Morphometric analysis of oral submucous fibrosis and its correlation with histological staging and clinical severity of trismus

Abstract

To quantify the histopathological changes in oral submucous fibrosis morphometrically and to correlate those findings with the histological grading and clinical severity of trismus. A total of hundred histological sections of oral submucous fibrosis were analysed morphometrically by using interactive image analysis system (Image Pro-Plus,V 6.0). Histological staging and the severity of trismus were then compared with the morphometry results. ANOVA and Pearson’s chi square tests were applied using the software SPSS V. 13.0 for statistical analysis. The thickness of the epithelium and subepithelial collagen showed no statistically significant differences between the different stages (p value > 0.05). However, blood vessel density, mean blood vessel area and mean diameter of the vessels were indirectly proportional to the histological stages (p value < 0.001). Histological stages directly correlate the frequency of trismus, but the severity of trismus showed relation neither with the staging nor with the degree of collagenization, measured morphometrically (p value > 0.05). The thickness of the epithelium and subepithelial collagen should not be included in the histological staging criteria of oral submucous fibrosis. Probably the degree of hyalinization of collagen fibres and involvement of muscle fibres are more important in causing trismus, rather than a simple increase in the subepithelial collagen thickness.