Facts and controversies regarding oral health in Parkinson's disease: A case-control study in Spanish patients

Background: Parkinson's disease (PD) is one of the leading neurological disorders, affecting more than 6 millionpeople worldwide. These patients present motor and non-motor symptoms, including oral pathology. The objective of this research is to determine the oral health of patients diagnosed with PD, in order to stablish a specificpreventive oral health programme.Material and Methods: Case-control study on 104 PD and 106 control patients. The pre-designed clinical protocolincluded a complete oral examination on general aspects, standardised epidemiological index for caries, periodontal disease and edentulism, analysis of oral hygiene, presence of mucous/ salivary/ functional disorder, anddental treatments.Results: A higher number of PD patients consumed daily sweets (p<0.004) and antidepressant drugs (p<0.004).Patients with PD practised less interdental hygiene (p<0.023). The mean plaque index was higher in PD (p<0.003).Drooling (p<0.001), xerostomia (p<0.001), hyposialia (p<0.001), dysphagia (p<0.001), hypogeusia/dysgeusia(p<0.025) and chewing difficulty (p<0.006) were more common in PD.Conclusions: Oral disorders are frequent in PD. A good knowledge of these alterations will allow us design a specific preventive protocol. Some oral alterations may be a sign of diagnostic alert or progression of PD. (AU)

Histopathological characterization of the oral lichenoid disease subtypes and the relation with the clinical data

BACKGROUND: The aim of the study was to analyze the histopathological characteristics of samples with a diagnosis of oral lichenoid disease (OLD) and their link with the location and the type of clinical lesion, and the clinicopathological subtypes. MATERIAL AND METHODS: Retrospective study on 85 consecutive patients diagnosed with OLD (58 women and 27 men, mean age of 57.7 years). Clinical and histopathological characterization of each case (modified WHO criteria). Collection of the clinical and histopathological data of the lesions. Descriptive and comparative statistical analysis of the results. RESULTS: The 78.8% of the cases were considered clinically typical while the 21.2% were considered compatible. Histologically, 52.9% were classified as typical and 47.1% as compatible. Biopsies from 'plaque-like' lesions presented hyperkeratosis (p < 0.001) and epithelial dysplasia (p = 0.06) more frequently. Furthermore, acute inflammation was more evident in erosive-ulcerative lesions (p = 0.001). Differences regarding the location of the biopsy were statistically non-significant. However, 42.9% of the tongue biopsies showed epithelial dysplasia. CONCLUSIONS: The histopathological aspect of this disorder is not specific and does not allow us to differentiate between the main subtypes. Therefore, the main reasons to perform a biopsy in this disorder are to define the differential diagnosis and to rule out epithelial dysplasia or a carcinoma. The final histopathological result may be subject to the type of lesion that is biopsied

Oral lichenoid disease as a premalignant condition: The controversies and the unknown

We grouped as oral lichenoid disease (OLD) a series of chronic inflammatory processes with autoimmune base that affect the epithelium of the oral mucosa. This disease is present in 2% of the population with a marked predilection for the female gender, especially perimenopausal women. Clinically, it is characterized by the presence of lineal reticular papules and histologically by liquefaction degeneration of the basal layer of the epithelium associated with an inflammatory infiltrate with a “band-like” disposition on the lamina propria, composed primarily of T lymphocyte cells. Its pathogenicity is associated with deregulation of the cellular immune system, where the activated cytotoxic CD8 and the CD4 T helper lymphocytes induce apoptosis of the epithelial cells. Classically it has been considered a precancerous condition, although the malignant transformation does not exceed 1% of the cases. In recent years the differentiation between oral lichen planus (OLP) and oral lichenoid lesions (OLL) has become important, since the latter might have a greater malignant potential. In this paper, we analyse and update some controversial aspects of this frequent oral disease in relation to the diagnosis and malignant potential (AU)

Oral lichenoid disease as a premalignant condition: the controversies and the unknown.

We grouped as oral lichenoid disease (OLD) a series of chronic inflammatory processes with autoimmune base that affect the epithelium of the oral mucosa. This disease presents in 2% of the population with a marked predilection for the female gender, especially perimenopausal women. Clinically, it is characterized by the presence of lineal reticular papules and histologically by liquefaction degeneration of the basal layer of the epithelium associated with an inflammatory infiltrate with a "band-like" disposition on the lamina propria, composed primarily of T lymphocyte cells. Its pathogenicity is associated with deregulation of the cellular immune system, where the activated cytotoxic CD8 and the CD4 T helper lymphocytes induce apoptosis of the epithelial cells. Classically it has been considered a precancerous condition, although the malignant transformation does not exceed 1% of cases. In recent years the differentiation between oral lichen planus (OLP) and oral lichenoid lesions (OLL) has become important, since the latter might have a greater malignant potential. In this paper, we analyse and update some controversial aspects of this frequent oral disease in relation to the diagnosis and malignant potential.