Malignant potential of oral submucous fibrosis due to intraoral trauma.

It is not very clear why oral submucous fibrosis (OSF) is prone to develop squamous cell carcinoma (SCC). Experimental studies on hamster have shown that wounding of oral mucosa promotes induction of epithelial dysplasia (ED) initiated with carcinogens. Hence, a study was undertaken to find the effect of intraoral traumatic factors (ITF) in OSF. Randomly selected 110 OSF patients were divided into 2 groups: Traumatic group (TG), having tooth/malposed impacted third molar/appliance/calculus; and Non-traumatic group (NTG). Clinico-pathological features of traumatic mucosa of TG were compared with non-traumatized mucosa of NTG. It was found that amongst 60 TG cases there were 8 cases of SCC, 4 cases of leukoplakia and 1 case of lichenoid dysplasia and erythema, erosion and ulcer were mostly observed with sharp tooth (28) cases and malposed impacted tooth (19) cases. Further, various degrees of ED were seen in more cases of TG (23%) than in NTG (8%). This study concludes that traumatised mucosa in OSF due to various ITF may concentrate the carcinogens which by penetrating cause carcinogenesis of susceptible cells.