Quantitative and qualitative analysis of collagen in oral submucous fibrosis

Background: Oral submucous fibrosis (OSMF) is considered as a potentially malignant disease, which is associated with betel quid and pan masala chewing. It is thought to be due to the defective collagen synthesis and degradation. The amount of collagen in the diseased varies with the functional stages and histopathological grades of the disease. Aims: The aim of the study was to assess the severity of the disease in oral submucous fibrosis, by correlating the functional staging with the histopathological grading and analyze the collagen distribution in different grades of OSMF using picrosirius red stain under polarizing microscope and also to assess the quantitative changes in collagen with respect to various histopathological grades of OSMF using spectrophotometry. Materials and Methods: The study conducted on 40 subjects, which included 30 subjects with different functional and histopathological grades of oral submucous fibrosis (OSMF), and 10 were in control group. Functional staging and histopathological grading was done based on the definite criteria. A Histopathological and quantitative analysis of collagen was conducted using picrosirius red stain, polarizing microscope and spectrophotometer, respectively. The results were analyzed using chi-square test, and the significance was tabulated. Results: The functional staging and the histopathological grading did not show statistical correlation, but as the histopathological grade of the disease increased; there was a shift in the polarizing color from yellow-green to orange-red. In the colorimetric estimation, the optical densities of the sample decreased as with increased grades of OSMF. Conclusion: In the present study, we observed that the histopathological grading of OSMF is not correlating with the functional staging of OSMF. Therefore, it mandates the proper correlation between the functional staging and the histopathological grading before the commencement of the treatment to render better outcome of the treatment.