Collagen in histologic stages of oral submucous fibrosis: A polarizing microscopic study

Background: Oral submucous fibrosis (OSF) is a precancerous condition in which there is excessive deposition of collagen in connective tissue. The purpose of present study was to compare changes in birefringence of collagen fibers in histopathological stages of OSF. Materials and Methods: Collagen in connective tissue of 91 cases of OSF was studied by staining 5 μm thick sections with picrosirius red. The polarization colors of thin (0.8 μm or less) and thick (1.6-2 μm) collagen fibers were recorded. Results: The birefringence of thin collagen fibers showed no difference in both histopathological connective tissue stages and degrees of epithelial dysplasia. The polarization colors of thick collagen fibers showed a gradual change from predominantly yellow-orange to greenish-yellow in advancing connective tissue stages and degrees of epithelial dysplasia. Conclusion: The results of present study show a significant change in birefringence of collagen between connective tissue stages and between mild, moderate to severe degree of epithelial dysplasia. This change in birefringence colors and arrangement of collagen fibers may give an implication of impending neoplastic change in OSF.