The role of dental prostheses in alveolar ridge squamous carcinomas

Molecular drivers of oral cavity squamous cell carcinoma in non-smoking and non-drinking patients: what do we know so far?

Oral cavity squamous cell carcinoma (OCSCC) is one of the most common head and neck cancers worldwide. It is well known that risk factors for OCSCC include tobacco and excess alcohol consumption. However, in recent years, OCSCC incidence has been increasing in patients without these traditional risk factors. The cause of this increase is unclear and various genetic, environmental, and infectious factors have been hypothesized to play a role. Additionally, there are expert opinions that oral cancer in non-smoking, non-drinking (NSND) patients have a distinct phenotype resulting in more aggressive disease presentation and poorer prognosis. In this review, we summarize the current state of knowledge for oral cavity cancer in patients without traditional risk factors.

The Role of Chronic Mucosal Trauma in Oral Cancer: A Review of Literature

Chronic mucosal trauma resulting from sharp teeth, dentures, faulty restoration, or implants has frequently been associated with the development of oral cancer. The definitive evidence for the same is lacking. We undertook a search using the terms – dental trauma, mucosal trauma, oral cancer, squamous cell carcinoma, risk factor, potentially malignant lesion, dental factor, mechanical irritation, dental irritation, and cancer in the following electronic databases: MEDLINE, PubMed, ScienceDirect, Cochrane Database of Systematic Reviews, and Wiley InterScience. The search yielded 788 articles. Of these articles, only 22 articles described chronic mucosal trauma as risk factors for oral cancers and were considered in this review. The review shows that chronic mucosal irritation resulting from ill-fitting dentures may be considered a risk factor for the development of oral cancer, such cancers occur commonly over the lateral border of the tongue. However, no association has been proven between the duration of denture use and cancer formation. In patients without any addiction, such cancers occur more frequently in females. These cancers may present with an early nodal disease but their prognosis and outcomes have not been studied separately till now.

An unexpected finding in the resection specimen of a carcinoma of the oral cavity: A case report

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The occurrence of two synchronous, primary cancers is rare.

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Thyroid carcinoma is incidentally found in the resection specimen after surgery for head and neck cancer in 0.3–1.9% of the patients.

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A papillary thyroid carcinoma was found coincidentally in lymph nodes recovered after a ‘commando’ procedure for carcinoma of the oral cavity.

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A tailor made therapeutic approach of incidental thyroid gland carcinoma in head and neck cancer depends on prognosis and life expectancy.

Introduction

The occurrence of two synchronous, primary cancers is rare. Thyroid carcinoma is incidentally found in the resection specimen after surgery for head and neck cancer in 0.3–1.9% of the patients.

Presentation of case

In this report, we describe the case of a 72-year-old patient in whom a primary (synchronous) papillary thyroid carcinoma was found coincidentally upon pathologic examination of lymph nodes recovered from the cervical neck lymph node dissection specimen after a ‘commando’ procedure for carcinoma of the oral cavity.

Discussion and conclusion

There is no gold standard concerning treatment of the incidentally discovered thyroid gland carcinoma. The decision to perform surgery depends on the life expectancy of the patient, whether the thyroid gland demonstrates clinical or radiologic lesions, the already completed treatment for the head and neck cancer and should always be adjusted to the specific patient.

Ill-fitting dentures and oral cancer: a meta-analysis

OBJECTIVES

Several studies have investigated the relationship between the use of dentures and the duration of denture use and cancer development. Of particular interest is whether ill-fitting dentures increase the likelihood of the development of oral cancer. We conducted a meta-analysis to determine the relationship between dentures and the development of cancer.

MATERIALS AND METHODS

We searched several databases (PubMed, Medline, EMBASE, Web of Science, and the Cochrane Database of Systematic Reviews) to find published papers on the topic. In particular, the duration of denture use and the comfort and fit of the dentures were investigated.

RESULTS

The use of dentures by itself is associated with an increased risk of developing cancer (OR: 1.42, 95% CI: 1.01-1.99). In addition, ill-fitting dentures appears to substantially increase the risk of developing cancer (OR: 3.90, 95% CI: 2.48-6.13). In addition, there was no link between the duration of denture use and cancer development. This might be due to the arbitrary nature of what we defined as short and long term denture use and may have been affected by the inconsistency in time categorization between different studies.

CONCLUSION

Ill-fitting dentures are a risk factor for the development of oral cancer, greater patient education and regular checking of dentures by dentists should be undertaken as a prevention measure.

The clinical and histologic presentation of gingival squamous cell carcinoma: a study of 519 cases

OBJECTIVES

Gingival squamous cell carcinoma (SCCA) often presents with benign features, which may lead to delay in treatment. This study describes the clinical and histologic characteristics of a series of gingival SCCA cases.

STUDY DESIGN

A retrospective consecutive case review was performed using the University of Florida College of Dentistry Biopsy service's database, which yielded clinical and histologic information on 519 cases of gingival SCCA.

RESULTS

The average age of affected patients was 72.3 years. The most common site was the mandibular posterior gingiva. Approximately 72% of lesions were present for >2 months at biopsy. The majority of clinicians considered a malignancy in their differential diagnosis (64%), although 15% considered only reactive lesions. Most of the carcinomas presented as exophytic masses and, histologically, were moderately differentiated.

CONCLUSIONS

Gingival SCCA may present with varied clinical and histologic appearances and should be considered in the differential diagnosis of benign appearing lesions of the gingiva.

Outcome of squamous cell carcinoma of the gingiva: a follow-up study of 83 cases

BACKGROUND

Squamous cell carcinomas of the gingiva are relatively rare tumours. Standard treatment is based on surgery and radiotherapy. The extent of bone involvement affects mandibulectary indications.

PURPOSE

A retrospective review of squamous cell carcinomas of the gingiva was performed to evaluate the incidence of mandibular or maxillary bone involvement. Indications for marginal and segmental bone resections are specified.

MATERIAL

From 1985 to 1996, 83 patients with squamous cell carcinoma of the gingiva were treated at the Department of Surgery (Institut Bergonié, Bordeaux, France) and at the Department of Maxillofacial and Plastic Surgery (Centre Hospitalier Universitaire, Bordeaux, France). Forty-three underwent surgery plus postoperative radiotherapy. Twenty-two had flap reconstructions. Clinical evaluation and panorex roentgenography were the means used to evaluate bony invasion and to decide on the extent of bone resection.

METHODS

A retrospective review of 83 consecutive patients was performed. This series is unusual in its homogeneity: surgery was performed by only two individuals and the radiotherapy was the responsibility of just two physicians. Outcome was calculated using the Kaplan-Meier method.

RESULTS

Primary local control was achieved in 72 patients (87%). Overall survival and rate of recurrence were comparable to those of other squamous cell carcinomas of the oral cavity and oropharynx.

CONCLUSION

Surgical resection continues to be the mainstay of treatment and this study tends to confirm the validity of modified neck dissection and marginal bone resection in suitably selected patients.