Frictional Keratoses on the Facial Attached Gingiva Are Rare Clinical Findings and Do Not Belong to the Category of Leukoplakia
Frictional Keratoses on the Facial Attached Gingiva Are Rare Clinical Findings and Do Not Belong to the Category of Leukoplakia
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DOI：
10.1016/j.joms.2010.05.087
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发表时间：
2011-05-01
影响因子：
1.9
通讯作者：
Cafiero, Carlo
中科院分区：
文献类型：
--
作者：
Mignogna, Michele D.;Fortuna, Giulio;Cafiero, Carlo
目的：探讨磨擦性角化病的临床和组织学特征，以确定其是否属于牙周病。材料和方法：对159例口腔角化斑块患者进行回顾性研究，这些角化斑块仅位于面部附着的牙周粘膜，不包括无牙牙槽脊和磨牙后垫区。结果：159例患者中有14例(8.8%)的临床和免疫组织学诊断为口腔摩擦性角化病。单侧受累11例(78.5%)，双侧受累3例(21.5%)。由于不良习惯的停止，14名患者中只有9名患者的皮损消失。临床上，这些病变表现为明显的、边界清晰的、孤立的、无症状的、均匀的白色斑块，既不能切除，也不痛。这些斑块没有造成不适，没有改变形状，也没有发展成恶性肿瘤。组织学上，这些斑块表现出与良性牙槽脊角化病重叠的特征。结论：面部附着的牙龈粘膜上的摩擦性角化病1)罕见，2)临床表现为“真白斑”，但组织学上具有与良性牙槽脊角化病相同的特征，3)无恶变倾向，4)预后良好，5)有特定的病因，如果消除摩擦因素，就能解决问题。因此，必须将这些从白斑的类别中移除。(C)2011年美国口腔颌面外科协会口腔颌面外科69：1367-13 74,2011
Purpose: To investigate the clinical and histologic features of frictional keratoses located exclusively on the facial attached gingiva and establish whether these belong to the category of leatkoplakia.Materials and Methods: Over a period of 15 years, 159 patients presenting with oral keratotic plaques, located exclusively on the facial attached gingival mucosa, excluding the edentulous alveolar ridge and retromolar pad area, were retrospectively selected. Clinical and histologic features and the symptoms and progression of these lesions were carefully assessed.Results: The presence of oral frictional keratosis located exclusively on the facial attached gingival mucosa was clinically and immunohistologically diagnosed in 14 of 159 patients (8.8%). Eleven patients (78.5%) showed unilateral involvement, whereas 3 patients (21.5%) had bilateral involvement. The disappearance of the lesions was accomplished in only 9 of 14 patients, resulting from discontinuation of bad habits. Clinically, these lesions appeared as distinct, sharply demarcated, isolated, asymptomatic, homogeneous whitish-plaques that were neither removable nor painful. The plaques did not create discomfort, change shape, or develop into malignancy. Histologically, these plaques showed features superimposable to those present in benign alveolar ridge keratoses.Conclusion: The results highlighted that frictional keratoses on the facial attached gingival mucosa 1) are rare findings, 2) clinically appear as "true leukoplakia" but histologically have the same features as benign alveolar ridge keratoses, 3) have no propensity for malignant transformation, 4) have a good prognosis, and 5) have a specific cause, and resolution is accomplished if the frictional element is eliminated. Thus, these must be removed from the category of leukoplakia. (C) 2011 American Association of Oral and Maxillofacial Surgeons Oral Maxillofac Surg 69:1367-13 74, 2011