An exfoliative cytology study to assess oral mucosa of oral submucous fibrosis patients in Chennai, Tamil Nadu

Background: Oral submucous fibrosis (OSMF) is a chronic, insidious disease that affects the oral mucosa. It is a progressive high risk potentially malignant disorder that leads to oral mucosa scarring. Aim: In this study, we aimed to study and compare the differences in the buccal cytological smear and the nuclear and cytoplasmic changes seen in the exfoliated cells of patients with OSMF and healthy controls, during preliminary screening. Materials and Methods: Patients with clinical OSMF (reduced mouth opening, blanched buccal mucosa, burning sensation in the buccal mucosa, palpable vertical bands) were included in the study. The cytological smears were stained with Papanicolaou stain and studied under light microscopy. The nuclear and cytoplasmic changes were recorded. The cytologic features that were assessed included the presence of keratinized squames, intermediate cells, inflammatory cells, cytoplasmic creasing, peri nuclear halo, and abnormal chromatin. In addition, the presence and absence of candidal organisms in the smear were assessed. Results: The cytological features which were seen to predominate in the OSMF patients were cells of intermediate and keratinized buccal epithelial cells, cytoplasmic creasing, and presence of inflammatory cells. Conclusion: We conclude that the results of our study indicate that there are cytological changes associated with OSMF that can be assessed with exfoliative cytology. The cellular pattern alterations recorded in our study adds on to the current knowledge pool and literature on OSMF. Further studies are necessary to validate the significance of such cellular alterations.