OBJECTIVE -Numerous publications have already demonstrated that diabetes is a risk factor for the development of periodontal diseases and various inflammatory lesions in the oral mucosa. A possible correlation between diabetes and oral premalignancies and tumors was examined in this study, as no literature data are available concerning this problem.RESEARCH DESIGN AND METHODS -Stomato-oncological screening was carried out on 200 diabetic patients in the medical departments; the control group included 280 adult dentistry outpatients. The lesions found were classified into three groups: inflammatory lesions, benign tumors, and precancerous lesions. A retrospective diabetes screening of 610 inpatients with histologically confirmed oral malignancies was also performed. The control group comprised 574 complaint-and tumor-free adults. Fasting blood glucose levels were determined in both groups, and the tumor location was registered in the cancer patients.RESULTS -Benign tumors were found in 14.5% and precancerous lesions in 8% of diabetic patients. In the control group these values were significantly lower, at 6.4 and 3.2%, respectively (P Ͼ 0.01). Earlier Hungarian screening studies indicated similar frequency of these lesions in the general population. The proportion of oral cavity lesions was higher among diabetic patients compared with that of the control patients. In the oral cancer patient group, diabetes was present in 14.6% and an elevated blood glucose level in 9.7%. These values are significantly higher than those for the tumor-free control group (P Ͻ 0.01). The gingival and labial tumor location was significantly more frequent among diabetic cancer patients than in the nondiabetic group (P Ͻ 0.01). The combination of diabetes and smoking means a higher risk for oral precancerous lesions and malignancies.CONCLUSIONS -Diabetes may be a risk factor for oral premalignancies and tumors. Diabetes Care 27:770 -774, 2004C orrelations between diabetes and inflammatory oral lesions were first published in the 19th century (1). Gingivitis and destructive periodontitis with a rapid loss of the teeth were described as cardinal, pathognomic symptoms of diabetes (2,3).The discovery of insulin treatment justified a close correlation between the disorder of the carbohydrate metabolism and oral inflammatory complications (4). The adequate treatment of diabetes results in marked improvement of the gingival and periodontal lesions.Diabetes patients have further inflammatory complications of the oral mucosa. The decreased rate of saliva secretion and the low pH value result in chronic cheilitis and glossitis with progressive atrophy of the covering epithelial layer (5).The inflammation-mediated carcinogenesis is a well-known empirical fact, but the exact pathway of this transition has not been perfectly clarified until now (6 -9). Is there any correlation between diabetes and tumor genesis of the oral cavity? Surprisingly, there are no literature data concerning this problem. Accordingly, in the present study, we have attempted...

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Multiple primary tumors occur more commonly in the region of the head and neck than elsewhere in the body. The chance of this is particularly high in patients treated for retinoblastoma, in part because of a genetic predisposition, and in part because of the possibility of irradiation treatment. However, triple tumors occur in only 0.5% of multiple tumors. A rare case of a triple (metachronous) tumor is reported: 12 years after the treatment of bilateral retinoblastoma (enucleation and irradiation), secondary leiomyosarcoma developed in the maxillofacial region, followed 5 years later by choriocarcinoma. Surgery was performed on all three types of tumor. As a result, the female patient (currently 21 years old) is now free of complaints and has married. It is extremely rare for either leiomyosarcoma or choriocarcinoma (CHC) to appear in the maxillofacial region. The long-term, systematic control of such patients is absolutely necessary, for the multiple tumors tend to develop only after a long latency period of 10 to 20 years.

Diabetes is considered an endemic medical condition with increasing prevalence globally. This tendency has been also detected in Hungary where the prevalence of diabetes among the adult population reached 7% according to the latest statistical data (1). Numerous data from several medical publications have shown that diabetes is a promoting factor in the formation of malignant tumors at different sites and has a negative impact on tumor progression and patient survival (2-16). Our medical research team has long studied the correlations between oral cavity cancer and diabetes, mainly type 2 diabetes (17, 18). Since type-2 diabetes has rapidly increased in prevalence globally and the morbidity and mortality rates of oral cavity cancer -especially in Hungary-do not show any significant decrease, we examined the relationship between glucose metabolic disorders and oral cancer in our clinic over the past 14 years. In the present study, we analyzed data of 758 patients with oral cavity cancer and 534 tumor-free control patients and examined the prevalence of diabetes and impaired fasting glucose (IFG), the distribution of tumor location and the role of smoking. Additionally, we compared our current results to data obtained 14 years ago. Patients and MethodsWe conducted a retrospective research study in the inpatient ward of the Semmelweis University Department of Oral and Maxillofacial Surgery, Budapest, Hungary. We examined patients who were diagnosed with histologically confirmed malignant oral tumors. The examination period was between the 1st of January, 2012 and 31st of December, 2015. These results were compared to an earlier study that was conducted in the same Department between the 1st of January, 1998 and 30th of June, 2002. We processed the data of 610 patients (435 males and 175 females) in the first interval and the data of 758 patients (400 male and 358 female) in the second interval. All patients were diagnosed with histologically confirmed malignant cancer. Based on these histological data, we confirmed that 606 cases among the 610 and 749 cases among the 758 were squamous cell carcinomas, while the remainder consisted of adenocarcinomas. The average age of the patients from the previous study was 56 years (range=36-85), whereas the average age of the patients in the follow-up study was 64 years (range=12-92).The control group in the first research interval was formed by 574 patients (351 male, 223 female). Their average age was 51 years (range=32-79).The control group in the second study interval was formed by 534 patients (318 male, 216 female) with an average age of 53 years (range=30-94). The patients of the control group in both study intervals volunteered for stomato-oncological screening and found symptom-and cancer-free.We considered patients with diabetes mellitus (DM) to be those who had been previously diagnosed and treated for diabetes by an internist or diabetologist. We classified patients into the IFG group when their fasting blood glucose values were between 6.1 and 6.9 mmol/l. We cons...

Background: Medication-related osteonecrosis of the jaw (MRONJ) is a type of jawbone necrosis caused by the use of drugs for some types of cancer and osteoporosis. The current study aimed to evaluate the associations between hyperglycemia and the development of medication-related osteonecrosis of the jaw. Methods: Our research group investigated data collected between 1 January 2019 and 31 December 2020. A total of 260 patients were selected from the Inpatient Care Unit, Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University. Fasting glucose data were used and included in the study. Results: Approximately 40% of the necrosis group and 21% of the control group presented with hyperglycemia. There was a significant association between hyperglycemia and MRONJ (p < 0.05, p = 0.003). Vascular anomaly and immune dysfunction caused by hyperglycemia can lead to necrosis after tooth extraction. Necrosis is more common in the mandible (75.0%) and in the case of parenteral antiresorptive treatment (intravenous Zoledronate and subcutaneous Denosumab). Hyperglycemia is a more relevant risk factor than bad oral habits (26.7%). Conclusions: Ischemia is a complication of abnormal glucose levels, a possible risk factor for necrosis development. Hence, uncontrolled or poorly regulated plasma glucose levels can significantly increase the risk of jawbone necrosis after invasive dental or oral surgical interventions.