{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T22:19:10Z","timestamp":1789510750179,"version":"build-2803163510"},"reference-count":166,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T00:00:00Z","timestamp":1601424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007300","name":"China Medical University","doi-asserted-by":"publisher","award":["CMU109-ASIA-12"],"award-info":[{"award-number":["CMU109-ASIA-12"]}],"id":[{"id":"10.13039\/501100007300","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 108-2314-B-039-009-MY3"],"award-info":[{"award-number":["MOST 108-2314-B-039-009-MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 109-2314-B-468 -006 -MY3"],"award-info":[{"award-number":["MOST 109-2314-B-468 -006 -MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Oral submucous fibrosis (OSF) is a collagen deposition disorder that affects a patient\u2019s oral function and quality of life. It may also potentially transform into malignancy. This review summarizes the risk factors, pathogenic mechanisms, and treatments of OSF based on clinical and bio-molecular evidence. Betel nut chewing is a major risk factor that causes OSF in Asia. However, no direct evidence of arecoline-induced carcinogenesis has been found in animal models. Despite identification of numerous biomarkers of OSF lesions and conducting trials with different drug combinations, clinicians still adopt conservative treatments that primarily focus on relieving the symptoms of OSF. Treatments focus on reducing inflammation and improving mouth opening to improve a patient\u2019s quality of life. In conclusion, high-quality clinical studies are needed to aid clinicians in developing and applying molecular biomarkers as well as standard treatment guidelines.<\/jats:p>","DOI":"10.3390\/ijms21197231","type":"journal-article","created":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T09:04:12Z","timestamp":1601543052000},"page":"7231","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":144,"title":["Oral Submucous Fibrosis: A Review on Biomarkers, Pathogenic Mechanisms, and Treatments"],"prefix":"10.3390","volume":"21","author":[{"given":"Yen-Wen","family":"Shen","sequence":"first","affiliation":[{"name":"School of Dentistry, China Medical University, Taichung 40402, Taiwan"},{"name":"Department of Dentistry, China Medical University Hospital, Taichung City 404332, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin-Hwa","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3008-8165","authenticated-orcid":false,"given":"Lih-Jyh","family":"Fuh","sequence":"additional","affiliation":[{"name":"School of Dentistry, China Medical University, Taichung 40402, Taiwan"},{"name":"Department of Dentistry, China Medical University Hospital, Taichung City 404332, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzong-Ming","family":"Shieh","sequence":"additional","affiliation":[{"name":"School of Dentistry, China Medical University, Taichung 40402, Taiwan"},{"name":"Department of Dental Hygiene, China Medical University, Taichung 40402, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1002\/ijc.28754","article-title":"Potentially malignant disorders of the oral cavity: Current practice and future directions in the clinic and laboratory","volume":"136","author":"Dionne","year":"2015","journal-title":"Int. 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