title: Comparative study of clinicofunctional staging of oral submucous fibrosis with qualitative analysis of collagen fibers under polarizing microscopy.
abstract: 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.
  
  
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Mangalore, India. ceen226@yahoo.com
authors.forename: Denny E
authors.initials: DE
authors.lastname: Ceena
authors.forename: T S
authors.initials: TS
authors.lastname: Bastian
authors.forename: L
authors.initials: L
authors.lastname: Ashok
authors.forename: Rajeshwari G
authors.initials: RG
authors.lastname: Annigeri
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001114:Areca / Q000009:adverse effects; D016022:Case-Control Studies; D005260:Female; D024022:Fibrillar Collagens / Q000145:classification* / Q000187:drug effects; D006801:Humans; D008297:Male; D008859:Microscopy, Polarization; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology*; D009914:Oral Submucous Fibrosis / Q000145:classification / Q000209:etiology / Q000473:pathology*; D016059:Range of Motion, Articular; D012016:Reference Values; D012720:Severity of Illness Index; D013194:Staining and Labeling; D018709:Statistics, Nonparametric; D013704:Temporomandibular Joint; D055815:Young Adult
chemical_list: D024022:Fibrillar Collagens