RESUMO
BACKGROUND: A study is made of the association between maxillary sinus pathology and odontogenic lesions in patients evaluated with cone beam computed tomography. MATERIAL AND METHODS: A literature search was made in five databases and OpenGrey. Methodological assessment was carried out using the Newcastle-Ottawa tool for observational studies. The random-effects model was used for the meta-analysis. RESULTS: Twenty-one studies were included in the qualitative review and 6 in the meta-analysis. Most presented moderate or low risk of bias. The periodontal disease showed to be associated with the thickening of the sinus membrane (TSM). Mucous retention cysts and opacities were reported in few studies. The presence of periapical lesions (PALs) was significantly associated to TSM (OR=2.43 (95%CI:1.71-3.46); I2=34.5%) and to odontogenic maxillary sinusitis (OMS) (OR=1.77 (95%CI: 1.20-2.61); I2=35.5%). CONCLUSIONS: The presence of PALs increases the probability of TSM and OMS up to 2.4-fold and 1.7-fold respectively. The risk differences suggests that about 58 and 37 of out every 100 maxillary sinuses having antral teeth with PALs are associated with an increased risk TSM and OMS respectively. The meta-evidence obtained in this study was of moderate certainty, and although the magnitude of the observed associations may vary, their direction in favor sinus disorders appearance, would not change as a result.
Assuntos
Sinusite Maxilar , Doenças dos Seios Paranasais , Tomografia Computadorizada de Feixe Cônico , Humanos , Seio Maxilar , OdontogêneseRESUMO
BACKGROUND: Periodontitis has been regarded as a potential risk factor for rheumatoid arthrosis (RA). A systematic review is made to determine whether nonsurgical periodontal treatment in patients with RA offers benefits in terms of the clinical activity and inflammatory markers of the disease. MATERIAL AND METHODS: A search was made of the Medline-PubMed, Cochrane, Embase and Scopus databases to identify studies on the relationship between the two disease processes, and especially on the effects of nonsurgical treatment in patients of this kind. The search was based on the following keywords: rheumatoid arthritis AND periodontitis (MeSH), rheumatoid arthritis AND periodontal treatment. RESULTS: Eight articles on the nonsurgical treatment of patients with periodontitis and RA were finally included in the study. All of them evaluated clinical (DAS28) and laboratory test activity (ESR, CRP, IL-6, TNFα) before and after treatment. A clear decrease in DAS28 score and ESR was recorded, while other parameters such as CRP, IL-6 and TNFα showed a nonsignificant tendency to decrease as a result of treatment. CONCLUSIONS: Nonsurgical treatment improved the periodontal condition of patients with periodontitis and RA, with beneficial effects upon the clinical and laboratory test parameters (DAS28 and ESR), while other inflammatory markers showed a marked tendency to decrease. However, all the studies included in the review involved small samples sizes and follow-up periods of no more than 6 months. Larger and particularly longitudinal studies are therefore needed to more firmly establish possible significant relations between the two disease processes.
Assuntos
Artrite Reumatoide/complicações , Periodontite/complicações , Artrite Reumatoide/terapia , Proteína C-Reativa , Humanos , Interleucina-6 , Doenças Periodontais , Periodontite/terapiaRESUMO
BACKGROUND: Bisphosphonates (BPs) and other antiresorptive agents such as denosumab are widely prescribed for the treatment of osteoporosis and are also used in patients with multiple myeloma and metastatic breast or prostate cancer for avoiding bone reabsorption and fractures that result in increased morbidity-mortality among such individuals. MATERIAL AND METHODS: We made a bibliographic search to analyze the concept, diagnosis and the different classifications for bisphosphonate-associated osteonecrosis of the jaws. RESULTS: Osteonecrosis of the jaws (ONJ) is an important complication of exposure to BPs or other antiresorptive agents, and although its prevalence is low, it can pose management problems. The definition, diagnosis and classification of osteonecrosis have evolved since Marx reported the first cases in 2003. CONCLUSIONS: The present study offers a literature review and update on the existing diagnostic methods and classification of the disorder, with a view to facilitating earlier and more effective treatment.
Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/diagnóstico , Conservadores da Densidade Óssea/efeitos adversos , Denosumab , Difosfonatos , Feminino , Humanos , Masculino , Osteonecrose , OsteoporoseRESUMO
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is usually initiated by dental surgery, but is occasionally exacerbated by other antiresorptive (denosumab) and anti-angiogenic therapies, and in such cases is currently termed medication-related osteonecrosis of the jaws (MRONJ). The case of a 58-year-old female with breast cancer who developed multiple and ultimately fatal metastases despite 3 years of treatment with chemotherapeutic drugs and intravenous bisphosphonates, is presented herein. Her malignant disease worsened and she was started on mitoxantrone. She developed a severe adverse reaction to this drug soon after starting treatment. As well as diarrhoea and vomiting, she had a very aggressive gingival inflammation with multiple ulcerations in both jaws and wide areas of necrotic bone, affecting the attached gingiva, and seemingly unrelated to dental plaque. These ulcerations and the exposed necrotic bone persisted for more that 6 months, until her death. This report describes a case in which severe gingival ulcerations that occurred after mitoxantrone treatment for metastatic breast cancer were a local factor that initiated MRONJ.
Assuntos
Antineoplásicos/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Doenças Maxilomandibulares/induzido quimicamente , Mitoxantrona/efeitos adversos , Osteonecrose/induzido quimicamente , Evolução Fatal , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: Complement C4d-containing fragments have been proposed as diagnostic markers for lung cancer. The purpose of this study was to evaluate the presence of C4d in oropharyngeal (OPSCC) and oral (OSCC) squamous cell carcinomas. SUBJECTS AND METHODS: C4d staining was analyzed by immunohistochemistry in 244 OPSCC surgical specimens. C4d levels were quantified by ELISA in resting saliva samples from 48 patients with oral leukoplakia and 62 with OSCC. Plasma samples from 21 patients with leukoplakia and 30 with oral carcinoma were also studied. RESULTS: C4d staining in OPSCC specimens was associated with nodal invasion (P = 0.001), histopathologic grade (P = 0.014), disease stage (P = 0.040), and focal-adhesion kinase expression (P < 0.001). No association was found between C4d and prognosis. Saliva C4d levels were higher in patients with oral cancer than in subjects with leukoplakia (0.07 ± 0.07 vs 0.04 ± 0.03 µg ml(-1) , P = 0.003). The area under the ROC curve was 0.63 (95%CI: 0.55-0.71). Salivary C4d levels in stage IV patients were higher than in patients with earlier stages (P = 0.028) and correlated with tumor size (P = 0.045). Plasma C4d levels also correlated with salivary C4d levels (P = 0.041), but differences between patients with oral cancer and subjects with leukoplakia were not significant (1.26 ± 0.59 vs 1.09 ± 0.39 µg ml(-1) , P = 0.232). CONCLUSION: C4d-containing fragments are detected in oral primary tumors and are increased in saliva from patients with OSCC.
Assuntos
Carcinoma de Células Escamosas/química , Carcinoma de Células Escamosas/patologia , Complemento C4b/análise , Neoplasias Bucais/química , Neoplasias Bucais/patologia , Neoplasias Orofaríngeas/química , Neoplasias Orofaríngeas/patologia , Fragmentos de Peptídeos/análise , Carcinoma de Células Escamosas/sangue , Complemento C4b/metabolismo , Feminino , Humanos , Leucoplasia Oral/metabolismo , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/sangue , Estadiamento de Neoplasias , Fragmentos de Peptídeos/metabolismo , Curva ROC , Saliva/química , Carga TumoralRESUMO
We analysed the degree of sclerosis in the different stages of bisphosphonate-related osteonecrosis of the jaws (BRONJ) and studied the relation between the grade of sclerosis, the clinical symptoms, and the depth of lucency. We compared 43 patients with mandibular BRONJ with a control group of 40 cases with no bony lesions. The presence of sclerotic bone, cortical irregularities, radiolucency, fragmentation or sequestration, periostitis, and narrowing of the mandibular canal were studied from computed tomographic (CT) scans using the program ImageJ 1.47v (National Institute of Health, Bethesda, USA) to measure the radiolucency, width of the cortices, and degree of sclerosis. Patients with BRONJ had more severe sclerosis than controls (p<0.01). There was also a significant difference among the different stages of BRONJ, with the highest values found in stage III (p=0.02). The degree of sclerosis differed according to sex, type of bisphosphonate, and the clinical characteristics such as pain, or suppuration, but not significantly so (p>0.05). We conclude that the degree of sclerosis increases with the clinical stage of BRONJ, and is correlated with the depth of lucency.
Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/complicações , Doenças Mandibulares/complicações , Osteosclerose/complicações , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/classificação , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/diagnóstico por imagem , Conservadores da Densidade Óssea/classificação , Fístula Dentária/etiologia , Difosfonatos/classificação , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imidazóis/classificação , Masculino , Doenças Mandibulares/classificação , Doenças Mandibulares/diagnóstico por imagem , Osteoporose/tratamento farmacológico , Osteosclerose/classificação , Osteosclerose/diagnóstico por imagem , Medição da Dor/métodos , Periostite/classificação , Periostite/complicações , Periostite/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Extração Dentária , Ácido ZoledrônicoRESUMO
OBJECTIVE: This study aimed to survey the presence of known oncoviruses in oral biopsies from patients diagnosed with the aetiologically undetermined proliferative verrucous leukoplakia and compare results to those from milder oral leukoplakia (OL) cases, oral squamous cell carcinoma, a common outcome of the lesions of interest, and healthy controls. DESIGN: Blind, retrospective, case-control study. SETTING: A stomatology unit in an academic Hospital and a Public Health laboratory. PARTICIPANTS: Forty patients were divided in four groups. Ten patients had been diagnosed with proliferative verrucous leukoplakia, 10 with OL and 10 with OSCC, and 10 were healthy subjects. MAIN OUTCOME MEASURES: The presence or absence of oncovirus DNA was assayed with the amplification of viral genetic markers using PCR and subsequent gel electrophoresis confirmation. Amplified fragments were sequenced and identified bioinformatically. RESULTS: No DNA from the herpesvirus, papillomavirus or polyomavirus species was detected in the samples. CONCLUSIONS: No association between proliferative verrucous leukoplakia and target viruses was detected. A higher throughput viral metagenomic approach may prove valuable for future analyses, as it would not be restricted to a priori knowledge of potential targets.
Assuntos
Carcinoma Verrucoso/patologia , Carcinoma Verrucoso/virologia , Leucoplasia Oral/patologia , Leucoplasia Oral/virologia , Programas de Rastreamento , Vírus Oncogênicos/isolamento & purificação , Viroses/patologia , Viroses/virologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/virologia , Estudos de Casos e Controles , DNA Viral/análise , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Neoplasias Bucais/virologia , Estudos RetrospectivosRESUMO
INTRODUCTION: Trigeminal neuropathy is most often secondary to trauma. The present study explores the underlying causes and the factors that influence recovery. MATERIAL AND METHODS: A retrospective case study was made involving 63 patients with trigeminal neuropathy of traumatologic origin, subjected to follow-up for at least 12 months. RESULTS: Fifty-four percent of all cases were diagnosed after mandibular third molar surgery. In 37 and 19 patients the sensory defect was located in the territory innervated by the mental and lingual nerve, respectively. Pain was reported in 57% of the cases, and particularly among the older patients. Regarding patient disability, quality of life was not affected in three cases, while mild alterations were recorded in 25 subjects and severe alterations in 8. Partial or complete recovery was observed in 25 cases after 6 months, and in 32 after one year. There were few recoveries after this period of time. Recovery proved faster in the youngest patients, who moreover were the individuals with the least pain. CONCLUSION: Our patients with trigeminal neuropathy recovered particularly in the first 6 months and up to one year after injury. The older patients more often suffered pain associated to the sensory defect. On the other hand, their discomfort was more intense, and the patients with most pain and the poorest clinical scores also showed a comparatively poorer course.
Assuntos
Traumatismos do Nervo Trigêmeo , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Traumatismos do Nervo Trigêmeo/tratamento farmacológico , Traumatismos do Nervo Trigêmeo/etiologia , Adulto JovemRESUMO
OBJECTIVE: Aneuploidy has been associated with malignant and premalignant oral lesions. In the past few years, its application in oral precancerous lesions and its prognostic meaning have been controversial issues. The aim of our study was to characterize alterations in DNA content by automated DNA image cytometry in oral scrapings of patients with oral lichen planus. METHODS: Cytological samples from 40 patients clinicopathologically diagnosed with oral lichen planus were analysed by DNA image cytometry. RESULTS: All the cases were classified as diploid, showing a predominant population of cells with normal DNA content (DNA index, 0.85-1.15). Atrophic/erosive lesions showed a higher percentage of tetraploid cells when compared with reticular/papular lesions but this was not statistically significant (P = 0.09). CONCLUSIONS: Aneuploidy does not seem a common event in oral lichen planus lesions. However, we consider that the use of DNA image cytometry of oral scrapings may be an easy and helpful methodology in the follow-up of patients with these lesions.
Assuntos
Aneuploidia , DNA/análise , Citometria por Imagem/métodos , Líquen Plano Bucal/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Malignant lymphomas represent approximately 5% of all malignant neoplasms of the head and neck area. They are classically divided into two subgroups, Hodgkin's lymphomas (HLs) and non-Hodgkin's lymphomas (NHLs). We describe the clinical characteristics of head and neck lymphomas and the methods to establish the diagnosis. The World Health Organization classification of lymphoid tissues describes more than 50 different histological types, and we analyse the most common staging system for lymphomas, the Ann Arbor staging system. Finally, the different therapeutic approaches are discussed.
Assuntos
Neoplasias de Cabeça e Pescoço/diagnóstico , Linfoma/diagnóstico , Neoplasias Faciais/diagnóstico , Doença de Hodgkin/diagnóstico , Humanos , Linfoma/classificação , Linfoma não Hodgkin/classificação , Linfoma não Hodgkin/diagnóstico , Neoplasias Bucais/diagnóstico , Terapia Neoadjuvante , Estadiamento de Neoplasias , Prognóstico , Neoplasias Cutâneas/diagnósticoRESUMO
Bisphosphonates are widely used drugs, primarily for osteoporosis and also in oncology. A drug-induced side effect or complication, which only recently came to light in 2003, is osteonecrosis of the jaw. This study reviews the chemical characteristics of the various bisphosphonates, their possible mechanism of action, relative potency, the commercial products available on the spanish pharmaceutical market and the indications for bisphosphonate treatment. The study also considers osteonecrosis of the jaw with regard to its onset, concept, clinical stages, why this pathology affects the jaws, its risk factors, incidence, the attitude to be adopted by dentists with patients taking bisphosphonates, a quick review of the treatment and the possible prediction of osteonecrosis.
Assuntos
Difosfonatos/efeitos adversos , Doenças Maxilomandibulares/induzido quimicamente , Osteonecrose/induzido quimicamente , Idoso , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To investigate the prevalence and aetiology of bacteraemia following third molar extractions (B-TME), analysing the factors affecting its development. METHODS: The study group was formed of 100 patients undergoing third molar extractions under general anaesthesia. Peripheral venous blood samples were collected at baseline, 30 s after a mandibular third molar extraction and 15 min after completing the final extraction. Samples were inoculated into BACTEC aerobic and anaerobic blood culture bottles and were processed in the BacT/Alert. Subculture and further identification of the bacteria isolated was performed using conventional microbiological techniques. RESULTS: The prevalence of bacteraemia following third molar surgery was 62% at 30 s after the first dental extraction and 67% at 15 min after finishing the final extraction. The bacteria most frequently identified in the positive blood cultures were Streptococcus viridans (87.9%). CONCLUSION: In our series, the prevalence of B-TME at 30 s after a single third molar extraction was high, principally being of streptococcal aetiology, and was independent of the oral health status and the magnitude of the surgical procedure. Positive blood cultures persisted for at least 15 min after three to four dental extractions in a higher number of patients, questioning the supposedly transient nature of bacteraemia following dental extractions.
Assuntos
Bacteriemia/microbiologia , Dente Serotino/cirurgia , Extração Dentária , Adolescente , Adulto , Índice de Placa Dentária , Feminino , Humanos , Masculino , Mandíbula , Pessoa de Meia-Idade , Neisseria/classificação , Neisseria/isolamento & purificação , Saúde Bucal , Índice de Higiene Oral , Índice Periodontal , Staphylococcus aureus/isolamento & purificação , Streptococcus anginosus/isolamento & purificação , Streptococcus mitis/isolamento & purificação , Streptococcus mutans/isolamento & purificação , Fatores de Tempo , Dente Impactado/cirurgia , Estreptococos Viridans/isolamento & purificaçãoRESUMO
CONCLUSIONS: The postoperative course was excellent for this type of surgery, and the functional recovery was comparable to that obtained with much more laborious techniques. OBJECTIVES: To compare the advantages and disadvantages of the described technique and oropharyngectomy with labial mandibulotomy. PATIENTS AND METHODS: A total of 46 patients underwent surgery by means of an oropharyngectomy without mandibulotomy. The pharynx was reconstructed using a plasty made of four regional flaps. RESULTS: In addition to obvious esthetic benefits, complications of the osteotomy were absent and surgical time was reduced. Some patients undergoing pull-through oropharyngectomy also underwent a marginal mandibulectomy, markedly reducing the frequency of radionecrosis compared with other statistics of techniques using mandibulotomy.
Assuntos
Carcinoma de Células Escamosas/cirurgia , Mandíbula/cirurgia , Neoplasias Orofaríngeas/cirurgia , Faringectomia/métodos , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Orofaríngeas/mortalidade , Neoplasias Orofaríngeas/patologia , Faringe/fisiopatologia , Período Pós-Operatório , Recuperação de Função Fisiológica/fisiologia , Índice de Gravidade de Doença , Espanha/epidemiologia , Taxa de Sobrevida/tendências , Fatores de Tempo , Resultado do TratamentoRESUMO
Trigeminal neuropathies (TNs) are well recognized disorders characterized and manifesting as skin and mucosal numbness in the region innervated by the trigeminal nerve. Facial numbness indicates trigeminal sensory alteration affecting the trigeminal system. TNs always pose differential location difficulties as multiple diseases are capable of producing them: they can be the result of traumatism, tumors, or diseases of the connective tissue, infectious or demyelinating diseases, or may be of idiopathic origin. Their importance is explained by the fact that TN may represent the first manifestation of tumor disease, or of relapse in patients with prior neoplastic processes. As such, these manifestations are ominous, and patient life expectancy is often short. The clinical exploration reveals a loss of sensitivity in the cutaneous territory corresponding to the affected nerve, which can be partial (hypoesthesia) or complete (anesthesia). The sensory defect is occasionally associated with hyperesthesia (i.e., the patient suffers a decrease in sensory perception, but when sensation is perceived, it may cause considerable discomfort). Complementary studies are needed to establish the etiologic diagnosis, with laboratory tests to discard the possible causative diseases underlying the trigeminal neuropathy, and the opportune radiographic examinations in the form of plain X-rays or a routine cranial computed tomography scan.
Assuntos
Doenças do Nervo Trigêmeo/etiologia , Neoplasias dos Nervos Cranianos/complicações , Humanos , Transtornos de Sensação/etiologia , Doenças do Nervo Trigêmeo/diagnóstico , Traumatismos do Nervo TrigêmeoRESUMO
The oral mucous membrane has features similar to skin but also differs in several ways. This paper reviews the aspects of epithelial biology necessary for an understanding of the vesiculoerosive disorders.
Assuntos
Células Epiteliais/química , Células Epiteliais/fisiologia , Animais , Membrana Basal , Caderinas/fisiologia , Adesão Celular , Comunicação Celular , Humanos , ProteínasRESUMO
BACKGROUND: We present a series of 10 patients with osteonecrosis of the jaws (ONJ) that appeared following cancer chemotherapy. MATERIAL AND METHODS: Of the 10 cases with ONJ, six had bone metastases from breast cancers and the other four had multiple myeloma. We analysed the location of bone metastases, as well as the characteristics of the ONJ, and the drugs with which they had been treated for their bone metastases. RESULTS: Of the 10 patients, all had ONJ in the mandible; 50% also had maxillary involvement. The average number of areas of painful exposed was 2.1 per patient (range 1-5). In seven patients a tooth extraction preceded the onset of ONJ. Two patients developed oroantral communications and another a cutaneous fistula to the neck with suppuration. In all the 10 patients the histopatholological diagnosis was of chronic osteomyelitis without evidence of metastatic disease to the jaws. All the patients had received treatment for their malignant bone disease with bisphosphonates. These were the only drugs that all patients had received. CONCLUSION: ONJ appears to have a relationship with the use of bisphosphonates.
Assuntos
Difosfonatos/efeitos adversos , Doenças Maxilomandibulares/induzido quimicamente , Osteonecrose/induzido quimicamente , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/secundário , Neoplasias da Mama/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/patologiaRESUMO
OBJECTIVES: To determine the relationship between oral leukoplakia (OL) and oral squamous cell carcinoma (OSCC), and to evaluate possible differences between those carcinomas with and without associated leukoplakia. MATERIAL AND METHODS: A total of 138 patients were studied at the Stomatology Service of the University General Hospital, Valencia, Spain. These patients were divided into two groups: group 1, patients with oral cancer and leukoplakia, and group 2, patients with OSCC but with no associated premalignant lesions. The relationship between this precancerous lesion and the OSCC was evaluated, as well as the possible clinical and histological differences between the tumours of the two groups. RESULTS: Leukoplakia was detected in 27 (19.56%) patients with OSCC. No differences were found between the two groups regarding age and tumour location. However, statistically significant differences were observed with respect to the form, tumour stage and the presence of adenopathies in the cancers with and without leukoplakia; in that the tumours associated with leukoplakia were diagnosed as being at a more initial stage. CONCLUSIONS: Those patients with OL associated with oral cancer presented with tumours at a less advanced stage than those where no associated leukoplakia existed.
Assuntos
Carcinoma de Células Escamosas/complicações , Leucoplasia Oral/complicações , Neoplasias Bucais/complicações , Distribuição de Qui-Quadrado , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , PrevalênciaRESUMO
The possible malignant potential of oral lichen planus (OLP) is still controversial. We present three new oral lichen planus (OLP) patients who developed oral squamous-cell carcinoma (OSCC). In all cases, were analyzed variables like sex, age, clinical type, localization, extension, follow-up study and treatment, moreover were considered the patient's habits, localization, stage and treatment of cancer. The average age was 59 years and both of them were non smoker or with no alcohol habits. The follow-up period was greater than two years and the malignant lesion developed after mean of nine years, after the diagnosis of OLP had been established. Oral squamous-cell carcinoma (OSCC) arose on lesions previously diagnosed clinically and histologically as atrophic and erosive oral lichen planus in two of our patients and on a plaque lesion LP in a patient. All of them had been using topical corticoids before the cancer was diagnosed. The appearance of new cases of OLP malignization framed inside the established approaches, suggests the realization of new researches in order to determine the factors involved in this process.
Assuntos
Líquen Plano Bucal/patologia , Neoplasias Bucais/patologia , Transformação Celular Neoplásica/patologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: Dental erosion has been considered an extraesophageal manifestation of gastro-oesophageal reflux disease, but few reports have studied the relationship between this disease and other periodontal or dental lesions. The aim of this study was to investigate the prevalence of dental and periodontal lesions in patients with gastro-oesophageal reflux disease. PATIENTS AND METHODS: A total of 253 subjects were prospectively studied between April 1998 and May 2000. Two study groups were established: 181 patients with gastro-oesophageal reflux disease and 72 healthy volunteers. Clinical assessment, including body mass index and consumption of tobacco and alcohol, was performed in all subjects, as well as a dental and periodontal examination performed by a dentist physician, blind as to the diagnosis of subjects. Parameters evaluated were: (a) presence and number of dental erosion, location and severity, according to the Eccles and Jenkins index [Prosthet Dent 1979;42:649-53], modified by Hattab [Int J Prosthes 2000;13:101-71; (b) assessment of dental condition by means of the CAO index; and (c) periodontal status analysed by the plaque index, the haemorrhage index, and gingival recessions. RESULTS: Clinical parameters were similar in both groups (p > 0.05). Age was statistically associated with the CAO index, presence of dental erosion, and gingival recession (p < 0.001, Student's t-test). Compared with the control group, the percentage of dental erosion was significantly higher in the gastro-oesophageal reflux disease group (12.5 vs. 47.5%, p < 0.001, chi2-test), as was the number and severity of dental erosions (p < 0.001, Student's t-test). Location of dental erosion was significantly different between groups. Age was not statistically related to either the amount or severity of dental erosion. CAO and periodontal indices were similarly distributed between groups. CONCLUSIONS: Dental erosion may even be considered as an extraesophageal manifestation of gastro-oesophageal reflux disease. The fact that the prevalence of caries and periodontal lesions is similar in patients with gastro-oesophageal reflux disease and in healthy volunteers suggests a lack of relationship with gastro-oesophageal reflux disease.