Oral Submucous Fibrosis

Classification Based on Clinical Features of OSMF
1. Desa (1957) divided OSMF into three stages as follows:
• Stage I: Stomatitis and vesiculation
• Stage II: Fibrosis
• Stage III: As its sequelae

2. Pindborg (1989) divided OSMF into three stages:
  • Stage I: Stomatitis includes erythematous mucosa, vesicles, mucosal ulcers, melanotic mucosal pigmentation, and mucosal petechiae.
  • Stage II: Fibrosis occurs in healing vesicles and ulcers, which is the characteristic of this stage.

-Early lesions demonstrate blanching of the oral mucosa.
-Older lesions comprise vertical and circular palpable fibrous bands in the buccal mucosa and around the mouth opening or lips.
-Vertical thick, fibrous bands in association with a blanched mucosa results in a mottled marble like appearance.
-Specific findings are reduction of mouth opening, blanched and leathery floor of the mouth, stiff and small tongue, depigmented and fibrotic gingiva, rubbery soft palate along with decreased mobility, blanched as well as atrophic tonsils, shrunken bud like uvula and sunken cheeks, not commensurate with age or nutritional status.

  • Stage III: Sequelae of OSMF are as follows:

    -Leukoplakia - in more than 25% of individuals with OSMF.

-Speech and hearing deficit may arise due to the involvement of tongue and the eustachian tube.