Rising incidence of oral cancer in Ahmedabad city.

CONTEXT: In 1999, an increase in mouth cancer incidence among young men (<50 years) in urban Ahmedabad was reported to be occurring along with decreasing mouth cancer incidence in older age groups and increasing oral submucous fibrosis incidence associated with areca nut consumption among young men in Gujarat. The aim was to investigate whether the increase in the incidence mouth cancer that had started among young men in the 1990s was continuing. SETTINGS AND DESIGN: Ahmedabad urban population, comparison of reported mouth cancer cases in the population across four time period. METHODS: Age‑specific incidence rates of mouth cancer (International Classification of Diseases [ICD]‑9:143–5; ICD‑10:C03–06) in five year age groups among men aged ≥15 years for the city of Ahmedabad for years 1985, 1995, 2007 and 2010 were extracted from published reports. For comparison, lung cancer (ICD‑9:169; ICD‑10:C33–C34) rates were also abstracted. STATISTICAL ANALYSIS USED: A cohort approach was used for further analysis of mouth cancer incidence. Age adjusted incidence rates of mouth and lung cancer for men aged ≥15 years were calculated and compared. RESULTS: The age specific incidence rates of mouth cancer among men increased over the 25‑year period while lung cancer rates showed a net decrease. Using a cohort approach for mouth cancer, a rapid increase in younger age cohorts was found. CONCLUSIONS: Mouth cancer incidence increased markedly among men in urban Ahmedabad between 1985 and 2010, apparently due to increasing consumption of areca nut products, mawa and gutka. Gutka has now been banned all over India, but a more vigorous implementation is necessary.

Isolated bilateral zygomatic complex and zygomatic arch fractures with oral submucous fibrosis: An unusual and rare case report.

Zygomatic bone forms major buttress of the facial skeleton and plays an important role in facial contour. Fractures of zygomatic complex are second most common only next to nasal bone fractures. Motor vehicle accidents and interpersonal violence are common causes. Bilateral fractures of zygomatic complex and zygomatic arch are very rare. We present a case report of isolated fractures involving bilateral zygomatic complex and zygomatic arch with oral submucous fibrosis, which is unique and first of its kind to be reported.

Oral sub-mucous fibrosis: realities of etiology / Fibrose de submucosa oral: a realidade da etiologia

Oral sub-mucous fibrosis (OSMF) is a well known potentially malignant condition resulting commonly due tothe use of areca nut. Areca nut chewing is a primordial tradition in Asian countries. It is also a psychoactiveessence. With the emergence of commercial pan masala and gutkha, witness of massive growth in the salesof these products, with huge worldwide export market developed. Various components in this quid have itsown mechanism of action resulting in OSMF. Other causes proposed were chillies, misi, nutritional deficiency,genetic predisposition, immunologic aspects, infection and saliva. This review attempts to give an overviewabout the postulated etiologies and its role in causation of OSMF.

Fibrose de submucosa oral (FSMO) é uma condição potencialmente maligna muito conhecida resultante geralmentedo uso da noz de areca ou betel. Mastigar a noz de betel é uma tradição primordial nos países asiáticos.É também uma essência psicoativa. O surgimento comercial da pan masala e da gutkha, aliado ao enorme crescimento nas vendas desses produtos, possibilitou um grande mercado de exportação em todo o mundodesenvolvido. Vários componentes neste material tem seu próprio mecanismo de ação, resultando em FSMO.Outras causas propostas foram pimentões, misi, deficiência nutricional, predisposição genética, aspectos imunológicos,infecção e saliva. Esta revisão procura dar uma visão geral sobre as etiologias postuladas e seu papelna causa da FSMO.

Expressão do fator de crescimento transformador-beta em mucosa oral submetida à radioterapia: uma revisão crítica da literatura / Expression of transforming growth factor: beta in oral mucosa submitted to radiotherapy. a critical literature review

A radiação ionizante é uma das terapias utilizadas para o tratamento de neoplasias malignas de cabeça e pescoço. Todavia, pode causar complicações agudas, como mucosite, e complicações crônicas, como fibrose tecidual. A radioterapia promove aumento na deposição de colágeno e incrementa a expressão e ativação precoce do fator de crescimento transformador ­ beta, que pode culminar nessa fibrose. O fator de crescimento transformador - beta é uma citocina multifuncional, excretada sob forma latente, com importante função na modulação do sistema fibroblasto-fibrócito, estimulando a síntese e depósito de colágeno, atuando no reparo tecidual, e diminuindo a sua degradação, especialmente em tecido irradiado. A presente revisão de literatura tem como objetivo esclarecer a relação da expressão do fator de crescimento transformador - beta em tecidos submetidos à radiação ionizante utilizada para tratamento antineoplásico, em especial na mucosa oral e reparo tecidual em lesões do tipo mucosite, realizando uma análise crítica dos trabalhos avaliados.

Ionizing radiation is a form of therapy used for the treatment of malignancies of head and neck. However, it can cause acute complications such as mucositis, and chronic complications, such as tissue fibrosis. Radiation promotes increase in collagen deposition and increases the expression and activation of the Transforming Growth Factor - beta, which may result in this fibrosis. The transforming growth factor - beta is a multifunctional cytokine, excreted latent, with an important role in the modulation of the fibroblasts- fibrocytes, stimulating synthesis and deposition of collagen, acting on tissue repair and decreasing its degradation, especially in tissue irradiated. This literature review aims to clarify the relationship between the expression of transforming growth factor - beta in tissues submitted to ionizing radiation used for anticancer treatment, particularly in the oral mucosa and wound repair in lesions with mucositis, performing a critical analyses of the assessed work.

Comparative study of clinicofunctional staging of oral submucous fibrosis with qualitative analysis of collagen fibers under polarizing microscopy.

Objective : The aim of the study was to assess the severity of the disease in oral submucous fibrosis (OSF), correlate the clinical, functional staging with histopathological staging, and analyze collagen distribution in different stages of OSF using the picrosirius red stain under polarizing microscopy. Materials and Methods : The study included randomly incorporated 50 subjects, of whom 40 were patients with OSF, and 10 were in the control group. Clinical, functional staging in OSF cases was done depending upon definite criteria. A histopathological study was conducted using the hematoxylin and eosin stain and picrosirius red stain. Collagen fibers were analyzed for thickness and polarizing colors. Furthermore, clinical, functional, and histopathological stages were compared. Statistical Analysis : Descriptive data which included mean, SD, and percentages were calculated for each group. Categorical data were analyzed by the chi-square test. Multiple group comparisons were made by one-way ANOVA followed by Student's t-test for pairwise comparisons. For all tests, a P-value of 0.05 or less was considered for statistical significance. Results : As the severity of the disease increased, clinically, there was definite progression in subjective and objective symptoms. Polarized microscopic, examination revealed, there was a gradual decrease in the green-greenish yellow color of the fibers and a shift to orange red-red color with increase in severity of the disease. Thereby, it appeared that the tight packing of collagen fibers in OSF progressively increased as the disease progressed from early to advanced stages. We observed that the comparison of functional staging with histopathological staging was a more reliable indicator of the severity of the disease. Conclusion : In the present study, we observed that mouth opening was restricted with advancing stages of OSF. The investigation also points to the importance of assessing the cases of OSF, especially with regard to functional and histological staging in planning the treatment.

The prevalence of oral mucosal lesions in alcohol misusers in Chennai, south India.

AIMS AND OBJECTIVES: This study was conducted to assess the prevalence of various oral mucosal lesions (OML) among alcohol misusers attending a rehabilitation center in Chennai, south India. MATERIALS AND METHODS: Qualified dental surgeons examined 500 consecutive alcohol misusers at Ragas Dental College and Hospital and TTK Hospital, India. Thorough history and oral findings were recorded in a pre-determined format. Data entry and statistical analysis were done using SPSS 10.0.5beta. The variables for this study were OML, Oral Hygiene Index (OHI), age, smoking, and alcohol misuse (type and units consumed and duration of misuse). RESULTS: Of the 500 patients, 77% were in the 25-44 years old age group and 84% were married. The mean age of initiation of alcohol misuse was 34 years. In addition to alcohol, 72% smoked tobacco and 96% used other psychoactive substances. The mean alcohol use duration was 12.6 years. A total of 25% of the study group had at least one OML. The common oral lesions were smoker's melanosis (10.2%), oral submucous fibrosis (8%), and leukoplakia (7.4%). Those who misused spirits had a higher incidence of OML than those who misused beer or both. Patients with fair oral hygiene had an odds ratio (OR) of 2.96 for OML compared with an OR of 2.08 for those who had OML with good oral hygiene. CONCLUSION: This study indicates that subjects who misuse alcohol have poor oral hygiene and are at risk for the development of periodontal disease and OML. This survey indicates that oral examination and treatment should be a part of the standard care for alcohol misusers at rehabilitation centers.

Epidemiological and etiological study of oral submucous fibrosis among gutkha chewers of Patna, Bihar, India.

An etiological and epidemiological study of oral submucous fibrosis (OSMF) has been done in Patna, Bihar. Total 157 cases of OSMF and 135 control subjects were selected for study in the period of 2002-2004. It was observed that Male:Female ratio was 2.7:1. The youngest case of OSMF was 11 year old and the oldest one was 54 years of age. Maximum number of cases were belonging to 21-40 years of age and they were belonging to low or middle socioeconomic class. Most of the OSMF cases used heavy spices and chillies, where as control mild spices and chillies. Gutkha was the most commonly used by the OSMF cases only 3 per cent did not use any gutkha or other areca nut product where as 80 per cent control did not have any chewing habit. The OSMF cases used gutkha and other products 2-10 pouches per day and kept in the mouth for 2-10 minutes and they were using since 2-4 years. Most of the OSMF cases kept gutkha in the buccal vestibule or they chewed and swallowed it, only a small number of patients chewed and spitted it out. It was also observed that OSMF developed on one side of the buccal vestibule where they kept the chew and other side was normal.