Oral submucous fibrosis and malignant transformation


Oral submucous is a persistent oral mucosal illness that’s certainly one of a gaggle of circumstances recognised as oral probably malignant problems (OPMD). The prevalence of oral submucous fibrosis is estimated to be between 2.3% to eight.6% with a latest evaluate (Dental Elf – 12th Dec 2022) estimating a malignant transformation fee of 6% (95percentCI: 2- 10%).

This umbrella evaluate of systematic opinions aimed to find out the proportion of oral most cancers improvement in oral submucous fibrosis sufferers.


Searches have been carried out within the Cochrane library, PubMed, Scopus and Net of science databases with no language restrictions. Systematic evaluate with or with out meta-analyses evaluating malignant transformation in oral submucous fibrosis (OSF) sufferers have been thought of. Two reviewers independently screened and chosen research and extracted information. Examine high quality was assessed utilizing A Measurement Device to Assess Systematic Opinions (AMSTAR 2 ). A story abstract was supplied.


  • 4 systematic opinions have been included.
  • Evaluation pattern sizes ranged from 4 research 3986 sufferers to 16 research 8516 sufferers.
  • 3 opinions had registered protocols on PROSPERO.
  • All 4 opinions undertook meta-analyses.
  • Two opinions have been thought of to be of top of the range and a pair of of critically low high quality utilizing the AMASTAR 2 software.
  • Imply values for malignant transformation for the 4 included opinions ranged from 4.2% to six% (see desk beneath).
Publication No. of research (sufferers) % Malignant transformation (95percentCI) *
Murthy V et al 2022 16 (8516) 6% (2% to 10%)
Nayanar et al 2022 10 (5428) 5.5% (3.9% to 7.2%)
Kujan O et al 2021 9 (6337) 4.2% (2.7% to five.6%)
Iocca O et al 2019 4 (3986) 5.2% (99% CI: 2.9% to eight.0%)

*Until the place indicated


The authors concluded: –

There may be lack of high quality of proof and critically low methodological high quality amongst systematic opinions (SRs) and meta-analyses, resulting in substantial heterogeneity. The outcomes recommend the estimated charges of malignant transformation (MT) assorted broadly throughout the included SRs on account of variations in research designs and definitions of OSF. Danger elements related to MT might embrace the length and severity of the illness, the presence of epithelial dysplasia and tobacco use.


No protocol was registered for this umbrella evaluate. Searches have been carried out in 4 main databases with no language restrictions. Solely 4 opinions have been included and whereas they have been printed over a short while scale 2019 to 2022 there was a large variation within the variety of included research, from 2 to 16.  We checked out the latest evaluate by Murthy et al., in a earlier weblog (Dental Elf – 12th Dec 2022) the place we additionally printed a desk summarising the malignant transformation information for the 4 opinions included on this umbrella evaluate. The authors point out that the standard of proof was not assessed in any of the included papers, though the Murthy evaluate did use the Newcastle-Ottawa scale to high quality and included a desk of their assessments.

This umbrella evaluate helpfully pulls collectively the info from 4 earlier opinions and features a helpful dialogue sectio. Nonetheless, it could have been useful if the authors had additionally assessed the diploma of overlap of research throughout the included opinions. This overview and the unique systematic opinions spotlight numerous points with the standard of the first research. Properly designed and reported long-term potential research are wanted to make clear malignant transformation charges in sufferers with submucous fibrosis.


Main Paper  

Gondivkar SM, Yuwanati M, Sarode SC, Gadbail AR, Gondivkar R, Mohsin SF, Gaikwad R. Malignant transformation in oral submucous fibrosis: Tertiary degree proof: An umbrella evaluate. Oral Dis. 2023 Aug 31. doi: 10.1111/odi.14718. Epub forward of print. PMID: 37650364.

Different references

 Dental Elf – 12th Dec 2022

Oral submucous fibrosis – malignant transformation fee

Murthy V, Mylonas P, Carey B, Yogarajah S, Farnell D, Addison O, Cook dinner R, Escudier M, Diniz-Freitas M, Limeres J, Monteiro L, Silva L, Fricain JC, Catros S, Fenelon M, Lodi G, Lombardi N, Brailo V, Ariyaratnam R, López-López J, Albuquerque R. Malignant Transformation Fee of Oral Submucous Fibrosis: A Systematic Evaluation and Meta-Evaluation. J Clin Med. 2022 Mar 24;11(7):1793. doi: 10.3390/jcm11071793. PMID: 35407401; PMCID: PMC8999767.

Nayanar, G, Reddy, MGS, Kakodkar, P & Dony, EC Malignant transformation fee of oral submucous fibrosis: A scientific evaluate and meta-analysis. Oral Surg. 2022; 00: 1– 8. https://doi.org/10.1111/ors.12771

 Kujan O, Mello FW, Warnakulasuriya S. Malignant transformation of oral submucous fibrosis: A scientific evaluate and meta-analysis. Oral Dis. 2021 Nov;27(8):1936-1946. doi: 10.1111/odi.13727. Epub 2020 Dec 9. PMID: 33205543.

Iocca O, Sollecito TP, Alawi F, Weinstein GS, Newman JG, De Virgilio A, Di Maio P, Spriano G, Pardiñas López S, Shanti RM. Doubtlessly malignant problems of the oral cavity and oral dysplasia: A scientific evaluate and meta-analysis of malignant transformation fee by subtype. Head Neck. 2020 Mar;42(3):539-555. doi: 10.1002/hed.26006. Epub 2019 Dec 5. PMID: 31803979.

Image Credit

Picture by Nationwide Most cancers Institute on Unsplash



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