Ultrasonographic evaluation of submucosal thickness in oral submucous fibrosis patients: a cross-sectional study

Purpose
To evaluate the role of ultrasonography in oral submucous fibrosis (OSMF) patients.

Material and methods
A total of 150 subjects were divided equally into six groups (Group I: 25 healthy subjects; Group II: 25 healthy subjects with habit; Group III: 25 OSMF stage I; Group IV: 25 OSMF stage II; Group V: 25 OSMF stage III; and Group VI: 25 stage OSMF IVA). The grading of OSMF were done according the clinical classification given by Khanna and Andrade (2005). After fulfilling inclusion and exclusion criteria each subject underwent extra­oral ultrasonographic evaluation of submucosal thickness and vascularity in terms of peak systolic velocity (PSV), bilaterally on buccal and labial mucosa. Furthermore, statistical comparison of each group was done, and sensitivity and specificity of USG measurements was obtained in comparison with clinical diagnosis. The statistical analysis was performed using SPSS ver. 20.0.

Results
A statistically significant increase in mean submucosal thickness was shown, and a decrease in PSV with the advancement of severity of the OSMF. In ultrasonographic diagnosis of OSMF, the reported submucosal thickness had a sensitivity, specificity, PPV, NPV, and accuracy was 80%, 100%, 100%, 71.4%, and 87%, respectively, but PSV failed to classify the lesion.

Conclusions
Because the severity of the disease showed a direct relationship with submucosal thickness and an inverse relationship with PSV, habit-induced mucosal alteration in submucosal thickness can be seen on USG, which cannot be appreciated on clinical examination. Hence, USG can be a promising tool for early diagnosis, assessment of the severity, and evaluation of prognosis of OSMF.