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      Role of mast cells in the pathogenesis of oral submucous fibrosis: a systematic review and meta-analysis

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          Abstract

          Background

          Oral Submucous Fibrosis (OSMF) is an oral potentially malignant disorder (OPMD) that commonly occurs in the South Asian population as there is high usage of areca nut. There has been extensive research on the pathogenesis and treatment of this condition. It is well-established in the scientific literature that mast cells (MC) have a definitive role in several inflammatory disorders. OSMF being a chronic inflammatory disorder, is also expected to have increased MCs. Hence, this review aims to evaluate the role of MCs in the pathogenesis of OSMF.

          Methods

          A systematic search of articles was performed by two of the authors independently in PubMed, Scopus, Embase, Web of Science, and Google Scholar using the appropriate keywords and Boolean terms. The risk of bias was assessed using the Modified Newcastle-Ottawa Scale. The meta-analysis was performed with R studio software (Version: 4.4.0, Year: 2024, Company: The R foundation for statistical computing).

          Results

          The search retrieved 36 studies, of which 16 were suitable for the review. There is evidence for a marked increase in the number of MCs in OSMF than the normal mucosa upon analyzing the retrieved articles. However, when comparing the grades of OSMF, there are variations in the reports. As all the retrieved articles were case-control studies, the risk of bias was analyzed using the Modified New Castle Ottawa Scale. All the studies scored in the good category (Score 6–9). The pooled effect size shows the Standard Mean Deviation (SMD) to be 0.09, 95% confidence interval (CI) [-0.18;0.37] to lie on either side of no effect. Hence the role of MCs in OSMF has not been established because of homogeneity and consistent sampling error.

          Conclusion

          Our systematic review does suggest a definitive role of mast cells in the progression of OSMF. However, there is a lack of methodological rigor in the included studies. This may contribute to diluting the results.

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          Most cited references35

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          The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

          Matthew J L Page, Joanne E McKenzie, Patrick Bossuyt … (2026)
          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
          Article 0 comments Cited 16032 times – based on 0 reviews     Review now
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            • Record: found
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            Oral Submucous Fibrosis: A Review on Etiopathogenesis, Diagnosis, and Therapy

            Yin-Hwa Shih, Tong-Hong Wang, Tzong-Ming Shieh … (2019)
            Oral submucous fibrosis (OSF) is characterized by abnormal collagen deposition. It is a precancerous disorder and transforms into a malignant tumor in 1.5–15% of all cases. Symptoms include submucous fibrosis, ulceration, xerostomia, a burning sensation, and restricted mouth opening. All of these greatly interfere with patient quality of life. The present review introduces OSF from a molecular perspective and summarizes what is known about its underlying mechanisms, diagnostic biomarkers, and therapeutic interventions. In addition to the aggressive treatment of OSF, its prevention is also important. Future research should, therefore, focus on improving the oral health literacy of the patients susceptible to OSF.
            Article 0 comments Cited 53 times – based on 0 reviews     Review now
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              Clinical evaluation of different treatment methods for oral submucous fibrosis. A 10-year experience with 150 cases.

              Alex Y C Huang, T. Lin, Hue Lai … (1995)
              Over a 10-year period (1982-1991); a total of 150 patients divided into two groups with varying degrees of oral submucous fibrosis (OSF) were treated by either medical or surgical therapies. Medical treatment involved (a) conservative oral administration of vitamin B-complex, buflomedial hydrochloride and topical triamcinolone acetonide 0.1%, or (b) conventional submucosal injections of a combination of dexamethasone and hyaluronidase, or (c) a combination of both (a) and (b). The surgical group was treated by the excision of fibrotic tissues and covering the defect with split-thickness skin, fresh human amnion, or buccal fat pad (BFP) grafts. Treatment was chosen according to the stage of clinical progression to gain maximal interincisal distance (ID). The cases were followed up by monthly examinations for at least two years, or when possible even longer. A combination of (a) and (b) medical treatment was satisfactory in cases of mild impairment (ID > 20 mm) but in the long term it led to symptomatic relief only. Surgical therapy, on the other hand, when accepted by the patients, led to a significant improvement of trismus in cases of severe limitation (ID < 20 mm). Following this strategy, an additional ID increase was observed in all patients. BFP grafting was particularly successful in diminishing scarring after two years as compared with the other two grafts. Together with a cessation of the betel quid chewing habit before and after therapy, these treatment regimens combined with daily mouth opening exercises were found to be necessary to manage OSF cases in early and advanced stages of progression.
              Article 0 comments Cited 45 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Laliytha Kumar Bijai: laliythaoralmed@gmail.com
                Journal
                Journal ID (nlm-ta): BMC Oral Health
                Journal ID (iso-abbrev): BMC Oral Health
                Title: BMC Oral Health
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1472-6831
                Publication date (Electronic): 14 October 2024
                Publication date PMC-release: 14 October 2024
                Publication date Collection: 2024
                Volume: 24
                Electronic Location Identifier: 1219
                Affiliations
                [1 ]Maxillofacial Surgery and Diagnostic Sciences Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, ( https://ror.org/0149jvn88) Riyadh, 11426 Saudi Arabia
                [2 ]King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, ( https://ror.org/009p8zv69) Riyadh, 11481 Saudi Arabia
                [3 ]Preventive Dental Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, ( https://ror.org/0149jvn88) Riyadh, 11426 Saudi Arabia
                Article
                Publisher ID: 5025
                DOI: 10.1186/s12903-024-05025-8
                PMC ID: 11476548
                PubMed ID: 39402549
                SO-VID: 24b95001-bd36-4ef7-a873-ddb860a88d79
                Copyright © © The Author(s) 2024
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date received : 29 April 2024
                Date accepted : 7 October 2024
                Categories
                Subject: Systematic Review
                Custom metadata
                issue-copyright-statement © BioMed Central Ltd., part of Springer Nature 2024

                ScienceOpen disciplines: Dentistry
                Keywords: mast cell count,intact mast cell,degranulated mast cell,oral submucous fibrosis,toluidine blue,immunohistochemistry
                Data availability:
                ScienceOpen disciplines: Dentistry
                Keywords: mast cell count, intact mast cell, degranulated mast cell, oral submucous fibrosis, toluidine blue, immunohistochemistry

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