Comparative Analysis of Oral Submucous Fibrosis: A Clinical Assessment and Genetic Biomarkers in Tobacco vs. Non-tobacco Consumers.

Objective: To evaluate the oral cavity of tobacco and non-tobacco consumers, focusing on the severity of oral submucous fibrosis (OSF) using clinical diagnostic scales and molecular biomarkers. Design: A comparative cross-sectional study. Methods: A total of 200 individuals scheduled for general surgeries (100 tobacco consumers and 100 non-tobacco consumers) were assessed. OSF severity was evaluated using Mallampati Classification (MPC), Maximal Mouth Opening (MMO), dysphagia scoring, and Thyromental Distance (TD). Additionally, the Kallikrein, Adam, and Cathepsin genes were examined as molecular biomarkers due to their relevance in various health conditions. Results: A significantly higher number of males were observed in the tobacco group (p-value = 0.0018). The mean age was 48.02 ± 16.5 years for tobacco users and 46.52 ± 13.3 years for non-users, with no significant age difference (p-value = 0.4805). Significant differences were found between the two groups in MPC, MMO, and dysphagia (all p-values = 0.000), indicating higher OSF severity in tobacco consumers. No significant difference was observed in TD (p-value = 0.761). Molecular analysis revealed that 10% of participants tested positive for Kallikrein gene amplification, while Adam and Cathepsin gene amplification was not detected. Conclusion: Tobacco consumption is associated with significant changes in oral diagnostic parameters, suggesting an elevated risk of OSF. The clinical diagnostic scales used are effective in identifying OSF severity, and Kallikrein gene amplification may serve as a potential molecular marker. These findings support the integration of clinical and molecular diagnostics for early detection in tobacco chewers.