Stromal changes in apparently normal mucosa of smokers and pan chewers: A multi-parametric approach using Histopathology, Ultrastructure and Autofluorescence

Karthikeyan, R (2006) Stromal changes in apparently normal mucosa of smokers and pan chewers: A multi-parametric approach using Histopathology, Ultrastructure and Autofluorescence. Masters thesis, Saveetha Dental College and Hospitals, Chennai.


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In the present study the following salient features were found, • Although there are many fluorophores in the tissues, only the emission characteristics of tryptophan, collagen and NADH provided measurable variations. • Our results showed distinct difference between normal mucosa and smokers. • Significant difference was also found between pan chewers and smokers. • However, we could also discriminate pan chewers from normal individuals. • Although we attributed the decreased fluorescence intensity in smokers, is probably due to the distortion caused by dense fibrosis as advocated by Tsai et al or due to the conformational changes in the collagen molecules, further studies are necessary to find the exact reason for the decreased fluorescence. • The intensity of smokers at 390nm is less when compared to normal and pan chewers, correlating with the findings of Tsai et al. Considering the histopathological parameters, the pattern of the subepithelial connective tissue, the presence of chronic inflammatory cells in the sub-epithelial connective tissue and deeper regions of connective tissue, presence of lysis of connective tissue was significant. The ultrastructure of the fibroblasts among the study group, revealed the presence of epithelioid, spindle or elongated and stellate shaped fibroblasts in the connective tissue. Our study showed that smokers had connective tissue changes similar to sub mucous fibrosis more than that seen in pan chewers. Literature states that sub mucous fibrosis is more prevalent in pan chewers and smokers have increased tendency to develop leukoplakia, though both are caused by tobacco products. The initial connective tissue changes could determine the progression of altered mucosa to pre-cancer or cancer. This transformation is related to complex interactions. A clear elucidation has to be obtained through molecular biological studies in the future. Further studies are required to evaluate the significance of our hypothesis. Smoking and pan chewing are preventable habits associated with considerable morbidity and mortality. Those who survive the ill-effects suffer personal consequences and become a considerable burden on the health care system. Even if patients cannot reverse their habits, modifications may reduce the risk. The awareness among the patients and the health care provider would facilitate early diagnosis of the disease.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Stromal changes, normal mucosa, smokers, pan chewers, multi-parametric approach, Histopathology, Ultrastructure, Autofluorescence.
Subjects: DENTAL > Oral Pathology and Microbiology
Depositing User: Kambaraman B
Date Deposited: 24 Jan 2018 03:53
Last Modified: 24 Jan 2018 03:53

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