ABSTRACT
Background: Among the oral potentially malignant disorders, leukoplakia stands out as the most prevalent. Thepurpose of this study was to analyse the clinical-pathological features of oral leukoplakia in groups of patientsfrom three major pathology centers in two different regions of Brazil, in order to determine which factors wouldbe associated to the clinical risk of malignant transformation.Material and Methods: A total of 148 patients was analyzed, and data regarding gender, age, site, classification ofthe clinical subtype, harmful habits such as use of tobacco and alcohol, time of evolution and presence of dyspla-sia were collected. The association between risk factors and malignant transformation was investigated using thechi-square test and Fischer's exact test for correlation of variables. A significance level of 5% (p≤0.05) was used.Results: The mean age of the patients was 60 years, and 56% were female. Most of the lesions (34,5%) were lo-cated in the lateral and ventral regions of the tongue. Of the 148 patients, ninety had clinical follow-up. Malignanttransformation occurred in 13 patients (8.8%), with an average of 44 months of follow up.Conclusions: Non-smoker, nonhomogeneous clinical presentation, location at the tongue, and the presence of highdegree of dysplasia were statistically relevant factors associated with a higher risk of transformation transformation.(AU)
Subject(s)
Humans , Male , Female , Leukoplakia, Oral/complications , Leukoplakia, Oral/diagnosis , Leukoplakia, Oral/pathology , Carcinoma, Squamous Cell , Retrospective Studies , Brazil , Oral Health , Pathology, Oral , Oral Medicine , Surgery, Oral , Risk FactorsABSTRACT
INTRODUCTION: This study aimed to analyze cases referred from a reference service in oral pathology that were initially misdiagnosed as periapical lesions of endodontic origin and to perform a review of the literature regarding lesions located in the apical area of teeth with a nonendodontic source. METHODS: A survey was made of clinical cases derived from the service of oral pathology from 2002 to 2012. The pertinent literature was also reviewed using ScienceDirect and PubMed databases. The lesions were grouped into benign lesions mimicking endodontic periapical lesions (BLMEPLs), malignant lesions mimicking endodontic periapical lesions (MLMEPLs), and Stafne bone cavities. The clinical presentations were divided into lesions with swelling without pain, lesions with swelling and pain, and lesions without swelling but presenting with pain. RESULTS: The results showed that 66% (37/56) of cases represented benign lesions, 29% (16/56) malignant lesions, and 5% (3/56) Stafne bone cavities. The most commonly reported BLMEPLs were ameloblastomas (21%) followed by nasopalatine duct cysts (13.5%). The most frequently cited MLMEPLs were metastatic injuries (31.5%) followed by carcinomas (25%). The main clinical presentation of BLMEPLs was pain, whereas that of MLMEPLs was swelling associated with pain; Stafne bone cavities displayed particular clinical findings. CONCLUSIONS: Clinical and radiologic aspects as well as the analysis of the patients' medical history, pulp vitality tests, and aspiration are essential tools for developing a correct diagnosis of periapical lesions of endodontic origin. However, if the instruments mentioned earlier indicate a lesion of nonendodontic origin, a biopsy and subsequent histopathological analysis are mandatory.
