Lockhart P B, Norris C M, Pulliam C
Department of Dentistry, Carolinas Medical Center, Charlotte, North Carolina, USA.
Oral Oncol. 1998 Mar;34(2):133-9. doi: 10.1016/s1368-8375(97)00086-9.
This study investigated the role of dental factors in the genesis of squamous cell carcinomas of the oral cavity. 99 newly diagnosed patients with advanced head and neck cancer were evaluated for potential demographic, dental and prosthetic risk factors. Patients with extra-oral malignancies were used as controls in the analysis of dental factors in patients with intra-oral cancers. We performed multiple comparisons of these factors against the primary tumour sites. An analysis of dental and prosthetic factors and patients with intra-oral versus extra-oral tumours revealed no significant differences. However, all 28 intra-oral malignancies arose in areas in contact with teeth and/or appliances. For example, all 10 oral tongue lesions arose on the lateral borders and all six floor of (drop) mouth primary tumours developed at the flange extension of a lower denture. Patients with partial or full dentures had significantly lower node (N) scores than patients without a prosthesis. Although this paper suggests a relationship between dental factors and the genesis of oral squamous cell malignancies, a larger prospective study would be required to achieve definitive data. Patients at risk should be followed carefully for the development of chronic irritation from teeth and appliances.
本研究调查了牙齿因素在口腔鳞状细胞癌发生过程中的作用。对99例新诊断的晚期头颈癌患者进行了潜在人口统计学、牙齿和修复体危险因素的评估。在分析口腔癌患者的牙齿因素时，将口外恶性肿瘤患者作为对照。我们对这些因素与原发肿瘤部位进行了多重比较。对牙齿和修复体因素以及口腔内与口腔外肿瘤患者的分析显示无显著差异。然而，所有28例口腔内恶性肿瘤均发生在与牙齿和/或矫治器接触的部位。例如，所有10例舌部病变均发生在舌侧缘，所有6例口底原发性肿瘤均发生在下颌义齿基托延伸处。佩戴部分或全口义齿的患者的淋巴结（N）评分显著低于未佩戴义齿的患者。尽管本文提示牙齿因素与口腔鳞状细胞恶性肿瘤的发生之间存在关联，但需要进行更大规模的前瞻性研究以获得确切数据。对有风险的患者应密切随访，观察牙齿和矫治器是否会产生慢性刺激。
