Nwhator Solomon O, Winfunke-Savage Kofo, Ayanbadejo Patricia, Jeboda Sunny O
Department of Preventive Dentistry, Faculty of Dentistry, Obafemi Awolowo University, Ife-Ife, Nigeria.
J Contemp Dent Pract. 2007 Jul 1;8(5):68-75.
Terms relating to pigmentation of the oral mucosa include physiologic (racial) pigmentation, oral pigmented nevi, oral melanotic maculae, melanoma, and smokers' melanosis. The literature is replete with studies about oral mucosal pigmentation which is thought to result from melanin incontinence. The documented etiological factors are both local and systemic and include hormones, drugs, smoking, and idiopathic causes. This study investigated the prevalence of melanosis among Nigerian smokers and controls who were non-smokers.
A total of 1270 sites were examined in 253 subjects consisting of 60 smokers and 193 non-smokers. They were all systemically healthy adults drawn from 12 factories located in different urban and rural settings in the state of Lagos in Nigeria. Five oral mucosal sites were examined per subject. A single examiner performed all examinations and recorded all findings. Pigmentation was scored either as "present" or "absent." Subjects' smoking status, degree, and duration of smoking were ascertained and recorded using an examiner-administered questionnaire.
There were five pigmented sites (0.52%) among non-smokers and 18 (6%) among smokers. The buccal mucosa was the most frequently pigmented site found in smokers while the lingual mucosa was the most common site found for non-smokers. The prevalence of pigmented sites increased directly among smokers with the duration of smoking (years); degree of smoking (cigarettes smoked per day); and smoking pack-years (degree of smoking divided by 20 and multiplied by duration of smoking, where 20 is the average number of cigarettes in a pack of cigarettes). SPSS version 11.0 was used for data entry and analysis. Frequency distributions were generated for all categorical variables for descriptive aspects of the analysis. Means were determined for quantitative variables such as age and number of cigarettes smoked. For homogenous variances, the student's t test was used for quantitative variables between smokers and non-smokers, while for non-homogenous variances the Mann-Whitney test was adopted. Chi-square statistic was used for comparisons between smokers and non-smokers. In tables with low expected frequencies, Fisher's exact test was adopted. Statistical tests yielding p-values = or <0.5 were considered significant.
Smokers in this study had a significantly higher prevalence of pigmented oral mucosal sites (melanosis) than non-smokers. The number of pigmented sites increased with the degree and duration of smoking. The buccal mucosa was the most frequently pigmented site found among the smokers in this study.
与口腔黏膜色素沉着相关的术语包括生理性（种族性）色素沉着、口腔色素痣、口腔黑斑、黑色素瘤和吸烟者黑变病。文献中充斥着关于口腔黏膜色素沉着的研究，认为其是由黑素失禁导致的。已记录的病因包括局部和全身因素，如激素、药物、吸烟和特发性病因。本研究调查了尼日利亚吸烟者和非吸烟对照者中黑变病的患病率。
对253名受试者的1270个部位进行了检查，其中包括60名吸烟者和193名非吸烟者。他们均为全身健康的成年人，来自尼日利亚拉各斯州不同城乡地区的12家工厂。每位受试者检查五个口腔黏膜部位。由一名检查者进行所有检查并记录所有结果。色素沉着按“有”或“无”进行评分。使用检查者提供的问卷确定并记录受试者的吸烟状况、吸烟程度和吸烟持续时间。
非吸烟者中有五个色素沉着部位（0.52%），吸烟者中有18个（6%）。颊黏膜是吸烟者中最常出现色素沉着的部位，而舌黏膜是非吸烟者中最常见的部位。吸烟者中色素沉着部位的患病率随吸烟持续时间（年）、吸烟程度（每天吸烟支数）和吸烟包年数（吸烟程度除以20再乘以吸烟持续时间，其中20是一包香烟的平均支数）直接增加。使用SPSS 11.0版本进行数据录入和分析。为分析的描述性方面生成所有分类变量的频率分布。确定定量变量（如年龄和吸烟支数）的均值。对于方差齐性的情况，使用学生t检验比较吸烟者和非吸烟者之间的定量变量，而对于方差不齐的情况则采用曼-惠特尼检验（Mann-Whitney test）。使用卡方统计量比较吸烟者和非吸烟者。在预期频率较低的表格中，采用费舍尔精确检验（Fisher's exact test）。产生p值等于或小于0.5的统计检验被认为具有显著性。
本研究中的吸烟者口腔黏膜色素沉着部位（黑变病）患病率显著高于非吸烟者。色素沉着部位的数量随吸烟程度和持续时间增加。颊黏膜是本研究中吸烟者中最常出现色素沉着的部位。
