Oral submucous fibrosis (OSMF) is a chronic, progressive fibrotic disorder with significant malignant potential, and limited effective treatments due to an incomplete understanding of its underlying molecular mechanisms. This narrative review synthesizes current evidence on the key molecular networks involved in OSMF pathogenesis, highlighting the central role of the TGF-β1/Smad, CTGF, and COL1A1 pathways in maintaining fibroblast activation, supporting myofibroblast activity, and promoting pathological collagen accumulation. It also integrates recent findings on how profibrotic signaling interacts with important angiogenic and epithelial growth factors such as VEGF, FGF, and EGF, creating a stage-dependent fibrotic microenvironment. In early OSMF, increased angiogenic signaling, especially through the VEGF/PI3K–Akt pathway, helps maintain blood supply. However, as the disease progresses, TGF-β-induced pathways become dominant, leading to vascular rarefaction, tissue hypoxia, epithelial instability and worsening fibrosis that increases the risk of malignant transformation. By critically appraising molecular, cellular, and translational studies, this review identifies key pathways linking fibrosis, angiogenesis, and epithelial changes in OSMF. It suggests that stage-specific and combined targeting of TGF-β1, CTGF, COL1A1, along with angiogenic and epithelial pathways, may help reverse fibrosis, restore normal tissue perfusion, reduce cancer risk, and support the development of better therapies and biomarkers beyond symptom relief.
Samar Kamran, Nabeel Reza, Zurairah Berahim et al.· International Journal of Mol...· 0 citations
Periodontal disease is among the most prevalent oral health issues globally. This condition compromises the supportive structures of teeth and is influenced by both local and systemic factors. The 2017 Diagnosis and Classification of Periodontal Diseases and Conditions characterized the severity and progression of periodontitis by staging (I to IV) and grading (A, B, C), respectively. Although this classification scheme has been gradually adopted in local settings since its introduction in 2018, data on the prevalence of periodontitis using this framework remain limited. This study intended to determine the prevalence of periodontitis and its associated factors based on the current classification system among patients attending Hospital Pakar USM (HPUSM). This is a retrospective record review study that utilized the retrieval of patients’ records, spanning 2018 to 2024. Data on sociodemographic and periodontal diagnosis were collected. Data were analysed by using descriptive statistics, chi-squared tests, and an independent t-test. Of 300 records retrieved, 262 had complete periodontal records. The mean age of patients was 42.48 years (SD14.32), with 91.2% being Malays. The overall prevalence of periodontitis was 50.8%, with generalized periodontitis stage III grade C being the most reported (31.4%). Significant associations were found between periodontitis and age (p<0.001), systemic diseases (p<0.001), medication taken (p=0.001), and smoking habits (p<0.001). Within study limitations, periodontitis stage III grade C was prevalent among the study population. Age, systemic diseases, medications, and smoking habits are the possible risk factors for periodontitis.
Syawal Fitri Rosli, Zurairah Berahim, N. S. Nordin et al.· IIUM Journal of Orofacial an...· 0 citations
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