Risk factors for oral soft tissue lesions in an adult Spanish population.

OBJECTIVES: The aims of this study were (i) to determine the prevalence of oral lesions in adults over 30 years old in the city of Oviedo (Spain), and (ii) to analyze the relationship between the prevalence of oral lesions, toxic habits (tobacco and alcohol) and denture wearers in these patients. METHODS: A representative sample of the adult population in Oviedo (Spain) was obtained through randomized sampling (n = 753); a total of 308 (41%) subjects were finally included in the study. The observed oral pathology was classified according to the WHO criteria and earlier epidemiological studies. RESULTS: A little over half of all patients (51.1%) had oral lesions. The most frequent lesions were frictional lesion (7.5%), traumatic ulcer (7.1%), denture stomatitis and pseudomembranous candidosis (6.5%), followed by melanin pigmentation (5.8%) and denture-induced hyperplasia (5.2%), plicated tongue (3.9%), lichen planus and hemangioma (3.2%), angular cheilitis and cheek biting (2.9%), fibrous hyperplasia and coated tongue (2.6%), recurrent aphthae (1.9%) and oral leukoplakia (1.6%). In relation to leukoplakia, the odds ratio (OR) of heavy drinkers was 15.98 and the OR of heavy smokers was 12.37. The OR of heavy smokers or heavy drinkers diagnosed of frictional lesion was four times greater than that of nonsmokers or nondrinkers. The OR of heavy smokers with melanic pigmentations was 4.08. The OR of complete denture wearers with candidosis was 11.38. The OR of partial removable denture wearers with hemangioma was 5.01. CONCLUSIONS: This study shows the relation of heavy tobacco and heavy alcohol to traumatic keratosis and leukoplakia, and of complete dentures to pseudomembranous candidosis, fibrous hyperplasia and stomatitis. Programs designed to eradicate toxic factors (alcohol and tobacco) should, therefore, be implemented with adequate maintenance of dentures.

Estudio epidemiológico de la patología de la mucosa oral en la población infantil de 6 años de Oviedo (España) / Prevalence of oral lesions in the 6year-old pediatric population of Oviedo (Spain)

Objetivo: Determinar la prevalencia de las enfermedades orales en la población infantil de 6 años de la ciudad de Oviedo (España). Diseño del estudio: Se seleccionó una muestra representativa de la población de 6 años de edad de Oviedo (n=786 niños), participando en la revisión 624 niños. Se siguió un protocolo elaborado específicamente para enfermedades y condiciones orales infantiles. Resultados: El número de lesiones observadas fue 344 en 243 niños. La lesión más frecuente fue la lengua saburral (16,02 por ciento), seguido de las lesiones traumáticas (12,17 por ciento) y la lengua geográfica (4,48 por ciento). La prevalencia de la estomatitis aftosa fue de 2,24 por ciento y del herpes labial del 1,6 por ciento. La anquiloglosia se manifestó en el 2,08 por ciento y el frenillo labial hipertrófico en el 1,28 por ciento. Conclusiones: En este estudio se pone de manifiesto la prevalencia de las lesiones de la mucosa oral en la población infantil española de 6 años. De los resultados del presente trabajo se desprende que los objetivos sanitarios orales públicos y privados en este campo deben ir enfocados hacia: 1) la erradicación de enfermedades de causa local (lengua saburral, ulceraciones traumáticas, etc.) por su elevada prevalencia; y 2) el diagnóstico precoz de anomalías del desarrollo (anquiloglosias y frenillo labial) por su relación con trastornos de la fonación y futuras maloclusiones (AU)

Leucoplasia oral / Oral leukoplasia

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Study comparative of Ki-67 expression in oral lichen planus and oral leukoplakia. Quantitative analysis.

OBJECTIVE: The aim of the present study has been to determine the proliferative differences in oral lichen planus and leukoplakia by means the quantification of Ki- 67 expression. STUDY DESIGN: The tissue analyzed were the following ones: oral lichen planus (n=10), oral leukoplakia (n=10), dysplasia (n=10). Normal oral mucosa (n=10) was used as the control group. The antibody employed was monoclonal PP-67 (Sigma). Immunoperoxidase detection was employed using the streptavidin- biotin complex. The quantification was carried out by a program of image analysis system Qwin colour RGB. In all cases 10 fields differences were scored. For analytic study were used analysis of the variance and Scheffe's exact test were used. The statistical significance level was considered to be P < 0.05. RESULTS: In all tissues analyzed there was some grade of proliferation in the basal layer, and in dysplasias so much in basal as suprabasal layer. Of the analytic results we emphasize that there were differences statistically significant among mean of the positive nuclei per mm of length in normal mucosa and leukoplakia (p=0.031), and between normal mucosa, lichen planus and leukoplakia with dysplasias. In these three cases the values were p=0.000. CONCLUSION: Ki-67 antigen is a marker of nuclear proliferation that allows to settle down the differences proliferatives between lichen planus and oral leukoplakia. Therefore it should take in consideration to think in successive studies that guide therapeutic attitude in these lesions in function of its positivity.

Estudio comparativo de la expresión del Ki-67 en el liquen plano oral y la leucoplasia oral. Análisis cuantitativo / Study comparative of Ki-67 expression in oral lichen planus and oral leukoplakia. Quantitative analysis

Objetivo. El objetivo del presente estudio ha sido determinar las diferencias en la proliferación del liquen plano oral y de la leucoplasia mediante la cuantificación de la expresión del Ki-67.Diseño del estudio. Los tejidos analizados fueron los siguientes: liquen plano oral (n=10), leucoplasia oral (n=10), displasia (n=10). Como grupo control se utilizó: mucosa normal (n=10).El anticuerpo empleado fue el monoclonal PP-67 (Sigma). La técnica inmunohistoquímica empleada fue la del complejo streptavidina-biotina. La cuantificación se realizó mediante un programa de análisis de imagen Qwin colour RGB, midiéndose 10 campos diferentes de cada tejido. Para el estudio analítico se utilizaron el análisis de la varianza y el test exacto de Scheffe. Se consideró estadísticamente significativo cuando el valor de p<0,05.Resultados. En todos los tejidos analizados hubo algún grado de marcaje de proliferación a nivel de la capa basal, y en las displasias tanto en la capa basal como la suprabasal. De los resultados analíticos destacamos que hubo diferencias estadísticamente significativas entre la media de los núcleos positivos por mm de longitud de las mucosas normales y las leucoplasias (p=0,031), y de la mucosa normal, liquen plano y leucoplasia con las displasias cuyos valores fueron en los tres casos de p=0,000.Conclusión. El Ki-67 es un marcador de proliferación nuclear que nos permite establecer las diferencias proliferativas del liquen plano y de la leucoplasia oral, y que por tanto debería de tomarse en consideración para plantearse estudios sucesivos que orienten sobre la actitud terapéutica en estas lesiones en función de su positividad (AU)

[Precancerous lesions (oral leukoplakia and lichen planus) in the geriatric patient]. / Lesiones precancerosas (leucoplasia y liquen plano oral) en el paciente geriátrico.

OBJECTIVES: To study the prevalence and histopathological behaviour of precancerous lesions of the oral mucous membrane, leukoplakia and lichen planus, among the geriatric population attended. DESIGN: A prospective, descriptive study. SETTING: Urban out-patient clinic and health centre in Health Area V in Asturias (population covered: 80,000). PATIENTS: All patients over 65 in whom one of the lesions under study was observed. MAIN MEASUREMENTS: All the patients had a complete oral examination. A clinical history was taken for those patients in whom a lesion under study was found, and a sample of the lesion by an incisional or excisional biopsy was taken. Later there were periodic checks and new biopsies were taken. RESULTS: During the study period, approximately 52,000 mouth and teeth examinations took place. 34 precancerous lesions were detected in patients over 65. The commonest type of lesion was Lichen planus with 20 cases. CONCLUSIONS: The prevalence found in the sample analysed was similar to that of other studies. The fact that the majority of the lesions had not been noticed clinically, along with the greater susceptibility of these patients to the activation of factors which could trigger malignant degeneration, may have made the presence of 7 lesions with dysplastic histological alterations possible.

[Adenoid cystic carcinoma and basal cell adenoma of the parotid gland: a compromised differential diagnosis]. / Carcinoma adenoideo quistico y adenoma de células basales de la glándula parótida: un diagnóstico diferencial comprometido.

The adenoid cystic carcinoma of the major and minor salivary glands grows slowly but spreads relentlessly into the surrounding tissues, in particular along the perineural spaces. It may appear clinically to be circumscribed, true encapsulation is lacking and the insidious invasion is demonstrated histologically. Another characteristic of the tumor is a high rate of metastases to distant organs such as lung, bobe or liver. The prognosis relatively poor despite surgical excision. The monomorphic basal cell adenoma of salivary glands is a rare tumor. Its diagnosis is, occasionally, difficult with adenoid cystic carcinoma on the clinical and pathology basis. The authors shown a method for this diagnosis consistent in a morphometric analysis of the neoplasic cells.

[Epidemiological study of inflammatory periapical cysts]. / Estudio epidemiológico de los quistes inflamatorios periapicales.

We have realized an epidemiologic study of 467 inflammatory periapical cysts. We have valued: age, sex, radiographic size, localization, clinic, evolution time and morphologic aspects. Ware not agree with some authors about some morphologic description.

[Periapical odontogenic processes of inflammatory origin. Enzyme activity]. / Procesos odontógenos periapicles de origen inflamatorio. Actividad ezimática.

A histoenzymological study was carried out on 40 tissues specimens removed at biopsy and for surgical operations of the following lesions: 5 normal oral mucosa, 5 periapical granulomas, and 30 periapical inflammatory cysts. The purpose of this study was to study some possibly significant variations in levels o activities of oxidative enzymes, and hydrolaxes enzymes. In inflammatory cysts, enzymatic activities were similar to normal epithelium. There was high levels of acid phosphatase LDH and G6PDH activity in the central cells of apical granulomas and in the exfoliating epithelial cells of periapical inflammatory cysts. There were differency in the glycosaminoglicans activity on the different epitelial pattern.

[Clinical criteria for calculating the risk of malignancy in leukoplastic lesions]. / Criterios clínicos para calcular el riesgo de malignización de la lesión leucoplásica.

We have studied 74 patients with leukoplasia to establish clinical and aetiological criterias. We wanted the criterias to permit us to have a guide line and follow them before and after their treatment.

[A morphometric study of 74 cases of oral lichen planus]. / Etude morphométrique dans 74 cas de lichen plan oral.

We have carried out a morphometric study of the lesions of 74 patients with oral lichen planus. We have found as important data that the parameters differentiating the reticulated clinical lesions from the atrophic or erosive lesions are the epithelial thickness and the length of the dermic papillae. On the other hand, we have seen no difference between both types of lesions as regards the quantity of infiltrate in the connective tissue.

[Pleo-morphic adenoma of the salivary glands: clinico-pathological study of 175 cases]. / Adenoma pleomorfo de las glandulas salivares: estudio clinicopatologico de 175 casos.

In this report we analyzed 175 benign pleomorphic adenomas from the salivary glands. We described epidemiologic, clinical aspects and light microscopic features. We connected the sized, evolution time and their microscopically findings.