Krüger Maximilian, Hansen Torsten, Kasaj Adrian, Moergel Maximilian
Department of Oral and Maxillofacial Surgery-Plastic Surgery, Johannes Gutenberg University of Mainz, Medical Center, Augustusplatz 2, 55131 Mainz, Germany.
Case Rep Dent. 2013;2013:262410. doi: 10.1155/2013/262410. Epub 2013 Jul 8.
Infections are increasingly considered as potential trigger for carcinogenesis apart from risk factors like alcohol and tobacco. The discussion about human papilloma virus (HPV) in oral squamous cell carcinoma (OSCC) points at a general role of infection for the development of oral carcinomas. Furthermore, first studies describe a correlation between chronic periodontitis and OSCC, thus, characterizing chronic inflammation as being a possible trigger for OSCC. In front of this background, we present four well-documented clinical cases. All patients showed a significant anatomical relation between OSCC and clinical signs of chronic periodontitis. The interindividual differences of the clinical findings lead to different theoretical concepts: two with coincidental appearance of OSCC and chronic periodontitis and two with possible de novo development of OSCC triggered by chronic inflammation. We conclude that the activation of different inflammatory cascades by chronic periodontitis negatively affects mucosa and bone. Furthermore, the inflammatory response has the potential to activate carcinogenesis. Apart from a mere coincidental occurrence, two out of four patients give first clinical hints for a model wherein chronic periodontitis represents a potential risk factor for the development of OSCC.
除了酒精和烟草等风险因素外，感染越来越被视为致癌的潜在触发因素。关于人乳头瘤病毒（HPV）与口腔鳞状细胞癌（OSCC）的讨论表明感染在口腔癌发展中具有普遍作用。此外，初步研究描述了慢性牙周炎与OSCC之间的相关性，因此将慢性炎症视为OSCC的可能触发因素。在此背景下，我们展示了四个记录充分的临床病例。所有患者的OSCC与慢性牙周炎的临床体征之间均存在显著的解剖学关系。临床发现的个体差异导致了不同的理论概念：两个病例中OSCC与慢性牙周炎同时出现，另外两个病例中OSCC可能由慢性炎症引发从头发展而来。我们得出结论，慢性牙周炎激活不同的炎症级联反应会对黏膜和骨骼产生负面影响。此外，炎症反应有可能激活致癌作用。除了单纯的同时发生外，四分之二的患者首次给出了临床线索，提示存在一种模型，其中慢性牙周炎是OSCC发生发展的潜在危险因素。
