presence of palpable vertical bands was recorded. Histopathological grading was done according to Pindborg and Sirsat. Percentage of reduction in mouth opening (PRMO) was calculated and the mean of PRMO in different clinical and histopathological stages was analysed by fisherman’s extract test. A new staging pattern for OSF was proposed from the data. Results: PRMO was assessed at different clinical stages. A range between 16% and 47% was obtained, and statistically the p value of <0.001 was very highly significant. Similarly, a range between 17% and 45.6% was obtained when PRMO was assessed at different histopathological grading; again the statistical value was very highly significant with a p value of <0.001. Conclusion: With the data obtained from our study, the following clinical staging pattern can be adapted: stage I indicates that the PRMO is <30%, Stage II between 30–45%, and stage III >45%. Hence it may be appropriate to asses the disease severity and stage by assessing the degree of disability (i.e., mouth opening reduction considering the individual normal mouth opening ability). The determination of PRMO may be a useful tool in this direction. Keywords: Maximum mouth opening, Three finger index, Percentage of reduction in mouth opening, Vernier caliper, Grading of oral submucous fibrosishttp://www.sciencedirect.com/science/article/pii/S1013905218307600
spellingShingle Shaul Hameed K.
Laxmikant Chatra
Prashanth Shenai
Establishing a new staging system for oral submucous fibrosis and correlation of the proposed staging system to traditional histopathological grading: A clinico-histopathological study
Saudi Dental Journal
title Establishing a new staging system for oral submucous fibrosis and correlation of the proposed staging system to traditional histopathological grading: A clinico-histopathological study
title_full Establishing a new staging system for oral submucous fibrosis and correlation of the proposed staging system to traditional histopathological grading: A clinico-histopathological study
title_fullStr Establishing a new staging system for oral submucous fibrosis and correlation of the proposed staging system to traditional histopathological grading: A clinico-histopathological study
title_full_unstemmed Establishing a new staging system for oral submucous fibrosis and correlation of the proposed staging system to traditional histopathological grading: A clinico-histopathological study
title_short Establishing a new staging system for oral submucous fibrosis and correlation of the proposed staging system to traditional histopathological grading: A clinico-histopathological study
title_sort establishing a new staging system for oral submucous fibrosis and correlation of the proposed staging system to traditional histopathological grading a clinico histopathological study
url http://www.sciencedirect.com/science/article/pii/S1013905218307600
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