PL EN
REVIEW PAPER
The most common oral cavity ailments in geriatric patients
 
More details
Hide details
1
Non Public Health Care Unit ‘Dental’ Katarzyna Bijowska, Białystok, Poland
2
Doctoral Study, Department of Periodontal and Oral Mucosa Diseases, Faculty of Medicine, Medical University Białystok, Poland
3
Non Public Health Care Unit ‘Family Dentistry’, Białystok, Poland
4
Independent Gerostomatology Laboratory, Medical University, Białystok, Poland
5
Department of Plastic, Reconstructive and Aesthetic Surgery, Norbert Barlicki University Teaching Hospital No. 1, Łódź, Poland
CORRESPONDING AUTHOR
Kamil Bijowski   

NZOZ Dental Katarzyna Bijowska, Bohaterów Monte Cassino 13a lok.3, 15-873, Białystok, Polska
 
Med Og Nauk Zdr. 2021;27(1):23–31
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Demographic forecasts for the Polish population indicate that in 2030 in Poland, that the elderly will constitute approximately 24% of the population. Functional dentition and providing physiological and social benefis are part of the physical and mental well-being of an elderly patient with missing dentition and general diseases.

Objective:
The aim of the study is to discusses the most common ailments encountered in geriatric patients treated by dentists. Etiology, characteristics and treatment options for the described ailments are taken into account. In dental treated patients age over 60, the most common problems encountered are: stomatopathies, xerostomia and burning mouth syndrome (BMS). Stomatopathies werethe most common in diabetic patients, and in patients using removable or fixed prosthetic restorations.

Material and Methods:
Analysis of the assumed aims of the paper was carried out based on the available literature. Particular attention was paid to the most common complaints in elderly patients.

Conclusions:
All the above-listed oral cavity health conditions affect the well-being, i.e. physical and mental health of a patient. Local pathological states, such as prosthetic stomatopathies, pass mainly by eliminating the cause of contact inflammation. Other ailments: periodontitis, BMS or xerostomia, are closely related to the general condition of the patient. Changes in the oral cavity depend on the intensity and stabilization of the general disease. His is the reason that a very important role is played by the attending physicians: diabetologists, neurologists or psychiatrists. The cooperation of a dentist with a general practitioner can significantly improve the health of geriatric patients.

 
REFERENCES (92)
1.
Koczorowski R. Prosthodontics for the geriatric patient. Conventional and implant prosthetic restorative methods. Poznań: Wydawnictwo Naukowe Uniwersytetu Medycznego; 2011.
 
2.
Kulik TB, Janiszewska M, Piróg E, et al. Sytuacja zdrowotna osób starszych w Polsce i w innych krajach europejskich. Med Og Nauk Zdr. 2018; 17(2): 90 –95.
 
3.
Gauch, LMR, Silveira-Gomes F, Pedrosa SS, et al. Relationship among local and functional factors in the development of denture stomatitis in denture wearers in northern Brazil. Rev odontol UNESP. 2014; 43(5): 314–8. https://dx.doi.org/10.1590/rou....
 
4.
Arnaud RR, Soares MSM, Santos MGC, et al. Denture stomatitis: prevalence and correlation with age and gender. R Bras Ci Saúde. 2012; 16(1): 59–62.
 
5.
Gendreau L, Loewy ZG. Epidemiology and etiology of denture stomatitis. J Prosthodont. 2011; 20(4): 251–260. https://doi.org/10.1111/j.1532....
 
6.
Spiechowicz E. Protetyka stomatologiczna. Warszawa: PZWL; 2016.
 
7.
Smolana A, Szypowska A, Wieczorek A, et al. Analiza nawyków higienicznych oraz stanu błony śluzowej jamy ustnej u pacjentów użytkujących akrylowe protezy ruchome. J Stoma. 2017; 70(3): 250–260. https://doi10.5604/01.3001.001....
 
8.
Kubicka K, Godlewski T. Interdyscyplinarne leczenie pacjenta z ziarni nującym stanem zapalnym błony śluzowej jamy ustnej – opis przypadku. Protet Stomatol. 2018; 68(3): 319–326. https://doi.org/10.5604/01.300....
 
9.
Cierech M, Szczypińska A, Wróbel K, et al. Analiza porównawcza chropowatości tworzyw akrylowych stosowanych w wykonawstwie protez płytowych oraz przylegania do nich grzybów Candida albicans – badania in vitro. Dental and Medical Problems. 2013; 50(3): 341–347.
 
10.
Gauch, LMR, Pedrosa SS, Silveira-Gomes F, et al. Isolation of Candida spp. from denture-related stomatitis in Pará. Braz J Microbiol. 2018; 49(1): 148–151. https://doi.org/10.1016/j.bjm.....
 
11.
Cierech M, Kolenda A, Osica I, et al. Wpływ fotopolimeryzującej żywicy łączącej na wybrane właściwości fizykochemiczne powierzchni tworzywa akrylowego. Dent Med Probl. 2015; 52(3): 298–303.
 
12.
Prabowo DMS, Widodo HB. Nicotine stomatitis in smokers: a case report. J Dentomaxillofac Sci. 2018; 3(1): 58–60. https://doi.org/10.15562/jdmfs....
 
13.
Jones KB, Jordan R. White lesions in the oral cavity:clinical presentation, diagnosis and treatment. Semin Cutan Med Surg. 2015; 34: 161–170. https://doi.org/10.12788/j.sde....
 
14.
Aoun G, Cassia A. Evaluation of denture-related factors predisposing to denture stomatitis in a Lebanese population. Mater Sociomed. 2016; 28(5): 392–6. https://doi.org/10.5455/msm.20....
 
15.
de Arruda CNF, Salles MM, Badaro MM, et al. Effect of sodium hypochlorite and Ricinus communis solutions on control of denture biofilm: A randomized crossover clinical trial. Journal of Prosthetic Dentistry. 2017; 117(6): 729–34. https://doi.org/10.1016/j.pros....
 
16.
Leite DP, Piva MR, Martins-Filho PRS. Identification of Candida species in patients with denture stomatitis and evaluation of susceptibility to miconazole and photodynamic therapy. Rev Odontol UNESP. 2015; 44(1): 12–7. https://doi.org/10.1590/1807-2....
 
17.
Czerninski R, Pikovsky A, Gati I, et al. Comparison of the efficacy of a novel sustained release clotrimazole varnish and clotrimazole troches for the treatment of oral candidiasis. Clinical Oral Investigations. 2015; 19(2): 467–73. doi: 10.1007/s00784-014-1259-5.
 
18.
Acosta-Torres LS, Mendieta I, Nuñez-Anita RE, et al. Cytocompatible antifungal acrylic resin containing silver nanoparticles for dentures. Int J Nanomedicine. 2012; 7: 4777–86. https://doi.org/10.2147/IJN.S3....
 
19.
Mauri-Obradors E, Jané-Salas E, Sabater-Recolons MDM, et al. Effect of nonsurgical periodontal treatment on glycosylated hemoglobin in diabetic patients: a systematic review. Odontology. 2014; 103: 301–13. https://doi.org/10.1007/s10266....
 
20.
Zalewska A, Knaś M, Maciejczyk M, et al. Antioxidant profile, carbonyl and lipid oxidation markers in the parotid and submandibular glands of rats in different periods of streptozotocin induced diabetes. Archives of Oral Biology. 2015; 60(9): 1375–1386. https://doi.org/10.1016/j.arch....
 
21.
Bajaj S, Prasad S, Gupta A, et al. Oral manifestations in type-2 diabetes and related complications. Indian J Endocr Methab. 2012; 16: 777–779. https://doi.org/10.4103/2230-8....
 
22.
Lim SG, Han K, Kim HA, et al. Association between insulin resistance and periodontitis in Korean adults. J Clin Periodontol. 2013; 41(2): 121–30. ht t ps://doi.org /10.1111/jcpe.12196.
 
23.
Wyszyńska M, Naporal M, Grabowska E, et al. Stan przyzębia u pacjentów ze świeżo rozpoznaną i leczoną cukrzycą typu II – analiza porównawcza. Dent. Med. Probl. 2016; 53(4): 459–467.
 
24.
Grover HS, Luthra S. Molecular mechanisms involved in the bidirectional relationship between diabetes mellitus and periodontal disease. J Indian Soc Periodontol. 2013; 17: 292–301. https://doi.org/10.4103/0972-1....
 
25.
Wilczyńska-Borawska M, Zbroch E, Małyszko J, et al. Stan uzębienia i przyzębia chorych na cukrzycę pacjentów hemodializowanych z terenu północno-wschodniej Polski. Postępy Nauk Medycznych. 2013; 26(3): 195–200.
 
26.
Mauri-Obradors E, Estrugo-Devesa A, Jané-Salas E, Viñas, et al. Oral manifestations of Diabetes Mellitus. A systematic review. Med Oral Patol Oral Cir Bucal. 2017; 22(5): e586–e594. https://doi.org/10.4317/medora l.21655.
 
27.
Simpson TC, Weldon JC, Worthington HV, et al. Treatment of periodontal disease for glycaemic control in people with diabetes mellitus. Cochrane Database Syst Rev. 2015; 11: CD004714. https://doi.org/10.1002/146518....
 
28.
Lewusz K, Perz A, Godzieba A, et al. Pacjent z cukrzycą w gabinecie stomatologicznym. Magazyn Stomatologiczny. 2016; 3: 74–78.
 
29.
Obradović RR, Kesić LG, Pejčić AN, et al. Diabetes mellitus and oral candidiasis. Acta Stomatologica Naissi. 2011; 27(63): 1025–1034. https://doi.org/10.5937/asn116....
 
30.
Premkumar J, Ramani P, Chandrasekar T, et al. Detection of species diversity in oral Candida colonization and anti-fungal susceptibility among non-oral habit adult diabetic patients. J Nat Sci Biol Med. 2014; 5(1): 148–54. https://doi.org/10.4103/0976-9....
 
31.
Gomes CC, Guimaraes LS, Pinto LCC, et al. Investigations of the prevalence and virulence of Candida albicans in periodontal and endodontic lesions in diabetic and normoglycemic patients. J Appl Oral Sci. 2017; 25(3): 274–281. https://doi.org/10.1590/1678-7....
 
32.
National institute of Diabetes and Digestive and Kidney Diseases. Diabetes, Gum Disease, & Other Dental Problems. 2017. https://www.niddk.nih.gov/heal.... (access: 2020.08.25).
 
33.
Cohen B, Thomson H. Dental Care for the Elderly. Chicago: Boca Raton, 2016.
 
34.
Yap T, McCullough M. Choroby jamy ustnej, a starzejące się społeczeństwo. Med Prakt Stomatol. 2015; 3: 15–26.
 
35.
Johansson AK, Johansson A, Unell L, et al. Self reported dry mouth in Swedish population samples aged 50, 65 and 75 years. Gerodontology. 2012; 29(2): 107–110. https://doi.org/10.1111/j.1741....
 
36.
Minicucci EM, Pires RBC, Vieira RA, et al. Assessing the impact of menopause on salivary flow and xerostomia. Aust Dent J. 2013; 58(2): 230–234. https://doi.org/10.1111/adj.12....
 
37.
Maciejczyk M, Dąbrowska BM, Sawczuk B, et al. Polekowe zaburzenia wydzielania śliny: Znaczenie kliniczne. Magazyn Stomatologiczny. 2015; 5: 123–126.
 
38.
Dutkowska A, Brukwicka I, Kopański Z, et al. Kserostomia u ludzi w podeszłym wieku. Journal of Clinical Healthcare. 2017; 2: 20–23.
 
39.
Walis M, Szymczak-Paluch M, Kłosek S. Profilaktyka i leczenie zmian w jamie ustnej u pacjentów onkologicznych. Onkol Dypl. 2016; 13(2): 22–30.
 
40.
Walis M, Kłosek S. Częstość występowania suchości w jamie ustnej u pacjentów po 65. roku życia. Gerontologia Polska. 2018; 26: 190–195.
 
41.
Spagnoli A, Ostino G, Borga AD, et al. Drug Compliance and Unreported Drugs in the Elderly. J Am Geriatr Soc. 2015; 37(7): 619–624. https://doi.org /10.1111/j.1532-5415.1989.tb01252 .x.
 
42.
Węgrzyn M, Wróbel A, Roemer-Ślimak R, et al. Kserostomia u pacjentów geriatrycznych. Problemy i możliwości terapeutyczne — przegląd literatury. Forum Medycyny Rodzinnej. 2018; 2(5): 197–203.
 
43.
Rehan F, Khan BR, Memon MS, et al. Analysis of resting mouth salivary flow rate and salivary pH of tobacco chewers and smokers. J Pak Dent Assoc. 2016; 4: 159–63.
 
44.
Shubha G, Fasalkar SS, Praveen BN, et al. Assessment of salivary flow rate and salivary pH in subjects with smoking and smokeless form of tobacco habits. Journal of Medicine, Radiology, Pathology & Surgery. 2018; 5: 11–15. https://doi.org/10.15713/ins.j....
 
45.
Mystkowska J, Car H, Dąbrowski JR, et al. Artificial Mucin-based Saliva Preparations – Physicochemical and Tribological Properties. Oral Health & Preventive Dentistry. 2018; 16(2): 183–193. https://doi.org/10.3290/j.ohpd....
 
46.
Villa A, Connell CL, Abati S. Diagnosis and management of xerostomia and hyposalivation. Ther Clin Risk Manag. 2015; 11: 45–51. https://doi.org/10.2147/TCR M.S76282.
 
47.
Netto FO, Diniz IM, Grossmann SM, et al. Risk factors in burning mouth syndrome: a case-control study based on patient records. Clin Oral Investig. 2011; 15: 571–575. https://doi.org/10.1007/s00784....
 
48.
Sardella A, Lodi G. Acupuncture and burning mouth syndrome: a pilot study. Pain Pract. 2013; 13: 627–632. https://doi.org/10.1111/papr.1....
 
49.
Kohorst JJ, Bruce AJ, Torgerson RR, et al. The Prevalence of Burning Mouth Syndrome: A Population-Based Study. Br J Dermatol. 2015; 172(6): 1654 –1656. ht t ps://doi.org /10.1111/ bjd.13613.
 
50.
Schiavone V, Adamo D, Ventrella G, et al. Anxiety, depression, and pain in burning mouth syndrome: first chicken or egg? Headache. 2012; 52: 1019–1025. https://doi.org/10.1111/j.1526....
 
51.
Souza FTA, Santos TPM, Bernardes VF, et al. The impact of burning mouth syndrome on health-related quality of life. Health and Quality of Life Outcomes. 2011; 9(57). https://doi.org/10.1186/1477-7....
 
52.
Sun A, Lin HP, Wang YP, et al. Significant reduction of serum homocysteine level and oral symptoms after different vitamin-supplement treatments in patients with burning mouth syndrome. J Oral Pathol Med. 2013; 42(6): 474–479. https://doi.org/10.1111/jop.12....
 
53.
López-Jornet P, Camacho-Alonso F, Molino-Pagan D. Prospective, randomized, double-blind, clinical evaluation of Aloe vera Barbadensis, applied in combination with a tongue protector to treat burning mouth syndrome. J Oral Pathol Med. 2013; 42: 295–301. https://doi.org/10.1111/jop.12....
 
54.
de Moraes M, do Amaral Bezerra BA, da Rocha Neto PC, et al. Randomized trials for the treatment of burning mouth syndrome: an evidence-based review of the literature. J Oral Pathol Med. 2012; 41: 281–287. ht t ps://doi.org /10.1111/j.160 0 - 0714.2011.0110 0.x.
 
55.
Corsalini M, di Venere D, Pettini F, et al. Temporomandibular disorders in burning mouth syndrome patients: an observational study. Int J Med Sci. 2013; 10(12): 1784–1789. https://doi.org/10.7150/ijms.6....
 
56.
Morr Verenzuela CS, Davis MDP, Bruce AJ, et al. Burning mouth syndrome: results of screening tests for vitamin and mineral deficiencies, thyroid hormone, and glucose levels—experience at Mayo Clinic over a decade. Int J Dermatol. 2017; 56(9): 952–956. https://doi.org/10.1111/ijd.13....
 
57.
Watanabe M, Nakatani E, Yoshikawa H, et al. Oral soft tissue disorders are associated with gastroesophageal reflux disease: retrospective study. BMC Gastroenterol. 2017; 17(1): 92. https://doi.org/10.1186/s12876... 0650 -5.
 
58.
Tu TTH, Takenoshita M, Matsuoka H, et al. Current management strategies for the pain of elderly patients with burning mouth syndrome: a critical review.Biopsychosoc Med. 2019; 13: 1. https://doi.org/10.1186/s13030....
 
59.
Laklouk M, Baranidharan G. Profile of the capsaicin 8% patch for the management of neurolppathic pain associated with postherpetic neuralgia: Safety, efficacy, and patient acceptability. Patient Preference and Adherence. 2016; 10: 1913–1918. https://doi.org/10.2147/PPA.S7....
 
60.
Tan SN, Song E, Dong XD, et al. Peripheral GABAA receptor activation modulates rat tongue afferent mechanical sensitivity. Archives of Oral Biolog. 2013; 59(3): 251–257.
 
61.
Jääskeläinen SK, Woda A. Burning mouth syndrome. Cephalalgia. 2017; 37(7): 627–647. https://doi.org/10.1177/033310....
 
62.
Cui Y, Xu H, Chen FM. Efficacy evaluation of clonazepam for symptom remission in burning mouth syndrome: a meta-analysis. Oral Dis. 2016; 22: 503 –511. ht t ps://doi.org /10.1111/od i.12422.
 
63.
Kaczkurkin AN, Foa EB. Cognitive-behavioral therapy for anxiety disorders: An update on the empirical evidence. Dialogues in Clinical Neuroscience. 2015; 17(3): 337–346.
 
64.
Komiyama O, Nishimura H, Makiyama Y, et al. Group cognitive-behavioral intervention for patients with burning mouth syndrome.Journal of oral science. 2013; 55(1): 17–22. https://doi.org/10.2334/j o s nu s d . 55.17.
 
65.
Terezhalmy GT, Huber MA. Oropharyngeal candidiasis: Etiology, epidemiology, clinical manifestations, diagnosis, and treatment. Crest Oral-B at dentalcare.com Contin Educ Course. 2011; 1–16.
 
66.
Wall G, Montelongo-Jauregui D, Vidal Bonifacio B, et al. Candida albicans biofilm growth and dispersal: Contributions to pathogenesis. Curr. Opin. Microbiol. 2019; 11: 1– 6. https://doi:10.1016/j.mib.2019....
 
67.
Jabra-Rizk MA, Kong E, Tsui C, et al. Candida albicans pathogenesis: Fitting within the host-microbe damage response framework. Infect. Immun. 2016; 84: 2724–2739. https://doi: 10.1128/IAI.00469-16.
 
68.
Sroussi HY, Epstein JB, Bensadoun RJ, et al. Common oral complications of head and neck cancer radiation therapy: Mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis. Cancer Med. 2017; 6: 2918–2931. https://doi: 10.1002/cam4.1221.
 
69.
Iinuma T, Arai Y, Abe Y, et al. Denture wearing during sleep doubles the risk of pneumonia in the very elderly. J. Dent. Res. 2015; 94: 28S–36S. https://doi: 10.1177/0022034514552493.
 
70.
Scully C, Giovanni L. Denture Related Stomatitis. European Association of Oral Medicine. http://www.eaom.eu/pdf/content.... (dostęp: 2020.12.24).
 
71.
Tejani S, Sultan A, Stojanov I, et al. Candidal carriage predicts candidiasis during topical immunosuppressive therapy: A preliminary retrospective cohort study. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. 2016; 122: 448–454. https://doi:10.1016/j.oooo.201....
 
72.
Mun M, Yap T, Alnuaimi AD, et al. Oral candidal carriage in asymptomatic patients. Aust. Dent. J. 2016; 61: 190–195. https://doi:10.1111/adj.12335.
 
73.
Manfredi MPL, Giovati L, Alnuaimi A, et al. Oral and Maxillofacial Fungal Infections. In: Farah C, Balasubramaniam R, McCullough M, editors. Contemporary Oral Medicine. Berlin/Heidelberg, Germany: Springer; 2018.
 
74.
Gasparoto TH, de Oliveira CE, Vieira NA, et al. The pattern recognition receptors expressed on neutrophils and the associated cytokine profile from different aged patients with Candida-related denture stomatitis. Exp Gerontol. 2012; 47: 741–748. https://doi: 10.1016/j.exger.2012.07.003.
 
75.
Vila T, Sultan AS, Montelongo-Jauregui D, et al. Oral Candidiasis: A Disease of Opportunity. J Fungi (Basel). 2020; 6(1): 15. https://doi: 10.3390/jof6010015.
 
76.
Hellstein JW, Marek CL. Candidiasis: Red and white manifestations in the oral cavity. Head Neck Pathol. 2019; 13: 25–32. https://doi:10.1007/s12105-019....
 
77.
Sultan AS, Rizk AM, Vila T, et al. Digital design of a universal rat intraoral device for therapeutic evaluation of topical formulation against Candida-associated denture stomatitis. Infect Immun. 2019; 87(12): e00617–19. https://doi:10.1128/IAI.00617-....
 
78.
Humbert L, Cornu M, Proust-Lemoine E, et al. Chronic mucocutaneous candidiasis in autoimmune polyendocrine syndrome Type 1. Front. Immunol. 2018; 9: 2570. https://doi: 10.3389/fimmu.2018.02570.
 
79.
Jopek-Sady A. Grzybica jamy ustnej. Praca specjalizacyjna z zakresu farmacji aptecznej, Kołobrzeg, https://docplayer.pl/2059475-G... (access: 2020.12.26).
 
80.
Scheibler E, Garcia MCR, Medina da Silva R, et al. Use of nystatin and chlorhexidine in oral medicine: Properties, indications and pitfalls with focus on geriatric patients. Gerodontology. 2017; 34: 291–8.
 
81.
Garcia-Cuesta C, Sarrion-Pérez MG, Bagán JV. Current treatment of oral candidiasis: A literature review. J Clin Exp Dent. 2014; 6(5): e576–e582. https://doi:10.4317/jced.51798.
 
82.
Kamiński T, Szerszeń M, Wiśniewska J, et al. Wczesna diagnostyka wizualizacyjna w raku płaskonabłonkowym błony śluzowej jamy ustnej: opis przypadku. Protet Stomatol, 2017; 67(4): 374–380. https://doi:10.5604/01.3001.00....
 
83.
Reibel J, Gale N, Hille J, et al. Tumours of the oral cavity and mobile tongue. In: El-Naggar AK, Chan JKC, Grandis JR, et al. eds. WHO classification of head and neck tumours, 4th ed. Lyon: IARC press; 2017. p. 112–4.
 
84.
Warnakulasuriya S, Ariyawardana A. Malignant transformation of oral leukoplakia: a systematic review of observational studies. J Oral Pathol Med. 2016; 45(3): 155 –166.
 
85.
Chaturvedi AK, Udaltsova N, Engels EA, et al. Oral Leukoplakia and Risk of Progression to Oral Cancer: A Population-Based Cohort Study. J Natl Cancer Inst. 2020; 112(10): 1047–1054. https://doi:10.1093/jnci/djz23....
 
86.
van der Waal I. Oral leukoplakia, the ongoing discussion on definition and terminology. Med Oral Patol Oral Cir Bucal. 2015; 20(6): e685–e692. https://doi: 10.4317/medoral.21007.
 
87.
Górska R, Nowak M. Selected issues about diagnosis and treatment of the oral mucose membrane; Pol Otorhino Rev. 2017; 6(2): 14–22. https://doi:10.5604/01.3001.00....
 
88.
De la Cour CD, Sperling CD, Belmonte F, et al. Human papillomavirus prevalence in oral potentially malignant disorders: Systematic review and meta-analysis. Oral Dis. 2020. https://doi: 10.1111/odi.13322.
 
89.
Yanik EL, Katki HA, Silverberg MJ, et al. Leukoplakia, oral cavity cancer risk, and cancer survival in the US elderly. Cancer Prev Res (Phila). 2015; 8(9): 857–863. https://doi: 10.1158/1940-6207.CAPR-15-0091.
 
90.
Dutkowska A, Brukwicka I, Kopański Z, et al. Zmiany w błonie śluzowej jamy ustnej i języka u ludzi w starszym wieku. Journal of Clinical Healthcare. 2017; 2: 16–19.
 
91.
Lodi G, Franchini R, Warnakulasuriya S, et al. Interventions for treating oral leukoplakia to prevent oral cancer. Cochrane Database Syst Rev. 2016; 7: CD001829.
 
92.
Brouns E, Baart JA, Bloemena E, et al. The relevance of uniform reporting in oral leukoplakia: Definition, certainty factor and staging based on experience with 275 patients. Med Oral Patol Oral Cir Bucal. 2012: 18756 –18756.
 
eISSN:2084-4905
ISSN:2083-4543