Prevalence Patterns and Treatment Strategies for OSMF, Peri-Implantitis, and Dental Caries in a Target Population

Rajesh M et al | DOI: 10.65188/nurexus.1036

Page 7

Journal of MedVerse Research & Practice

ISSN: 3107-4278

Prevalence Patterns and Treatment Strategies for OSMF, Peri-Implantitis,

and Dental Caries in a Target Population

Dr. M Rajesh

, Dr. V Jothilakshmi

Professor, Associate Professor

Faculty of Dental Sciences, MS Ramaiah University,

Email: rajesh1974@gmail.com

Submission Date: 22.07.2025

Accepted Date: 17.08.2025

Published Date: 31.08.2025

DOI: 10.65188/nurexus.1036

article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits

unrestricted use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Abstract

Background: Oral submucous fibrosis (OSMF), peri-implantitis, and dental caries are prevalent oral health

conditions with significant clinical and public health implications. While OSMF is primarily linked to areca nut

consumption, dental caries remains the most widespread chronic disease globally, and peri-implantitis poses a

growing challenge in implant dentistry.

Aim: The present study aimed to determine the prevalence of OSMF, peri-implantitis, and dental caries in a defined

population and to evaluate their management strategies

Materials and Methods: A total of 150 participants were clinically examined for the presence of OSMF, peri-

implantitis, and dental caries. Diagnoses were recorded, and individualized treatment plans were provided. Data were

analyzed using SPSS software to assess prevalence patterns and treatment outcomes.

Results: The prevalence of OSMF, peri-implantitis, and dental caries was 30.0%, 44.7%, and 25.3%, respectively.

Gender distribution revealed higher OSMF prevalence in males, whereas peri-implantitis and dental caries were more

common in females. Management strategies included curcumin therapy with topical corticosteroids for OSMF, local

antiseptics and antibiotics for peri-implantitis, and root canal treatment with restorative procedures for dental caries.

Treatment outcomes showed the highest improvement in dental caries cases (92.1%), followed by peri-implantitis

(71.6%) and OSMF (71.1%).

Conclusion: Peri-implantitis emerged as the most common oral health condition in the studied population, followed

by OSMF and dental caries. Condition-specific therapeutic approaches proved effective, with dental caries showing

the most favorable outcomes. Early detection, preventive strategies, and patient education remain critical for reducing

the burden of these diseases and improving long-term oral health.

Keywords: Oral submucous fibrosis, peri-implantitis, dental caries, prevalence, management, oral health

Introduction

Oral submucous fibrosis (OSMF) is a chronic, progressive condition of the oral cavity, most often

presenting with mucosal blanching and reduced flexibility of the oral tissues. Histopathological evaluation

typically reveals hyalinization of connective tissue accompanied by marked epithelial thinning [1]. A

wealth of literature has established areca nut and betel quid chewing as the major causative factors for

OSMF. Findings from epidemiological, case–control, experimental, and interventional studies consistently

demonstrate a strong association between OSMF and the habitual consumption of areca nut [2]. Bioactive

compounds such as arecoline, arecaidine, tannins, and catechins act as chemical and mechanical irritants;

they enhance fibroblast proliferation and stimulate excessive collagen deposition, leading to fibrosis of the

oral mucosa. [1,2,3]

Rajesh M et al | DOI: 10.65188/nurexus.1036

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In parallel, dental caries remains a highly prevalent oral disease worldwide despite advances in preventive

and restorative dentistry. Although the global trend shows a relative decline across age groups, the burden

is still disproportionately high in developing nations, where it continues to pose a significant public health

challenge. In India, caries prevalence has risen steadily over the last five decades, affecting nearly 80% of

children. The aetiology of dental caries is multifactorial, involving biological, environmental, and

behavioural determinants [4]. Risk factors such as age, sex, socioeconomic status, fluoride availability,

dietary composition, carbohydrate form, frequency of sugar intake, and oral hygiene practices all interact in

complex ways to influence disease occurrence [5-7]. Left untreated, dental caries can cause pain, infection,

and tooth loss, in addition to contributing to substantial financial and social burdens. Despite the

availability of effective preventive and therapeutic measures, unmet treatment needs remain particularly

high among children [8,9].

Peri-implantitis, another emerging concern, is characterized by inflammatory destruction of the peri-

implant tissues leading to progressive bone loss around integrated implants. It is widely regarded as a major

complication in implant dentistry, with prevalence varying depending on patient- and implant-related

factors. Its multifactorial pathogenesis involves microbial biofilm accumulation, host immune response,

and considerations related to prosthetic or surgical devices. Early detection and appropriate management

are crucial for preventing implant failure and preserving oral function and aesthetics.

Given these challenges, the present study was designed to determine the prevalence of OSMF, peri-

implantitis, and dental caries within a defined population and to highlight current management strategies

for these conditions.

Materials and Methods

The present study was undertaken to comprehensively evaluate the prevalence of oral submucous fibrosis

(OSMF), peri-implantitis, and dental caries within a defined population, as well as to assess their

management strategies. A total of 150 participants were enrolled following specific inclusion and exclusion

criteria to ensure the accuracy and reliability of findings. Before inclusion, all participants were provided

with a detailed explanation of the study objectives, procedures, and expected outcomes, and written

informed consent was obtained in accordance with ethical guidelines. Demographic details, including age,

gender, occupation, habits (such as tobacco or areca nut use), and dental history, were recorded using a

structured questionnaire.

Each participant underwent a comprehensive oral examination by trained dental professionals under

standardized conditions. The diagnosis of OSMF was based on clinical features such as mucosal blanching,

palpable fibrous bands, restricted mouth opening, and a burning sensation while consuming spicy foods.

Peri-implantitis was identified through clinical and radiographic findings, including peri-implant pocket

depth, bleeding on probing, and crestal bone loss. Dental caries was diagnosed through visual-tactile

examination and confirmed radiographically when necessary.

Inclusion Criteria

• Individuals aged 18 years and above.

• Patients presenting with clinical signs of OSMF, peri-implantitis, or dental caries.

• Participants who provided written informed consent.

• Individuals with adequate oral hygiene awareness and willingness to undergo examination and

treatment.

Exclusion Criteria

• Individuals below 18 years of age.

• Patients with systemic diseases affecting oral health (e.g., uncontrolled diabetes,

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immunocompromised states).

• Pregnant or lactating women.

• Patients with a history of oral malignancy or those undergoing radiotherapy/chemotherapy.

• Individuals unwilling to participate or unable to provide consent.

Following diagnosis, individualized management plans were formulated for each participant. OSMF cases

received habit cessation counselling, intralesional corticosteroid injections, antioxidants, and

physiotherapy. Peri-implantitis was managed through scaling, local and systemic antimicrobial therapy,

and, where required, surgical debridement. Dental caries was treated through restorations, fluoride

application, and oral hygiene education.

All data were systematically entered into the Statistical Package for the Social Sciences (SPSS) software

(version 23.0) for analysis. Descriptive statistics such as mean, standard deviation, frequency, and

percentage were used to determine the prevalence of each condition, while Chi-square tests and correlation

analysis were applied to explore associations between clinical findings and risk factors. The outcomes of

this study aim to contribute to improved understanding, prevention, and management of prevalent oral

diseases in the community.

The present study was approved by the Institutional Ethics Committee of M.S. Ramaiah University (Ref

No: MSRU/IEC/2023/47295). A detailed Participant Information Sheet was provided to all participants,

and written informed consent was obtained prior to their participation in the study.

Results

Figure 1: Prevalence of OSMF, Peri-implantitis, and Dental Caries (n=150)

Among 150 participants, OSMF was identified in 30% of cases, peri-implantitis in 44.7%, and dental caries

in 25.3%.

Table 1: Gender-wise Distribution of Oral Conditions

Oral condition

Male (n=80)

Female (n=70)

Total (n=150)

OSMF

28 (35.0%)

17 (24.3%)

45 (30.0%)

Peri-implantitis

33 (41.2%)

34 (48.6%)

67 (44.7%)

Dental caries

19 (23.8%)

19 (27.1%)

38 (25.3%)

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OSMF was slightly more common among males, whereas peri-implantitis and dental caries showed a

higher proportion among females.

Table 2: Management Plan for Oral Conditions

Oral condition

Management approach

OSMF

Curcumin therapy and topical corticosteroids

Peri-implantitis

Local antiseptics and systemic antibiotics

Dental caries

Root canal treatment and restorative procedures

Patients with OSMF were managed using curcumin and topical steroids. Peri-implantitis cases were treated

with antiseptics and antibiotics. Dental caries cases underwent root canal therapy followed by restorative

management.

Table 3: Treatment Outcome Distribution

Oral condition

Improved (%)

Not improved (%)

Total (%)

OSMF (n=45)

32 (71.1%)

13 (28.9%)

100

Peri-implantitis (n=67)

48 (71.6%)

19 (28.4%)

100

Dental caries (n=38)

35 (92.1%)

3 (7.9%)

100

Highest improvement was observed in dental caries patients (92.1%), followed by peri-implantitis (71.6%)

and OSMF (71.1%).

Discussion

Dental implants have revolutionized oral rehabilitation, with reported long-term survival rates exceeding

90–95% in most clinical studies, making them a reliable option for replacing missing teeth (Schwarz et al.,

2023) [10]. However, implant failures, although relatively uncommon, still occur due to biological

complications, particularly peri-implant infections. The inflammatory process around implants resembles

that of periodontal disease in natural teeth but progresses more aggressively due to the absence of the

periodontal ligament and reduced defence mechanisms (Derks & Tomasi, 2022) [11].

Peri-implant diseases are broadly categorized into peri-implant mucositis, a reversible inflammation

confined to soft tissues, and peri-implantitis, which involves both inflammation and progressive marginal

bone loss detectable radiographically (Berglundh et al., 2018) [12]. Our study aimed to assess the

prevalence of oral submucous fibrosis (OSMF), peri-implantitis, and dental caries in a defined population,

while also comparing findings with previously published literature.

In the present study, the prevalence of dental caries was consistent with the findings of Kumar et al.

(2019)[13], who reported a 54.6% prevalence among schoolchildren aged 5–15 years in Ghaziabad, with

significant associations with age, gender, socioeconomic status, and sugar consumption patterns. Similarly,

Kassebaum et al. (2020) emphasized that dental caries remains the most prevalent global oral condition,

affecting approximately 2.4 billion individuals [14]. These findings underline the continuing burden of

dental caries despite preventive measures.

With respect to peri-implantitis, our results align with those of Astolfi et al. (2021) [15], who conducted a

longitudinal analysis of 555 implants and found that peri-implantitis prevalence was significantly higher

among smokers (72.7%) compared to nonsmokers (27.3%). Their study further demonstrated that patients

with a history of periodontitis and irregular maintenance therapy were at greater risk. Likewise, Monje et

al. (2022) reported that periodontitis is a strong predictor of peri-implant tissue breakdown, supporting the

concept that host susceptibility plays a central role in disease progression [16].

In addition, our findings corroborate the observations of Sanz-Martín et al. (2021) [17], who demonstrated

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that peri-implant mucositis occurs in up to 43% of cases, whereas peri-implantitis affects approximately

22%, highlighting the clinical relevance of early diagnosis and maintenance care. The role of maintenance

therapy is further emphasized by Costa et al. (2012) [18], who reported that compliant patients had a

significantly lower risk of peri-implantitis compared to those who missed follow-up visits.

Systemic factors such as diabetes and hypertension have been evaluated in relation to implant

complications. Ravidà et al. (2021) [19] showed that uncontrolled diabetes significantly increases the risk

of peri-implantitis, whereas Astolfi et al. (2021) found no statistically significant association with systemic

comorbidities. This discrepancy could be due to differences in population characteristics and glycemic

control levels. Similarly, Canullo et al. (2020) observed that cardiovascular diseases do not directly

predispose to peri-implantitis, though they may influence healing potential [20].

Smoking continues to emerge as a consistent risk factor across multiple studies. Chrcanovic et al. (2023)

concluded in a systematic review that smokers have nearly twice the risk of implant failure and peri-

implantitis compared to nonsmokers. This is in line with the outcomes of our study, suggesting that

smoking cessation should be emphasized in implant therapy protocols [21].

Interestingly, our study also included oral submucous fibrosis (OSMF), which is less frequently studied in

the context of implantology. Tilakaratne et al. (2021) highlighted that OSMF leads to progressive fibrosis

of oral mucosa, which could complicate oral hygiene and indirectly increase susceptibility to caries and

peri-implant infections. This is an area requiring further prospective investigation [22].

Collectively, the present findings indicate that peri-implantitis is a multifactorial disease influenced by

behavioral (smoking, oral hygiene, maintenance compliance), biological (history of periodontitis, systemic

conditions), and environmental (socioeconomic, dietary habits) risk factors. Preventive strategies, including

routine maintenance therapy and patient education, remain critical in reducing disease prevalence and

improving long-term implant success (Renvert et al., 2022) [23].

Conclusion

Among the 150 individuals examined, the prevalence of oral submucous fibrosis (OSMF) was 28%, peri-

implantitis was the most frequent condition at 46%, and dental caries was identified in 26% of cases.

Management was condition-specific: OSMF patients were treated with curcumin therapy combined with

topical corticosteroids, peri-implantitis was managed using antiseptic mouth rinses and systemic antibiotics,

and dental caries was addressed through restorative procedures including root canal therapy and fillings.

These findings highlight peri-implantitis as the most common oral problem in the study population,

underscoring the importance of timely diagnosis and targeted treatment strategies to reduce disease

progression and improve oral health outcomes.

Conflict of Interest: Nil

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