Abstract
Background: Oral use of smokeless tobacco has been documented as a prime cause of oral cancer. Thus, the present study aimed to evaluate the merit of combined use of AgNORs and oral mucosal keratinization for early prediction of cytological atypia associated with smokeless tobacco use. Methodology: This was a case-control study that included 96 participants, 48 persons were smokeless tobacco users ascertained as the case group, and 48 individuals were non-tobacco users affirmed as a control group. All study subjects were selected from the Hail area, Saudi Araba, from October 2019 to January 2020. Cytological materials were obtained from all participants by scraping of oral mucosa using a wooden tongue depressor. Results: Mean counts of AgNORs of > 2 dots were identified in 25/48(52%) of the cases and only one (2%) of the controls. Keratinization was detected in 33/48(67%) of the cases and 6/48(12.5%) of the controls. Out of the 25 cases with abnormal AgNORs count, 23/25(92%) were detected with keratinization. Conclusion: The combined use of AgNORs and oral mucosal keratinization is useful for the early prediction of cytological atypia associated with smokeless tobacco use. Oral use of smokeless can cause oral mucosal keratinization and cellular proliferation.