Periodontal status and patient characteristics in oral mucosal malignant and benign lesions: A preliminary study

Document Type : Original Article


1 Department of Oral and Maxillofacial Radiology, School of Dentistry, Ege University, Izmir, Turkey

2 Professor, Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey

3 Professor, Department of Oral and Maxillofacial Radiology, School of Dentistry, Ege University, Izmir, Turkey

4 Associate Professor, Department of Statistics, School of Scıence, Ege University, Izmir, Turkey



BACKGROUND AND AIM: Head and neck cancers are the sixth most common type of cancers in the world and it has been emphasized that chronic inflammation may be associated with carcinogenesis in recent years. In the present study, the purpose is to investigate the patient characteristics and the periodontal health status of patients with malignant and benign oral mucosal lesions.
METHODS: 34 patients with suspicious mucosal lesions were registered. The patients’ demographic variables, tobacco use, and clinical periodontal measurements such as probing pocket depth (PD), plaque index (PI), and bleeding on probing (BOP) were established for statistical analysis. All lesions were stained using Toluidine blue solution in order to determine the biopsy site and punch biopsy was performed prior to the histological examination. The patients’ test parameters including demographic variables, tobacco use, and clinical periodontal measurements were statistically analyzed for benign and malignant groups. T-test, chi square, and Fisher’s exact tests and logistic regression test were utilized for data analyses using SPSS program. The level of significance was set at P = 0.050.
RESULTS: 34 patients [15 (44.0%) females and 19 (56.0%) males] with suspicious oral mucosal lesions were enrolled into the study. Of the 34 lesions, 8 (23.5%) were histologically diagnosed as malignant whereas 26 (76.5%) were benign. Although periodontal parameters and tobacco use were clearly granted higher scores in the malignant group, the logistic regression analysis revealed that none of the variables were influential on the diagnosis of the lesions [gender (P = 0.487), age (P = 0.891), duration of the lesion (P = 0.526), lesion localization (P = 0.356), tobacco use (P = 0.873), pocket depth (P = 0.741), plaque index (P = 0.672), bleeding index (P = 0.707)].
CONCLUSION: Despite the fact that the present study did not report statistically significant results, meaningful values related to tobacco use and periodontal measurements were observed in the patients with malignant mucosal lesions when compared to those with benign mucosal lesions.


Main Subjects

Rivera C, Venegas B. Histological and molecular aspects of oral squamous cell carcinoma (Review). Oncol Lett 2014; 8(1): 7-11.
Guneri P, Gurhan C, Karaca B. The role of the human papilloma virus in head and neck squamous cell carcinoma. Ege Univ Dis Hekim Fak Derg 2018; 39(3), 123-4.
World Health Organization. Oral health: Action plan for promotion and integrated disease prevention (60th world health assembly resolution A16). Geneva, Switzerland: WHO; 2007.
Javed F, Warnakulasuriya S. Is there a relationship between periodontal disease and oral cancer? A systematic review of currently available evidence. Crit Rev Oncol Hematol 2016; 97: 197-205.
Ye L, Jiang Y, Liu W, Tao H. Correlation between periodontal disease and oral cancer risk: A meta-analysis. J Cancer Res Ther 2016; 12(Supplement): C237-40.
Heikkila P, But A, Sorsa T, Haukka J. Periodontitis and cancer mortality: Register-based cohort study of 68,273 adults in 10-year follow-up. Int J Cancer 2018; 142(11): 2244-53.
Nazir MA. Prevalence of periodontal disease, its association with systemic diseases and prevention. Int J Health Sci (Qassim) 2017; 11(2): 72-80.
Guven DC, Dizdar O, Akman AC, Berker E, Yekeduz E, Ceylan F, et al. Evaluation of cancer risk in patients with periodontal diseases. Turk J Med Sci 2019; 49(3): 826-31.
Chung SD, Tsai MC, Huang CC, Kao LT, Chen CH. A population-based study on the associations between chronic periodontitis and the risk of cancer. Int J Clin Oncol 2016; 21(2): 219-23.
10. Michaud DS, Fu Z, Shi J, Chung M. Periodontal disease, tooth loss, and cancer risk. Epidemiol Rev 2017; 39(1): 49-58.
11. Nwizu NN, Marshall JR, Moysich K, Genco RJ, Hovey KM, Mai X, et al. Periodontal disease and incident cancer risk among postmenopausal women: Results from the Women's Health Initiative Observational Cohort. Cancer Epidemiol Biomarkers Prev 2017; 26(8): 1255-65.
12. Dizdar O, Hayran M, Guven DC, Yilmaz TB, Taheri S, Akman AC, et al. Increased cancer risk in patients with periodontitis. Curr Med Res Opin 2017; 33(12): 2195-200.
13. Moraes RC, Dias FL, Figueredo CM, Fischer RG. Association between chronic periodontitis and oral/oropharyngeal cancer. Braz Dent J 2016; 27(3): 261-6.
14. Laprise C, Shahul HP, Madathil SA, Thekkepurakkal AS, Castonguay G, Varghese I, et al. Periodontal diseases and risk of oral cancer in Southern India: Results from the HeNCe Life study. Int J Cancer 2016; 139(7): 1512-9.
15. Tezal M, Sullivan MA, Reid ME, Marshall JR, Hyland A, Loree T, et al. Chronic periodontitis and the risk of tongue cancer. Arch Otolaryngol Head Neck Surg 2007; 133(5): 450-4.
16. Tezal M, Grossi SG, Genco RJ. Is periodontitis associated with oral neoplasms? J Periodontol 2005; 76(3): 406-10.
17. Guha N, Boffetta P, Wunsch FV, Eluf NJ, Shangina O, Zaridze D, et al. Oral health and risk of squamous cell carcinoma of the head and neck and esophagus: Results of two multicentric case-control studies. Am J Epidemiol 2007; 166(10): 1159-73.
18. Divaris K, Olshan AF, Smith J, Bell ME, Weissler MC, Funkhouser WK, et al. Oral health and risk for head and neck squamous cell carcinoma: The Carolina Head and Neck Cancer Study. Cancer Causes Control 2010; 21(4): 567-75.
19. Talamini R, Vaccarella S, Barbone F, Tavani A, La Vecchia C, Herrero R, et al. Oral hygiene, dentition, sexual habits and risk of oral cancer. Br J Cancer 2000; 83(9): 1238-42.
20. Guneri P, Epstein JB, Ilhan B, Kaya A, Boyacioglu H. Clinical application of a digital method to improve the accuracy of color perception in toluidine blue stained oral mucosal lesions. Quintessence Int 2013; 44(8): 619-27.
21. Guneri P, Epstein JB, Kaya A, Veral A, Kazandi A, Boyacioglu H. The utility of toluidine blue staining and brush cytology as adjuncts in clinical examination of suspicious oral mucosal lesions. Int J Oral Maxillofac Surg 2011; 40(2): 155-61.
22. Ribeiro AC, Silva AR, Simonato LE, Salzedas LM, Sundefeld ML, Soubhia AM. Clinical and histopathological analysis of oral squamous cell carcinoma in young people: A descriptive study in Brazilians. Br J Oral Maxillofac Surg 2009; 47(2): 95-8.
23. Speight PM, Khurram SA, Kujan O. Oral potentially malignant disorders: risk of progression to malignancy. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125(6): 612-27.
24. Allen K, Farah CS. Patient perspectives of diagnostic delay for suspicious oral mucosal lesions. Aust Dent J 2015; 60(3): 397-403.
25. Johnson N. Tobacco use and oral cancer: A global perspective. J Dent Educ 2001; 65(4): 328-39.
26. Winn DM. Tobacco use and oral disease. J Dent Educ 2001; 65(4): 306-12.