Objective: Aim of this current study was to determine the malignant transformation associated with hypoxia inducible factor-1α among patients of oral submucous fibrosis (OSF).

Study Design: This Retrospective study was carried from 1^st January, 2021 to 31^st December, 2021 at the Department of Dental Materials, Sardar Begum Dental College, Gandhara University, Peshawar

Methods: There were forty five diagnosed patients of oral submucous fibrosis with ages 18-50 years were included in the current study. After taking informed consent for baseline details were recorded which includes age, gender, causes and symptoms of OSF. Inter Incisal Opening (IIO) of mouth among all the patients were measured. Hypoxia inducible factor-1α was observed among all the cases. Staining intensity of fibroblast and correlation of different grades of staining intensity with blood vessels were assessed in terms of mild, moderate and severe. SPSS 26.0 version was used to analyze complete data.

Results: There were 32 (71.1%) males and 13 (28.9%) females in this study. 22.13±5.29 kg/m² was the mean body mass index of patients with mean age 31.02±3.45 years. Most common cause was tobacco found in 20 (44.4%) cases, followed by smoking in 15 (33.3%) patients and areca nut found in 10 (22.2%) cases. Most common symptom was burning sensation, pain, ulceration and dry mouth. Twenty four (53.3%) patients had IIO level <27mm and >27mm level was in 21 (46.7%) patients. Mean blood vessels were 11.1±2.34 with majority of the cases had mild staining intensity in 23 (51.1%) cases. Mean fibroblasts were 42.23±5.64 and had mild staining intensity in majority cases 21 (46.7%).

Conclusion: According to our study HIF-1α was an effective factor in the malignant transformation of oral submucous fibrosis. Aside from that, our findings revealed that OSF malignancy can be detected by the use of HIF-1 as a biomarker.