Lama El Banna

1. Oral submucosal fibrosis
Prepared by :
Dalia Al siksik
Nahla Al - Talaa
Boshra Al Shaear
Haneen Al - Ghaliz
Lama El Banna

2. supervision: Dr. Ashraf Shamia

3. Oral submucous fibrosis is a chronic,complex,
progressive,scarring premalignant condition of
the oral cavity, characterized by
juxta-epithelial inflammatory reaction and
progressive fibrosis of the submucosal tissues .
Oral submucosal fibrosis

5. ● Mainly in India and Pakistan due
to smokeless tobacco / chewing
of betel quid
● Reactive, but risk factor for
squamous cell carcinoma
●
● Early lesions show blanching,
mottled, marble-like
appearance; later fibrous bands
lead to stiffness, restricting
ability to open mouth (trismus)
Oral submucosal fibrosis

6. Oral submucosal fibrosis
Sites
● Buccal mucosa, lips, retromolar areas, soft palate

7. ETiology

8. Etiology
Oral submucous fibrosis is multifactorial….
placement of betel quid.
eating hot pepper.
tobacco chewing.
natural deficiency ex. Iron.

9. Betel quid

10. Hot pepper

11. tobacco

12. pathophysiology for betel quid .
$ arcea nut component of betel quid.
$ acrolin active alkaloid found in it stimulate
fibroblast to increase product of
collagen.
How
They are many studies

13. There are many studies
1 acroline elevate mRNA and protein
expression in cystin C
2 upregulated keratocyte growth factor 1
,insulinlike growth factor 1 ,interleuken
expression 6
3 inhibit metalloprotinase
Also betel quid contain
1 flavanoid ,catechin and tannin
2 solubile copper

14. Clinical Features

15. Age : 20-40 years old.
Site: oral cavity may extent to pharynx.
Vesicles formation and ulceration.
Oral burning sensation.
Xerostomia decreased salivary flow.
Why
The affected mucosa soft palate buccal
mucosa loses its resilience and become firm
and pde.

16. tongue become immobile diminish in
size devoiced of papilla defect
taste sensation.
stuff in the cheek difficult open
the mouth.
hearing loss stenosis the eustachian
tube.
Clinical Features

17. tongue become immobile diminish in
size devoiced of papilla defect
taste sensation.

18. Blanching in ventral surface of
tongue floor of the mouth and
difficulty in movement.
Clinical Features

19. stuff in the cheek difficult open the mouth.
Clinical Features

20. Clinical Features
Blanching over buccal mucosa.

21. Blanching soft palate
with deviation uvula.

22. Histology

28. Treatment

29. Treatment and Prognosis:
The treatment of patients with oral submucous fibrosis depends on the
degree of clinical involveme.
Most patients with oral submucous fibrosis present with moderate-to-severe
disease
If the disease is detected at a very early stage, cessation of the habit is
sufficient. Severe oral submucous fibrosis is irreversible.
Moderate oral submucous fibrosis is reversible with cessation of habit and
mouth opening exercise.
Intra lesional injection of corticosteroids or interferon gamma improved
maximum mouth opening .redused mucosal burning and increased flexibility of the
buccal tissue
Supplementing the diet with foods rich in vitamins A, B complex, and C and
iron Lycopene, 16 mg a day helps in improvement of OSF
.

31. Thank you