fibrosis due to preoperation. Oral submucous fibrosis is a collagen disorder affecting the submucosal layer and often severely limiting mouth opening. The surgical method includes the complete surgical release of fibrotic buccal mucosa with radial forearm free flaps.]]>
Ankylosis ; Collagen ; Fibrosis ; Forearm ; Free Tissue Flaps ; Head ; Mouth ; Mouth Mucosa ; Neck ; Oral Submucous Fibrosis ; Osteomyelitis

OBJECTIVES: There is currently a lack of economic and suitable animal models that can accurately recapitulate the oral submucous fibrosis (OSF) disease state for indepth study. This is one of the primary reasons for the limited therapeutic methods available for OSF. Based on the underlying logic of pan-cancer analysis, this study systematically compares OSF and the other four types of organ fibrosis from the aspects of molecules, signaling pathways, biological processes, etc. A comprehensive analysis of the similarities and differences between OSF and other organ fibrosis is helpful for researchers to discover some general rules of fibrosis disease and may provide new ideas for studying OSF. METHODS: Microarray data of the GSE64216, GSE76882, GSE171294, GSE92592, and GSE90051 datasets were downloaded from GEO. Differentially expressed mRNAs (DEmRNAs) of each type of fibrosis were identified by Limma package. Weighted gene co-expression network analysis (WGCNA) was used to identify each type of fibrosis-related module. The similarities and differences of each fibrosis-related-module genes were analyzed by function and pathway enrichment analysis. RESULTS: A total of 6 057, 10 910, 27 990, 10 480, and 4 801 DEmRNAs were identified in OSF, kidney intestinal fibrosis (KIF), liver fibrosis (LF), idiopathic pulmonary fibrosis (IPF), and skin fibrosis (SF), respectively. By using WGCNA, each type of fibrosis-related module was identified. The co-expression networks for each type of fibrosis were constructed respectively. Except that KIF and LF have 5 common hub genes, other fibrotic diseases have no common hub genes with each other. The common pathways of OSF, KIF, LF, IPF, and SF mainly focus on immune-related pathways. CONCLUSIONS OSF and the other 4 types of fibrotic diseases are tissue- and organ-specific at the molecular level, but they share many common signaling pathways and biological processes, mainly in inflammation and immunity.
Animals ; Oral Submucous Fibrosis/genetics* ; Gene Expression Profiling ; Inflammation ; Signal Transduction ; Fibrosis

OBJECTIVETo apply the bioinformatics tools for analyzing the differentially expressed genes in oral submucous fibrosis (OSF) to obtain the implied biological significance.

METHODSBy using DAVID and Onto-express bioinformatic tools, 865 differentially expressed genes in OSF were analyzed and the analysis of chromosome location, gene ontology (GO) and genetic-association diseases were performed.

RESULTSA majority of the differentially expressed genes were located on chromosome 1,2,5,6,7,11,12 (P < 0.01). GO classification of the differentially expressed genes identified the biological process subgroups, including genes involved in immune response, defense response and so on. The cellular component subgroups were associated with extracellular matrix, cytoskeleton and membrane, molecular function subgroups related to protein binding, extracellular matrix structural constituent and signal transducer activity. The diseases genetically associated with these genes included infection, immune and cardiovascular diseases.

CONCLUSIONSBioinformatics can provide the quick and parallel analysis of massive data got from gene microarrays and enable the function classification of the differentially expressed genes, which provides new ideas on the research of pathogenesis and epidemiology of OSF.

BACKGROUND: To assess and compare the salivary flow rate (SFR) and salivary pH among areca nut chewers, oral submucous fibrosis (OSMF) patients and apparently healthy individuals. METHODS: A comparative study was conducted to assess and compare the SFR and pH among 135 outpatients (45 areca nut chewers + 45 OSMF + 45 control) at The Oxford Dental College and Research Hospital, Bangalore, India. Subjects were interviewed using structural proforma and Modified Schirmer strips and pH paper were implemented for assessing SFR and pH respectively. Statistical analysis was done using IBM SPSS ver. 21.0 software. RESULTS: A statistically significant increase in SFR (35.7 mm at 3rd minutes) among areca nut group and a decrease in SFR among OSMF group (23.4 mm at 3rd minutes) when compared to apparently healthy subjects (30.7 mm at 3rd minutes). The mean pH among areca nut, OSMF and control groups was 6.76, 6.82, and 6.74 respectively with no statistical significance. CONCLUSIONS: The observation and findings of the study clearly showed hypersalivation among areca nut group and hyposalivation among OSMF group, with no significant change in salivary pH when compared to healthy subjects.
Areca* ; Humans ; Hydrogen-Ion Concentration* ; India ; Nuts* ; Oral Submucous Fibrosis* ; Outpatients ; Saliva ; Sialorrhea ; Xerostomia

OBJECTIVEThis study was conducted to investigate the effect of chewing fresh or dried betel nut on the inci-dence and canceration of oral mucosa disease in Haikou City in Hainan Province.

METHODSThrough a survey questionnaire, clinical examination, and regular follow-up, we collected clinical data from 1 722 cases and divided them into two groups, among which 704 of the afflicted people chew dried betel nut, whereas the other 1 018 chew fresh betel nut. The data were 
statistically analyzed using different variables which included age, number, time of onset of the disease, and the cancerous condition associated with common oral mucosa disease, including oral submucous fibrosis (OSF), oral leukoplakia (OLK), and oral Lichen planus (OLP).

RESULTS1) The study found no significant difference in the prevalence of oral mucosa diseases between the dried betel nut group (n=704) and fresh betel nut group (n=1 018) among the 1 722 cases (P>0.05), but the peak age of oral mucosal disease was more advanced in the dried betel nut group (P<0.01). 2) The incidence within 5 years of OSF, OLK, OLP, and oral mucosa diseases in the dried betel nut group was significantly higher than that in the fresh betel nut group (P<0.01). 3) The incidence of cancer for oral mucosa disease in patients included in the dried betel nut group was significantly higher than that in the fresh betel nut group (P<0.01).

CONCLUSIONSChewing dried betel nut is more pathogenic and carcinogenic than chewing fresh betel nut. The extremely harmful components of the dried betel nut synergistically play a vital role in the occurrence and carcinogenesis of oral mucosal diseases.

OBJECTIVE: The aim of this study was to induce oral submucous fibrosis (OSF) in Sprague-Dawley(SD) rat models by arecoline and mechanical stimulation. METHODS: Two factors factorial design was used to divide 48 rats into 8 groups (n=6). Different concentrations of arecoline (0, 0.5, 2, and 8 mg·mL⁻¹) and mechanical stimulation (with or without brush) were treated. After 16 weeks of treatment, the mouth opening was measured, the pathological changes of the buccal mucosa were observed, and the expressions of type Ⅲ collagen, transforming growth factor β1 (TGF-β1), and interferon-γ (IFN-γ) were detected. RESULTS: In rats with moderate and high concentrations of arecoline, typical OSF pathological features were observed in the buccal mucosa, the mouth openings were significantly reduced, and the expression levels of type Ⅲ colla-gen and TGF-β1 were significantly increased (P<0.05). Although mechanical stimulation can increase the three indexes of mucosa (P<0.05), no pathological change and difference in the mouth opening was observed (P>0.05). CONCLUSIONS Moderate and high concentrations of arecoline can induce OSF in SD rats, but mechanical stimulation cannot induce OSF.
Animals ; Arecoline ; pharmacology ; Fibroblasts ; Mouth Mucosa ; Oral Submucous Fibrosis ; Rats ; Rats, Sprague-Dawley

OBJECTIVES: The objective of the study was to evaluate the results of nasolabial/extended nasolabial flaps as a modality for treatment of oral submucous fibrosis. MATERIALS AND METHODS: Eleven patients of Stage III or IVa maximum interincisal opening were selected to be operated. Nasolabial/extended nasolabial flaps were done for both the sides. All of the flaps were done in a single stage and were inferiorly based. A similar flap harvest/surgical technique was utilized for all the cases. RESULTS: The preoperative mouth opening ranged from 5 to 16 mm, with a mean of 10.09 mm. At 6 months the mouth opening ranged from 29 to 39 mm. Some of the complications encountered were poor scar, wisdom tooth traumatising the flap, decreased mouth opening due to non compliance and too much bulk. All of theses were managed satisfactorily. CONCLUSION: The nasolabial flap is a very reliable flap to restore the function of oral cavity. Important adjuvant measures are habit cessation, lifestyle changes, and aggressive physiotherapy.
Cicatrix ; Compliance ; Humans ; Life Style ; Molar, Third ; Mouth ; Mucous Membrane ; Oral Submucous Fibrosis*

The relationship between areca nut as a primary carcinogen and oral cancer has been widely concerned. Areca can change the levels of reactive oxygen species (ROS) and autophagy in cells, and the levels of ROS and autophagy are closely related to the occurrence and development of tumors. This paper reviewed the relationships among areca nut, intracellular ROS, and autophagy.
Areca ; Autophagy ; Humans ; Mouth Neoplasms ; Nuts ; Oral Submucous Fibrosis ; Reactive Oxygen Species

To evaluate therapeutic effect of combined injection of salvizanolic acid B with triamcinolone acetonide on the treatment of the soft palate with oral submucous fibrosis.
 Methods: Salvizanolic acid B combined with triamcinolone acetonide was consecutively applied once a week for 30 weeks for 33 patients with middle and later periods of oral submucous fibrosis. The response rate of color change in the soft palate and the increase of capillary vessels (determined by degree I-IV visual analog scale) were evaluated at the 12th, 24th, and 36th months after 30 weeks treatment.
 Results: Thirty-three patients were fulfilled the study without obvious adverse reactions and they were followed up for 24 months, while 31 patients were followed up for 36 months. The color change in the soft palatal mucus and the increase of capillary vessels at the 36th month follow-up after treatment were significantly better than those at the 12th month (P=0.004).
 Conclusion: Combined injection of salvizanolic acid B with triamcinolone acetonide in the treatment of the soft palate with oral submucous fibrosis is effective.
Glucocorticoids ; Humans ; Oral Submucous Fibrosis ; drug therapy ; Palate, Soft ; Treatment Outcome ; Triamcinolone Acetonide ; therapeutic use

OBJECTIVES: This study was performed to review the efficacy of curcumin in the treatment of oral submucous fibrosis systematically. METHODS: We searched seven databases, including Web of Science, PubMed, EBSCO, The Cochrane Library, CNKI, WanFang Data, and VIP, to obtain randomized controlled trials related to the treatment of oral submucous fibrosis by curcumin. Each database was searched from inception to 30 June 2019. RevMan 5.3 software was used for the meta-analysis. RESULTS: Six randomized controlled trials involving 350 patients were included in this study. Meta-analysis showed that curcumin can increase the maximal mouth opening and improve burning sensation compared with placebo treatment. Curcumin was not as effective as the controls in achieving maximal mouth opening after 1 month of treatment. However, no statistically significant difference was observed between the treatments from 2 months to 6 months. Curcumin significantly improved burning sensation compared with the controls after 3 months of treatment. No statistically significant diffe-rence in burning sensation was observed between the curcumin and control groups after 1, 2, and 6 months of treatment. CONCLUSIONS The current evidence shows that curcumin is an effective treatment for improving maximal mouth opening and burning sensation in patients with oral submucous fibrosis. Given the limited number and low quality of the included studies, however, more high-quality studies are needed to verify these findings.
Curcumin ; Databases, Factual ; Humans ; Oral Submucous Fibrosis/drug therapy* ; Randomized Controlled Trials as Topic ; Treatment Outcome