0000000000277224
AUTHOR
I. Van Der Waal
A clinical diagnosis of oral leukoplakia: A guide for dentists
Background In view of the many white or predominantly white lesions of the oral mucosa it is a challenge for dentists to clinically identify a leukoplakia, being a potentially (pre)malignant lesion. Material and Methods Based on the available literature and experience of the authors the parameters of a clinical diagnosis of oral leukoplakia have been studied. Results A guide has been presented that should help dentists to establish a clinical diagnosis of leukoplakia as accurate as possible. Conclusions Probably in most parts of the world dentists will need the help of a specialist for confirmation or exclusion of the clinical diagnosis of oral leukoplakia and for further management of the …
Professional diagnostic delay in osteosarcomas of the jaws
A series of 20 consecutive patients with an osteosarcoma of the jaws has been evaluated with regard to possible professional diagnostic delay. When set at an arbitrarily chosen period beyond three months, professional delay occurred in 15 patients, the mean being 21 months and the median 11 months. In five of the 15 patients a wrong diagnosis has been rendered on the biopsy specimen, being fibrous dysplasia (2x), osteoma (2x) and, in case of palatomaxillary swelling, pleomorphic adenoma (1x). In the other ten patients the initial clinicoradiographic features were misleading and apparently not indicative of a malignancy, except for one patient in whom a distinct widening of the periodontal l…
Proliferative verrucous leukoplakia; a critical appraisal of the diagnostic criteria
Since its introduction in the literature in 1985, the term proliferative verrucous leukoplakia (PVL) has been the subject of an ongoing discussion with regard to its definition. Widespread or multifocal occurrence of oral leukoplakia is not just synonymous to PVL. In the present treatise the proposal is made to require the involvement of more than two oral oral subsites, a total added seizeof the leukoplakic areas of at least 3 centimeters, and a well documented period of at least five years of disease evolution being characterized by spreading and the occurrence of one or more recurrences in a previously treated area. Key words:Oral premalignant lesions, leukoplakia, verrucous leukoplakia.
How general dentists could manage a patient with oral lichen planus
Background The literature hardly contains information on how patients suffering from oral lichen planus could be managed by dentists. Material and Methods Based on the limited available literature and particularly on the long-term clinical and histopathological experience of one of the authors, suggestions on how dentists could manage patients with oral lichen planus have been put forward. Results: In most cases, the dentist should be able to establish a correct diagnosis. Results In most cases, the dentist should be able to establish a correct diagnosis. Occasionally, the dentist may call upon a specialist, usually an oral medicine specialist or an oral and maxillofacial surgeon for confir…
Oral lichen planus and oral lichenoid lesions; a critical appraisal with emphasis on the diagnostic aspects
Oral lichen planus (OLP) has a prevalence of approximately 1%. The etiopathogenesis is poorly understood. The annual malignant transformation is less than 0.5%. There are no effective means to either predict or to prevent such event. Oral lesions may occur that to some extent look like lichen planus but lacking the characteristic features of OLP, or that are indistinguishable from OLP clinically but having a distinct cause, e.g. amalgam restoration associated. Such lesions are referred to as oral lichenoid lesions (OLLs). The management of OLP and the various OLLs may be different. Therefore, accurate diagnosis should be aimed at.
Are we able to reduce the mortality and morbidity of oral cancer; Some considerations
Oral cancer makes up 1%-2% of all cancers that may arise in the body. The majority of oral cancers consists of squamous cell carcinomas. Oral cancer carries a considerable mortality rate, being mainly dependent on the stage of the disease at admission. Worldwide some 50% of the patients with oral cancer present with advanced disease. There are several ways of trying to diagnose oral cancer in a lower tumor stage, being 1) mass screening or screening in selected patients, 2) reduction of patients’ delay, and 3) reduction of doctors’ delay. Oral cancer population-based screening (“mass screening”) programs do not meet the guidelines for a successful outcome. There may be some benefit when foc…
Clinicopathological evaluation of 164 dental follicles and dentigerous cysts with emphasis on the presence of odontogenic epithelium in the connective tissue. The hypothesis of "focal ameloblastoma"
Objectives: Some ameloblastomas presumably originate from odontogenic epithelium within the connective tissue of dental follicles and dentigerous cysts. Therefore, it would seem reasonable to discuss as whether odontogenic epithelium proliferations, frankly displaying ameloblastomatous features (“focal ameloblastoma”), should be considered as an “early” ameloblastoma. Study Design: Histopathological reports from 164 dental follicles and dentigerous cysts from the Department of Oral and Maxillofacial Surgery/Oral Pathology of the VU Free University medical center in Amsterdam, The Ne-therlands, were reviewed. Histopathological slides from 39 cases reporting the presence of odontogenic epithe…
Oral cancer trends in a single head-and-neck cancer center in the Netherlands; decline in T-stage at the time of admission
OBJECTIVES:In this study we evaluated the possible epidemiologic changes of oral cancer patients in the Netherlands between the years 1980-1984 and 2000-2004. We specifically studied the differences in male-female ratio, age, TNM-stage, site distribution, and alcohol and tobacco use.MATERIALS AND METHODS:Patients from the VU University Medical Center with an oral squamous cell carcinoma of the oral cavity registered in 1980-1984 (n=200), group 1, were compared to patients registered in 2000-2004 (n=184), group 2. Trends in prevalence, site distribution, TNM-stage, alcohol and tobacco use, age and gender were studied.RESULTS:The male-female ratio has decreased from 1.8 to 1.2. There were no …