Chronic mechanical irritation enhances the effect of tobacco and alcohol on the risk of oral squamous cell carcinoma: a case-control study in Argentina.

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.

Differences among oral carcinomas arising de novo from those associated with oral potentially malignant disorders: a systematic review and meta-analysis.

OBJECTIVE: To analyze the frequency of sequential oral squamous cell carcinomas (s-OSCC), preceded by oral potentially malignant disorders, and OSCC de novo (OSCC-dn) and explore differences in their clinicopathologic presentations. STUDY DESIGN: A structured electronic search strategy identified studies that analyzed frequency, clinical, biological, demographic, biomarkers, and prognostic features of s-OSCC and OSCC-dn according to PRISMA guidelines in PubMed, Scopus, Cochrane Library, and Google Scholar, up to January 31, 2023. Inclusion criteria were original English, Spanish, Portuguese, French, Italian, and German cross-sectional, cohort, and case-control studies. The quality of studies was assessed using the Agency for Research and Health Quality tool and the Newcastle-Ottawa Scale tool. RESULTS: The final selection included 40 studies. OSCC-dn and s-OSCC represent, respectively, 71% and 29% of cases of OSCC (P = .00), showing a higher percentage of T1 or of T1+T2 in s-OSCC (P < .0001). The association meta-analysis showed OSCC-dn with a significant association. The meta-analysis showed that s-OSCC was significantly associated with smaller tumor size, absence of distant metastases, relapses, male sex, and tumor sites different from tongue; and OSCC-dn was associated with more advanced tumor size, more regional and distant metastases, more advanced stages, and worse survival. CONCLUSIONS: S-OSCC was less frequent than expected. OSCC-dn seems to have specific clinical, biological, and prognostic features. Future perspectives on oral cancer prevention should address novel approaches and alternatives to screening, such as urgent referral of OSCC-dn.

Effect of the accumulation of risk factors on the risk of oral squamous cell carcinoma / [Efecto de la acumulación de factores de riesgo en el riesgo de carcinoma de células escamosas bucal]

Introduction: the causative factors of oral squamous cell carcinoma are not necessary and not sufficient causes, even the most accepted ones, such as tobacco and alcohol. Little is known about the cumulative effect of all risk factors for oral cancer. The objective of this work was to analyze whether the sum of oral cancer risk factors is associated with an increase in its risk. Methods: a case-control study was carried out to determine the risk factors for oral cancer in the population under study, and then correlate the number of risk factors in each individual with the risk of oral cancer. Results: the accumulation of oral cancer risk factors, analyzed using different strategies, was always associated with a significant increase in the risk of oral cancer. Having 3 or more risk factors was associated with an increased risk of oral cancer (OR 110, p <0.0001) Conclusion: the main risk factor for oral cancer is the accumulation of its risk factors. The accumulation of risk factors could be considered a necessary cause for the development of oral cancer.

Introducción: los factores causales de carcinoma de células escamosas bucal son causas no necesarias y no suficientes, incluso los más aceptados, como tabaco y alcohol. Poco se conoce sobre el efecto acumulativo de todos los factores de riesgo de cáncer bucal. El objetivo de este trabajo fue analizar si la sumatoria de factores de riesgo de cáncer bucal se asocia con un aumento de su riesgo. Métodos: se realizó un estudio de casos y controles para determinar los factores de riesgo de cáncer bucal en la población bajo estudio, para luego correlacionar el número de factores de riesgo en cada individuo, con el riesgo de cáncer bucal. Resultados: la acumulación de factores de riesgo de cáncer bucal, analizada mediante diferentes estrategias, estuvo siempre asociada con un aumento significativo del riesgo de cáncer bucal. Tener 3 o más factores de riesgo estuvo asociado con mayor riesgo de cáncer bucal (OR 110, p<0,0001) Conclusión: el principal factor de riesgo de cáncer bucal es la acumulación de sus factores de riesgo. La acumulación de factores de riesgo podría considerarse una causa necesaria para el desarrollo de cáncer bucal.

Relationship between chronic trauma of the oral mucosa, oral potentially malignant disorders and oral cancer.

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.

Manifestaciones gingivales de sífilis secundaria: serie de casos / Gingival manifestations of secondary syphilis: case series

Objetivo: La sífilis es una enfermedad de transmisión sexual con una incidencia creciente a nivel mundial. En la sí- filis secundaria, las lesiones orales son frecuentes, siendo a veces la única manifestación. El objetivo de este artículo es presentar una serie de casos clínicos de sífilis con localización predominante o exclusivamente gingival, destacando las ca- racterísticas clínicas más relevantes para su diagnóstico. Casos clínicos: Esta serie de casos clínicos incluyó nueve casos de sífilis secundaria con manifestaciones gingi- vales. El diagnóstico se realizó mediante pruebas serológicas (VDRL, TPPA, FTA-ABS y MHA-TP), y se describieron le- siones tanto gingivales como extragingivales. En la encía se observó sífilis secundaria afectando principalmente la región anterior ­tanto superior como inferior­, presentándose pla- cas rojas o blancas. Algunos casos también presentaban le- siones en otros sitios intraorales, tenían síntomas como dolor o sensación de ardor, o presentaban enfermedad periodontal dependiente de placa. El diagnóstico diferencial de sífilis se- cundaria gingival con condiciones periodontales inespecíficas es fundamental para un diagnóstico adecuado. Por lo tanto, se debe considerar el diagnóstico de sífilis secundaria cuando se enfrentan casos gíngivo-periodontales atípicos en la práctica diaria (AU)

Aim: Syphilis is a sexually transmitted disease with growing incidence worldwide. In secondary syphilis, oral le- sions are common, sometimes being the only manifestation. Gingival features of syphilis are rare and usually present mul- tiple oral lesions. The aim of this article is to present a series of clinical cases of syphilis with predominantly or exclusively gingival localization, highlighting the most relevant clinical characteristics for its diagnosis. Clinical cases: This clinical case series included nine cases of secondary syphilis with gingival manifestations. The diagnosis was made using serological tests (VDRL, TPPA, FTA-ABS, and MHA-TP), and both gingival and extragingi- val lesions were described. Secondary syphilis was observed in the gum, mainly affecting the anterior region ­both up- per and lower­, depicting red or white plaques. Some cases also presented lesions in other intraoral sites, had symptoms such as pain or burning sensation, or showed plaque induced periodontal disease. The differential diagnosis of second- ary syphilis considering non-specific periodontal conditions with gingival involvement is essential for a proper diagnosis. Thus, the diagnosis of secondary syphilis should be consid- ered when dealing with atypical gingivo-periodontal cases in everyday practice (AU)

Assessment of maxillary central incisor crown form.

Incisor crown form is thought to be associated with different periodontal features, and it is hypothesized that there are measures of the maxillary central incisor that can be used to characterize its form. The aim of this study was to assess maxillary central incisor crown dimensions to determine morphologic groups. One-hundred fifty sound maxillary central incisors without excessive evidence of incisal wear were utilized. On each crown, several reference points were marked and mesiodistal and axial diameters were measured using a digital caliper. A ratio between the minor and major mesiodistal diameters was determined to assess dental forms. Maxillary central incisor form was categorized into three groups based on the upper limits of three intervals as cutoff points. The measurements were performed in a double blind fashion. The reliability of measurements was estimated by the Pearson correlation coefficient for each tooth, setting a value > 0.8. The percentage of maxillary central incisors in each group was 56.67% for group 1 (stout), 22.67% for group 2 (intermediate), and 20.66% for group 3 (strangled). The results suggest that maxillary central incisor morphology can be properly assessed through quantifiable methods. The minor/major mesiodistal ratio is simple, quantitative, and easily reproduced. It is a quantifiable definition of dental forms based on characteristics that are not modified by the position of the gingival margin or incisal wear. Hence, the grade of cervical convergence could help clinicians assess tooth shape before performing restorative, orthodontic, or surgical treatments.

Lesiones estomatológicas asociadas a terapia oncológica / Stomatological lesions associated with oncologic therapy

El propósito de este estudio fue analizar la prevalencia de efectos adversos bucales de la terapia oncológica (radioterapia más cirugía o quimioterapia) en pacientes con CCC. Se estudiaron 14 pacientes con CCC que recibieron como terapéutica alguna de las modalidades citadas. Los resultados mostraron que las lesiones más frecuentes fueron: hipo/disgeusia, 14 casos (100 por ciento); mucositis, 13 casos (92,8 por ciento) y xerostomía, 10 casos (76,9 por ciento). Concluimos que la terapia oncológica combinada siempre se acompaña de daños tisulares clínicamente observables, que deben ser tratados apropiadamente con el objeto de mejorar la calidad de vida de los pacientes con CCC sometidos a terapia oncológica