Chronic periodontitis is an independent risk factor for head and neck squamous cell carcinoma, according to a study to be published in the journal Cancer Epidemiology, Biomarkers & Prevention.
Mine Tezal, D.D.S., Ph.D., an assistant professor in the department of oral diagnostic sciences at the University of Buffalo School of Dental Medicine, and colleagues in the department of dentistry and maxillofacial prosthetics at Roswell Park Cancer Institute assessed the role of chronic periodontitis on head and neck squamous cell carcinoma and three subsites: oral cavity, oropharynx, and larynx.
They used radiographic measurement of bone loss to measure periodontitis in 463 patients, 207 of whom were controls.
Findings showed that chronic periodontitis might represent a clinical high-risk profile for head and neck squamous cell carcinoma. The strength of the association was greatest in the oral cavity, followed by the oropharynx, and larynx, according to Dr. Tezal.
When the researchers stratified the relationship by tobacco use, they found that the association persisted in patients who never used tobacco. The researchers did not expect the association between periodontitis and head and neck squamous cell carcinoma to be weaker in current smokers compared to former and never smokers, according to Dr. Tezal. However, this interaction, although statistically significant, was not very strong.
"Confirmatory studies with more comprehensive assessment of smoking, such as duration, quantity, and patterns of use, as well as smokeless tobacco history are needed," she said. "Our study also suggests that chronic periodontitis may be associated with poorly differentiated tumor status in the oral cavity. Continuous stimulation of cellular proliferation by chronic inflammation may be responsible for this histological type. However, grading is subjective, and we only observed this association in the oral cavity. Therefore, this association may be due to chance and needs further exploration."
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