{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T14:19:12Z","timestamp":1768486752382,"version":"3.49.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2017,8,4]],"date-time":"2017-08-04T00:00:00Z","timestamp":1501804800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2017,8,4]],"date-time":"2017-08-04T00:00:00Z","timestamp":1501804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BDJ Open"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objectives\/Aims:<\/jats:title>\n                <jats:p>The actinic cheilitis (AC) is a precancerous lip lesion seen as a consequence of chronic sun exposure. Clinically, the border between the lip\u2019s skin and the semimucosa could be blurred; in the more aggressive cases, leucoplakia and ulcers also represent its clinical feature. It seems that no clinical criterion is universally accepted for this disease yet. Therefore, this study was carried out to make a proposition of a clinical score to actinic cheilitis (Grade I starting from dryness of vermilion to endured ulcers representing Grade IV) and to assess its reproducibility.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and Methods:<\/jats:title>\n                <jats:p>Fifty subjects were assessed, most of whom were male, Caucasian farmers, with an average age of 46.12 (18\u201374) years. The obtained data were analysed by means of descriptive statistics and by Kappa test to assess the inter-examiners and the clinical Golden-Pattern concordance (95% CI).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results:<\/jats:title>\n                <jats:p>During calibration, 15 patients were examined three times a week by each examiner (4) until Kappa test observed <jats:italic>k<\/jats:italic>=0.8 or more. In the main experiment, the inter-examiner concordance was classified between good (<jats:italic>k<\/jats:italic>=0.779; <jats:italic>P<\/jats:italic>&lt;0.05) and very good (<jats:italic>k<\/jats:italic>=0.925; <jats:italic>P<\/jats:italic>&lt;0.05) from the 35 examined subjects. With the Golden-Pattern, it was considered very good (<jats:italic>k<\/jats:italic>=0.812; <jats:italic>P<\/jats:italic>&lt;0.05 to <jats:italic>k<\/jats:italic>=0.925; <jats:italic>P<\/jats:italic>&lt;0.05).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Discussion:<\/jats:title>\n                <jats:p>Four examiners with different experiences could strongly suggest that after adequate calibration, it could be well applied by examiners with as much experience as a dental student.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions:<\/jats:title>\n                <jats:p>The authors concluded that the proposed classification was easily applied and had a very good reproducibility.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1038\/bdjopen.2017.16","type":"journal-article","created":{"date-parts":[[2017,8,4]],"date-time":"2017-08-04T05:20:21Z","timestamp":1501824021000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Actinic cheilitis: proposition and reproducibility of a clinical criterion"],"prefix":"10.1038","volume":"3","author":[{"given":"N\u00e1dia Antunes","family":"Poitevin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana Sudati","family":"Rodrigues","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen Loureiro","family":"Weigert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen L\u00facia Rodrigues","family":"Macedo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6304-1235","authenticated-orcid":false,"given":"Rubem Beraldo","family":"dos Santos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2017,8,4]]},"reference":[{"key":"BFbdjopen201716_CR1","first-page":"274","volume":"54","author":"MA Hubner","year":"2006","unstructured":"Hubner MA, Terezhalmy GT . Patient with actinic cheilitis. Gen Dent 2006; 54: 274\u2013282.","journal-title":"Gen Dent"},{"key":"BFbdjopen201716_CR2","first-page":"104","volume-title":"Oral and Maxillofacial Pathology","author":"BW Neville","year":"2015","unstructured":"Neville BW, Damm DD, Allen CM, Chi AC . Oral and Maxillofacial Pathology 4th edn. Elsevier: Rio de Janeiro, 2015, pp 104\u2013107."},{"key":"BFbdjopen201716_CR3","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1111\/j.1600-0714.2004.00242.x","volume":"9","author":"IG Rojas","year":"2004","unstructured":"Rojas IG, Martinez A, Pineda A, Spencer ML, Jim\u00e9nez M, Rudolph MI . Increased mast cell density and protease content in actinic cheilitis. J Oral Pathol Med 2004; 9: 567\u2013573.","journal-title":"J Oral Pathol Med"},{"key":"BFbdjopen201716_CR4","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1111\/j.1600-0714.2004.00299.x","volume":"34","author":"A Martinez","year":"2005","unstructured":"Martinez A . Expression of apoptotic and cell proliferation regulatory proteins in actinic cheilitis. J Oral Pathol Med 2005; 34: 257\u2013262.","journal-title":"J Oral Pathol Med"},{"key":"BFbdjopen201716_CR5","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1111\/j.1600-0714.2009.00761.x","volume":"38","author":"A Mart\u00ednez","year":"2009","unstructured":"Mart\u00ednez A, Spencer ML, Brethauer U, Grez P, Marchesani FJ, Rojas IG . Reduction of syndecan-1 expression during lip carcinogenesis. J Oral Pathol Med 2009; 38: 580\u2013583.","journal-title":"J Oral Pathol Med"},{"key":"BFbdjopen201716_CR6","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1111\/jop.12453","volume":"45","author":"FI Daniel","year":"2016","unstructured":"Daniel FI, Alves SR, Vieira DS, Biz MT, Daniel IW, Modolo F . Immunohistochemical expression of DNA methyltransferases 1, 3a, and 3b in actinic cheilitis and lip squamous cell carcinomas. J Oral Pathol Med 2016; 45: 774\u2013779.","journal-title":"J Oral Pathol Med"},{"key":"BFbdjopen201716_CR7","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/S1079-2104(99)70115-0","volume":"88","author":"GE Kaugars","year":"1999","unstructured":"Kaugars GE, Pillion T, Svirsky JA, Page DG, Burns JC, Abbey LM . Actinic cheilitis: a review of 152 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88: 181\u2013186.","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"BFbdjopen201716_CR8","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1016\/j.joms.2006.09.016","volume":"66","author":"A Cavalcante","year":"2008","unstructured":"Cavalcante A, Anbinder A, Carvalho Y . Actinic Cheilitis: Clinical and Histological Features. J Oral Maxillofac Surg 2008; 66: 498\u2013503.","journal-title":"J Oral Maxillofac Surg"},{"key":"BFbdjopen201716_CR9","volume-title":"The prevalence and risk factors to Actinic Cheilitis in elderly people institutionalized in home geriatric","author":"AN Johann","year":"2006","unstructured":"Johann AN, Caurio C . The prevalence and risk factors to Actinic Cheilitis in elderly people institutionalized in home geriatric. ULBRA: Cachoeira do Sul, 2006."},{"key":"BFbdjopen201716_CR10","first-page":"37","volume":"21","author":"FD Silva","year":"2006","unstructured":"Silva FD, Daniel FI, Grando LJ, Calvo MC, Rath IBS, Fabro SML . Prevalence of lips pathologies in fishermen of Santa Catarina island. Rev Odonto Ci\u00eancia 2006; 21: 37\u201342.","journal-title":"Rev Odonto Ci\u00eancia"},{"key":"BFbdjopen201716_CR11","first-page":"200","volume":"55","author":"FR Pires","year":"2001","unstructured":"Pires FR, Alves FA, Almeida OP, Bueno RH . Actinic Cheilitis: clinic and preventive features. Rev APCD 2001; 55: 200\u2013203.","journal-title":"Rev APCD"},{"key":"BFbdjopen201716_CR12","first-page":"215","volume-title":"Tratado de patologia bucal","author":"WG Shafer","year":"1987","unstructured":"Shafer WG, Hine MK, Levy BM, Tomich CE . Tratado de patologia bucal 4 edn. Guanabara Koogan: Rio de Janeiro, 1987, pp 215."},{"key":"BFbdjopen201716_CR13","first-page":"76","volume-title":"Patologia bucal correla\u00e7\u00f5es clinicopatol\u00f3gicas","author":"JA Regezi","year":"2000","unstructured":"Regezi JA, Sciubba JJ . Patologia bucal correla\u00e7\u00f5es clinicopatol\u00f3gicas 3 edn. Guanabara Koogan: Rio de Janeiro, 2000, pp 76\u2013109."},{"key":"BFbdjopen201716_CR14","first-page":"377","volume-title":"Diagn\u00f3stico em patologia bucal","author":"AF Tommasi","year":"2002","unstructured":"Tommasi AF . Les\u00f5es e condi\u00e7\u00f5es canceriz\u00e1veis In: Diagn\u00f3stico em patologia bucal 3 edn. Pancast: S\u00e3o Paulo, 2002, pp 377\u2013389."},{"key":"BFbdjopen201716_CR15","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1590\/S0102-311X2001000100016","volume":"17","author":"MA Peres","year":"2001","unstructured":"Peres MA, Traebert J, Marcenes W . Calibration of examiners for dental caries epidemiology studies. Cad Saude Publica 2001; 17: 153\u2013159.","journal-title":"Cad Saude Publica"},{"key":"BFbdjopen201716_CR16","unstructured":"National Cancer Institute of Brazil (INCA). Estimative of cancer Prevalence to 2016. Available at: http:\/\/www.inca.gov.br\/Estimativa\/2016\/. Accessed on 18 December 2016."},{"key":"BFbdjopen201716_CR17","unstructured":"Kirchhoff VWJH, Schuch NJ, Hilsenrath E . \u2018The Ozone Hole: News in the South\u2019-Ci\u00c3\u00aancia Hoje, 1994; 17: 6\u20137."},{"key":"BFbdjopen201716_CR18","first-page":"258","volume-title":"Oncology","author":"SE Otto","year":"2002","unstructured":"Otto SE . Cutaneous Cancer. In: Otto SE ed. Oncology. Reichmann & Affonso Editores: Rio de Janeiro, 2002, pp 258\u2013271."},{"key":"BFbdjopen201716_CR19","unstructured":"Pontifical Catholic University of Rio Grande do Sul (PUCRS). Laboratory of Physical Radiation. Available on http:\/\/www.pucrs.br\/portal\/?p=noticias&n=1385989981.html. Accessed on 26th September 2015."},{"key":"BFbdjopen201716_CR20","doi-asserted-by":"publisher","first-page":"60","DOI":"10.4067\/S0034-98872003000100009","volume":"131","author":"G Ochsenius","year":"2003","unstructured":"Ochsenius G, Ormeno A, Godoy L, Rojas RA . Retrospective study of 232 cases of lip cancer and pr\u00e9 cancer in Chilean patients. Clinical-histological correlation. Rev Med Chile 2003; 131: 60\u201366.","journal-title":"Rev Med Chile"}],"container-title":["BDJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/bdjopen201716.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/bdjopen201716","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.nature.com\/articles\/bdjopen201716","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/www.nature.com\/articles\/bdjopen201716.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T17:15:34Z","timestamp":1671729334000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/bdjopen201716"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,4]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2017,12,22]]}},"alternative-id":["BFbdjopen201716"],"URL":"https:\/\/doi.org\/10.1038\/bdjopen.2017.16","relation":{},"ISSN":["2056-807X"],"issn-type":[{"value":"2056-807X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,4]]},"assertion":[{"value":"21 March 2017","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 June 2017","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 August 2017","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no conflict of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"17016"}}