Challenges in the Classification of Oral Submucous Fibrosis and Proposing a New Classification Based on Systematic Review of Literature

Sonia Gupta; Anitha Subbappa; Shivani Singh; Pallavi Sharma; Ankita Singh; Aakash Kumar; Harman Sandhu; Karthick Thangamani Nadar

doi:10.4103/jispcd.JISPCD_207_22

Challenges in the Classification of Oral Submucous Fibrosis and Proposing a New Classification Based on Systematic Review of Literature

J Int Soc Prev Community Dent. 2023 Feb 27;13(1):17-31. doi: 10.4103/jispcd.JISPCD_207_22. eCollection 2023 Jan-Feb.

Authors

Sonia Gupta¹, Anitha Subbappa², Shivani Singh³, Pallavi Sharma⁴, Ankita Singh⁵, Aakash Kumar⁶, Harman Sandhu⁷, Karthick Thangamani Nadar⁸

Affiliations

¹ Department of Oral Pathology and Microbiology and Forensic Odontology, Rayat and Bahra Dental College and Hospital, Mohali, Punjab, India.
² Department of Periodontology, JSS Dental College & Hospital, JSSAHER, Karnataka, India.
³ Department Of Dentistry, Heritage Institute of Medical sciences, Varanasi, Uttar Pradesh, India.
⁴ Department of Periodontology, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pardesh, India.
⁵ Department of Prosthodontics, Crown and Bridge, MMCDSR, Mullana, Ambala, Haryana, India.
⁶ CHC Chiri, Rohtak, Haryana, India.
⁷ Building Smiles Dental Clinic, Sec 86, Mohali, Punjab, India.
⁸ Sai Dental and Orthodontic Clinic, Mumbai, Maharashtra, India.

Abstract

Aims and objectives: Oral submucous fibrosis is one of the common oral potentially malignant disorders that can result in severe morbidity. Due to its widespread involvement in the oral cavity and high risk of malignant transformation, the diagnosis and treatment of this disease at an early stage is essential to prevent further complications. This research was carried out to review various classification systems of oral submucous fibrosis documented in the literature to date, including their benefits and drawbacks, thus focusing on a need to discover some reliable classification systems.

Materials and methods: An electronic search of the published English literature was performed without publication year limitation in PubMed/Medline, Science Direct, Web of Science, Google Scholar, and Scopus databases using keywords like ('Oral submucous fibrosis' OR 'Oral submucous fibroses'), AND ('Classification' OR 'Grade' OR 'Stage'), AND ('Clinical', OR/ AND 'Histological', OR/AND 'Functional') following PRISMA guidelines. A manual search of all related Dental and Medical journals was also performed. We also checked the reference lists of the relevant articles for any other possible information on the subject.

Results: The search strategy revealed 31 relevant articles and it could be appreciated that oral submucous fibrosis has been classified in seven different ways. Each system is enclosed with its own limitations and benefits.

Conclusion: From this research, it can be concluded that despite the existence of several classification systems for oral submucous fibrosis, at present, no classification scheme is considered to be reliable that could help in the accurate assessment of the progression of the disease and classifying oral submucous fibrosis still remains a challenging task for clinicians, surgeons, and pathologists. We have postulated a proposed new classification system based on our literature research, but still robust research is needed in this aspect.

Keywords: Challenges; classification; oral submucous fibrosis.

Publication types

Review