Proliferative verrucous leukoplakia (PVL) is a potentially malignant oral disorder first described by Hansen et al. (1985). It is characterized as a distinct aggressive form of oral leukoplakia, due to its progressive and multifocal behaviour, characterized by relapses, spreading and high rates of malignant transformation (Bombeccari Giannì et al., 2018;Hansen et al., 1985). Its aetiology is not related to known risk factors for conventional oral leukoplakia or oral squamous cell carcinomas (OSCCs), such as tobacco and alcohol; however, some genetic factors have been observed in PVL but without a definition of pathogenesis and aetiology (El-Naggar et al., 2017;Okoturo et al., 2018).PVL has distinct clinical stages, such as the appearance of one or more white plaques or spots on the oral mucosa; the increase and spread of these lesions to cover other sites; a verrucous surface appearance to some or all the leukoplakia and, finally, malignant transformation into verrucous carcinoma or OSCC (Gillenwater et al.,
Purpose: Radiation caries (RC) is a highly prevalent chronic complication of head and neck radiotherapy (HNRT) and a challenge for clinicians and patients. The present study aimed to assess the impact of RC on the morbidity and mortality outcomes of head and neck squamous cell carcinoma (HNSCC) patients.
Methods: Patients were divided into 3 groups: RC (n=20), control (n=20) and edentulous (n=20). Information regarding the number of appointments, dental procedures, osteoradionecrosis (ORN), prescriptions, and hospital admissions werecollected. Mortality outcomes were assessed through disease-free survival (DFS) and overall survival (OS) rates.
Results: RC patients required more dental appointments (p<0.001), restorations (p<0.001), extractions (p=0.001), and antibiotic and analgesic prescriptions (p<0.001). Kaplan–Meier subgroup analyses showed a significantly impaired risk of ORN in RC compared to edentulous patients (p=0.015). RC presented lower DFS rates (46.5 months) than the control and edentulous groups (53.5 and 52.8 months, respectively).
Conclusion: RC impacts morbidity outcomes for cancer survivors due to increased demand for medication prescriptions, multiple specialized dental appointments, invasive surgical treatments, risk of ORN, and hospital admissions.
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