We aimed to describe and analyze the epidemiologic and clinical variables associated with, treatment for, and development of cervicofacial infection (CFI).
We retrospectively examined 201 patients ...older than 14 years who had met the CFI diagnostic criteria and whose treatment required hospitalization and intervention under general anesthesia at our hospital. We performed chi-square tests to compare proportions in categorical variables and either the Student t test or the Wilcoxon signed-rank test to compare quantitative variables. We performed an analysis of variance to compare 3 or more categories and either Pearson or Spearman correlation coefficient analysis to examine the correlations between quantitative variables.
The majority (85.07%) of the CFIs were of odontogenic origin. The mean hospitalization length was 4.58 days. Patients with diabetes who used tobacco and/or alcohol had a significantly longer length of hospitalization and several postoperative complications.The most common symptoms were pain, trismus and toothache. Symptoms of fever and nausea were associated with longer hospitalization. The most affected anatomic spaces were submandibular and pterygomandibular. Buccal and infraorbital, temporal, and parotid spaces were associated with longer hospitalization.
Most CFIs are of odontogenic origin. Diabetes and tobacco and alcohol use are important risk factors. Treatment should be surgical and target the cause of infection. Timely referrals are important when patients present symptoms compatible with CFI for immediate treatment.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Objectives
Oral squamous cell carcinoma (OSCC) is a multifactorial disease. The individual effect of each risk factor for OSCC may be conditioned by the frequency of other factors. The objective of ...this study was to identify the association between chronic mechanical irritation (CMI) and OSCC and to analyse the influence of CMI on other important risk factors for OSCC.
Materials and methods
A prospective and age/sex-matched case-control study was performed in two institutions from Argentina between 2009 and 2019, with consecutive and newly diagnosed OSCC. The frequencies of tobacco, alcohol, and CMI were analysed using conditional logistic regression. Cumulative tobacco consumption and the presence of CMI were analysed using the Mann-Whitney test.
Results
CMI and OSCC were associated with an
OR
of 7.02 (95%
CI
3.57–13.78,
p
< 0.001). The combination of CMI and alcohol demonstrated the highest risk of OSCC (
OR
53.83,
CI
95% 8.04–360,
p
< 0.0001), followed by the combination of CMI, tobacco, and alcohol (
OR
48.06,
CI
95% 8.47–272,
p
< 0.0001). The combination of CMI and tobacco was also significant (
OR
5.61,
CI
95% 1.07–29.54,
p
= 0.042). Patients with CMI developed OSCC with less cumulative tobacco use compared with those without CMI.
Conclusion
CMI is an independent risk factor for OSCC, and it could act as a risk modifier among tobacco and alcohol users having an enhancing effect.
Clinical relevance
Elimination of CMI could decrease the risk of OSCC.
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CMK, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
J Oral Pathol Med (2010) 39: 513–517
Background: Oral cancer represents 2%–5% of all cancers, being one of the 10 most frequent ones. Apart from oral cancer risk factors already described in ...literature, such as tobacco and alcohol consumption, others emerging risk factors have been proposed, such as chronic irritation from dental factors. The aim of this work was to assess the influence of chronic trauma of the oral mucosa (CTOM) in patients with oral potentially malignant disorders (OPMD) and cancer.
Methods: A retrospective study of 406 patients (both sexes; aged between 18 and 80 years; with OPMD and cancer) who attended the Department of Clinical Stomatology A of the National University of Cordoba was performed by non‐probabilistic sampling. The association of variables and outcome variable diagnosis, with levels control, OPMD, oral cancer, was evaluated by multinomial regression model.
Results: Population under study was represented by 72% of control patients, 16% patients with OPMD and 11% of patients with oral cancer. It was observed a significant association between diagnosis and CTOM (P = 0.000), after adjustment of confounding factors (smoking and drinking habits, sex, cancer inheritance and denture use).
Conclusions: Our results suggest that CTOM is, together with other factors, an important risk factor in patients with oral cancer diagnosis, but not for patients with OPMD.
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BFBNIB, CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
BACKGROUNDChronic wounds were previously related to cancer. Chronic Traumatic Ulcers (CTU) are lesions caused by chronic mechanical irritation (CMI) frequently diagnosed in Oral Medicine. Although ...these conditions may reflect a benign nature, some authors have proposed its relationship with malignant transformation. Currently, there are scarce investigations that evaluate biomarkers within CTU. The aim of this study was to evaluate cell differentiation and proliferation biomarkers patterns of CTU and OSCC through recognized markers such as cytokeratin 19 and Ki67 and correlate it with clinical features of both groups of patients. MATERIAL AND METHODSA Cross-sectional study of adult patients (n=79), both sexes, attended at Oral Medicine Department, Facultad de Odontología, Universidad Nacional de Córdoba. The patients were classified into two groups: CTU (n=41), and OSCC (n=38). A subset of specimens were immunolabeled with Ki67 and Ck19. RESULTSThe population consisted of 51.9% male and 48.1% female, with an average of 57.0 ± 13.9. years (OSCC group) and 60.9 ± 14.9 years (CTU group). OSCC group presented higher scores for both biomarkers (Ki67 and Ck19), but only there were differences statistically significant for Ki67 (p=0.032). 25% of non-healing CTU were positive with medium scores of Ck19 and showed an immunohistochemical profile similar to OSCC. The lateral tongue was the most frequent site in both groups. CONCLUSIONThe altered immunohistochemical pattern found in many specimens of CTU was also observed in OSCC. The tongue border presents physiological conditions that could offer a suitable environment for the development of neoplastic events associated with CMI. Further studies are needed to understand the underlying mechanisms that could link oral non-healing ulcers with early malignant changes.
Objective. Oral mucosa could host many lesions originated by chronic mechanical irritation (CMI) from teeth or dentures, and it has been proposed as risk factor for oral cancer. Nevertheless, the ...features of CMI factors in oral cancer and other lesions are not assessed. The aim of this study is to describe CMI features regarding type (dental, prosthetic, and/or functional), localization, and time span. Materials and Methods. Three groups were studied in this cross-sectional study: Oral Cancer (OC); Chronic Traumatic Ulcer (CTU); and Benign Irritative Mechanical Lesions (BIML). All sources of mechanical irritation were included: dental, prosthetic, and functional. Results. 285 patients (176 females, 109 males) were studied: OC = 38, CTU = 44, and BIML = 203. The most frequent CMI factor was dental, followed by functional and prosthetic in all groups; 76.5% (n=218) presented functional factors. Buccal mucosa (45%) and tongue (42%) were the most affected sites. Time of action of CMI displayed statistically significant differences between BIML, CTU, and OC groups, with a mean of 21, 33, and 49 months, respectively. Conclusions. CMI should be properly recorded with as much detail as alcohol and tobacco consumption. CMI associated lesions are produced by dental or prosthetic factors, usually in relation to functional factors, involving mainly tongue and buccal mucosa.
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CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Objetivo: Los desórdenes de mucosa bucal potencialmente malignos pueden presentar áreas displásicas. En estos casos, la biopsia es un procedimiento imprescindible para un correcto diagnóstico. La ...inspección visual y la palpación,como método de selección del área de biopsia, ofrecen sensibilidad y especificidad adecuadas pero mejorables. El objetivo de este artículo es presentar una serie de casos clínicos en los que se describen el empleo y la interpretación de la tinción vital con azul de toluidina como método complementario para contribuir a una mejor elección del área de biopsia.
Casos clínicos: Se trata de siete casos de lesiones con sospecha de displasia epitelial en mucosa bucal. En cada uno se detalla la correlación de las áreas teñidas con las manifestaciones clínicas y con el diagnóstico de displasia. Además, se muestran patrones de tinción considerados falsos positivos. En la interpretación de la tinción positiva, se tuvieron en cuenta el aspecto superficial y el color de la lesión teñida. El empleo combinado de inspección, palpación y tinción vital podría constituir un procedimiento integral de utilidad para obtener mayor precisión en la determinación del sitio de biopsia en comparación con los mismos procedimientos aplicados de manera individual. En la interpretación de la tinción positiva con azul de toluidina deberían considerarse el aspecto superficial y el color de la lesión teñida.
Biopsia, carcinoma de células escamosas de cabeza y cuello, cloruro de telonio, condiciones precancerosas, detección precoz del cáncer.
Oral venous varicosities (OV) are a common condition, increasing its incidence with age. They are also mentioned in association with several medical conditions, but the evidence is scarce and ...inconsistent. The aim was to describe OV clinical features and to analyze the association with medical conditions.
An observational, cross-sectional study was carried out in the Oral Medicine Department from 2012 to 2016. Oral cavity was examined by calibrated professionals double blind (kappa >0.60) in a standard dental chair. Chi-square test and logistic regression analysis were used to assess variables.
The final sample was 672 individuals. OV were found in 46 %, (62 % = female and 38 % = male) and they were asymmetric (96.8 %, p < 0.0001). Age showed a statistically significant difference between OV and Control (p < 0.0001). Also, there was significant difference in mean age regarding extension (p < .0001, years): G1 (only sublingual OV) = 48.61; G2 (sublingual OV plus one site) = 63.56 and G3 (sublingual OV + 2 or more sites) = 75.13 (95 % CI: ±1.9763). The most frequent medical conditions were: lower limb varices (n = 162), tobacco consumption (n = 98), family history of varices (n = 81), hypertension (n = 50), Type 2 diabetes (n = 25). OV of advanced grades (G2 & G3) were more common in association to lower limb varices, heart failure, diabetes, arterial and portal hypertension.
OV occurrence rises with age, and its presence could be a sign of certain medical conditions. Our study offers an insight into OV supporting the research of its potential use in primary health population screening.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Introducción: La osteonecrosis maxilar asociada a medicamentos es una complicación encontrada en pacientes bajo tratamiento con drogas antirresortivas. Patologías oncológicas como mieloma múltiple, ...cáncer de mama y próstata y alteraciones óseas-metabólicas como la osteoporosis lideran las indicaciones para estas terapias antirresortivas. Aún con una baja frecuencia, los síndromes mielodisplásicos también son entidades que previamente han sido vinculadas al desarrollo de osteonecrosis. Objetivo: el objetivo de este trabajo es presentar un caso de un paciente masculino de 78 años con síndrome mielodisplásico y osteoporosis secundaria, tratado con Ácido Zoledrónico a altas dosis y que en su evolución desarrolló un cuadro clínico compatible con osteonecrosis maxilar asociada a medicamentos. Metodología: el caso fue registrado y tratado en la Cátedra de Estomatología “A” de la Facultad de Odontología, Universidad Nacional de Córdoba, durante un periodo de dos años con una resolución parcial del cuadro, el cual recurrió a los catorce meses, donde finalmente se llegó al éxito terapéutico mediante terapéuticas conservadoras. Conclusión: debido al uso cada vez más extendido de fármacos antirresortivos, es posible el desarrollo de osteonecrosis maxilar asociada a patologías menos frecuentes, como el síndrome mielodisplásico. El éxito del tratamiento en estos pacientes depende del manejo interdisciplinario y de un riguroso seguimiento clínico médico y odontológico.
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