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Oral Mucosal Lesions and Developmental Anomalies in Dental Patients of a Teaching Hospital in Northern Taiwan

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Oral Mucosal Lesions and Developmental Anomalies in Dental Patients of a Teaching Hospital in Northern Taiwan Journal of Dental Sciences (2014) 9,69e77 Available online at www.sciencedirect.com journal homepage: www.e-jds.com ORIGINAL ARTICLE Oral mucosal lesions and developmental anomalies in dental patients of a teaching hospital in Northern Taiwan Meng-Ling Chiang a,b, Yu-Jia Hsieh b,c, Yu-Lun Tseng d, Jr-Rung Lin e, Chun-Pin Chiang f,g* a Department of Pediatric Dentistry, Chang Gung Memorial Hospital, Taipei, Taiwan b College of Medicine, Chang Gung University, Taoyuan, Taiwan c Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan, Taiwan d Department of Psychiatry, College of Medicine, China Medical University, Taichung, Taiwan e Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan f Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan g Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan Received 1 June 2013; Final revision received 10 June 2013 Available online 27 July 2013 KEYWORDS Abstract Background/purpose: Oral mucosal lesions and developmental anomalies are dental patient; frequently observed in dental practice. The purpose of this study was to evaluate the preva- developmental lence of oral mucosal lesions and developmental anomalies in dental patients in a teaching anomaly; hospital in northern Taiwan. northern Taiwan; Materials and methods: The study group comprised 2050 consecutive dental patients. From oral mucosal lesion; January 2003 to December 2007, the patients received oral examination and treatment in prevalence; the dental department of the Chang Gung Memorial Hospital (Taipei, Taiwan). type Results: Only 7.17% of dental patients had no oral mucosal lesions or developmental anoma- lies. Twenty-three different types of oral mucosal lesions or developmental anomalies were diagnosed. The most common lesion was Fordyce granules (82.8%), followed by buccal exos- tosis (34.1%), torus mandibularis (24.2%), torus palatinus (21.1%), lingual varices (16.2%), and recurrent aphthous ulcerations (4.3%). Fordyce granules, lingual varices, and buccal exos- tosis were the three most common oral developmental anomalies in elderly patients. Fordyce granules, buccal exostosis, torus mandibularis, lingual varices, and oral submucous fibrosis were more prevalent in men than in women. Fordyce granules occurred more commonly in adults than in children and were more commonly present in the labial and buccal mucosae than * Corresponding author. Department of Dentistry, National Taiwan University Hospital, Taipei 10048, Taiwan. E-mail address: [email protected] (C.-P. Chiang). 1991-7902/$36 Copyright ª 2013, Association for Dental Sciences of the Republic of China. Published by Elsevier Taiwan LLC. All rights reserved. http://dx.doi.org/10.1016/j.jds.2013.06.004 70 M.-L. Chiang et al in any other oral mucosal sites. The anterior region of the jaws frequently contained buccal exostoses. Torus palatinus occurred more frequently in female patients than in male patients. Recurrent aphthous ulcerations were more common in patients under 18 years old. Conclusion: This study provides important data about the types and prevalence of oral mucosal lesions and developmental anomalies in dental patients in a teaching hospital in northern Taiwan. Copyright ª 2013, Association for Dental Sciences of the Republic of China. Published by Elsevier Taiwan LLC. All rights reserved. Introduction Statistical analyses were performed with SPSS version 15.0 software (SPSS, Chicago, IL, USA). The Chi-square test The presence of oral mucosal lesions and developmental and Fisher’s exact tests were used to analyze the associa- < anomalies are relatively common reasons that patients visit tion between variables. For all analyses, P 0.05 was dental clinics. Diagnosis of a wide variety of oral mucosal le- considered statistically significant. sions and developmental anomalies is an essential part of a daily dental practice. It is important for every dentist to have a Results knowledge of the type and prevalence of oral mucosal lesions and developmental anomalies. Only four reports of massive e The study group included 912 (44.5%) male dental patients oral mucosa screening have been published.1 4 Various studies and 1138 (55.5%) female dental patients. The mean age of have also reported the prevalence of oral mucosal lesions and patients was 45.7 Æ 20.2 years (age range, 4e91 years). Of developmental anomalies in a select population or group of the 2050 patients, 81 patients were younger than 18 years patients in Brazil,5 Turkey,6 Saudi Arabia,7 Slovenia,8 south old; 1006 patients were between 18 and 44 years; 486 pa- India,9 Malaysia,10 Thailand,10 Jordan,11 and Cambodia.12 tients were between 45 and 64 years old; 477 patients were To date, there has been no studies on the type and 65 years or older. Table 1 summarizes the distribution of prevalence of oral mucosal lesions and developmental oral mucosal lesions and developmental anomalies, ac- anomalies in dental patients residing in northern Taiwan. cording to the age and gender of the patients. Only 7.17% of The aim of this study was to evaluate the type and preva- the patients had no oral mucosal lesions or developmental lence of oral mucosal lesions and developmental anomalies anomalies. Twenty-three different oral mucosal lesions or in dental patients in a teaching hospital in northern Taiwan. developmental anomalies were diagnosed, the most com- mon of which was Fordyce granules (82.8%; Fig. 1A), fol- Materials and methods lowed in descending order by buccal exostosis (34.1%; Fig. 1B), torus mandibularis (24.2%; Fig. 1C), torus palatinus (21.1%; Fig. 1D), lingual varices (16.2%; Fig. 1E), and The study group comprised 2050 consecutive dental pa- recurrent aphthous ulcerations (4.3%; Fig. 1FeH). tients who received oral examinations and treatment in the dental department of the Chang Gung Memorial Hospital (Taipei, Taiwan) from January 2003 to December 2007. To Fordyce granules record the clinical characteristics of each oral lesion or developmental anomaly of interest, history-taking and a Fordyce granules were more common in adults (83.6%; 1647 thorough oral examination (which included a radiographic of 1969 adults) than in children (63.0%; 51 of 81 children) examination of each patient) were performed by a certified (P < 0.001) (Table 1). Most (56.8%) Fordyce granules oral pathologist in the standard manner. occurred at the buccal mucosae and the labial mucosae Twenty-three types of oral mucosal lesions and devel- (Table 2). The labial mucosa was the more common site for opmental anomalies were recorded on a special sheet Fordyce granules. For the labial mucosal region, the fre- developed for the survey. Recurrent aphthous ulcerations quency of Fordyce granules on the upper labial mucosa, were recorded only if they were present on the day the lower labial mucosa, and buccal mucosa near the mouth individual was examined. Finger palpation of the oral angle were nearly equal in adults. However, the buccal mucosal lesions and developmental anomalies such as ex- mucosa near mouth angle was the most common site for ostoses or suspected malignancies was performed routinely Fordyce granules in children under 18 years old (P < 0.05). to confirm the diagnosis. An oral biopsy was obtained for For the buccal mucosal region, bilateral involvement was lesions that were suspected of being malignant, if neces- more common (at 74.3%, representing 838 of 1128 patients) sary. The diagnosis of oral mucosal lesions and develop- than unilateral involvement (P < 0.05). In 0.4% of cases, mental anomalies was based on World Health Organization Fordyce granules were present in other locations (e.g., the (WHO) guidelines13 and on the characteristic clinical fea- retromolar area or the anterior tonsillar pillar), and when tures of oral mucosal lesions and developmental anomalies present in these areas, Fordyce granules were also present described in the Color Atlas of Common Oral Diseases.14 in the buccal or the labial mucosa. In adults, there was a The participants were further referred to the appropriate higher frequency of unilateral involvement (i.e., buccal or dental department in the Chang Gung Memorial Hospital for labial mucosa only or unilateral buccal mucosa) in females treatment in accordance with their requests or needs. than in males, (P < 0.05). Oral mucosal lesions and developmental anomalies 71 Table 1 The distribution of oral mucosal lesions and developmental anomalies, according to the age and sex of dental patients. Sex <18 years 18e44 years 45e64 years 65 years Subtotal Total n (%) P n (%) n (%) n (%) n (%) n (%) Age Sex Fordyce granules F 29 (64.4) 467 (77.8) 217 (94.2) 169 (73.2) 882 (77.5) 1698 (82.8) <0.001a <0.001a M 22 (61.1) 366 (90.1) 206 (92.0) 222 (90.2) 816 (89.5) Exostosis Buccal exostosis F 3 (6.7) 188 (31.3) 97 (37.0) 58 (25.1) 346 (30.4) 699 (34.1) <0.001a <0.001a M 7 (19.4) 172 (42.4) 88 (39.3) 86 (35.0) 353 (38.7) Mandible F 3 (6.7) 161 (26.8) 81 (30.9) 50 (21.6) 295 (26.0) 569 (81.4)y <0.001a 0.04a M 4 (11.1) 141 (34.7) 65 (29.0) 64 (26.0) 274 (30.0) Maxilla F 1 (2.2) 114 (19.0) 55 (21.0) 29 (12.6) 199 (17.5) 447 (64.0)y 0.001a <0.001a M 5 (13.9) 118 (29.1) 66 (29.5) 59 (24.0) 248 (27.2) Torus mandibularis F 5 (11.1) 173 (28.8) 51 (19.5) 29 (12.6) 258 (22.7) 495 (24.2) <0.001a 0.08a M 4 (11.1) 142 (35.0) 61 (27.2) 30 (12.2) 237 (26.0) Torus palatinus F 11 (24.4) 202 (33.7) 75 (28.6) 42 (18.2) 330 (29.0)
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