Characterization of Chronic Mechanical Irritation in Oral Cancer

Abstract

Objective. Oral mucosa could host many lesions originated by chronic mechanical irritation (CMI) from teeth or dentures, and it has been proposed as risk factor for oral cancer. Nevertheless, the features of CMI factors in oral cancer and other lesions are not assessed. The aim of this study is to describe CMI features regarding type (dental, prosthetic, and/or functional), localization, and time span. Materials and Methods. Three groups were studied in this cross-sectional study: Oral Cancer (OC); Chronic Traumatic Ulcer (CTU); and Benign Irritative Mechanical Lesions (BIML). All sources of mechanical irritation were included: dental, prosthetic, and functional. Results. 285 patients (176 females, 109 males) were studied: OC = 38, CTU = 44, and BIML = 203. The most frequent CMI factor was dental, followed by functional and prosthetic in all groups; 76.5% (n = 218) presented functional factors. Buccal mucosa (45%) and tongue (42%) were the most affected sites. Time of action of CMI displayed statistically significant differences between BIML, CTU, and OC groups, with a mean of 21, 33, and 49 months, respectively. Conclusions. CMI should be properly recorded with as much detail as alcohol and tobacco consumption. CMI associated lesions are produced by dental or prosthetic factors, usually in relation to functional factors, involving mainly tongue and buccal mucosa.

Management of chronic traumatic ulcer mimicking oral squamous cell carcinoma on the tongue

“…There are three contributory factors of chronic mechanical irritation that can cause CTU and OSCC, namely: dental factors (dental malposition, diastema, sharp/jagged teeth and/or restoration, jagged teeth), prosthetic factors (sharp/rough dentures, denture retainers, overextended flanges, lack of retention and/or stability) and functional factors (tongue interposition, sucking, biting and parafunctional habits). 1 From the anamnesa and clinical examination, the etiology factors were identified as sharp 15, 44 and 47 teeth as well as parafunctional factors such as the interposition of the tongue because of the missing 16, 14, 24, 26, 36, 45 and 46 teeth. These factors lead to the formation of ulcers due to their constant contact with the right lateral of the tongue.…”

“…The most common lesion is a chronic traumatic ulcer. 1 A traumatic ulcer is usually a single lesion with erythematous, irregular margins and a clean base covered with a pseudo-membrane. Usually painful, they occur due to a bite or trauma from sharp teeth or ill-fitting dentures.…”

“…For this reason, chronic mechanical irritation may also play a role in provoking a continuous inflammatory state. 1 The management of CTU is largely based on eliminating all factors underlying the injury. Needless to say, prompt diagnosis and elimination of the causative factors is expected to promote the healing process.…”

Expresiones clínicas de los trastornos potencialmente malignos en la cavidad oral. Revisión integrativa de la literatura

“…Desde el punto de vista histopatológico, las UTC muestran una solución de continuidad del epitelio y corion con tejido hiperplásico en los márgenes y un tejido de granulación mixto a lo largo de la base y en profundidad. También se evidencia un exudado brinoso que cubre el conectivo expuesto, con un inltrado inamatorio con polimorfonucleares, linfocitos y células plasmáticas (66).…”

Trends in oral squamous cell carcinoma: Diagnosis for effective, evidence-based treatment 2017

“…[ 2 ] There is also evidence to indicate that chronic mechanical irritation is a factor that predisposes to OSCC. [ 7 ] Mitochondrial DNA as a source of maternal genetic susceptibility has been recently demonstrated in tongue cancer patients. [ 8 ]…”