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J Oral Maxillofac Pathol. 2019 May-Aug;23(2):301. doi: 10.4103/jomfp.JOMFP_191_18.

Expression of cyclooxygenase 2 in oral submucous fibrosis: An immunohistochemical pilot study.

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Department of Oral and Maxillofacial Surgery, Rajarajeshwari Dental College and Hospital, Bengaluru, Karnataka, India.
Department of Oral and Maxillofacial Surgery, V. S. Dental College and Hospital, Bengaluru, Karnataka, India.
Department of Oral and Maxillofacial Pathology, AECS Maaruti College of Dental Sciences and Research Center, Bengaluru, Karnataka, India.



Oral submucous fibrosis (OSF) is associated with inflammatory changes in at least some stages of the disease. Prostaglandin is one of the main inflammatory mediators and its production is controlled by various enzymes such as cyclooxygenase (COX). The genetic and pharmacological data strongly indicate that COX-2 should be investigated as a potential target for the prevention and treatment of OSF.


The study group comprised histologically confirmed specimens (n = 10 each) of early OSF, moderate OSF, advanced OSF and normal oral mucosa for comparison. Immunohistochemistry was performed with avidin-biotin technique and evaluated with scoring methods.


The difference in percentage of expression in normal tissue and OSF was statistically highly significant (P < 0.001). Positive COX-2 exhibited cytoplasmic staining. One-way analysis of variances test was performed to evaluate COX-2 expression in different grades of OSF. Cytoplasmic staining assessed in terms of intensity, percentage of expression and Q Score did not show any statistical difference (percentage of expression F = 0.029, P = 0.971; Q Score F = 0.154, P = 0.858).


Our study indicates that COX-2 may be an important marker of disease progression and might be a reliable prognostic indicator.


Cyclooxygenase-2; immunohistochemistry; oral submucous fibrosis; salivary expression

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