Sarode Gargi S, Sarode Sachin C, Sengupta Namrata, Ghone Urmi, Kumar Sharma Nilesh, Gadbail Amol R, Gondivkar Shailesh, Patil Shankargouda
Department of Oral Pathology and Microbiology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune 411018, MH, India.
Department of Oral Pathology and Microbiology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune 411018, MH, India.
Med Hypotheses. 2021 Mar;148:110507. doi: 10.1016/j.mehy.2021.110507. Epub 2021 Jan 22.
Mechanical stresses in the form of substrate rigidity, hydrostatic pressure, compressive, tensile and shear stress has been regarded as an important motive for the epithelial carcinogenesis brought about by the activation of Hippo signaling pathways. Masticatory forces generated in edentulous patients with dentures are transferred directly to the palatal mucosa (maxillary denture) and alveolar mucosa (mandibular denture). Thus, the oral mucosa present underneath the dentures experiences compressive, shear and tensile stresses on a day-to-day basis. These stresses can induce carcinogenesis by mechano-transduction and subsequent activation of numerous carcinogenesis relevant signaling pathways such as the HIPPO pathway. With this contention in mind, we proposed a hypothesis, which explains the pathogenesis for the presence of oral squamous cell carcinoma in denture wearer patients. Efforts were made to envisage the appropriate experimentations for the evaluation of the hypothesis. As a therapeutic implication, flexible dentures, soft denture, or medicated dentures could be prescribed for the high-risk groups having potentially malignant lesions in the oral cavity.
以基质硬度、静水压力、压缩、拉伸和剪切应力形式存在的机械应力,被认为是由Hippo信号通路激活所引发的上皮细胞癌变的重要诱因。佩戴假牙的无牙患者所产生的咀嚼力会直接传递至上腭黏膜(上颌假牙)和牙槽黏膜(下颌假牙)。因此,假牙下方的口腔黏膜每天都会承受压缩、剪切和拉伸应力。这些应力可通过机械转导以及随后激活众多与癌变相关的信号通路(如HIPPO通路)来诱发癌变。基于这一观点,我们提出了一个假说,用以解释佩戴假牙患者口腔鳞状细胞癌的发病机制。我们努力设想合适的实验来评估这一假说。作为一种治疗意义,可以为口腔中存在潜在恶性病变的高危人群开具柔性假牙、软质假牙或含药假牙。