Oral squamous cell carcinomas and oral potentially malignant disorders: A Latin American study.

OBJECTIVE: To determine the frequency of oral squamous cell carcinoma (OSCC) associated or not with oral potentially malignant disorders (OPMD), and the epidemiological profile and traditional risk factors in Latin America. METHODS: A retrospective observational study was conducted in 17 Latin American centres. There were included cases of OSCC, analysing age, gender, OSCC and their association with previous OPMD. Clinicopathological variables were retrieved. The condition of sequential-OSCC versus OSCC-de novo (OSCC-dn) was analysed concerning the aforementioned variables. Quantitative variables were analysed using Student's t-test, and qualitative variables with chi-square. RESULTS: In total, 2705 OSCC were included with a mean age of 62.8 years old. 55.8% were men. 53.75% of the patients were smokers and 38% were common drinkers. The lateral tongue border was the most affected site (24.65%). There were regional variations in OPMD, being leukoplakia the most frequent. Of the overall 2705 OSCC cases, 81.4% corresponded to OSCC-dn, while s-OSCC were 18.6%. Regarding lip vermillion SCC, 35.7% corresponded to de novo lip SCC and 64.3% were associated with previous OPMD. CONCLUSIONS: In Latin America, OSCC-dn seems to be more frequent with regional variations of some clinical and histopathological features. Further prospective studies are needed to analyse this phenomenon.

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.

Lesiones bucales, factores de riesgo de cáncer bucal y autopercepción de irritación mecánica crónica en una campaña de prevención en la Ciudad de Buenos Aires / Oral lesions, oral cancer risk factors and self-perception of chronic mechanical irritation in a prevention campaign in Buenos Aires City

Objetivos: i) Describir las características poblaciona- les, la frecuencia de patologías de mucosa bucal y de factores de riesgo asociados al cáncer bucal en una Campaña de Pre- vención y Diagnóstico Precoz de Cáncer Bucal (CPDPCB) en la Ciudad de Buenos Aires; ii) establecer concordancia entre diagnóstico clínico profesional de irritación mecánica crónica (IMC) y autopercepción de trauma. Materiales y métodos: Se realizó un estudio descrip- tivo retrospectivo, en el que se utilizaron encuestas de 640 pa- cientes que participaron en las CPDPCB del Servicio de Odon- tología del Hospital Alemán entre los años 2016, 2017 y 2018. Se describen las variables demográficas, clínicas y cognitivas, y se analizan empleando chi cuadrado para variables cualitativas y ANOVA para variables cuantitativas comparando los años de campaña. Se realizó un estudio de concordancia entre el diag- nóstico clínico profesional de IMC y el trauma autopercibido mediante test Kappa, sensibilidad y especificidad. Resultados: Los sujetos participantes fueron predomi- nantemente mayores de edad, con bajo consumo de tabaco y alcohol. El porcentaje de pacientes con desórdenes potencial- mente malignos y cáncer bucal fue de 17,2%. La cartelería del hospital y la radio fueron las principales vías de información a los pacientes. El trauma autopercibido no presentó concor- dancia con el diagnóstico clínico profesional de IMC, y mos- tró sensibilidad de 0,41 y especificidad de 0,72. Conclusiones: El nivel de participación de los grupos de mayor riesgo de CBCE en la CPDPCB es bajo, y el perfil epidemiológico de los participantes no coincide generalmente con el perfil de los pacientes con CBCE. La autopercepción de trauma no sería una herramienta confiable para el diagnóstico de IMC (AU)

Aims: i) To describe population characteristics, frequency of oral mucosa pathologies, and risk factors for oral squamous cell carcinoma (OSCC) in a Campaign for the Prevention and Early Diagnosis of Oral Cancer (CPEDOC), and ii) to establish concordance between professional clinical diagnosis of chronic mechanical irritation (CMI) and self-perception of trauma. Materials and methods: A retrospective descriptive study was performed using surveys of 640 patients who had participated in the CPEDOC conducted by the Dentistry Ser- vice at the Hospital Alemán during 2016, 2017 and 2018. De- mographic, clinical and cognitive variables were described and analyzed, using chi-square for qualitative variables and ANOVA for quantitative variables, to compare campaign years. Concordance was studied between the professional clinical diagnosis of CMI and self-perceived trauma using the Kappa test, sensitivity and specificity. Results: Participants were predominantly older, with low consumption of tobacco and alcohol. The percentage of patients with potentially malignant disorders and oral cancer was 17.2%. Hospital posters and radio broadcasting were the main channels of information to patients. Self-perceived trauma did not agree with the professional clinical diagnosis of CMI. Self-perceived trauma sensitivity and specificity were 0.41 and 0.72, respectively. Conclusions: The level of participation in the CPEDOC by the groups at higher risk of OSCC was low, and the epide- miological profile of the participants did not generally coincide with the profile of patients with OSCC. Self-perception of trau- ma does not seem to be a reliable tool for the diagnosis of CMI (AU)

Acquired oral syphilis: A multicenter study of 339 patients from South America.

OBJECTIVE: To report the clinicopathologic features of acquired oral syphilis cases in South American countries. MATERIALS AND METHODS: Clinical data were retrospectively collected from the records of 18 oral diagnostic services in Argentina, Brazil, Chile, Colombia, Venezuela, Uruguay, and Peru. Serologies of nontreponemal and treponemal tests were used for diagnosis. RESULTS: The series comprised 339 cases of acquired oral syphilis. Secondary syphilis ranked as the most common stage (86.7%). Lesions were more frequent among males (58.0%) and young adults with a mean age of 33.3 years. Individuals aged 20-29 years were most affected (35.3%). The most commonly involved sites were the tongue (31.6%), lip/labial commissure (25.1%), and hard/soft palate (20.4%). Clinically, acquired oral syphilis usually presented as mucous patches (28.4%), papules (25.7%), and ulcers (18.1%). Skin manifestations occurred in 67.7% of individuals, while lymphadenopathy and fever were observed in 61.3% and 11.6% of all subjects, respectively. Most patients were treated with the benzathine penicillin G antibiotic. CONCLUSION: This report validates the spread of acquired oral syphilis infection among young adults in South America. Our directives include accessible diagnostic tools for proper disease screening, surveillance, and counselling of affected individuals, especially in low- and middle-income countries.

Tipificación del virus del papiloma humano en lesiones de cavidad bucal. Estudio desarrollado en los servicios de estomatología, Facultad de Odontología de la Universidad de Cartagena y el Hospital Alemán de Buenos Aires / Typing of human papillomavirus in oral cavity lesions in stomatology services at the Faculty of Dentistry of the Universidad de Cartagena and the Hospital Alemán de Buenos Aires

Objetivo: describir las características clínicas epidemiológicas en cavidad bucal de la infección por VPH y la asociación con su tipificación molecular. Métodos: se realizó un estudio analítico de corte transversal en 52 pacientes que acudieron a los servicios de estomatología en la Facultad de Odontología de la Universidad de Cartagena y al Hospital Alemán de Buenos Aires, a quienes se les abrió historia clínica y se les practicó prueba de PCR en tiempo real para la tipificación del VPH. Resultados: el análisis de los datos se efectuó a través de frecuencia y porcentaje. En cuanto a la parte inferencial, se usó la prueba chi cuadrado con un nivel de confianza P<0,05. De los 52 pacientes analizados, 67.3% eran mujeres con un predominio de edad entre los 50-59 años. El serotipo mayormente encontrado fue VPH 6, seguido del VPH 11 y otros tipos de VPH. La lesión elemental más preponderante fue la verrugosidad y la ubicación de predominio, la lengua. Conclusión: las infecciones por VPH se manifiestan frecuentemente en cavidad bucal con verrugosidades en lengua. Su estudio epidemiológico, incluyendo su tipificación, permitiría encontrar lesiones características para un diagnóstico, seguimiento y tratamiento oportuno.

Objective: Analyze the most common epidemiological clinical characteristics of HPV infection in the oral cavity and its molecular typing. Methods: An observational, analytical, cross-sectional study was carried out in 52 patients who attended the stomatology services of the Universidad de Cartagena and the Hospital Alemán de Buenos Aires; a complete clinical history was carried out, including stomatological examination, biopsy, pathological study and real-time PCR test for HPV typing. Results: The data analysis was carried out by means of frequency and percentage. Regarding the inferential part, the chi-square test was used with a confidence level of P <0.05. Of the 52 studied patients 67.3% were women; with a predominant age between 50-59 years. The most common serotype found was HPV 6, followed by HPV 11 and other types of HPV. The predominant lesion was the wart and the predominant location, the tongue. Conclusion: The HPV infections are frequently manifested in oral cavity with Verrugosities in language and its typing, would allow a timely diagnosis of pharynx cancer.

Placas protectoras de mucosa: su aplicación estomatológica / Occlusal splints for mucosal protection

El objetivo de esta comunicación es divulgar el uso de las placas de protectoras de mucosa (PPM) en el ámbito de la patología bucal, así como en la consulta odontológica diaria. Tomando como antecedente los primitivos protectores bucales diseñados para deportes de contacto, se desarrolló su uso en odontología con un diseño particular para el tratamiento de los desórdenes temporomandibulares. Describimos aquí la aplicación de las PPM en estomatología en el contexto de coadyuvancia terapéutica para diferentes entidades de muy frecuente consulta. Asimismo, se detallan la técnica de confección y las indicaciones de uso y cuidado para los pacientes (AU)

The aim of this report is to emphasize the usefulness of oral splints for mucosa protection in oral pathology as well as in every day dental practice. There is substantial evidence that mouthguards were first developed for use in boxing. The most common therapeutic use of occlusal splints in dentistry is the treatment of temporomandibular joint disorders. The present work describes the use of oral splints for mucosa protection in the context of adjuvant therapy as a protective device for many common disorders of the oral mucosa. At the same time it explains the fabrication technique and provides proper use and handling guidelines (AU)