Association of Oral Melanosis with Soft Tissue Pathologies: A Hospital- based Observational Study

Abstract

Introduction: Oral pigmentation can be physiological/pathological, exogenous/endogenous. Melanin is the most important pigment responsible for normal pigmentation. Recent increasing evidence shows that melanosis occurs in many oral soft tissue pathologies. Aim: To assess the pigmentation in various oral soft tissue lesions with that of normal oral mucosa. Materials and Methods: An observational study was conducted at Maulana Azad Institute of Dental Sciences, New Delhi, India, for a period of six months. A total of 805 study participants were included in the study population. Among these, 605 study participants with soft tissue pathologies with or without tobacco habits were selected and 200 study participants without any pathology and habit comprised were taken as controls. Assessment of oral melanosis was done at various sites within the oral cavity. Prevalence of melanosis with oral lesions and habits was estimated using Statistical Package for the Social Sciences (SPSS) statistical software (version 16.0). Results: Out of 605, 280 cases (46.28%), and out of 200, 54 controls (27%) showed melanosis which was statistically significant. Melanosis was most prevalent in men, in the age group of 21-40 years predominantly involving the buccal mucosa. Maximum cases presenting melanosis were amongst smoked tobacco users and with both tobacco habits were found in leukoplakia (37.7% and 28.3%, respectively). However, 74.2% smokeless tobacco users with melanosis showed Oral Submucous Fibrosis (OSMF) which was statistically significant. Conclusion: Various forms of tobacco consumption commonly induce intra mucosal pigmentation which could be due to high chemical and mechanical irritation by tobacco. The study attempts to assess the overall prevalence of melanosis in study participants with pathologies and habits to understand the implications of melanosis in pathologies in the general population.