Department of Biomedical Sciences and Human Oncology, Oral Medicine Section, Lingotto Dental School, University of Turin, Turin, Italy.
Med Oral Patol Oral Cir Bucal. 2012 Jul 1;17(4):e555-61. doi: 10.4317/medoral.17809.
Only few studies on gingival lesions considered large enough populations and contemporary literature does not provide a valid report regarding the epidemiology of gingival lesions within the Italian population. The histopathological and clinical appearance of 538 gingival lesions from northern Italians are described and discussed here.
The case records of patients referred for the diagnosis and management of gingival lesions, from October 1993 to October 2009, were reviewed. Data regarding the histological type of lesion were also obtained from the biopsy register for each case, and blindly re-examined.
We reported a greater frequency of benign lesions (reactive and/or inflammatory) in non-plaque/non-calculus induced gingival disorders. We confirmed an unambiguous prevalence of oral squamous cell carcinoma above all other malignant neoplasia, and a prevalence of neoplastic malignant lesions in the maxilla, with a slight increase in females and a drift of the incidence peak from the seventh to the eighth decade. There was a prevalence of precancerous gingival lesions in the maxilla, with a higher incidence in females and with a drift from the sixth to the seventh decade. We also reported a prevalence of oral lichen planus and lichenoid lesions as major manifestations of desquamative gingivitis.
The high frequency of gingival involvement of such different diseases emphasizes the importance of histological characterization and differential diagnosis for periodontists, but more prospective studies are needed to better describe the true incidence of the non-plaque related gingival diseases.
仅有少数关于牙龈病变的研究纳入了足够大的人群,且目前的文献也没有提供关于意大利人群中牙龈病变的流行病学的有效报告。本文描述并讨论了来自意大利北部的 538 例牙龈病变的组织病理学和临床特征。
回顾了 1993 年 10 月至 2009 年 10 月期间因诊断和治疗牙龈病变而转诊的患者的病历记录。还从每个病例的活检登记处获得了关于病变组织学类型的数据,并进行了盲法复查。
我们报告称,在非菌斑/非牙石引起的牙龈疾病中,良性病变(反应性和/或炎症性)的频率更高。我们证实,口腔鳞状细胞癌的患病率明显高于其他恶性肿瘤,且恶性肿瘤在上颌骨中更为常见,女性略有增加,发病高峰从 70 岁移至 80 岁。上颌骨中癌前性牙龈病变的患病率较高,女性发病率更高,发病高峰从 60 岁移至 70 岁。我们还报告了口腔扁平苔藓和苔藓样病变的高患病率,它们是脱屑性龈炎的主要表现。
如此不同的疾病中牙龈受累的高频率强调了组织学特征和鉴别诊断对牙周病医生的重要性,但需要更多的前瞻性研究来更好地描述非菌斑相关牙龈疾病的真实发病率。