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[White lesions of the oral mucosa. Auxiliary diagnostic methods].

The purpose of this study was to assess the reliability of toluidine blue stain in determinating the biopsy site in 65 patients with red and white oral lesions. These patients were studied by comparing toluiding blue dye uptake clinically with a simultaneous biopsy. The microscopic analysis resulted in a false positive rate of 10.5% (previously we had established that the 6% were inflammatory lesions, always positive). We did not find false negatives. The reliability of the toluidine blue technique was 95.38%.

Biopsy↗

Oral pathology.

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Adenocarcinoma↗

[Environmental pathology and dentistry. III. Carcinogenic process of the soft tissues of the oral cavity].

The context in which a relationship between environmental pathologies and dentistry is most easily distinguished is with reference to the carcinogenic processes of soft tissues in the oral cavity. In this study, a distinction is made between potentially cancerous lesions and true carcinomas, and the relationship between tumour pathology of the oral cavity and the surrounding environment is analysed. Clinical aspects are also illustrated.

Environmental Exposure↗

[Changes in oral mucosa and tumors in elderly patients].

Intraoral and perioral tissues demonstrate exemplary age-related atrophic changes that are due to endogenous factors, as well as to exogenic damage. Age-related physiological changes in intraoral mucosa, salivary glands, tongue, musculature, and the nerve system are discussed. Pathological changes in the mucosa, especially the different types of leukoplakia are demonstrated; they play a crucial role in the early diagnosis of intraoral cancer. The development of intraoral cancer is very much related with age. Age-related changes of oral mucosa increase the risk of cancer, and the risk is further increased by the long-term influence of exogenic damages. Surgery is the treatment of choice, especially in the elderly patient, in whom quality of life must be maintained as much as possible. The prognosis of intraoral cancer is mainly influenced by the size of the tumor at treatment. Therefore, early diagnosis and prophylaxis, which is often neglected in elderly patients, may improve this situation.

Aged↗

Clinical manifestations of oral precancer and cancer.

Oral squamous cell carcinomas generally metastasise early and are associated with a poor survival rate. Their prevention depends largely on timeous identification of precancerous oral mucosal lesions, which may present clinically as a homogeneous or nodular white plaque (leucoplakia), a mixed white and red lesion (erythroleucoplakia) or a homogeneous or nodular red lesion (erythroplakia). Red premalignant lesions generally have a higher malignant potential than white lesions.

Carcinoma, Squamous Cell↗

Erythroplakic lesions in relation to oral lichen planus.

In a cohort of 740 referred patients with oral lichen planus eight patients were found with a sharply demarcated slightly depressed erythroplakic area. The histological examination of the biopsies from the erythroplakic lesion of the 8 patients showed seven with epithelial dysplasia. In addition, two of the lesions revealed a squamous cell carcinoma. In the erythroplakic lesion without dysplasia the histological picture was found to be characteristic of lichen planus. All eight patients were seen at later follow-up examinations (median observation period: 3.6 years) and in one patient a squamous cell carcinoma arose in the erythroplakic lesion during the control period. It is concluded that the reported erythroplakic lesions in relation to oral lichen planus seem to be premalignant and they should be followed and/or treated like oral erythroplakias.

Aged↗