Oral potentially malignant disorders (OPMDs) are associated with an increased risk of occurrence of cancers of the lip or oral cavity. This paper presents an updated report on the nomenclature and the classification of OPMDs, based predominantly on their clinical features, following discussions by an expert group at a workshop held by the World Health Organization (WHO) Collaborating Centre for Oral Cancer in the UK. The first workshop held in London in 2005 considered a wide spectrum of disorders under the term "potentially malignant disorders of the oral mucosa" (PMD) (now referred to as oral potentially malignant disorders: OPMD) including leukoplakia, erythroplakia, proliferative verrucous leukoplakia, oral lichen planus, oral submucous fibrosis, palatal lesions in reverse smokers, lupus erythematosus, epidermolysis bullosa, and dyskeratosis congenita. Any new evidence published in the intervening Medical Sciences,
Data on the oral health of the elderly depict a worrying situation, with an elevated prevalence of caries and moderate periodontal disease, frequent edentulism, and numerous cases of dry mouth and oral cancer. There is wide evidence that periodontitis is a risk factor for certain systemic diseases, and impaired oral health has been associated with mastication and nutritional problems, especially among the elderly, with highly negative effects on their quality of life. In this nonsystematic review, the authors discuss the importance of evaluating the oral health of the geriatric population in a comprehensive manner, beyond simple clinical assessments.
Studies of the malignant potential of oral lichen planus (OLP) have been hampered by inconsistencies in the diagnostic criteria used for OLP, the criteria adopted to identify a true case of malignant transformation in OLP, the risk factors for malignant transformation and the optimum management of patients to ensure the early diagnosis of transformation. Consensus remains elusive, and leading workers in this field have recently published conflicting reports on the malignant potential of OLP and on the important question of the advisability of excluding patients with epithelial dysplasia or a tobacco habit from studies on this issue. The present review outlines these debates and proposes a possible a molecular basis for the malignant transformation in this disease.
Background. Dementia is a multi-etiologic syndrome characterized by multiple cognitive deficits but not always by the presence of cognitive impairment. Cognitive impairment is associated with multiple non-modifiable risk factors but few modifiable factors. Epidemiological studies have shown an association between periodontitis, a potentially modifiable risk factor, and cognitive impairment.Objectives. To determine whether clinical periodontitis is associated with the diagnosis of cognitive impairment/dementia after controlling for known risk factors, including age, sex, and educational level.Methods. A case-control study was conducted in Granada, Spain, in two groups of dentate individuals over 50 years of age: cases with a firm diagnosis of mild cognitive impairment or dementia of any type or severity, and controls with no subjective memory loss complaints and a score >30 in the "Phototest" cognitive test (screening test for cognitive impairment). Periodontitis was evaluated by measuring tooth loss, plaque and bleeding indexes, pocket depths, and clinical attachment loss.Results. The study included 409 dentate adults, 180 with cognitive impairment and 229 without. A moderate and statistically significant association was observed between clinical attachment loss and cognitive impairment after controlling for age, sex, educational level, oral hygiene habits, and hyperlipidemia (p=0.049). No significant association was found between tooth loss and cognitive impairment.Conclusion. Periodontitis appears to be associated with cognitive impairment after controlling for confounders such as age, sex, and educational level. KEY WORDS.Periodontitis, periodontal attachment loss, mild cognitive impairment, dementia.Dementia is a multi-etiologic syndrome characterized by the acquired involvement of multiple cognitive/behavioral domains that compromise the sufferer's functional capacity 1 . It largely affects the elderly, although it can commence at any age 1 . Mild cognitive impairment is an intermediate state, frequently appearing before the development of dementia, in which the cognitive and behavioral impairment is not sufficiently severe to have functional repercussions 2 . The main cause of dementia is Alzheimer's Disease (AD), a neurodegenerative process of multifactorial and complex etiology associated with multiple risk and protective factors; its prevalence increases exponentially with age from 65 years on, and it represents one of the main socio-health problems faced by the developed world 3 . It is estimated that there will be 35.6 million individuals with dementia worldwide in 2010 and that this number will double every 20 years, reaching more than 115 million by 2050 1 . The magnitude of the challenge and the 1 Journal of Periodontology; absence of curative treatments make the development of preventive measures a matter of extreme urgency. Although many risk factors are non-modifiable (e.g., age, sex, and genetic risk factors), others are susceptible to modification through individual choices, e.g., certain dieta...
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