A systematic review of medical interventions for oral submucous fibrosis and future research opportunities

New York University College of Dentistry, NY, USA.
Oral Diseases (Impact Factor: 2.43). 04/2011; 17 Suppl 1(s1):42-57. DOI: 10.1111/j.1601-0825.2011.01791.x
Source: PubMed


Oral Diseases (2011) 17 (Suppl. 1), 42–57
Oral submucous fibrosis (OSF) is a chronic, insidious disease caused by areca nut use, and is associated with both significant morbidity (including pain and reduced oral opening) and an increased risk for malignancy. This systematic review explored and updated the current medical (i.e., non-surgical) interventions available for the management of OSF. Of the 27 published medical interventions, there were four randomized controlled trials. The overall quality of these randomized controlled studies was assessed using the GRADE approach and significant limitations that challenged the conclusions were found. However, this review was valuable in terms of identifying opportunities to provide recommendations for future research, in terms of the populations to research, the types of interventions needed, the types of outcomes to be measured, the study designs needed, and the infrastructure required to conduct studies. The next step is to initiate a pathway for a low-cost research plan leading to the development of a brief protocol for future clinical trials in this field, with an emphasis on conducting studies in regions of the world where OSF is prevalent.

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Available from: Michael Bornstein, Jun 09, 2014
    • "Individuals with clinical features of OSMF and associated habits of betel/paan chewing were included.[11] Individuals with clinical manifestations of OLP, based on the WHO diagnostic criteria, were included.[12] "
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    ABSTRACT: Oral submucous fibrosis (OSMF) and oral lichen planus (OLP) are two frequently reported, potentially malignant disorders with multifactorial etiologies and ambiguous pathogenesis. An immunological pathogenesis has been hypothesized as a causative factor for both. The present study aims to evaluate the role of serum and salivary immunoglobulin G (IgG) and immunoglobulin A (IgA) in both these conditions, by their quantitative estimation. Saliva and serum samples were collected from 30 patients, clinically diagnosed and histopathologically confirmed with OSMF, 30 with OLP and 30 age and sex matched controls. The levels of IgG and IgA were estimated by nephelometry. The mean values of serum IgG were marginally higher in both OSMF and OLP groups compared to the controls but this difference was not significant and the mean values of serum immunoglobulin A were marginally decreased in both the study groups compared to the controls but this difference was also not significant. Inconclusively low levels of salivary IgG and IgA were obtained in the three groups. The present study suggests an insignificant association of these immunoglobulins in the pathogenesis of both these diseases.
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    • "A growing number of studies suggest that myofibroblasts are the major effector cells in OSF (Angadi et al., 2011). Many drugs as well as surgical intervention and physical therapy have been used in OSF's therapy but a definitive, effective treatment is still elusive (Fedorowicz et al., 2008; Jiang and Hu, 2009; Kerr et al., 2011). Curcumin, 1, 7-bis (4-hydroxy-3-methoxyphenol)-1, 6-heptadiene-3, 5-dione, is the primary active substance isolated from Curcuma Longa L. rhizome. "
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    ABSTRACT: Myofibroblasts play an important role in the development of oral submucous fibrosis (OSF). In the current study, we investigate the effect of curcumin on growth and apoptosis of myofibroblasts derived from human oral mucosa. Myofibroblasts were generated by incubating fibroblasts, obtained from human oral mucosa, with transforming growth factor-β 1 (TGF-β 1). MTT, PI staining, and FACS assays were used to investigate curcumin's effect on proliferation and cell cycle of fibroblasts and myofibroblasts. Annexin V/PI binding and FACS assays were used to examine apoptosis of myofibroblasts, Western blotting to determine the levels of Bcl-2 and Bax, and enzyme-linked immunosorbant assay was employed to examine the levels of collagen type I and III in the supernatants of myofibroblasts. Curcumin inhibits proliferation of fibroblasts and myofibroblasts; it also disturbs the cell cycle, induces apoptosis and decreases the generation of collagen type I and III in myofibroblasts, which are more sensitive to its effects than fibroblasts. Curcumin induces apoptosis in myofibroblasts by down-regulating the Bcl-2/ Bax ratio. Our results demonstrate the antifibrotic effect of curcumin in vitro. It may therefore be a candidate for the treatment of OSF.
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    Journal of applied oral science: revista FOB 02/2011; 19(1). DOI:10.1590/S1678-77572011000100001 · 0.92 Impact Factor
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